40 results on '"Kruse,Marcelo Lapa"'
Search Results
2. Non-fluoroscopic catheter ablation: A randomized trial
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Pires, Leonardo Martins, Leiria, Tiago Luiz Luz, Kruse, Marcelo Lapa, and de Lima, Gustavo Glotz
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- 2019
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3. Catheter ablation of typical right atrial flutter in a 20‐day‐old neonate with tachycardiomyopathy.
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Leiria, Tiago Luiz Luz, Cabral, Israel Wolski, Schäfer, Stephanie, Nicoloso, Luiz Henrique Soares, Filho, Raul Ivo Rossi, Kruse, Marcelo Lapa, Saffi, Marco Aurélio Lumertz, and de Lima, Gustavo Glotz
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ATRIOVENTRICULAR node ,NEONATAL intensive care ,CARDIOMYOPATHIES ,ATRIAL flutter ,CATHETER ablation ,NEONATAL intensive care units ,TREATMENT effectiveness ,ELECTROPHYSIOLOGY ,FLUOROSCOPY ,ELECTROCARDIOGRAPHY ,CESAREAN section ,ELECTRIC countershock ,CHILDREN - Abstract
Background: Fetal echocardiography can diagnose neonatal atrial flutter, which can cause heart failure in newborns. Little is known about catheter ablation in this population. Methods: Case report that aimed to review a successful ablation in a 20‐day‐old patient with refractory atrial flutter. Results: This is the first report of a successful neonatal atrial flutter ablation without any early recurrence after the procedure. Conclusions: Atrial flutter ablation performed on newborns is a reliable and long‐lasting treatment option. [ABSTRACT FROM AUTHOR]
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- 2024
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4. Electrophysiological study as a predictor of mortality in unexplained syncope
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Pinos, Javier, primary, De Lima, Gustavo Glotz, additional, Sant'Anna, Roberto, additional, Kruse, Marcelo Lapa, additional, Dall'Agnese, Marco Antônio Vinciprova, additional, Tietz, Pedro Henrique Torres, additional, Saffi, Marco Aurélio Lumertz, additional, and Leiria, Tiago Luiz Luz, additional
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- 2023
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5. Ablação da Fibrilação Atrial: Impacto da Ecocardiografia Intracardíaca na Redução do Tempo de Procedimento e Internação
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Sant`Anna, Roberto Tofani, primary, Lima, Gustavo Glotz de, additional, Saffi, Marco Aurélio Lumertz, additional, Kruse, Marcelo Lapa, additional, and Leiria, Tiago Luiz Luz, additional
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- 2023
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6. The Clinical Utility of Electrocardiographic Holter Monitoring for Detecting Sleep Apnea
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Kruse, Marcelo Lapa, primary
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- 2022
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7. Clinical Characteristics of Patients with Tetralogy of Fallot who Underwent an Invasive Procedure for Arrhythmias
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de Lima, Barbara Adelmann, primary, da Silva, Antonio Carlos Gallo, additional, Saffi, Marco Aurélio Lumertz, additional, Fröemming Junior, Clóvis, additional, Castilhos, Gabriela, additional, Kruse, Marcelo Lapa, additional, de Lima, Gustavo Glotz, additional, and Leiria, Tiago Luiz Luz, additional
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- 2021
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8. Brugada syndrome unmasked by left ventricle posteromedial papillary muscle ventricular tachycardia: Coincidence or consequence
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Pinos, Javier, primary, Leiria, Tiago Luiz Luz, additional, Boccalon, Bernardo, additional, Kruse, Marcelo Lapa, additional, and De Lima, Gustavo Glotz, additional
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- 2021
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9. CHA2DS2VASc Score as a Predictor of Cardiovascular Events in Ambulatory Patients without Atrial Fibrillation
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POLENZ, GUSTAVO FREB, LEIRIA, TIAGO LUIZ LUZ, ESSEBAG, VIDAL, KRUSE, MARCELO LAPA, PIRES, LEONARDO MARTINS, NOGUEIRA, THAIZE BRISOLARA, GUIMARøES, RAPHAEL BOESCHE, SANTANNA, ROBERTO TOFANI, and DE LIMA, GUSTAVO GLOTZ
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- 2015
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10. Early Repolarization Pattern and Idiopatic Sustained Monomorphic Ventricular Tachycardia: an Infrequent Combination
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Vásquez, Javier Pinos, primary, Leiria, Tiago Luiz Luz, additional, Kruse, Marcelo Lapa, additional, and Lima, Gustavo Glotz de, additional
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- 2021
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11. Analysis of Conduction Intervals in Normal Electrophysiological Studies: Establishment of Reference Values the Brazilian Population
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Leiria,Tiago Luiz Luz, Santos,Catarine Benta Lopes dos, Sant'anna,Roberto Tofani, Trombetta,Julia Santana, Osterkamp,Gabriela, Kruse,Marcelo Lapa, Pires,Leonardo Martins, and Lima,Gustavo Glotz
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Treatment Outcome ,Electrocardiography/methods ,Syncope/therapy ,Predictive Value of Tests ,Brazil/epidemiology ,Arrhythmias, Cardiac ,Syncope/physiopathology - Abstract
Background In the investigation of cardiac rhythm disorders, a normal electrophysiological (EPS) study is associated with a favorable prognosis. One of the normality criteria is established by conduction intervals within expected range. Objective To establish reference values in EPS for the intracavitary conduction intervals (PA, AH and HV) in a Brazilian population. Methods A retrospective cohort study of the first 1,500 patients submitted to EPS ablation was performed at Instituto de Cardiologia do Rio Grande do Sul, Brazil. The EPS was considered normal if the test was performed for diagnostic purpose; absence of induced arrhythmias; and conduction intervals within the expected range. The REDCap software was used for data collection and management, and the SPSS Statistics 22.0 used for data analysis. Continuous variables were compared with Student's t-test for independent samples and categorical variables with the chi-square test (X 2 ). Values of p ≤ 0.05 were considered significant. Results A total of 124 (8.3%) with EPS considered normal were included; mean age was 52 ± 21 years, and 63 were male. The mean values in milliseconds of PA, AH and HV were 23 ± 9, 88 ± 25 and 44 ± 7, respectively. The PA, AH, and HV percentile ranges were 13 - 25, 81-107 and 40 - 52, respectively. When the patients were divided into three age groups (1 to 18 years, 19 to 64 years and 65 or more), we observed that the group of older patients had significantly higher values of PA, AH and HV compared with younger patients. Conclusion This study showed that intracavitary conduction intervals in a sample of the Brazilian population were similar to previously published studies. Elderly patients tend to have higher values of intracavitary conduction intervals in EPS. Future studies including broader age ranges could enable the acquisition of more reliable and reproducible reference values. (Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0)
