DENISE TESSARIOL HACHUL
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
21 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 21
- Effects of anthracycline, cyclophosphamide and taxane chemotherapy on QTc measurements in patients with breast cancer(2018) VERONESE, Pedro; HACHUL, Denise Tessariol; SCANAVACCA, Mauricio Ibrahim; HAJJAR, Ludhmila Abrahao; WU, Tan Chen; SACILOTTO, Luciana; VERONESE, Carolina; DARRIEUX, Francisco Carlos da CostaAim Acute and subacute cardiotoxicity are characterized by prolongation of the corrected QT interval (QTc) and other measures derived from the QTc interval, such as QTc dispersion (QTdc) and transmural dispersion of repolarization (DTpTe). Although anthracyclines prolong the QTc interval, it is unclear whether breast cancer patients who undergo the ACT chemotherapy regimen of anthracycline (doxorubicin: A), cyclophosphamide (C) and taxane (T) may present with QTc, QTdc and DTpTe prolongation. Methods Twenty-three consecutive patients with breast cancer were followed prospectively during ACT chemotherapy and were analyzed according to their QT measurements. QTc, QTdc and DTpTe measurements were determined by a 12-lead electrocardiogram (EKG) prior to chemotherapy (baseline), immediately after the first phase of anthracycline and cyclophosphamide (AC) treatment, and immediately after T treatment. Serum troponin and B-type natriuretic peptide (BNP) levels were also measured. Results Compared to baseline values, the QTc interval was significantly prolonged after the AC phase (439.7 +/- 33.2 ms vs. 472.5 +/- 36.3 ms, p = 0.001) and after T treatment (439.7 +/- 33.2 ms vs. 467.9 +/- 42.6 ms, p < 0.001). Troponin levels were elevated after the AC phase (23.0 pg/mL [min-max: 6.0-85.0] vs. 6.0 pg/mL [min-max: 6.0-22.0], p < 0.001) and after T treatment (25.0 pg/mL [min-max: 6.0-80.0] vs. 6.0 pg/mL [min-max: 6.0-22.0], p < 0.001) compared to baseline values. Conclusion In this prospective study of patients with non-metastatic breast cancer who underwent ACT chemotherapy, significant QTc prolongation and an elevation in serum troponin levels were observed.
conferenceObject Brugada syndrome: value of electrophysiologic study in the risk stratification(2017) PAIXAO, G.; LAMES, C.; ROSA, X.; SACILOTTO, L.; DARRIEUX, F.; CHORK, M.; WU, T. C.; PISANI, C.; HACHUL, D.; SCANAVACCA, M.- Trombo Atrial Esquerdo e Contraste Espontaneo Denso no Uso de Anticoagulante Oral de Acao Direta em Fibrilacao Atrial: Visao de Centro Referenciado(2022) MARQUES, Thiago; DARRIEUX, Francisco; GOUVEA, Fabio; GARAMBONE, Leandro; LINDOSO, Ana Paula; LAGE, Joao; SACILOTTO, Luciana; COIMBRA, Ana Lucia; PINHEIRO, Martina; OLIVETTI, Natalia; LARA, Sissy; HARDY, Carina; ATHAYDE, Guilherme; HACHUL, Denise; PISANI, Cristiano; WU, Tan Chen; SCANAVACCA, MauricioBackground: In the treatment of atrial fibrillation (AF), the most frequently sustained arrhythmia, with catheter ablation (CA) or electrical cardioversion (ECV), the periprocedural period is one of the most critical phases. Currently, the use of new direct action oral anticoagulants (DOAC) is increasingly frequent; however, in the real world, there are still few data on studies on the thrombus incidence in the left atrium (TrLA) or dense spontaneous contrast (DSC) on transesophageal echocardiogram (TEE). Objective: To evaluate the prevalence of events and association with risk factors in patients using DOACs. Primary objective: to analyze the prevalence of thrombus in the LA by TEE in patients using DOAC undergoing ECV/CA. Second, evaluate the association of comorbidities with the presence of thrombi and DSC. Methods: Retrospective cohort, single-center study with patients followed at the Arrhythmia Outpatient Unit (InCor-HCFMUSP). Patients indicated for procedures and using DOACs were selected, and their clinical/echocardiographic data were analyzed. A significance level of 5% was considered. Results: 354 patients were included, a total of 400 procedures, from March 2012-March 2018. Thrombus in the LA was found in 11 patients (2.8%), associated with advanced age (p=0.007) and higher CHA2DS2-VASc (p<0.001) score. DSC in the LA before TEE was found in 29 patients (7.3%), with lower LVEF (p<0.038) and greater LA dimension (p<0.0001). Conclusion: The incidence of LA thrombus and DSC in patients using DOC in the context of AF ECV/CA, although small, is not negligible. Patients with higher CHA2DS2-VASc scores, especially older and with larger LA diameter, are more prone to these echocardiographic findings.
