RESUMO
Background: Electrophysiological study can help in the diagnosis of arrhythmic syncope. According to the electrophysiological study finding, the prognosis of patients with syncope is still a matter of study. Objective: The aim of this study was to assess the survival of patients undergoing electrophysiological study according to their findings and to identify clinical and electrophysiological independent predictors of all-cause mortality. Methods: A retrospective cohort study included patients with syncope who underwent electrophysiological study from 2009 to 2018. A Cox logistic regression analysis was performed to identify independent prognostic factors for all-cause mortality. Results: We included 383 patients in our study. During a mean follow-up of 59 months, 84 (21.9%) patients died. The split His group had the worst survival compared with the control group, followed by sustained ventricular tachycardia and HV interval ≥ 70 ms, respectively (p = .001; p < .001; p = .03). The supraventricular tachycardia group showed no differences compared with the control group (p = .87). In the multivariate analysis, independent predictors of all-cause mortality were Age (OR 1.06; 1.03-1.07; p < .001); congestive heart failure (OR 1.82; 1.05-3.15; p = .033); split His (OR 3.7; 1.27-10.80; p = .016); and sustained ventricular tachycardia (OR 1.84; 1.02-3.32; p = .04). Conclusion: Split His, sustained ventricular tachycardia, and HV interval ≥ 70 ms groups had worse survivals when compared to the control group. Age, congestive heart failure, split His, and sustained ventricular tachycardia were independent predictors for all-cause mortality.
RESUMO
Abstract Background The SARS-CoV-2 outbreak has led to radical transformation in social, economic, and healthcare systems. This may lead to profound indirect consequences on clinical presentation and management of patients with ST-segment-elevation myocardial infarction. Objectives The objective of this study was to describe the characteristics, management, and outcomes of patients admitted with acute myocardial infarction with ST-segment elevation (STEMI), in two tertiary reference hospitals during the SARS-CoV-2 outbreak and compare them with patients admitted in the previous year. Methods We analyzed data from a multicenter STEMI registry from reference centers in the South Region of Brazil from March 2019 to May 2021. The beginning of the COVID-19 outbreak was considered to be March 2020 and compared to the same period in 2019. Only patients with STEMI submitted to primary percutaneous coronary intervention (PCI) were included in the analysis. Mortality rates were compared with chi-square test. All hypothesis tests had a two-sided significance level of 5%. Results A total of 1169 patients admitted with STEMI were enrolled in our registry, 635 of whom were admitted during the pandemic period. The mean age of our sample was 61.6 (± 12.4) years, and 66.7% of patients were male. Pain-to-door time and door-to-balloon time were longer during the pandemic period. However, there was no difference in mortality rates or major adverse cardiovascular outcomes (MACE). Conclusions We observed a stable incidence of STEMI cases in our registry during the SARS-CoV-2 outbreak with higher pain-to-door time and door-to-balloon time, without any influence on mortality rates however.