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- 2020
12. A Brief review of the risks and the stratification of sudden death in the ventricular Pre-excitation syndrome.
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Fröemming Junior, Clóvis, primary, Leiria, Tiago Luiz Luz, additional, Lima, Gustavo Glotz de, additional, Pires, Leonardo Martins, additional, Kruse, Marcelo Lapa, additional, Moreira, Thiago Camargo, additional, Pinos, Javier Fernando Vasquez, additional, Finkler, Bruno Schaaf, additional, and Zanotta, Danilo Barros, additional
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- 2020
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13. Early Repolarization, Fragmented QRS and Tpeak-Tend Interval as Electrocardiographic Markers in Patients with Idiopathic Ventricular Arrhythmias: a Brief Review
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Vásquez, Javier Pinos, primary, Leiria, Tiago Luiz Luz, additional, Froemming Jr, Clóvis, additional, Finkler, Bruno Schaaf, additional, Zanotta, Danilo Barros, additional, Moreira, Thiago Camargo, additional, Kruse, Marcelo Lapa, additional, Pires, Leonardo Martins, additional, and Lima, Gustavo Glotz de, additional
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- 2020
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14. “Kiss of the girl from Ipanema” and syncope: A variant presentation of atrioventricular nodal reentrant tachycardia
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Pinos, Javier, primary, Luz Leiria, Tiago Luiz, additional, Kruse, Marcelo Lapa, additional, Pires, Leonardo Martins, additional, and De Lima, Gustavo Glotz, additional
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- 2020
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15. Heart Failure with Preserved Ejection Fraction and Sudden Death: How to Identify High Risk Patients?
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Finkler, Bruno, primary, Leiria, Tiago Luiz Luz, additional, Fröemming Jr, Clovis, additional, Pinos, Javier, additional, Zanotta, Danilo Barros, additional, Kruse, Marcelo Lapa, additional, Pires, Leonardo Martins, additional, and Lima, Gustavo Glotz de, additional
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- 2020
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16. Internal Validation of a Risk Score for Prediction of Postoperative Atrial Fibrillation after Cardiac Surgery
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Ronsoni,Rafael de March, Leiria,Tiago Luiz Luz, Pires,Leonardo Martins, Kruse,Marcelo Lapa, Pereira,Edemar, Silva,Rogerio Gomes da, and Lima,Gustavo Glotz de
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Atrial Fibrillation ,Myocardial Revascularization ,Heart Valves/surgery ,Risk Score ,Prevention and Control ,Perioperative Care - Abstract
Background: Postoperative atrial fibrillation (POAF) after cardiac surgery has great clinical and economic implications. Many attempts have been made to identify risk factors aiming at a better evaluation of prophylactic treatment strategies. Objective: To perform an internal validation of a risk score for POAF. Methods: A prospective cohort of 1,054 patients who underwent myocardial revascularization and/or valve surgery was included. The risk score model was developed in 448 patients, and its performance was tested in the remaining 606 patients. Variables with a significance level of 5% in the cohort were included and subjected to a multiple logistic regression model with backward selection. Performance statistics was performed using the c-statistic, the chi-square and the Hosmer-Lemeshow (HL) goodness-of-fit, Pearson's correlation coefficient. Results: Four variables were considered predictors of outcome: age (≥ 70 years), mitral valve disease, the non-use or discontinuation of beta-blockers and a positive water balance (> 1,500 mL). The ROC curve was 0.76 (95% confidence interval [CI]: 0.72-0.79). The risk model showed a good ability according to the performance statistics - HL test x(2) = 0.93; p = 0.983 and r = 0.99 (Pearson's coefficient). There was an increase in the frequency of POAF with the increase of the score: very low risk = 0.0%; low risk = 3.9%; intermediate risk = 10.9%; and high risk = 60.0%; p < 0.0001. Conclusion: The predictive variables of POAF allowed us to construct a simplified risk score. This scoring system showed good accuracy and can be used in routine clinical practice.
