Subject(s)
Betacoronavirus , Coronavirus Infections/complications , Coronavirus Infections/physiopathology , Electrocardiography/instrumentation , Pneumonia, Viral/complications , Pneumonia, Viral/physiopathology , Aged , COVID-19 , Clinical Protocols , Coronavirus Infections/therapy , Female , Hospitalization , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/therapy , SARS-CoV-2ABSTRACT
Pulmonary vein isolation is an effective treatment for patients with symptomatic paroxysmal atrial fibrillation. Cryoablation balloon therapy has been developed as an alternative. Cryoablation complications have primarily been related to phrenic nerve palsy, vascular complications, stroke, and others of lesser incidence. Esophageal lesions are rare and they are not yet completely understood.
Subject(s)
Catheter Ablation/adverse effects , Cryosurgery/adverse effects , Esophageal Diseases , Peptic Ulcer , Postoperative Complications/surgery , Pulmonary Veins/surgery , Adult , Esophageal Diseases/etiology , Esophageal Diseases/surgery , Female , Humans , Peptic Ulcer/etiology , Peptic Ulcer/surgeryABSTRACT
Introducción y objetivos: La taquicardia ventricular polimórfica catecolaminérgica (TVPC) es una enfermedad hereditaria caracterizada por arritmias ventriculares (AV) polimórficas o bidireccionales desencadenadas por estrés físico o emocional en jóvenes con corazón estructuralmente normal. El pilar del tratamiento son los bloqueadores beta y recientemente se ha incorporado la flecainida al arsenal terapéutico. El objetivo de este trabajo es exponer nuestra experiencia con su uso. Métodos: De un total de 174 pacientes pertenecientes a 7 familias afectadas de TVPC con genotipo positivo, se analizó a los que tomaron flecainida. Se valoraron la indicación, los efectos secundarios, la dosificación, los eventos clínicos, las AV y la ventana arrítmica en las pruebas de esfuerzo y las descargas del desfibrilador automático (DAI). Resultados: Recibieron flecainida 18 pacientes (10,4%); 17 en combinación con bloqueadores beta y 1 como tratamiento único por intolerancia al bloqueador beta. Ningún paciente sufrió efectos secundarios. La indicación fue la persistencia de AV complejas en la prueba de esfuerzo en 13 pacientes (72,2%) y descargas frecuentes del DAI en los otros 5 (27,8%). En el 66,7% de la familia 1, la puntuación cuantitativa de AV en la prueba de esfuerzo se redujo más de un 50% (32,76 ± 84,06 frente a 74,38 ± 153,86 lpm; p = 0,018). La ventana arrítmica fue menor (5,8 ± 11,9 frente a 19,69 ± 21,27 lpm; p = 0,007) y 4 de los 5 pacientes con descargas apropiadas del DAI no sufrieron más descargas. Conclusiones: En pacientes con TVPC, la flecainida reduce los eventos clínicos, las AV, la ventana arrítmica y las descargas del DAI y los pacientes la toleran bien (AU)
Introduction and objectives: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is an inherited disease characterized by polymorphic or bidirectional ventricular arrhythmias (VA) triggered by physical or emotional stress in young people with a structurally normal heart. Beta-blockers are the cornerstone of treatment, while flecainide has recently been incorporated into the therapeutic arsenal. The aim of this study was to report our experience with this drug. Methods: The cohort included 174 genotype-positive CPVT-patients from 7 families. We collected data from patients who were receiving flecainide and analyzed the indications, adverse effects and dosage, clinical events, VA and arrhythmic window during exercise testing, and implantable cardioverter-defibrillator (ICD) shocks during follow-up. Results: Eighteen patients (10.4%) received flecainide; 17 patients in combination with beta-blockers, and 1 patient as monotherapy due to beta-blocker intolerance. None of the patients presented side effects. In 13 patients (72.2%) the indication was the persistence of exercise-induced VA and in 5 patients (27.7%) persistent ICD-shocks, despite on beta-blockers. After flecainide initiation, the exercise-induced VA quantitative score was reduced by more than 50% in 66.7% of the members of family 1 (32.76 ± 84.06 vs 74.38 ± 153.86; P = .018). The arrhythmic window was reduced (5.8 ± 11.9 bpm vs 19.69 ± 21.27 bpm; P = .007), and 4 of 5 patients with appropriate ICD shocks experienced no further shocks in the follow-up. Conclusions: In CPVT-patients flecainide reduces clinical events, exercise-induced VA, the arrhythmic window, and ICD shocks, with good tolerance (AU)
Subject(s)
Humans , Male , Female , Arrhythmias, Cardiac/diagnostic imaging , Arrhythmias, Cardiac/drug therapy , Tachycardia, Ventricular/complications , Tachycardia, Ventricular/diagnostic imaging , Defibrillators, Implantable , Electrocardiography , Heart Rate , 28599ABSTRACT
INTRODUCTION AND OBJECTIVES: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is an inherited disease characterized by polymorphic or bidirectional ventricular arrhythmias (VA) triggered by physical or emotional stress in young people with a structurally normal heart. Beta-blockers are the cornerstone of treatment, while flecainide has recently been incorporated into the therapeutic arsenal. The aim of this study was to report our experience with this drug. METHODS: The cohort included 174 genotype-positive CPVT-patients from 7 families. We collected data from patients who were receiving flecainide and analyzed the indications, adverse effects and dosage, clinical events, VA and arrhythmic window during exercise testing, and implantable cardioverter-defibrillator (ICD) shocks during follow-up. RESULTS: Eighteen patients (10.4%) received flecainide; 17 patients in combination with beta-blockers, and 1 patient as monotherapy due to beta-blocker intolerance. None of the patients presented side effects. In 13 patients (72.2%) the indication was the persistence of exercise-induced VA and in 5 patients (27.7%) persistent ICD-shocks, despite on beta-blockers. After flecainide initiation, the exercise-induced VA quantitative score was reduced by more than 50% in 66.7% of the members of family 1 (32.76 ± 84.06 vs 74.38 ± 153.86; P = .018). The arrhythmic window was reduced (5.8 ± 11.9 bpm vs 19.69 ± 21.27 bpm; P = .007), and 4 of 5 patients with appropriate ICD shocks experienced no further shocks in the follow-up. CONCLUSIONS: In CPVT-patients flecainide reduces clinical events, exercise-induced VA, the arrhythmic window, and ICD shocks, with good tolerance.
Subject(s)
Flecainide/therapeutic use , Mutation , Ryanodine Receptor Calcium Release Channel/genetics , Tachycardia, Ventricular/genetics , Adult , Anti-Arrhythmia Agents/administration & dosage , DNA Mutational Analysis , Death, Sudden, Cardiac/epidemiology , Death, Sudden, Cardiac/prevention & control , Electrocardiography , Female , Follow-Up Studies , Genotype , Humans , Male , Ryanodine Receptor Calcium Release Channel/metabolism , Tachycardia, Ventricular/metabolism , Tachycardia, Ventricular/mortalityABSTRACT
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