[Recommendations for the management of COVID 19 patients regarding proarrhythmic effects of some current treatments, specifically if these patients suffer from arrhythmias, and for those receiving antiarrhythmic therapy.]

Recommendation provides information to employees of medical departments at any level and primarily primary care about the possible proarrhythmic and adverse effects of drugs used for the treatment of COVID-19 patients and the features of therapy for COVID-19 patients with heart rhythm and conduction disorders receiving permanent antiarrhythmic therapy.

Recommendations for the organization of electrophysiology and cardiac pacing services during the COVID-19 pandemic : Latin American Heart Rhythm Society (LAHRS) in collaboration with: Colombian College Of Electrophysiology, Argentinian Society of Cardiac Electrophysiology (SADEC), Brazilian Society Of Cardiac Arrhythmias (SOBRAC), Mexican Society Of Cardiac Electrophysiology (SOMEEC).

COVID-19 is a rapidly evolving public health emergency that has largely impacted the provision of healthcare services around the world. The challenge for electrophysiology teams is double; on one side preventing disease spread by limiting all nonessential face-to-face interactions, but at the same time ensuring continued care for patients who need it. These guidelines contain recommendations regarding triaging in order to define what procedures, device checks and clinic visits can be postponed during the pandemic. We also discuss best practices to protect patients and healthcare workers and provide guidance for the management of COVID-19 patients with arrhythmic conditions.

Seguimiento de 134 pacientes pediátricos con patrón de Wolff-Parkinson-White: evolución natural e intervención médica* / Follow-up of 134 Pediatric Patients with Wolff-Parkinson-White Pattern: Natural Outcome and Medical Treatment

Objetivos Evaluar la evolución de una población pediátrica con patrón de preexcitación ventricular, presencia de taquicardia supraventricular, fibrilación auricular, cardiopatías, mortalidad e intervención médica. Material y métodos Estudio descriptivo observacional. Se registraron pacientes con preexcitación ventricular en el electrocardiograma desde 1976 a 2011. Todos tenían ecocardiograma, 101 pacientes Holter (75,3%) y 69 (51,5%) ergometría. En pacientes seleccionados se realizó ablación por radiofrecuencia. Los datos se expresaron como media y desviación estándar. Resultados Se incluyeron en el estudio 134 pacientes, 80 varones (59,7%). Edad al diagnóstico: 2 días a 18 años, media 6,5 ± 5 años. Seguimiento clínico: 1 mes a 20 años, media 3,6 ± 3,9 años. Consultaron por taquicardia supraventricular 35 pacientes (26,1%), por preexcitación ventricular 16 pacientes (11,9%) y por otras causas 83 pacientes (61,9%); 76 pacientes (56,7%) evidenciaron vía izquierda, 3 pacientes doble vía; 16 pacientes (11,9%) presentaron taquicardia supraventricular durante el seguimiento. En total, 51 pacientes (38%) tuvieron taquicardia ortodrómica a los 6,3 ± 5,8 años, 10 pacientes en el período neonatal; 38 pacientes (28,3%) recibieron antiarrítmicos. No se observó fibrilación auricular. Veintiocho pacientes (20,9%) presentaron cardiopatía, 9 con taquicardia supraventricular. No hubo variables vinculadas con taquicardia supraventricular. En 43 pacientes (32,1%) se realizó ablación por radiofrecuencia. Un paciente murió súbitamente. Otro paciente falleció en el posoperatorio de cardiopatía. Conclusiones 1) Más del 60% de los pacientes permanecieron asintomáticos. 2) No se registró fibrilación auricular. 3) La tasa de muerte súbita fue del 0,75%. 4) Los pacientes con taquicardia supraventricular no sometidos a ablación evolucionaron bien. 5) No se asociaron variables con taquicardia supraventricular. 6) Las vías múltiples siempre desarrollaron taquicardia supraventricular.

Objectives The aim of the study was to evaluate the outcome of a pediatric population with ventricular preexcitation pattern, supraventricular tachycardia, atrial fibrillation, cardiomyopathies, mortality and medical treatment. Methods From 1976 to 2011, a descriptive observational study was conducted on patients with ventricular preexcitation in the electrocardiogram. All patients underwent an echocardiogram, 101 (75.3%) Holter monitoring, and 69 (51.5%) an ergometric test. Radiofrequency ablation was performed in selected patients. Data were expressed as mean and standard deviation. Results The study population consisted of 134 patients, 80 (59.7%) of whom were male. Age at diagnosis ranged from 2 days to 18 years, with a mean of 6.5±5 years. Clinical follow-up lasted 1 month to 20 years, with a mean of 3.6±3.9 years. Thirty five patients (26.1%) consulted for supraventricular tachycardia, 16 (11.9%) for ventricular preexcitation, and the remaining 83 patients (61.9%) for other abnormalities. Seventy-six patients (56.7%) evidenced left conduction pathway and 3 patients a double conduction pathway. Sixteen patients (11.9%) presented supraventricular tachycardia during follow-up. Overall, 51 patients (38%) had orthodromic tachycardia at 6.3±5.8 years, 10 patients during the neonatal period. Thirty-eight patients (28.3%) received antiarrhythmic drugs. No atrial fibrillation was observed. Twenty-eight patients (20.9%) presented cardiomyopathy, 9 with supraventricular tachycardia. No association was found between supraventricular tachycardia and another variable. Forty-three patients (32.1%) underwent radiofrequency ablation. A patient suffered sudden death and another patient died during the postoperative period of corrective surgery. Conclusions 1) More than 60% of patients remained asymptomatic. 2) No atrial fibrillation was recorded. 3) Sudden death rate was 0.75%. 4) Patients with supraventricular tachycardia not submitted to ablation had a favorable outcome. 5) Supraventricular fibrillation was not associated with any variable. 6) Multiple conduction pathways always developed supraventricular tachycardia.