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- 2019
17. Cohort of Patients Referred for Brugada Syndrome Investigation in an Electrophysiology Service - 19-Year Registry
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Warpechowski Neto, Stefan, Leiria, Tiago Luiz Luz, Ley, Laura Lessa Gaudie, Ley, Antonio Lessa Gaudie, Dutra, Luiza Zwan, Pires, Leonardo Martins, Kruse, Marcelo Lapa, and Lima, Gustavo Glotz de
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Sudden Death ,Morte Súbita ,Ventricular Tachycardia ,Taquicardia Ventricular ,Síndrome de Brugada ,Brugada Syndrome - Abstract
Background: Brugada syndrome (SBr) is an arrhythmic condition characterized by ST-T segment abnormalities in the right precordial leads associated with a high risk of ventricular arrhythmias and sudden death. Local data regarding the clinical characteristics of patients with a typical electrocardiographic (ECG) pattern undergoing electrophysiological study are scarce. Objective: To evaluate patients with an ECG pattern suggestive of SBr referred for electrophysiological evaluation in a specialized center. Methods: Cohort study of patients referred for electrophysiological study because of an ECG pattern compatible with SBr between January 1998 and March 2017. Results: Of the 5506 procedures, 35 (0.64%) were for SBr investigation, 25 of which (71.42%) were performed in men. The mean age was 43.89 ± 13.1 years. The ECG patterns were as follows: type I, 22 (62.85%); type II, 12 (34.30%); and type III, 1 (2.85%). Twenty-three patients (65.7%) were asymptomatic, 6 (17.14%) had palpitations, 5 (14.3%) had syncope, and 3 (8.6%) had a family history of sudden death. Electrophysiological study induced ventricular tachyarrhythmias in 16 cases (45.7%), the mean ventricular refractory period being 228 ± 36 ms. Ajmaline / procainamide was used in 11 cases (31.4%), changing the ECG pattern to type I in 7 (63.6%). Sixteen cases (45.7%) received an implantable cardioverter defibrillator (ICD). In a mean 5-year follow-up, 1 of the 16 patients (6.25%) with ICD had appropriate therapy for ventricular fibrillation. There was no death. Other arrhythmias occurred in 4 (11.4%) cases. Conclusions: Most patients are men, and a type I ECG pattern is the main indication for electrophysiological study. Class IA drugs have a high ECG conversion rate. The ICD event rate was 6%. (Arq Bras Cardiol. 2018; [online].ahead print, PP.0-0) Resumo Fundamento: Síndrome de Brugada (SBr) é uma condição arrítmica definida por anormalidades do segmento ST-T em derivações V1-V3 associada a risco elevado de arritmias ventriculares e morte súbita. Dados locais quanto às características clínicas dos pacientes com padrão eletrocardiográfico (ECG) típico avaliados por estudo eletrofisiológico (EEF) são escassos. Objetivo: Avaliar pacientes com padrão ECG sugestivo de SBr encaminhados para EEF em um centro especializado. Métodos: Estudo de coorte de casos encaminhados para EEF por padrão ECG compatível com SBr, entre janeiro de 1998 e março de 2017. Resultados: Dos 5506 procedimentos, 35 (0,64%) foram para investigação de SBr. Vinte e cinco (71,42%) eram homens. Idade média 43,89 ± 13,1 anos. Apresentação ECG foi tipo I em 22 casos (62,85%), tipo II em 12 (34,30%) e tipo III em 1 (2,85%). Vinte e três (65,7%) eram assintomáticos, 6 (17,14%) apresentavam palpitações, 5 (14,3%) síncope, 3 (8,6%) história familiar de morte súbita. Estudo eletrofisiológico induziu taquiarritmias ventriculares em 16 casos (45,7%), sendo o período refratário ventricular médio de 228 ± 36 ms. Utilizou-se ajmalina/procainamida em 11 casos (31,4%), sendo o padrão ECG transformado em tipo I em 7 (63,6%). Dezesseis casos (45,7%) receberam cardiodes fibrilador (CDI). Em seguimento médio de 5 anos, 1 dos 16 pacientes (6,25%) com CDI teve terapia apropriada para fibrilação ventricular. Nenhuma morte foi registrada. Outras arritmias ocorreram em 4 (11,4%) casos. Conclusões: Homens são maioria, sendo o padrão ECG tipo I a principal indicação de EEF. Droga classe IA possui alta taxa de conversão do padrão ECG. A taxa de eventos no CDI foi de 6%. (Arq Bras Cardiol. 2018; [online].ahead print, PP.0-0)
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- 2018
18. Cohort of Patients Referred for Brugada Syndrome Investigation in an Electrophysiology Service - 19-Year Registry
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Warpechowski Neto, Stefan, primary, Leiria, Tiago Luiz Luz, additional, Ley, Laura Lessa Gaudie, additional, Ley, Antonio Lessa Gaudie, additional, Dutra, Luiza Zwan, additional, Pires, Leonardo Martins, additional, Kruse, Marcelo Lapa, additional, and Lima, Gustavo Glotz de, additional
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- 2018
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19. Uninterrupted Use of Oral Anticoagulants for the Ablation of Atrial Flutter: A Single Center Cohort of 154 Patients
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Leiria, Tiago Luiz Luz, primary, Medeiros, Alexandre Kreling, additional, Almeida, Eduardo Dytz, additional, Ley, Antonio Lessa Gaudie, additional, Santos, Catarine Benta Lopes dos, additional, Sant'Anna, Roberto Toffani, additional, Kruse, Marcelo Lapa, additional, Pires, Leonardo Martins, additional, and Lima, Gustavo Glotz de, additional
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- 2017
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20. Electrophysiological Studies and Radiofrequency Ablations in Children and Adolescents with Arrhythmia
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Simão, Mariana Fernandez, Rios, Matheus Nardi, Leiria, Tiago Luiz Luz, Kruse, Marcelo Lapa, Pires, Leonardo Martins, SantAnna, Roberto Tofani, and Lima, Gustavo Glotz de
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Arritmias cardíacas ,Adolescent ,Técnicas Eletrofisiológicas Cardíacas ,Catheter Ablation ,Criança ,Arrhythmias ,Child ,Electrophysiologic Techniques, Cardiac ,Cardiac ,Ablação por Cateter ,Adolescente - Abstract