conferenceObject Atrial fibrillation as a cornerstone of laminopathy(2018) CALIL, Z. O.; PESSENTE, G. A.; SACILOTTO, L.; OLIVETTI, N. Q. S.; HACHUL, D. T.; WU, T. C.; GRUPPI, C. J.; CARVALHO, M. L. P.; ARANHA, A. F.; PEDROSA, A. A. A.; HARDY, C. A.; PISANI, C. F.; PEREIRA, A. C.; SCANAVACCA, M. I.; DARRIEUX, F. C. C.conferenceObject Electrocardiographic correlation and clinical aspects in Andersen-Tawil Syndrome: a case series description(2017) OLIVETTI, N.; SACILOTTO, L.; DARRIEUX, F. C. C.; WULKAN, F.; PESSENTE, G. D.; OLIVEIRA, T. G. M.; PINHEIRO, M. B.; WU, T. C.; HACHUL, D. T.; HARDY, C.; PEREIRA, A.; SCANAVACCA, M. I.article Cardiac Arrhythmias Guideline in Children and Congenital Cardiomyopathies SOBRAC and DCC - CP(2016) MAGALHAES, L. P.; GUIMARAES, I. C. B.; MELO, S. L.; MATEO, E. I. P.; ANDALAFT, R. B.; XAVIER, L. F. R.; LORGA FILHO, A. M.; FAGUNDES, A. A.; MOREIRA, D. A. R.; HACHUL, D. T.; STERNICK, E. B.; ANDREA, E. M.; CANNAVAN, F. P. S.; OLIVEIRA, F. J. B.; DARRIEUX, F. C. C.; LIMA, G. G.; ATIE, J.; ELIAS NETO, J.; ZIMERMAN, L. I.; MIANA, L.; PELLANDA, L. C.; SACILOTTO, L.; JATENE, M. B.; SOARES, M. M.; BINOTTO, M. A.; SCANAVACCA, M. I.; OLIVEIRA JUNIOR, N. A.; ZIELINSKY, P.; SALERNO, P. R.; TEIXEIRA, R. A.; KUNIYOSHI, R. R.; COSTA, R.; SCHAMES NETO, S.; PEDRA, S. R. F. F.; GIMENEZ, S. C.; WU, T. C.; AIELLO, V. D.- Efficacy and safety of combined endocardial/epicardial catheter ablation for ventricular tachycardia in Chagas disease: A randomized controlled study(2020) PISANI, Cristiano F.; ROMERO, Jorge; LARA, Sissy; HARDY, Carina; CHOKR, Muhieddine; SACILOTTO, Luciana; WU, Tan Chen; DARRIEUX, Francisco; HACHUL, Denise; KALIL-FILHO, Roberto; BIASE, Luigi Di; SCANAVACCA, MauricioBACKGROUND Epicardial mapping and ablation are frequently necessary to eliminate ventricular tachycardia (VT) in patients with Chagas disease. Nonetheless, there are no randomized controlled trials demonstrating the role of this strategy. OBJECTIVE We conducted this randomized controlled trial to evaluate the efficacy and safety of combined epicardial ablation in patients with Chagas disease. METHODS We randomized patients with Chagas disease and VT in a 1:1 fashion to either the endocardial (endo) mapping and ablation group or the combined endocardial/epicardial (endo/epi) mapping and ablation group. The efficacy end points were measured by VT inducibility and all-ventricular arrhythmia recurrence. Safety was assessed by the rate of periprocedural complications. RESULTS Thirty patients were enrolled, and most were male. The median age was 67 (Q1: 58; Q3: 70) years in the endo group and 58 (Q1: 43; Q3: 66) years in the endo/epi group. The left ventricular ejection fraction was 33.0% +/- 9.5% and 35.2% +/- 11.5%, respectively P = .13. Acute success (non-reinducibility of clinical VT) was obtained in 13 patients (86%) in the endo/epi group and in 6 patients (40%) in the endo-only group (P = .021). There were 12 patients with VT recurrence (80%) in the endo-only group and 6 patients (40%) in the endo/epi group (P = .02) (by intention-to-treat analysis). Epicardial ablation was ultimately per formed in 9 patients (60%) in the endo-only group because of an absence of endocardial scar or maintenance of VT inducibility. There was no difference in complications between the groups. CONCLUSION Combining endo/epi VT catheter ablation in patients with Chagas disease significantly increases shortand long-term freedom from all-ventricular arrhythmias. Epicardial access did not increase periprocedural complication rates.