Seguimiento de 134 pacientes pediátricos con patrón de Wolff-Parkinson-White: evolución natural e intervención médica* / Follow-up of 134 Pediatric Patients with Wolff-Parkinson-White Pattern: Natural Outcome and Medical Treatment

Objetivos Evaluar la evolución de una población pediátrica con patrón de preexcitación ventricular, presencia de taquicardia supraventricular, fibrilación auricular, cardiopatías, mortalidad e intervención médica. Material y métodos Estudio descriptivo observacional. Se registraron pacientes con preexcitación ventricular en el electrocardiograma desde 1976 a 2011. Todos tenían ecocardiograma, 101 pacientes Holter (75,3%) y 69 (51,5%) ergometría. En pacientes seleccionados se realizó ablación por radiofrecuencia. Los datos se expresaron como media y desviación estándar. Resultados Se incluyeron en el estudio 134 pacientes, 80 varones (59,7%). Edad al diagnóstico: 2 días a 18 años, media 6,5 ± 5 años. Seguimiento clínico: 1 mes a 20 años, media 3,6 ± 3,9 años. Consultaron por taquicardia supraventricular 35 pacientes (26,1%), por preexcitación ventricular 16 pacientes (11,9%) y por otras causas 83 pacientes (61,9%); 76 pacientes (56,7%) evidenciaron vía izquierda, 3 pacientes doble vía; 16 pacientes (11,9%) presentaron taquicardia supraventricular durante el seguimiento. En total, 51 pacientes (38%) tuvieron taquicardia ortodrómica a los 6,3 ± 5,8 años, 10 pacientes en el período neonatal; 38 pacientes (28,3%) recibieron antiarrítmicos. No se observó fibrilación auricular. Veintiocho pacientes (20,9%) presentaron cardiopatía, 9 con taquicardia supraventricular. No hubo variables vinculadas con taquicardia supraventricular. En 43 pacientes (32,1%) se realizó ablación por radiofrecuencia. Un paciente murió súbitamente. Otro paciente falleció en el posoperatorio de cardiopatía. Conclusiones 1) Más del 60% de los pacientes permanecieron asintomáticos. 2) No se registró fibrilación auricular. 3) La tasa de muerte súbita fue del 0,75%. 4) Los pacientes con taquicardia supraventricular no sometidos a ablación evolucionaron bien. 5) No se asociaron variables con taquicardia supraventricular. 6) Las vías múltiples siempre desarrollaron taquicardia supraventricular.(AU)

Objectives The aim of the study was to evaluate the outcome of a pediatric population with ventricular preexcitation pattern, supraventricular tachycardia, atrial fibrillation, cardiomyopathies, mortality and medical treatment. Methods From 1976 to 2011, a descriptive observational study was conducted on patients with ventricular preexcitation in the electrocardiogram. All patients underwent an echocardiogram, 101 (75.3%) Holter monitoring, and 69 (51.5%) an ergometric test. Radiofrequency ablation was performed in selected patients. Data were expressed as mean and standard deviation. Results The study population consisted of 134 patients, 80 (59.7%) of whom were male. Age at diagnosis ranged from 2 days to 18 years, with a mean of 6.5±5 years. Clinical follow-up lasted 1 month to 20 years, with a mean of 3.6±3.9 years. Thirty five patients (26.1%) consulted for supraventricular tachycardia, 16 (11.9%) for ventricular preexcitation, and the remaining 83 patients (61.9%) for other abnormalities. Seventy-six patients (56.7%) evidenced left conduction pathway and 3 patients a double conduction pathway. Sixteen patients (11.9%) presented supraventricular tachycardia during follow-up. Overall, 51 patients (38%) had orthodromic tachycardia at 6.3±5.8 years, 10 patients during the neonatal period. Thirty-eight patients (28.3%) received antiarrhythmic drugs. No atrial fibrillation was observed. Twenty-eight patients (20.9%) presented cardiomyopathy, 9 with supraventricular tachycardia. No association was found between supraventricular tachycardia and another variable. Forty-three patients (32.1%) underwent radiofrequency ablation. A patient suffered sudden death and another patient died during the postoperative period of corrective surgery. Conclusions 1) More than 60% of patients remained asymptomatic. 2) No atrial fibrillation was recorded. 3) Sudden death rate was 0.75%. 4) Patients with supraventricular tachycardia not submitted to ablation had a favorable outcome. 5) Supraventricular fibrillation was not associated with any variable. 6) Multiple conduction pathways always developed supraventricular tachycardia.(AU)