Background:Radiofrequency ablation is the standard non-pharmacological treatment for arrhythmias in pediatric patients. However, arrhythmias and their associated causes have particular features in this population.Objective:To analyze the epidemiological characteristics and findings of electrophysiological diagnostic studies and radiofrequency ablations in pediatric patients referred to the Electrophysiology Unit at Instituto de Cardiologia do Rio Grande do Sul, in order to characterize the particularities of this population.Methods:Cross-sectional study with 330 electrophysiological procedures performed in patients aged less than 20 years between June 1997 and August 2013.Results:In total, 330 procedures (9.6% of the overall procedures) were performed in patients aged less than 20 years (14.33 ± 3.25 years, age range 3 months to 19 years), 201 of which were males (60.9%). A total of 108 (32.7%) electrophysiological diagnostic studies were performed and of these, 48.1% showed abnormal findings. Overall, 219 radiofrequency ablations were performed (66.3%) with a success rate of 84.8%. The presence of an accessory pathway was the most prevalent finding, occurring in 158 cases (72.1%), followed by atrioventricular nodal reentrant tachycardia (16.8%), typical atrial flutter (3.1%) and extrasystoles originating from the right ventricular outflow tract (2.7%). Three patients developed complications during ablation (1.4%). Among congenital heart diseases, which occurred in 51 (15.4%) patients, atrial sept defect was the most frequent (27.4%), followed by ventricular sept defect (25.4%) and Ebstein's anomaly (17.6%).Conclusion:Electrophysiological study and radiofrequency ablation are effective tools for diagnosis and treatment of arrhythmias in the pediatric population. Fundamento:A ablação com radiofrequência é o tratamento não farmacológico de eleição para arritmias na população pediátrica. Porém, as arritmias e suas causas apresentam características particulares nesta população.Objetivos:Analisar as características epidemiológicas e os achados de estudo eletrofisiológico diagnóstico e ablação com radiofrequência na população pediátrica encaminhada à Eletrofisiologia do Instituto de Cardiologia do Rio Grande do Sul, a fim de caracterizar as suas particularidades.Resultados:Foram realizados 330 procedimentos (9,6% do total de procedimentos) em pacientes com idade inferior a 20 anos (14,33 ± 3,25 anos, variação entre 3 meses e 19 anos), dos quais 201 eram do sexo masculino (60,9%). Foram realizados 108 (32,7%) exames eletrofisiológicos diagnósticos e destes, 48,1% apresentaram anormalidades em seus achados. Ao todo, 219 ablações com radiofrequência foram realizadas (66,3%), obtendo-se sucesso em 84,8%. A presença de feixe acessório foi o achado mais prevalente, responsável por 158 casos (72,1%), seguida de taquicardia por reentrada nodal atrioventricular (16,8%), flutter atrial típico (3,1%) e extrassístole de via de saída de ventrículo direito (2,7%). Três pacientes apresentaram complicações durante a ablação (1,4%). Cardiopatia congênita esteve presente em 51 (15,4%) casos, sendo a comunicação interatrial a mais encontrada (27,4%), seguida de comunicação interventricular (25,4%) e anomalia de Ebstein (17,6%).Conclusão:Estudo eletrofisiológico e ablação com radiofrequência constituem ferramentas eficazes no diagnóstico e tratamento das arritmias na população pediátrica.
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- 2014
21. Risco da radiação ionizante em mulheres férteis submetidas à ablação por radiofrequência
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Lima, Gustavo Glotz de, Gomes, Daniel Garcia, Gensas, Caroline Saltz, Simão, Mariana Fernandez, Rios, Matheus N., Pires, Leonardo Martins, Kruse, Marcelo Lapa, and Leiria, Tiago Luiz Luz
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lcsh:Diseases of the circulatory (Cardiovascular) system ,Mulheres ,Medição de Risco ,Fertile Period ,lcsh:RC666-701 ,Radiação Ionizante ,Radiation, Ionizing ,Período Fértil ,Catheter Ablation ,Women ,Risk Assessment ,Ablação por Cateter - Abstract
FUNDAMENTO: A Comissão Internacional de Radiologia indica rastreamento com teste de gravidez a todas pacientes do gênero feminino em período fértil que serão submetidas a exame radiológico. Sabe-se que a radiação é teratogênica e que seu efeito é cumulativo. O potencial teratogênico inicia-se com doses próximas às das utilizadas durante esses procedimentos. Não se sabe a prevalência de teste de gravidez positivo em pacientes submetidos a estudo eletrofisiológico e/ou à ablação por cateter em nosso meio. OBJETIVO: Avaliar a prevalência de teste de gravidez positivo em pacientes do gênero feminino encaminhadas para estudo eletrofisiológico e/ou ablação por radiofrequência. MÉTODOS: Estudo transversal com análise de 2.966 pacientes submetidos a estudo eletrofisiológico e/ou ablação por cateter, de junho 1997 a fevereiro 2013, no Instituto de Cardiologia do Rio Grande do Sul. Foram realizados 1.490 exames em mulheres sendo que, destas, 769 encontravam-se em idade fértil. Todas as pacientes foram rastreadas com teste de gravidez no dia anterior ao procedimento. RESULTADOS: Detectou-se positividade do teste em três pacientes, impossibilitando a realização do exame. Observou-se prevalência de 3,9 casos por 1.000 mulheres em idade fértil. CONCLUSÃO: Devido ao baixo custo e à segurança, indica-se a realização de teste de rastreamento para gravidez a todas pacientes em idade fértil, uma vez que o grau de radiação ionizante necessária nesse procedimento é muito próximo ao limiar de teratogenicidade, principalmente no primeiro trimestre, quando os sinais de gestação não são exuberantes. BACKGROUND: The International Commission of Radiology recommends a pregnancy screening test to all female patients of childbearing age who will undergo a radiological study. Radiation is known to be teratogenic and its effect is cumulative. The teratogenic potential starts at doses close to those used during these procedures. The prevalence of positive pregnancy tests in patients undergoing electrophysiological studies and/or catheter ablation in our midst is unknown. OBJECTIVE: To evaluate the prevalence of positive pregnancy tests in female patients referred for electrophysiological study and/or radiofrequency ablation. METHODS: Cross-sectional study analyzing 2966 patients undergoing electrophysiological study and/or catheter ablation, from June 1997 to February 2013, in the Institute of Cardiology of Rio Grande do Sul. A total of 1490 procedures were performed in women, of whom 769 were of childbearing age. All patients were screened with a pregnancy test on the day before the procedure. RESULTS: Three patients tested positive, and were therefore unable to undergo the procedure. The prevalence observed was 3.9 cases per 1000 women of childbearing age. CONCLUSION: Because of their safety and low cost, pregnancy screening tests are indicated for all women of childbearing age undergoing radiological studies, since the degree of ionizing radiation needed for these procedures is very close to the threshold for teratogenicity, especially in the first trimester, when the signs of pregnancy are not evident.
