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Case Report: Mutation in NPPA Gene As a Cause of Fibrotic Atrial Myopathy

Silva Cunha, P; Antunes, D; Laranjo, S; Coutinho, A; Abecasis, J; Oliveira, MM

Early-onset atrial fibrillation (AF) can be the manifestation of a genetic atrial myopathy. However, specific genetic identification of a mutation causing atrial fibrosis is rare. We report a case of a young patient with an asymptomatic AF, diagnosed during a routine examination. The cardiac MRI revealed extensive atrial fibrosis and the electrophysiology study showed extensive areas of low voltage. The genetic...


Quadripolar Left Ventricle Only Single Lead Pacing in a Patient With a Tricuspi...

Grazina, A; Teixeira, B; Silva Cunha, P; Oliveira, M

In the presence of prosthetic tricuspid valve, the inaccessibility to the right ventricle makes permanent pacing challenging. The placement of a left ventricle (LV) single lead in the coronary sinus (CS) is a well-accepted alternative, with some limitations regarding sensing and threshold. We describe a clinical case of a patient who had a previous LV only lead in the CS due to the presence of a prosthetic tric...


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, MM

Background: 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...


Non-Vitamin K Oral Anticoagulants Assessment in High Risk of Bleeding Patients ...

Silva Cunha, P; Viveiros Monteiro, A; Coutinho Cruz, M; Malveiro, P; Reis, JP; Portugal, G; Dias, A; Cruz Ferreira, R; Oliveira, MM

Atrial fibrillation (AF) is commonly associated with advanced age and the presence of multiple, concomitant acute and chronic health conditions, placing this population at high risk for serious therapeutic side effects. Nonvitamin K antagonist oral anticoagulants (NOACs) are increasingly used for stroke prevention in patients with atrial fibrillation. The purpose of this study was to investigate the effectivene...


A Systemic Review of Endocardial Left Ventricular Pacing

Santos, H; Santos, M; Almeida, I; Paula, S; Figueiredo, M; Portugal, G; Valente, B; Silva Cunha, P; Almeida, L; Oliveira, MM

Background: Endocardial left ventricular pacing is an alternative technique used in cardiac resynchronization therapy (CRT), when placement of a left ventricular lead is not possible via the coronary sinus or in non-responders to conventional CRT. Objectives: To review the evidence regarding the efficacy and safety of endocardial left ventricular pacing. Methods: Systematic research on Medline (PubMed), Clinica...


Long-Term Outcomes of Non-Contact Multi-Electrode Balloon Catheter Mapping-Guid...

Almeida, I; Lousinha, A; Silva Cunha, P; Valente, B; Paulo, M; Delgado, AS; Cruz Ferreira, R; Oliveira, MM

Introduction: The outflow tract (OT) regions of the ventricles are a common location of origin for idiopathic ventricular arrhythmias (VA). Non-contact mapping (NCM) with a multi-electrode balloon catheter Ensite-Array enables three-dimensional reconstruction of the geometry of the cardiac chambers and accurate mapping of the propagation map, based on a single beat analysis, facilitating the ablation and contri...


Remote versus In-Office Monitoring for Implantable Cardioverter Defibrillators:...

Martins Oliveira, M; Fernandes, M; Reis, H; Primo, J; Sanfins, V; Silva, V; Silva Cunha, P; Silva, M; Nicola, P; PORTLink Study Investigators

Introduction: Remote monitoring (RM) is a safe and effective alternative to in-office conventional follow-up. Objective: We aimed to evaluate patient satisfaction with RM and its impact on healthcare resources in a population with cardiac implantable electronic devices. Methods: Randomized, pragmatic, open-label controlled trial, with adult wearers of implantable cardioverter-defibrillator (ICD) or cardiac resy...


The Atrium in Atrial Fibrillation - A Clinical Review on How to Manage Atrial F...

Silva Cunha, P; Laranjo, S; Heijman, J; Oliveira, MM

Atrial fibrillation (AF) is the most common sustained arrhythmia in the population and is associated with a significant clinical and economic burden. Rigorous assessment of the presence and degree of an atrial arrhythmic substrate is essential for determining treatment options, predicting long-term success after catheter ablation, and as a substrate critical in the pathophysiology of atrial thrombogenesis. Cath...


Lockdown Measures for COVID-19 Outbreak and Variation in Physical Activity in P...

Silva Cunha, P; Laranjo, S; Lourenço, A; Rodrigues, L; Cardoso, I; Portugal, G; Valente, B; Delgado, AS; Cruz Ferreira, R; Abreu, A; Oliveira, M

Aims: The present study analysed the patterns of physical activity pre-, during and post-lockdown measures for COVID-19 pandemic in patients with chronic heart failure (CHF) and cardiac implantable electronic devices (CIED) under remote monitoring (RM), and assessed the physical activity patterns during these periods. Methods: The raw data from 95 patients with CHF (age 67,7 ± 15,1 years, 71,5% male) correspond...


An Unusual Pacemaker-Induced Tachycardia

Coutinho-Cruz, M; Portugal, G; Silva Cunha, P; Oliveira, MM


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