TAN CHEN WU
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
2 resultados
Resultados de Busca
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- Catheter Ablation of Focal Atrial Tachycardia with Early Activation Close to the His-Bundle from the Non Coronary Aortic Cusp(2021) CHOKR, Muhieddine; MOURA, Lucas G. de; SOUSA, Italo Bruno dos Santos; PISANI, Cristiano Faria; HARDY, Carina Abigail; MELO, Sissy Lara de; PONTE FILHO, Arnobio Dias da; COSTA, Ieda Prata; TAVORA, Ronaldo Vasconcelos; SACILOTTO, Luciana; WU, Tan Chen; DARRIEUX, Francisco Carlos da Costa; HACHUL, Denise Tessariol; AIELLO, Vera; SCANAVACCA, MauricioBackground: Atrial tachycardia (AT) ablation with earliest activation site close to the His-Bundle is a challenge due to the risk of complete AV block by its proximity to His-Purkinje system (HPS). An alternative to minimize this risk is to position the catheter on the non-coronary cusp (NCC), which is anatomically contiguous to the para-Hisian region. Objectives: The aim of this study was to perform a literature review and evaluate the electrophysiological characteristics, safety, and success rate of catheter-based radiofrequency (RF) delivery in the NCC for the treatment of para-Hisian AT in a case series. Methods: This study performed a retrospective evaluation of ten patients (Age: 36 +/- 10 y-o) who had been referred for SVT ablation and presented a diagnosis of para-Hisian focal AT confirmed by classical electrophysiological maneuvers. For statistical analysis, a p-value of <0.05 was considered statistically significant. Results: The earliest atrial activation at the His position was 28 +/- 12ms from the P wave and at the NCC was 3 +/- 2ms earlier than His position, without evidence of His potential in all patients. RF was applied on the NCC (4-mm-tip catheter; 30W, 55 degrees C), and the tachycardia was interrupted in 5 +/- 3s with no increase in the PR interval or evidence of junctional rhythm. Electrophysiological tests did not reinduce tachycardia in 9/10 of patients. There were no complications in all procedures. During the 30 +/- 12 months follow-up, no patient presented tachycardia recurrence. Conclusion: The percutaneous treatment of para-Hisian AT through the NCC is an effective and safe strategy, which represents an interesting option for the treatment of this complex arrhythmia.
- Peculiar Aspects of Patients with Inherited Arrhythmias during the COVID-19 Pandemic(2021) SACILOTTO, Luciana; OLIVETTI, Natalia Quintella Sangiorgi; PISANI, Cristiano Faria; WU, Tan Chen; HAJJAR, Ludhmila Abrahao; MELO, Sissy Lara de; BUENO, Savia Christina Pereira; RIVAROLA, Esteban Wisnivesky Rocca; CHOKR, Muhieddine Omar; HARDY, Carina Abigail; HACHUL, Denise Tessariol; DARRIEUX, Francisco Carlos da Costa; SCANAVACCA, Mauricio IbrahimSince December 2019 we have observed the rapid advance of the severe acute respiratory syndrome caused by the new coronavirus (SARS-CoV-2). The impact of the clinical course of a respiratory infection is little known in patients with hereditary arrhythmias, due to the low prevalence of these diseases. Patients who present with infectious conditions may exacerbate hidden or well-controlled primary arrhythmias, due to several factors, such as fever, electrolyte disturbances, drug interactions, adrenergic stress and, eventually, the septic patient's own myocardial damage. The aim of this review is to highlight the main challenges we may encounter during the Covid 19 pandemic, specifically in patients with hereditary arrhythmias, with emphasis on the congenital long QT syndrome (LQTS), Brugada syndrome (SBr), ventricular tachycardia polymorphic catecholaminergic (CPVT) and arrhythmogenic right ventricular cardiomyopathy. Since December 2019 we have observed the rapid advance of the severe acute respiratory syndrome caused by the new coronavirus (SARS-CoV-2), the first cases of which arose in Wuhan, China, subsequently arriving in Brazil. Retrospective studies have shown that old age was an independent predictor of mortality by COVID-19. Other risk factors impacting mortality were systemic arterial hypertension, chronic pulmonary obstructive disease, immunosuppression, type-2 diabetes mellitus, obesity, and severe cardiopathy (heart failure, coronary disease, or cardiomyopathies).1,2 Overall, complications due to arrhythmias in patients with pneumonia, particularly atrial fibrillation, are relatively common.3,4 Cardiac arrest occurs in about 3% of hospitalized patients;5 however, less than 20% of cardiac rhythms of in-hospital events are reported as being electrically reversible to sinus rhythm (by cardioversion or defibrillation), i.e., ventricular tachycardia/fibrillation (VT/VF).6 In such patients, the primary arrhythmogenic mechanism is myocardial injury due to ischemia or inflammation.