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- 2013
22. Ablação de arritmias por cateter com mapeamento eletroanatômico exclusivo: uma série de casos
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Pires,Leonardo Martins, Leiria,Tiago Luiz Luz, Kruse,Marcelo Lapa, Ronsoni,Rafael, Gensas,Caroline Saltz, and Lima,Gustavo Glotz de
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lcsh:Diseases of the circulatory (Cardiovascular) system ,Arrimtias Cardíacas ,Fluoroscopia ,lcsh:RC666-701 ,Arrimtias Cardíacas/terapia ,Fluoroscopy ,Catheter Ablation ,Arrhythmias, Cardiac ,Ablação por Cateter - Abstract
FUNDAMENTO: A ablação por cateter possibilita tratamento curativo para diversas arritmias cardíacas. A fluoroscopia é utilizada para localizar e direcionar os cateteres aos pontos causadores de arritmias. Contudo, a fluoroscopia apresenta diversos riscos. O mapeamento eletroanatômico (MEA) apresenta imagem tridimensional sem utilizar raios X, reduzindo os riscos da fluoroscopia. OBJETIVO: Descrevemos uma série de pacientes nos quais foi realizada ablação de arritmias cardíacas com o uso exclusivo de MEA. MÉTODOS: Foram selecionados prospectivamente, de março de 2011 a março de 2012, pacientes com arritmias cardíacas refratárias ao tratamento farmacológico para realização de ablação de arritmias com o uso exclusivo de MEA. Não participaram aqueles com indicação de estudo eletrofisiológico diagnóstico e ablação de fibrilação atrial, taquiarritmias de átrio esquerdo e arritmia ventricular hemodinamicamente instável. Observamos tempo total de procedimento, taxa de sucesso, complicações e se ocorreu necessidade de uso de fluoroscopia durante o procedimento. RESULTADOS: Participaram 11 pacientes, sendo sete do sexo feminino (63%), com idade média de 50 anos (DP ± 16,5). As indicações dos procedimentos foram quatro casos (35%) de flutter atrial, três casos (27%) de síndrome de pré-excitação, dois casos (19%) de taquicardia supraventricular paroxística e dois casos (19%) de extrassístoles ventriculares. A média de duração do procedimento foi de 86,6 min (DP ± 26 min). O sucesso imediato (na alta hospitalar) do procedimento ocorreu em nove pacientes (81%). Não houve complicações durante os procedimentos. CONCLUSÃO: Neste estudo, foi demonstrado que é viável a realização de ablação de arritmias apenas com o uso do MEA, com resultados satisfatórios. BACKGROUND: Catheter ablation is a treatment that can cure various cardiac arrhythmias. Fluoroscopy is used to locate and direct catheters to areas that cause arrhythmias. However, fluoroscopy has several risks. Electroanatomic mapping (EAM) facilitates three-dimensional imaging without X-rays, which reduces risks associated with fluoroscopy. OBJECTIVE: We describe a series of patient cases wherein cardiac arrhythmia ablation was exclusively performed using EAM. METHODS: Patients who presented with cardiac arrhythmias that were unresponsive to pharmacological therapy were prospectively selected between March 2011 and March 2012 for arrhythmia ablation exclusively through EAM. Patients with indications for a diagnostic electrophysiology study and ablation of atrial fibrillation, left atrial tachyarrhythmias as well as hemodynamically unstable ventricular arrhythmia were excluded. We documented the procedure time, success rate and complications as well as whether fluoroscopy was necessary during the procedure. RESULTS: In total, 11 patients were enrolled in the study, including seven female patients (63%). The mean age of the patients was 50years (SD ±16.5). Indications for the investigated procedures included four cases (35%) of atrial flutter, three cases (27%) of pre-excitation syndrome, two cases (19%) of paroxysmal supraventricular tachycardia and two cases (19%) of ventricular extrasystoles. The mean procedure duration was 86.6 min (SD ± 26 min). Immediate success (at discharge) of the procedure was evident for nine patients (81%). There were no complications during the procedures. CONCLUSION: This study demonstrates the feasibility of performing an arrhythmia ablation exclusively using EAM with satisfactory results.
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- 2013
23. Agenesia da veia cava inferior
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Gensas, Caroline Saltz, Pires, Leonardo Martins, Kruse, Marcelo Lapa, Leiria, Tiago Luiz Luz, Gomes, Daniel Garcia, and Lima, Gustavo Glotz de
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Veia cava inferior ,Electrophysiology ,Eletrofisiologia ,Anormalidades cardiovasculares ,cardiovascular system ,Cardiovascular abnormalities ,Vena cava, inferior - Abstract
Agenesia da veia cava inferior é uma malformação rara. Sua causa mais comum é a disgenesia durante a embriogênese, mas também pode estar relacionada a trombose intrauterina ou perinatal. Normalmente é assintomática, em associação, ou não, com outras malformações congênitas, e pode cursar com maior risco de insuficiência venosa crônica e trombose venosa profunda, especialmente em jovens. Seu diagnóstico frequentemente é acidental, durante cirurgias abdominais ou procedimentos radiológicos. Relatamos cinco casos de agenesia da veia cava inferior detectada durante procedimentos eletrofisiológicos. Agenesis of the inferior vena cava is a rare malformation. Its most common cause is dysgenesis during embryogenesis, but it may also be related to intrauterine or perinatal thrombosis. It is usually asymptomatic, associated or not with other congenital malformations and may be related to increased risk of chronic venous insufficiency and deep vein thrombosis, especially in young individuals. Diagnosis is often incidental, during abdominal surgery or radiological procedures. We reported five cases of agenesis of the inferior vena cava detected during electrophysiological procedures.
