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Clinical Outcome of a Single Procedure Cryoballoon Ablation for the Treatment o...
Silva Cunha, P; Fonseca, P; Laranjo, S; Montenegro Sá, F; Valente, B; Portugal, G; Gonçalves, H; Nogueira da Silva, M; Brandão, L; Oliveira, MMBackground: Cryoballoon ablation (CBA) for pulmonary vein isolation (PVI) has been growing as an alternative technique, not only in patients with paroxysmal atrial fibrillation (PAF) but also in persistent atrial fibrillation (AF). Cryoballoon ablation has demonstrated encouraging acute and mid-term results. However, data on long-term follow-up of CB-based PVI are scarce. Objective: We sought to examine efficac...
Single Puncture Approach Guided by Transesophageal Echocardiography for Atrial ...
Oliveira, M; Sousa, L; Trindade, A; Nogueira da Silva, MBackground: Atrial septal defect (ASD) is associated with a risk of developing atrial fibrillation (AF) higher than in the general population, even after percutaneous or surgical septal closure. Catheter ablation is an effective treatment strategy for preventing recurrences and reducing the AF burden. However, electrophysiologists are faced with technical difficulties and the risk of complications with the left...
Response and Outcomes of Cardiac Resynchronization Therapy in Patients with Ren...
Ilhão Moreira, R; Cunha, PS; Rio, P; Nogueira da Silva, M; Branco, LM; Galrinho, A; Feliciano, J; Soares, R; Cruz Ferreira, R; Oliveira, MMPURPOSE: Renal dysfunction is often associated with chronic heart failure, leading to increased morbi-mortality. However, data regarding these patients after cardiac resynchronization therapy (CRT) is sparse. We sought to evaluate response and long-term mortality in patients with heart failure and renal dysfunction and assess renal improvement after CRT. METHODS: We analyzed 178 consecutive patients who underwe...
What Happens to Non-Responders in Cardiac Resynchronization Therapy?
Rio, P; Oliveira, MM; Cunha, PS; Nogueira da Silva, M; Branco, LM; Galrinho, A; Soares, R; Feliciano, J; Pimenta, R; Cruz Ferreira, RINTRODUCTION AND OBJECTIVES: Left ventricular reverse remodeling (LVRR) is strongly related to the long-term prognosis of patients undergoing cardiac resynchronization therapy (CRT). The aim of this study was to assess the long-term clinical outcome of patients without LVRR at six months after CRT implantation and to determine the prognostic impact of clinical response in this population. METHODS: We analyzed 1...
Time to Left Ventricular Reverse Remodeling after Cardiac Resynchronization The...
Viveiros Monteiro, A; Oliveira, MM; Cunha, PS; Nogueira da Silva, M; Feliciano, J; Branco, LM; Rio, P; Pimenta, R; Delgado, AS; Cruz Ferreira, RINTRODUCTION: Left ventricular reverse remodeling (LVRR), defined as reduction of end-diastolic and end-systolic dimensions and improvement of ejection fraction, is associated with the prognostic implications of cardiac resynchronization therapy (CRT). The time course of LVRR remains poorly characterized. Nevertheless, it has been suggested that it occurs ≤6 months after CRT. OBJECTIVE: To characterize the long...
Short QT Syndrome Presenting As Syncope: How Short Is Too Short?
Portugal, G; Oliveira, MM; Silva Cunha, P; Filipa, F; Lousinha, A; Fiarresga, A; Nogueira da Silva, M; Cruz Ferreira, RWe report the case of a 52-year-old man who presented to our emergency department (ED) after three episodes of syncope in the seven hours before admission. During his stay in the ED he had recurrent ventricular tachycardia (VT) requiring external electrical cardioversion. A 12-lead electrocardiogram (ECG) showed a short QT (SQT) interval (270 ms, QTc 327 ms), with frequent R-on-T extrasystoles triggering sustai...
Femoral Approach: an Exceptional Alternative for Permanent Pacemaker Implantation
Valente, B; Conceição, JM; Nogueira da Silva, M; Oliveira, MM; Silva Cunha, P; Lousinha, A; Galrinho, A; Cruz Ferreira, RThe classic transvenous implantation of a permanent pacemaker in a pectoral location may be precluded by obstruction of venous access through the superior vena cava or recent infection at the implant site. When these barriers to the procedure are bilateral and there are also contraindications or technical difficulties to performing a thoracotomy for an epicardial approach, the femoral vein, although rarely used...
The Proarrhythmic Effect of Cardiac Resynchronization Therapy: an Issue that Sh...
Cabanelas, N; Oliveira, MM; Nogueira da Silva, M; Silva Cunha, P; Valente, B; Lousinha, A; Santos, S; Branco, LM; Cruz Ferreira, RThe demonstrated benefits of cardiac resynchronization therapy (CRT) in reducing mortality and hospitalizations for heart failure, improving NYHA functional class and inducing reverse remodeling have led to its increasing use in clinical practice. However, its potential contribution to complex ventricular arrhythmias is controversial.We present the case of a female patient with valvular heart failure and severe...
Monitorização à Distância no Seguimento de Portadores de Dispositivos Cardíacos...
Oliveira, MM; Silva Cunha, P; Nogueira da Silva, MO aumento significativo registado nas implantações de dispositivos cardíacos, sobretudo como consequência dos benefícios demonstrados com a utilização de cardioversoresdesfibrilhadores e sistemas de ressincronização cardíaca na redução da mortalidade, trouxe para a prática clínica hospitalar o problema da gestão de recursos para responder ao crescimento exponencial do número de doentes em consultas regulares de...
Syncope and Intermittent Brugada ECG Pattern
Piçarra, B; Silva Cunha, P; Oliveira, MM; Valente, B; Nogueira da Silva, M; Santos, S; Cruz Ferreira, RA síndrome de Brugada é uma síndrome rara, com uma prevalência aproximada na Europa de 1-5/10 000 habitantes, mas cuja apresentação clínica inicial pode ser morte súbita. Embora com um padrão eletrocardiográfico típico, este é por vezes intermitente. Os autores apresentam o caso clínico de um doente de sexo masculino, de 32 anos, sem fatores de risco pessoais conhecidos e história familiar de morte súbita, que ...