Asunto(s)
Anticoagulantes/uso terapéutico , Enfermedades Cardiovasculares/tratamiento farmacológico , Inhibidores de Agregación Plaquetaria/uso terapéutico , Síndrome Coronario Agudo/tratamiento farmacológico , Fibrilación Atrial/tratamiento farmacológico , Brasil , Enfermedad de Chagas/tratamiento farmacológico , Femenino , Insuficiencia Cardíaca/tratamiento farmacológico , Humanos , Ataque Isquémico Transitorio/tratamiento farmacológico , Infarto del Miocardio/tratamiento farmacológico , Periodo Perioperatorio , Sociedades Médicas , Accidente Cerebrovascular/tratamiento farmacológico , Tromboembolia Venosa/tratamiento farmacológicoRESUMEN
As taquicardias ventriculares idiopáticas são formas de arritmia ventricular que ocorrem na ausência de cardiopatia estrutural. São mais freqüentes em indivíduos jovens e, na maioria das vezes, apresentam bom prognóstico. As vezes, provocam sintomas limitantes e necessitam de intervençöes para sua reversão. O avanço das técnicas de ablação por cateter com radiofreqüência possibilitou a cura definitiva dessas arritmias: no entanto, o tratamento clínico continua sendo uma opção terapêutica segura, em particular quando há limitaçöes para o procedimento ablativo ou por outra opção do paciente.
Asunto(s)
Humanos , Adolescente , Adulto , Antiarrítmicos/administración & dosificación , Taquicardia Ventricular/clasificación , PrevalenciaRESUMEN
PURPOSE: To determine the clinical importance of a bi-directional line of block demonstration in the inferior vena cava-tricuspid annulus isthmus as an end-point for radiofrequency (RF) atrial flutter (FL) ablation. METHODS: Forty consecutive patients (51 +/- 11 years) with type I FL were divided in 2 groups: GI (30 patients) anatomic, non-electrophysiologic isthmus ablation technique (interruption and non-induction FL criteria); and GII (10 patients) anatomic with electrophysiologic evaluation of bi-directional isthmus conduction. The isthmus activation was analyzed before and after anatomic RF ablation with a cateter exploring each side of the line of block, depending on the conduction evaluation (anterograde or retrograde). RESULTS: FL was interrupted and not reinduced in 26/ 30 (86.6%) GI patients and in 10 (100%) GII patients (p = 0.5558). During follow-up FL recurred in 30% of the patients in both groups. In GII, 6 patients with bi-directional block remained assymptomatic, whereas 3 patients with unidirectional block presented recurrence (p = 0.012). CONCLUSION: Electrophysiologic demonstration of bidirectional line of block in the isthmus is related to long-term success and should be the criterion for interruption of type I atrial FL RF ablation.