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- 2012
24. Agenesia da veia cava inferior
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Gensas,Caroline Saltz, Pires,Leonardo Martins, Kruse,Marcelo Lapa, Leiria,Tiago Luiz Luz, Gomes,Daniel Garcia, and Lima,Gustavo Glotz de
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Veia cava inferior ,Eletrofisiologia ,Anormalidades cardiovasculares - Abstract
Agenesia da veia cava inferior é uma malformação rara. Sua causa mais comum é a disgenesia durante a embriogênese, mas também pode estar relacionada a trombose intrauterina ou perinatal. Normalmente é assintomática, em associação, ou não, com outras malformações congênitas, e pode cursar com maior risco de insuficiência venosa crônica e trombose venosa profunda, especialmente em jovens. Seu diagnóstico frequentemente é acidental, durante cirurgias abdominais ou procedimentos radiológicos. Relatamos cinco casos de agenesia da veia cava inferior detectada durante procedimentos eletrofisiológicos.
- Published
- 2012
25. Clinical Differences between Subtypes of Atrial Fibrillation and Flutter: Cross-Sectional Registry of 407 Patients
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Almeida, Eduardo Dytz, primary, Guimarães, Raphael Boesche, additional, Stephan, Laura Siga, additional, Medeiros, Alexandre Kreling, additional, Foltz, Katia, additional, Santanna, Roberto Tofani, additional, Pires, Leonardo Martins, additional, Kruse, Marcelo Lapa, additional, Lima, Gustavo Glotz de, additional, and Leiria, Tiago Luiz Luz, additional
- Published
- 2015
- Full Text
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26. Relationship between silent atrial fibrillation and the maximum heart rate in the 24-hour Holter: cross-sectional study
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Kruse, Marcelo Lapa, primary, Kruse, José Cláudio Lupi, additional, Leiria, Tiago Luiz Luz, additional, Pires, Leonardo Martins, additional, Gensas, Caroline Saltz, additional, Gomes, Daniel Garcia, additional, Boris, Douglas, additional, Mantovani, Augusto, additional, and Lima, Gustavo Glotz de, additional
- Published
- 2014
- Full Text
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27. Supraventricular tachycardia and syncope during pregnancy: A case for catheter ablation without fluoroscopy
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Leiria, Tiago Luiz Luz, primary, Pires, Leonardo Martins, additional, Kruse, Marcelo Lapa, additional, and de Lima, Gustavo Glotz, additional
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- 2014
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- View/download PDF
28. Electrophysiological Studies and Radiofrequency Ablations in Children and Adolescents with Arrhythmia
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Simão, Mariana Fernandez, primary, Rios, Matheus Nardi, additional, Leiria, Tiago Luiz Luz, additional, Kruse, Marcelo Lapa, additional, Pires, Leonardo Martins, additional, SantAnna, Roberto Tofani, additional, and Lima, Gustavo Glotz de, additional
- Published
- 2014
- Full Text
- View/download PDF
29. Struck by Lightning
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Leiria, Tiago Luiz Luz, primary, Pires, Leonardo Martins, additional, Kruse, Marcelo Lapa, additional, and de Lima, Gustavo Glotz, additional
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- 2013
- Full Text
- View/download PDF
30. Catheter Ablation of Arrhythmias Exclusively Using Electroanatomic Mapping: A Series of Cases
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Pires, Leonardo Martins, primary, Leiria, Tiago Luiz Luz, additional, Kruse, Marcelo Lapa, additional, Ronsoni, Rafael, additional, Gensas, Caroline Saltz, additional, and Lima, Gustavo Glotz de, additional
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- 2013
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31. Risk of Ionizing Radiation in Women of Childbearing Age undergoing Radiofrequency Ablation
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Lima, Gustavo Glotz de, primary, Gomes, Daniel Garcia, additional, Gensas, Caroline Saltz, additional, Simão, Mariana Fernandez, additional, Rios, Matheus N, additional, Pires, Leonardo Martins, additional, Kruse, Marcelo Lapa, additional, and Leiria, Tiago Luiz Luz, additional
- Published
- 2013
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- View/download PDF
32. CHA2DS2VASc Score as a Predictor of Cardiovascular Events in Ambulatory Patients without Atrial Fibrillation.
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POLENZ, GUSTAVO FREB, LEIRIA, TIAGO LUIZ LUZ, ESSEBAG, VIDAL, KRUSE, MARCELO LAPA, PIRES, LEONARDO MARTINS, NOGUEIRA, THAIZE BRISOLARA, GUIMARÃES, RAPHAEL BOESCHE, SANTANNA, ROBERTO TOFANI, and DE LIMA, GUSTAVO GLOTZ
- Subjects
HEART disease risk factors ,THROMBOEMBOLISM risk factors ,AGE distribution ,CHI-squared test ,CONFIDENCE intervals ,LONGITUDINAL method ,RISK assessment ,SEX distribution ,STATISTICS ,SURVIVAL analysis (Biometry) ,T-test (Statistics) ,DATA analysis ,RELATIVE medical risk ,DATA analysis software ,DESCRIPTIVE statistics - Abstract
Background: New evidence suggests that the CHA
2 DS2 VASc (congestive heart failure, hypertension [HTN], age, diabetes, stroke, vascular disease, and female gender) score may be a reliable tool to predict the risk of thromboembolic events in patients without documented atrial fibrillation (AF). Methods: We performed a prospective cohort study of outpatients without AF or flutter, who were not using oral anticoagulation. Clinical characteristics were assessed and patients were stratified according to the CHA2 DS2 VASc score. We evaluated the incidence of major adverse cardiac outcomes and its relation to the CHA2 DS2 VASc score during the follow-up. Results: Four hundred sixty-eight patients without AF were enrolled with a mean follow-up of 12 ± 6 months. Age was 64.9 ± 11.3 years. The prevalence of HTN was 88.4%, diabetes 37.6%, heart failure 26.3%, and vascular disease 61.7%. Overall, CHA2 DS2 VASc score was 3.4 ± 1.4. There were 15 major adverse cardiac outcomes during 12.2 months of follow-up (overall incidence of 3.2 per 100 personyears). We found significant differences in relation to gender, age, previous stroke, and follow-up length in patients with and without adverse outcomes. The CHA2 DS2 VASc score was higher in those with adverse outcomes (4.2 ± 1.7 vs 3.4 ± 1.4; P = 0.035). Patients with a CHA2 DS2 VASc ≥6 had a relative risk for adverse outcomes of 4.2 (95% confidence interval: 1.27-13.90). Conclusions: In our population, CHA2 DS2 VASc score predicts major adverse cardiac outcomes, including stroke and death, in a cohort of patients without AF. [ABSTRACT FROM AUTHOR]- Published
- 2015
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33. Agenesia da veia cava inferior
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Gensas, Caroline Saltz, primary, Pires, Leonardo Martins, additional, Kruse, Marcelo Lapa, additional, Leiria, Tiago Luiz Luz, additional, Gomes, Daniel Garcia, additional, and Lima, Gustavo Glotz de, additional
- Published
- 2012
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34. Agenesis of the Inferior Vena Cava
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Gensas, Caroline Saltz, primary, Pires, Leonardo Martins, additional, Kruse, Marcelo Lapa, additional, Luz Leiria, Tiago Luiz, additional, Gomes, Daniel Garcia, additional, and de Lima, Gustavo Glotz, additional
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- 2012
- Full Text
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35. Struck by Lightning: A Case of Nature-Induced Pre-excited Atrial Fibrillation.
