CRISTIANO FARIA PISANI
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/65, Hospital das Clínicas, Faculdade de Medicina
LIM/65, Hospital das Clínicas, Faculdade de Medicina
16 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 16
- Stereotactic Body Radiation Therapy for Recurrent Ventricular Tachycardia in Chagas Disease: First Case in Latin America(2023) SCANAVACCA, Mauricio I.; PISANI, Cristiano F.; SALVAJOLI, Bernardo; KULCHETSCKI, Rodrigo M.; MAYRINK, Marina P.; SALVAJOLI, Joao Victor; KALIL, Roberto
conferenceObject Mechanical Esophageal Displacement for Esophageal Safety of Mechanical Esophageal Displacement for Esophageal Thermal Injury Prevention During Atrial Fibrillation Ablation in Swine(2019) PEREIRA, Renner; PISANI, Cristiano F.; AIELLO, Vera; CESTARI, Idagene A.; MOURA, Daniel; CHOKR, Muhieddine; HARDY, Carina; SISSY, Melo; SCANAVACCA, Mauricio; HACHUL, Denise- Outcomes of a combined vs non-combined endo-epicardial ventricular tachycardia ablation strategy(2023) MATOS, Daniel; ADRAGAO, Pedro; PISANI, Cristiano; HATANAKA, Vinicius; FREITAS, Pedro; COSTA, Francisco; CHOKR, Muhiedinne; HARDY, Carina; FERREIRA, Antonio Miguel; CARMO, Pedro; LAURA, Sissy; MORGADO, Francisco; CAVACO, Diogo; MENDES, Miguel; SCANAVACCA, MauricioBackground Direct comparisons of combined (C-ABL) and non-combined (NC-ABL) endo-epicardial ventricular tachycardia (VT) ablation outcomes are scarce. We aimed to investigate the long-term clinical efficacy and safety of these 2 strategies in ischemic heart disease (IHD) and non-ischemic cardiomyopathy (NICM) populations. Methods Multicentric observational registry included 316 consecutive patients who underwent catheter ablation for drug-resistant VT between January 2008 and July 2019. Primary and secondary efficacy endpoints were defined as VT-free survival and all-cause death after ablation. Safety outcomes were defined by 30-day mortality and procedure-related complications. Results Most of the patients were male (85%), with IHD (67%) and mean age of 63 +/- 13 years. During a mean follow-up of 3 +/- 2 years, 117 (37%) patients had VT recurrence and 73 (23%) died. Multivariate survival analysis identified electrical storm (ES) at presentation, IHD, left ventricular ejection fraction (LVEF), New York Heart Association (NYHA) functional class III / IV, and C-ABL as independent predictors of VT recurrence. In 135 patients undergoing repeated procedures, only C-ABL and ES were independent predictors of relapse. The identified independent predictors of mortality were C-ABL, ES, LVEF, age, and NYHA class III / IV. C-ABL survival benefit was only seen in patients with a previous ablation (P for interaction = 0.04). Mortality at 30 days was similar between NC-ABL and C-ABL (4% vs. 2%, respectively, P = 0.777), as was complication rate (10.3% vs. 15.1%, respectively, P = 0.336). Conclusion A combined or sequential endo-epicardial TV ablation strategy was associated with lower VT recurrence and lower all-cause death in IHD and NICM patients undergoing repeated procedures. Both approaches seemed equally safe.
conferenceObject Transseptal puncture using electroanatomical mapping: a safe and cost-effective technique(2023) BRIGIDO, A. Dantas; RASSI, G. M.; RODRIGUES, L. V.; LOVISI, V. B.; PISANI, C. F.; CHOKR, M. O.; HARDY, C. A.; MELO, S. L.; GONCALVES, A. L. M.; MAYRINK, M. P.; KULCHETSCKI, R. M.; SCANAVACCA, M. I.- Myocardial Injury Progression after Radiofrequency Ablation in School-Age Children(2024) MELO, Sissy Lara de; FERRAZ, Alberto Pereira; LEMOUCHE, Stephanie Ondracek; DEVIDO, Marcela Santana; SOUSA, Gabriela Liberato de; ROCHITTE, Carlos E.; PISANI, Cristiano Faria; HACHUL, Denise Tessariol; SCANAVACCA, MauricioBackground: The past decades have seen the rapid development of the invasive treatment of arrhythmias by catheter ablation procedures. Despite its safety and efficacy being well-established in adults, to date there has been little data in pediatric scenarios. One of the main concerns is the possible expansion of the ablation procedure scar in this population and its consequences over the years. Objectives: This study aimed to analyze the risk of myocardial injury progression after radiofrequency catheter ablation in pediatric patients. Methods: This is a retrospective study of 20 pediatric patients with previous ablation for treatment of supraventricular arrhythmia that underwent cardiac magnetic resonance and coronary angiography for evaluation of myocardial fibrosis and the integrity of the coronary arteries during follow-up. Results: The median age at ablation procedure was 15.1 years (Q1 12.9, Q3 16.6) and 21 years (Q1 20, Q3 23) when the cardiac magnetic resonance was performed. Fourteen of them were women. Nodal reentry tachycardia and WolfParkinson-White Syndrome were the main diagnosis (19 patients), with one patient with atrial tachycardia. Three patients had ventricular myocardial fibrosis, but with a volume < 0.6 cm(3) . None of them developed ventricular dysfunction and no patient had coronary lesions on angiography. Conclusion: Radiofrequency catheter ablation did not show to increase the risk of myocardial injury progression or coronary artery lesions.
