RESUMO
The aim of this prospective registry is to evaluate a new algorithm designed to reduce the percentage of unnecessary ventricular pacing (%VP) in patients implanted with a dual-chamber pacemaker, through a dedicated pacing mode (called AAISafeR2) operating in AAI mode with back-up ventricular pacing in DDD mode, and to describe the incidence and distribution of atrioventricular (AV) block in this population. Investigators were free to assign patients to AAISafeR2 mode or to standard DDD (if AAISafeR was contraindicated, mainly due to permanent high-degree AV block). Patients underwent routine follow-up visits at 3, 6, 12, 18 and 24 months after implantation. At each follow-up visit, data were retrieved from pacemaker memories and analyzed to extract %VP and incidence of AV block. Up to December 2006, 158 patients (94 men, mean age 69 +/- 14 years) from nine Portuguese centers had been consecutively included. We also determined the distribution of AV block (according to the criteria used by the pacemaker to classify AV block and switch to DDD mode). AAISafeR was shown to be effective in reducing unnecessary VP in our patient population. The analysis also reveals a high incidence of paroxysmal AV block, often unknown at the time of implantation. There were no complications associated with AAISafeR programming.
Assuntos
Estimulação Cardíaca Artificial/estatística & dados numéricos , Procedimentos Desnecessários/estatística & dados numéricos , Idoso , Algoritmos , Feminino , Humanos , Masculino , Portugal , Estudos Prospectivos , Sistema de RegistrosRESUMO
The authors report a case of a 68-year-old male, with no known cardiac disease until he suffered a cerebral embolic event related to the presence of a papillary fibroelastoma located in the mid third of the inferior left ventricular wall. They also perform a literature review, particularly of the specific characteristics of the tumor and the surgical approach. They point out that the location of the fibroelastoma described is very unusual; its clinical and echocardiographic characteristics are similar to those described for fibroelastomas with this location and the surgical approach should be decided for each individual patient. Thus transaortotomy, which provided better visualization and enabled complete removal of the tumor (which is essential for good clinical evolution and to avoid recurrence), was the option for surgical removal of this tumor.