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Leiria, Tiago Luiz Luz, Pires, Leonardo Martins, Kruse, Marcelo Lapa, and de Lima, Gustavo Glotz
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- 2013
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36. Catheter ablation of typical right atrial flutter in a 20-day-old neonate with tachycardiomyopathy.
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Leiria TLL, Cabral IW, Schäfer S, Nicoloso LHS, Filho RIR, Kruse ML, Saffi MAL, and de Lima GG
- Abstract
Background: Fetal echocardiography can diagnose neonatal atrial flutter, which can cause heart failure in newborns. Little is known about catheter ablation in this population., Methods: Case report that aimed to review a successful ablation in a 20-day-old patient with refractory atrial flutter., Results: This is the first report of a successful neonatal atrial flutter ablation without any early recurrence after the procedure., Conclusions: Atrial flutter ablation performed on newborns is a reliable and long-lasting treatment option., Competing Interests: All authors have no conflicts of interest to disclose., (© 2023 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society.)
- Published
- 2023
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37. Atrial Fibrillation Ablation: Impact of Intracardiac Echocardiography in Reducing Procedure Time and Hospitalization.
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Sant Anna RT, Lima GG, Saffi MAL, Kruse ML, and Leiria TLL
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- Humans, Prospective Studies, Treatment Outcome, Echocardiography, Transesophageal, Length of Stay, Cardiac Catheterization methods, Atrial Fibrillation diagnostic imaging, Atrial Fibrillation surgery, Atrial Fibrillation complications, Atrial Appendage diagnostic imaging
- Abstract
Background: Intracardiac echocardiography (ICE) allows visualization of cardiac structures and recognition of complications during atrial fibrillation ablation (AFA). Compared to transesophageal echocardiography (TEE), ICE is less sensitive to detecting thrombus in the atrial appendage but requires minimal sedation and fewer operators, making it attractive in a resource-constrained setting., Objective: To compare 13 cases of AFA using ICE (AFA-ICE group) with 36 cases of AFA using TEE (AFA-TEE group)., Methods: This is a single-center prospective cohort study. The main outcome was procedure time. Secondary outcomes: fluoroscopy time, radiation dose (mGy/cm2), major complications, and length of hospital stay in hours. The clinical profile was compared using the CHA2DS2-VASc score. A p-value <0.05 was considered a statistically significant difference between groups., Results: The median CHA2DS2-VASc score was 1 (0-3) in the AFA-ICE group and 1 (0-4) in the AFA-TEE group. The total procedure time was 129 ± 27 min in the AFA-ICE group and 189 ± 41 min in the AFA-TEE group (p<0.001); the AFA-ICE group received a lower dose of radiation (mGy/cm2, 51296 ± 24790 vs. 75874 ± 24293; p=0.002), despite the similar fluoroscopy time (27.48 ± 9. 79 vs. 26.4 ± 9.32; p=0.671). The median length of hospital stay did not differ; 48 (36-72) hours (AFA-ICE) and 48 (48-66) hours (AFA-TEE) (p=0.27)., Conclusions: In this cohort, AFA-ICE was related to shorter procedure times and less exposure to radiation without increasing the risk of complications or the length of hospital stay.
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- 2023
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38. Uninterrupted Use of Oral Anticoagulants for the Ablation of Atrial Flutter: A Single Center Cohort of 154 Patients.