- SBC Guideline on the Diagnosis and Treatment of Patients with Cardiomyopathy of Chagas Disease-2023(2023) MARIN-NETO, Jose Antonio; JR, Anis Rassi; OLIVEIRA, Glaucia Maria Moraes; CORREIA, Luis Claudio Lemos; RAMOS JUNIOR, Alberto Novaes; LUQUETTI, Alejandro Ostermayer; HASSLOCHER-MORENA, Alejandro Marcel; SOUSA, Andrea Silvestre de; PAOLA, Angelo Amato Vincenzo de; SOUSA, Antonio Carlos Sobral; RIBEIRO, Antonio Luiz Pinho; CORREIA FILHO, Dalmo; SOUZA, Dilma do Socorro Moraes de; CUNHA-NETO, Edecio; RAMIRES, Felix Jose Alvarez; BACAL, Fernando; NUNES, Maria do Carmo Pereira; MARTINELLI FILHO, Martino; SCANAVACCA, Maurici Ibrahim; SARAIVA, Roberto Magalhaes; OLIVEIRA JUNIOR, Wilson Alves de; LORGA-FILHO, Adalberto Menezes; GUIMARAES, Adriana de Jesus Benevides de Almeida; BRAGA, Adriana Lopes Latado; OLIVEIRA, Adriana Sarmento de; SARABANDA, Alvaro Valentim Lima; PINTO, Ana Yece das Neves; CARMO, Andre Assis Lopes do; SCHMIDT, Andre; COSTA, Andrea Rodrigues da; IANNI, Barbara Maria; MARKMAN FILHO, Brivaldo; ROCHITT, Carlos Eduardo; MACEDO, Carolina The; MADY, Charles; CHEVILLARD, Christophe; VIRGENS, Claudio Marcelo Bittencourt das; CASTRO, Cleudson Nery de; BRITTO, Constanca Felicia De Paoli de Carvalho; PISANI, Cristiano; RASSI, Daniel do Carmo; SOBRAL FILHO, Dario Celestino; ALMEIDA, Dirceu Rodrigues de; BOCCHI, Edimar Alcides; MESQUITA, Evandro Tinoco; MENDES, Fernanda de Souza Nogueira Sardinha; GONDIM, Francisca Tatiana Pereira; SILVA, Gilberto Marcelo Sperandio da; PEIXOTO, Giselle de Lima; LIMA, Gustavo Glotz de; VELOSO, Henrique Horta; MOREIRA, Henrique Turin; LOPES, Hugo Bellotti; PINTO, Ibraim Masciarelli Francisco; FERREIRA, Joao Marcos Bemfica Barbosa; NUNES, Joao Paulo Silva; BARRETO-FILHO, Jose Augusto Soares; SARAIVA, Jose Francisco Kerr; LANNES-VIEIRA, Joseli; OLIVEIRA, Joselina Luzia Menezes; ARMAGANIJAN, Luciana Vidal; MARTINS, Luiz Claudio; SANGENIS, Luiz Henrique Conde; BARBOSA, Marco Paulo Tomaz; ALMEIDA-SANTOS, Marcos Antonio; SIMOES, Marcos Vinicius; YASUDA, Maria Aparecida Shikanai; MOREIRA, Maria da Consolacao Vieira; HIGUCHI, Maria de Lourdes; MONTEIRO, Maria Rita de Cassia Costa; MEDIANO, Mauro Felippe Felix; LIMA, Mayara Maia; OLIVEIRA, Maykon Tavares de; ROMANO, Minna Moreira Dias; ARAUJO, Nadjar Nitz Silva Lociks de; MEDEIROS, Paulo de Tarso Jorge; ALVES, Renato Vieira; TEIXEIRA, Ricardo Alkmim; PEDROSA, Roberto Coury; ARAS JUNIOR, Roque; TORRES, Rosalia Morais; POVOA, Rui Manoel dos Santos; RASSI, Sergio Gabriel; ALVES, Silvia Marinho Martins; TAVARES, Suelene Brito do Nascimento; PALMEIRA, Swamy Lima; SILVA JUNIOR, Telemaco Luiz da; RODRIGUES, Thiago da Rocha; MADRINI JUNIOR, Vagner; BRANT, Veruska Maia da Costa; DUTRA, Walderez Ornelas; DIAS, Joao Carlos Pinto
- Intracardiac Echocardiography Must Be Used in All Patients Who Underwent AFAblation?(2023) PISANI, Cristiano F.; SCANAVACCA, Mauricio
- Initial experience on cardiac magnetic resonance-aided VT ablation in South America(2023) PISANI, Cristiano F.; ALEXANDRE, Felipe Kalil; KULCHETSCKI, Rodrigo; MAYRINK, Marina; WU, Tan Chen; CHOKR, Muhieddine; HARDY, Carina; MELO, Sissy Lara; ROCHITTE, Carlos; NOMURA, Cesar; SCANAVACCA, MauricioBackground: Cardiac magnetic resonance (CMR) allowed to precisely identify the substrate in scar-related ventricular tachycardia (VT). New software has been developed to define the 3D scar and corridors to help VT ablation by integrating the scar and electroanatomical mapping (EAM). The objective of this study is to evaluate the results of VT ablation aided by the integration of EAM and CMR software processed