SISSY LARA DE MELO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
6 resultados
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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.- 2023 HRS expert consensus statement on the management of arrhythmias during pregnancy(2023) JOGLAR, Jose A.; KAPA, Suraj; SAAREL, Elizabeth V.; DUBIN, Anne M.; GORENEK, Bulent; HAMEED, Afshan B.; MELO, Sissy Lara de; LEAL, Miguel A.; MONDESERT, Blandine; PACHECO, Luis D.; ROBINSON, Melissa R.; SARKOZY, Andrea; SILVERSIDES, Candice K.; SPEARS, Danna; SRINIVAS, Sindhu K.; STRASBURGER, Janette F.; TEDROW, Usha B.; WRIGHT, Jennifer M.; ZELOP, Carolyn M.; ZENTNER, DominicaThis international multidisciplinary expert consensus statement is intended to provide comprehensive guidance that can be referenced at the point of care to cardiac electrophysiologists, cardiologists, and other health care professionals, on the management of cardiac arrhythmias in pregnant patients and in fetuses. This document covers general concepts related to arrhythmias, including both brady-and tachyarrhythmias, in both the patient and the fetus during pregnancy. Recommendations are provided for optimal approaches to diagnosis and evaluation of arrhythmias; selection of invasive and noninvasive options for treatment of arrhythmias; and disease-and patient-specific considerations when risk stratifying, diagnosing, and treating arrhythmias in pregnant patients and fetuses. Gaps in knowledge and new directions for future research are also identified.
- Diretriz Brasileira de Dispositivos Cardiacos Eletronicos Implantaveis-2023(2023) TEIXEIRA, Ricardo Alkmim; FAGUNDES, Alexsandro Alves; JR, Jose Mario Baggio; OLIVEIRA, Julio Cesar de; MEDEIROS, Paulo de Tarso Jorge; VALDIGEM, Bruno Pereira; TENO, Luiz Antonio Castilho; SILVA, Rodrigo Tavares; MELO, Celso Salgado de; ELIAS NETO, Jorge; JR, Antonio Vitor Moraes; PEDROSA, Anisio Alexandre Andrade; PORTO, Fernando Mello; JR, Helio Lima de Brito; SOUZA, Thiago Goncalves Schroder e; MATEOS, Jose Carlos Pachon; MORAES, Luis Gustavo Belo de; FORNO, Alexander Romeno Janner Dal; D'AVILA, Andre Luiz Buchele; CAVACO, Diogo Alberto de Magalhaes; KUNIYOSHI, Ricardo Ryoshim; PIMENTEL, Mauricio; CAMANHO, Luiz Eduardo Montenegro; SAAD, Eduardo Benchimol; ZIMERMAN, Leandro Ioschpe; OLIVEIRA, Eduardo Bartholomay; SCANAVACCA, Mauricio Ibrahim; MARTINELLI FILHO, Martino; LIMA, Carlos Eduardo Batista de; PEIXOTO, Giselle de Lima; DARRIEUX, Francisco Carlos da Costa; DUARTE, Jussara de Oliveira Pinheiro; GALVAO FILHO, Silas dos Santos; COSTA, Eduardo Rodrigues Bento; MATEO, Enrique Indalecio Pachon; MELO, Sissy Lara De; RODRIGUES, Thiago da Rocha; ROCHA, Eduardo Arrais; HACHUL, Denise Tessariol; LORGA FILHO, Adalberto Menezes; NISHIOKA, Silvana Angelina D'Orio; GADELHA, Eduardo Barreto; COSTA, Roberto; ANDRADE, Veridiana Silva de; TORRES, Gustavo Gomes; OLIVEIRA NETO, Nestor Rodrigues de; LUCCHESE, Fernando Antonio; MURAD, Henrique; WANDERLEY NETO, Jose; BROFMAN, Paulo Roberto Slud; ALMEIDA, Rui M. S.; LEAL, Joao Carlos Ferreira
- 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.
- Feasibility of Transatrial Access for Epicardial Ablation Evaluation of 2 Different Techniques in Swine(2023) CHOKR, Muhieddine O.; VANDONI, Pedro Mario Pinto; NETO, Jose Nilo de Carvalho; MOURA, Lucas G. de; SOUSA, Italo Bruno dos Santos; AIELLO, Vera D.; BRITO, Fabio Sandoli de; PISANI, Cristiano F.; HARDY, Carina A.; MELO, Sissy L. deBACKGROUND The subxiphoid pericardial access is technically difficult and has a considerable rate of complications, thus transatrial access may be an alternative. OBJECTIVES This study sought to assess the feasibility and safety of this strategy regarding periprocedural period and after 1-week follow-up. METHODS The investigators performed epicardial mapping through transatrial puncture in 20 swine. Animals were divided into group A, in which aspiration of the sheath was performed to maintain negative pressure after the withdraw of the catheters, and group B, in which a device (Konar-MF VSD Occluder) was delivered to occlude the right atrial appendage perforation. Bleeding was investigated immediately and 1 week after. RESULTS Access was safe in 19 of 20 animals (95%) with small amount of bleeding (6.4 +/- 6 mL). In group A (n = 10), 1 animal presented hemopericardium right after the puncture. In the other 9, epicardial ablation was performed and 60.0 +/- 28.0 mL of blood was aspirated without events. After 1 week, fibrin-hemorrhagic pericarditis was identified in 3 animals. In group B (n = 10), reaching the epicardial surface was possible in all animals. An adequate position of the prosthesis was obtained in 90% (9 of 10). One death occurred in the immediate postoperative period, secondary to pneumothorax. After 1 week, postmortem analysis showed absence of pericardial bleeding and a normal-appearing pericardium in the 8 animals with adequate prosthesis position. CONCLUSIONS Transatrial access allows epicardial mapping and ablation. Sheath removal after negative pressure contributes to achieving acute bleeding control but does not prevent its occurrence. The use of the device prevents bleeding and hemorrhagic pericarditis.
conferenceObject OUTCOMES OF CATHETER ABLATION OF ELECTRICAL STORM IN CHAGAS DISEASE(2023) KULCHETSCKI, Rodrigo; PISANI, Cristiano F.; MAYRINK, Marina; ALEXANDRE, Felipe Kalil; CHOKR, Muhieddine; HARDY, Carina; II, Sissy Lara Melo; SCANAVACCA, Mauricio Ibrahim