- Is It Safe for Patients With Cardiac Channelopathies to Undergo Routine Dental Care? Experience From a Single-Center Study(2019) OLIVEIRA, Ana Carolina Guimaraes; NEVES, Itamara Lucia Itagiba; SACILOTTO, Luciana; OLIVETTI, Natalia Quintella Sangiorgi; SANTOS-PAUL, Marcela Alves dos; MONTANO, Tania Cristina Pedroso; CARVALHO, Cintia Maria Alencar; WU, Tan Chen; GRUPI, Cesar Jose; BARBOSA, Silvio Alves; PASTORE, Carlos Alberto; SAMESIMA, Nelson; HACHUL, Denise Tessariol; SCANAVACCA, Mauricio Ibrahim; NEVES, Ricardo Simoes; DARRIEUX, Francisco Carlos CostaBackground-Brugada syndrome and long-QT syndrome may account for at least one third of unexplained sudden cardiac deaths. Dental care in patients with cardiac channelopathies is challenging because of the potential risk of life-threatening events. We hypothesized that the use of local dental anesthesia with lidocaine with and without epinephrine is safe and does not result in life-threatening arrhythmias in patients with channelopathies. Methods and Results-We performed a randomized, double-blind pilot trial comparing the use of 2% lidocaine without a vasoconstrictor and with 1:100 000 epinephrine in 2 sessions of restorative dental treatment with a washout period of 7 days (crossover trial). Twenty-eight-hour Holter monitoring was performed, and 12-lead electrocardiography, digital sphygmomanometry, and anxiety scale assessments were also conducted at 3 time points. Fifty-six dental procedures were performed in 28 patients (18 women, 10 men) with cardiac channelopathies: 16 (57.1%) had long-QT syndrome, and 12 (42.9%) had Brugada syndrome; 11 (39.3%) of patients had an implantable defibrillator. The mean age was 45.9 +/- 15.9 years. The maximum heart rate increased after the use of epinephrine during the anesthesia period from 82.1 to 85.8 beats per minute (P=0.008). In patients with long-QT syndrome, the median corrected QT was higher, from 450.1 to 465.4 ms (P 0.009) at the end of anesthesia in patients in whom epinephrine was used. The other measurements showed no statistically significant differences. No life-threatening arrhythmias occurred during dental treatment. Conclusions-The use of local dental anesthesia with lidocaine, regardless of the use of a vasoconstrictor, did not result in life-threatening arrhythmias and appears to be safe in stable patients with cardiac channelopathies.
- 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.
- QT Interval Control to Prevent Torsades de Pointes during Use of Hydroxychloroquine and/or Azithromycin in Patients with COVID-19(2020) WU, Tan Chen; SACILOTTO, Luciana; DARRIEUX, Francisco Carlos da Costa; PISANI, Cristiano Faria; MELO, Sissy Lara de; HACHUL, Denise Tessariol; SCANAVACCA, Mauricio
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