Electrocardiogramas durante el tercer trimestre de embarazo: / Electrocardiography During the Third Trimester of Pregnancy:

RESUMEN Objetivo: Analizar las características electrocardiográficas en embarazadas sin patología cardiovascular. Material y métodos: Estudio de corte transversal, descriptivo, multicéntrico. Se incluyeron pacientes sin patología cardiovascular que cursaban el tercer trimestre de embarazo y que concurrieron a una evaluación cardiológica preparto entre abril y julio de 2020; todas ellas firmaron el consentimiento correspondiente. Resultados: Se analizaron 80 trazados. La mediana de la frecuencia cardíaca fue 82 lpm (RIC: 70-93 lpm). La mediana del eje QRS fue 54° (RIC: 39°-71°). Ondas q e infradesnivel del segmento ST en cara inferior y de V4 a V6 fueron hallazgos relativamente frecuentes. La mediana del QTc fue 422 mseg (RIC: 404 mseg-445 mseg). La mediana del tiempo del pico de la onda T a su fin fue 86 mseg (RIC: 74-95 mseg). Conclusión: Las alteraciones más frecuentes ocurrieron en DIII, DII, aVf y de V4 a V6. Las ondas q y el infraST fueron los cambios principales. Fueron infrecuentes las desviaciones del eje, la taquicardia sinusal o el QTc prolongado.

ABSTRACT Objective: The aim of this study was to analyze the electrocardiographic characteristics in pregnant women without cardiovascular disease. Methods: This was a descriptive, cross-sectional, multicenter study, including patients without cardiovascular disease in their third trimester of pregnancy, who underwent cardiac evaluation before delivery between April and July 2020. All patients signed the corresponding informed consent. Results: A total of 80 tracings were analyzed. Median heart rate was 82 bpm (IQR 70-93 bpm) and median QRS axis was 54° (IQR 39°-71°). Q waves and ST segment depression were relatively frequent in inferior leads and from V4 to V6. Median QTc was 422 msec (IQR 404-445 msec) and median time from T wave peak to T wave end was 86 msec (IQR 74-95 msec). Conclusion: The most common changes occurred in T wave peak to T wave end and from V4 to V6. Main changes included q waves and ST-segment depression. Axis deviations, sinus tachycardia or prolonged QTc were rare.

Randomized trials of PCIs versus CABG surgery: why coronary stenting should remain the first choice of revascularization in non-diabetic patients and why the controversy is still present in diabetics.

Knowing the best revascularization option for diabetic patients with multiple vessel disease is a challenge without a definitive answer. There have been several randomized clinical trials and subsequent meta-analyses comparing current available technology trying to reach an exhaustive conclusion; comparisons between coronary artery bypass grafts and bare-metal stents, coronary artery bypass grafts and first generation drug-eluting stents and, most recently, first generation versus latest generation drug-eluting stents generated some interesting results. Information provided by pooled data from some of the most important randomized clinical cardiology trials from the last two decades have produced surprising results. The authors analyze these data to discuss the best therapeutic procedures for each patient.