scar.Methods: We selected patients that underwent VT ablation with the integration of EAM and CMR processed using ADAS software and imported to the CARTO system using VTK file format.Results: From 2019 to 2021, eight patients (mean age 63 +/- 4.4, 62.5% male; EF 47 +/- 12%) underwent CMR-aided VT ablation. Mean procedural time was 281 +/- 77 min. There was of 9 +/- 4.4 epicardial and 7.9 +/- 4.3 endocardial bulls eye segments with at least 2 g of border zone or core scar. In a median follow-up time of 532 days (Q1: 284, Q3: 688), three patients (37.5%) presented VT recurrence, all three underwent a second procedure, with no VT recurrence on the follow-up. No patient died in the follow-up.Conclusion: CMR aided is ablation is feasible and effective in patients with scar related VT.
- How to use digital devices to detect and manage arrhythmias: an EHRA practical guide (vol 24, pg 979, 2022)(2023) SVENNBERG, Emma; TJONG, Fleur; GOETTE, Andreas; AKOUM, Nazem; BIASE, Luigi Di; BORDACHAR, Pierre; BORIANI, Giuseppe; BURRI, Haran; CONTE, Giulio; DEHARO, Jean Claude; DENEKE, Thomas; DROSSART, Inga; DUNCKER, David; HAN, Janet K.; HEIDBUCHEL, Hein; JAIS, Pierre; FIGUEIREDO, Marcio Jansen de Oliveira; LINZ, Dominik; LIP, Gregory Y. H.; MALACZYNSKA-RAJPOLD, Katarzyna; MARUEZ, Manlio F.; PLOEM, Corrette; SOEJIMA, Kyoko; STILES, Martin K.; WIERDA, Eric; VERNOOY, Kevin; LECLERCQ, Christophe; MEYER, Christian; PISANI, Cristiano; PAK, Hui Nam; GUPTA, Dhiraj; PURERFELLNER, Helmut; CRIJNS, H. J. G. M. C.; CHAVEZ, Edgar Antezana; WILLEMS, Stephan; WALDMANN, Victor; DEKKER, Lukas; WAN, Elaine; KAVOOR, Pramesh; TURAGAM, Mohit K.; SINNER, Moritz
- Safety of an esophageal deviator for atrial fibrillation catheter ablation(2023) PEREIRA, Renner; PISANI, Cristiano; AIELLO, Vera; CESTARI, Idagene; OYAMA, Helena; SANTOS, Osmar; OTUBO, Jorge; MOURA, Daniel; SCANAVACCA, MauricioBACKGROUND Esophageal thermal injury is a complication of atrial fibrillation (AF) ablation, and it can be avoided by esophageal deviation during left atrial posterior wall radiofrequency catheter ablation.OBJECTIVE This study aimed to evaluate the safety of a nitinol-based mechanical esophageal displacement device (MEDD) and its performance.METHODS This preclinical safety study was conducted on 20 pigs, with 10 undergoing radiofrequency AF ablation using the MEDD and 10 serving as a control group under anticoagulation but without radiofrequency application. Esophageal traumatic injuries were classified from 0 to 4 and were grouped as absent (grade 0), minor (grade 1 or 2), moderate (grade 3), or major risk lesions (grade 4) by anatomopathological study. Grades 1 and 2 were considered accept-able. Fluoroscopy was used to measure displacement.RESULTS Five (25%) pigs developed traumatic lesions, 4 with grade 1 and 1 with grade 2 (2-mm superficial ulcer). There was no difference in lesion occurrence between the radiofrequency and control groups (30% and 20%, respectively; P = .43). Under rightward displacement, the right edge moved 23.9 (interquartile range [IQR] 21.3- 26.3) mm and the left edge moved 16.3 (IQR 13.8-18.4) mm (P , .001) from baseline. Under leftward displacement, the right edge moved 13.5 (IQR 10.9-15.3) mm and the left edge moved 16.5 (IQR 12.3-18.5) mm (P = .07). A perforation to the pharyngeal diverticulum occurred in 1 pig, related to an accidental extubation.CONCLUSION In pigs, the MEDD demonstrated safety in relation to esophageal tissue, and successful deviation. Esophageal traumatic injuries were acceptable, but improper manipulation led to pharyngeal lesion.