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Leiria TLL, Medeiros AK, Almeida ED, Ley ALG, Santos CBLD, Sant'Anna RT, Kruse ML, Pires LM, and Lima GG
- Subjects
- Administration, Oral, Adult, Aged, Anticoagulants adverse effects, Cohort Studies, Female, Hemorrhage chemically induced, Humans, Ischemic Attack, Transient etiology, Male, Middle Aged, Risk Factors, Stroke etiology, Stroke prevention & control, Anticoagulants administration & dosage, Atrial Flutter complications, Catheter Ablation, Venous Thromboembolism prevention & control, Vitamin K antagonists & inhibitors
- Abstract
Background: The uninterrupted use of oral anticoagulation (OAC) with vitamin K antagonists (VKAs) for electrophysiology procedures has been more and more recommended. The clinical practice in our service recommends the continuous use of these drugs for atrial flutter ablation. There is little evidence as to the uninterrupted use of non-vitamin K antagonist oral anticoagulants (NOACs) in this scenario., Objective: To compare the rates of complications related with the uninterrupted use of different types of oral anticoagulants in patients referred to atrial flutter (AFL) ablation., Methods: Historical, single-center cohort of ablation procedures by AFL conducted from November 2012 to April 2016. The primary outcome was the occurrence of hemorrhagic or embolic complication during the procedure. The secondary outcome was the occurrence of stroke or transient ischemic attack (TIA) in follow-up. The statistical significance level was 5%., Results: There were 288 ablations per AFL; 154 were carried out with the uninterrupted use of OAC (57.8% with VKA and 42.2% with NOAC). Mean age was 57 ± 13 years. The rate of hemorrhagic complication during the procedure was 3% in each group (p = NS). The rate of stroke/TIA was, respectively, of 56/1,000 people-year in the VKA group against zero/1,000 people-year in the NOAC group (p = 0.02)., Conclusion: In our population there were no hemorrhagic complications regarding the procedure of OAC use uninterruptedly, including NOACs. There was higher occurrence of stroke/TIA in the follow-up of the group of patients undergoing VKAs; however, this difference may not only be a result of the type of OAC used.
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- 2018
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39. CHA2 DS2 VASc Score as a Predictor of Cardiovascular Events in Ambulatory Patients without Atrial Fibrillation.
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Polenz GF, Leiria TL, Essebag V, Kruse ML, Pires LM, Nogueira TB, Guimarães RB, Santanna RT, and DE Lima GG
- Subjects
- Age Distribution, Aged, Ambulatory Care, Atrial Fibrillation, Brazil epidemiology, Comorbidity, Death, Sudden, Cardiac, Female, Humans, Incidence, Male, Prognosis, Reproducibility of Results, Sensitivity and Specificity, Sex Distribution, Survival Rate, Cardiovascular Diseases mortality, Diabetes Complications mortality, Proportional Hazards Models, Risk Assessment methods, Stroke mortality
- Abstract
Background: New evidence suggests that the CHA(2)DS(2)VASc (congestive heart failure, hypertension [HTN], age, diabetes, stroke, vascular disease, and female gender) score may be a reliable tool to predict the risk of thromboembolic events in patients without documented atrial fibrillation (AF)., Methods: We performed a prospective cohort study of outpatients without AF or flutter, who were not using oral anticoagulation. Clinical characteristics were assessed and patients were stratified according to the CHA(2)DS(2)VASc score. We evaluated the incidence of major adverse cardiac outcomes and its relation to the CHA(2)DS(2)VASc score during the follow-up., Results: Four hundred sixty-eight patients without AF were enrolled with a mean follow-up of 12 ± 6 months. Age was 64.9 ± 11.3 years. The prevalence of HTN was 88.4%, diabetes 37.6%, heart failure 26.3%, and vascular disease 61.7%. Overall, CHA(2)DS(2)VASc score was 3.4 ± 1.4. There were 15 major adverse cardiac outcomes during 12.2 months of follow-up (overall incidence of 3.2 per 100 person-years). We found significant differences in relation to gender, age, previous stroke, and follow-up length in patients with and without adverse outcomes. The CHA(2)DS(2)VASc score was higher in those with adverse outcomes (4.2 ± 1.7 vs 3.4 ± 1.4; P = 0.035). Patients with a CHA(2)DS(2)VASc ≥6 had a relative risk for adverse outcomes of 4.2 (95% confidence interval: 1.27-13.90)., Conclusions: In our population, CHA(2)DS(2)VASc score predicts major adverse cardiac outcomes, including stroke and death, in a cohort of patients without AF., (© 2015 Wiley Periodicals, Inc.)
- Published
- 2015
- Full Text
- View/download PDF
40. Electrophysiological studies and radiofrequency ablations in children and adolescents with arrhythmia.
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Simão MF, Rios MN, Leiria TL, Kruse ML, Pires LM, SantAnna RT, and Lima GG
- Subjects
- Adolescent, Age Factors, Child, Child, Preschool, Cohort Studies, Cross-Sectional Studies, Electrophysiologic Techniques, Cardiac methods, Female, Humans, Infant, Male, Treatment Outcome, Young Adult, Arrhythmias, Cardiac physiopathology, Arrhythmias, Cardiac surgery, Catheter Ablation methods
- Abstract
Background: Radiofrequency ablation is the standard non-pharmacological treatment for arrhythmias in pediatric patients. However, arrhythmias and their associated causes have particular features in this population., Objective: To analyze the epidemiological characteristics and findings of electrophysiological diagnostic studies and radiofrequency ablations in pediatric patients referred to the Electrophysiology Unit at Instituto de Cardiologia do Rio Grande do Sul, in order to characterize the particularities of this population., Methods: Cross-sectional study with 330 electrophysiological procedures performed in patients aged less than 20 years between June 1997 and August 2013., Results: In total, 330 procedures (9.6% of the overall procedures) were performed in patients aged less than 20 years (14.33 ± 3.25 years, age range 3 months to 19 years), 201 of which were males (60.9%). A total of 108 (32.7%) electrophysiological diagnostic studies were performed and of these, 48.1% showed abnormal findings. Overall, 219 radiofrequency ablations were performed (66.3%) with a success rate of 84.8%. The presence of an accessory pathway was the most prevalent finding, occurring in 158 cases (72.1%), followed by atrioventricular nodal reentrant tachycardia (16.8%), typical atrial flutter (3.1%) and extrasystoles originating from the right ventricular outflow tract (2.7%). Three patients developed complications during ablation (1.4%). Among congenital heart diseases, which occurred in 51 (15.4%) patients, atrial sept defect was the most frequent (27.4%), followed by ventricular sept defect (25.4%) and Ebstein's anomaly (17.6%)., Conclusion: Electrophysiological study and radiofrequency ablation are effective tools for diagnosis and treatment of arrhythmias in the pediatric population.
- Published
- 2015
- Full Text
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