RODRIGO MELO KULCHETSCKI

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Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico

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Agora exibindo 1 - 10 de 21
  • article 3 Citação(ões) na Scopus
    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
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    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.
  • article 0 Citação(ões) na Scopus
  • article 1 Citação(ões) na Scopus
    Management of massive hemopericardium in the electrophysiology laboratory: The double long sheath technique
    (2022) CHOKR, Muhieddine Omar; SANTOS, Italo Bruno dos Santos Sousa; GOUVEA, Fabio Cesar; KULCHETSCKI, Rodrigo; ANDERE, Tamer El; HARDY, Carina; PISANI, Cristiano; MELO, Sissy; SCANAVACCA, Mauricio
    Aim To describe a simple and useful technique for acute management of massive hemopericardium inside the Electrophysiology (EP) laboratory Methods and results Five patients from a single center experience were identified, all with blood loss above 1000 ml after initial pericardiocenthesis. Using two long 8.5 F transseptal sheaths inside the pericardium space, with continuous negative pressure, allowed the complete cessation of bleeding or hemodynamic maintenance until definitive surgical repair in all patients Conclusion The use of two long sheaths for blood drainage, instead of conventional pericardiocenthesis, might be helpful to manage massive hemopericardium inside EP lab, avoiding urgent cardiac surgery or maintaining clinical stability until surgical staff is available.
  • article 0 Citação(ões) na Scopus
    Cardiac Magnetic Resonance to Evaluate Complete Substrate Elimination after Endocardial Ventricular Tachycardia Ablation in Chagas Disease
    (2024) SCANAVACCA, Mauricio I.; KULCHETSCKI, Rodrigo M.; ROCHITTE, Carlos E.; PISANI, Cristiano F.
  • conferenceObject
    STATIN THERAPY IN A PRIMARY PREVENTION PATIENT WITH SEVERE HYPERCHOLESTEROLEMIA AND ELEVATED LIVER ENZYME LEVELS
    (2018) ALBUQUERQUE, Jose; KULCHETSCKI, Rodrigo; ROCHA, Viviane; MINAME, Marcio; SALGADO, Wilson; CHACRA, Ana; SANTOS, Raul
  • article 0 Citação(ões) na Scopus
    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, Mauricio
    Background: 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.
  • conferenceObject
    Catheter ablation for ventricular tachycardia in Chagas disease
    (2020) KULCHETSCKI, R.; FERRAZ, A. P.; GOUVEA, F. C.; ALEXANDRE, F. K. B.; MAYRINK, M. P.; GONCALVES, A. L. M.; DIAS, V. H.; BALBO, C. P.; PAUCAR, A. D. R.; HARDY, C. A.; MELO, S. L.; CHOKR, M. O.; PISANI, C. F.; I, M. Scanavacca
  • article 1 Citação(ões) na Scopus
    CULPRIT-SHOCK study
    (2018) SOUZA JUNIOR, Jorge Mangabeira de; KULCHETSCKI, Rodrigo Melo; LINHARES FILHO, Jaime Paula Pessoa; LIMA, Eduardo Gomes; SERRANO JUNIOR, Carlos Vicente
    The treatment of patients with ST-segment elevation myocardial infarction concomitant with the presence of multivessel disease has been studied in several recent studies with the purpose of defining the need, as well as the best moment to approach residual lesions. However, such studies included only stable patients. The best therapeutic approach to cardiogenic shock secondary to acute coronary syndrome, however, remains controversial, but there are recommendations from specialists for revascularization that include nonevent related injuries. Recently published, the CULPRIT-SHOCK study showed benefit of the initial approach only of the injury blamed for the acute event, in view of the multivessel percutaneous intervention, in the context of cardiogenic shock. In this perspective, the authors discuss the work in question, regarding methodological questions, limitations and clinical applicability.
  • article 4 Citação(ões) na Scopus
    Applicability of the PAINESD risk score for 30-day mortality prediction post ventricular tachycardia catheter ablation in Chagas disease
    (2021) KULCHETSCKI, R. M.; PISANI, C. F.; ALEXANDRE, F. K. B.; MAYRINK, M. P.; FERRAZ, A. P.; GOUVEA, F. C.; GONCALVES, A. L. M.; HARDY, C. A.; MELO, S. L.; CHOKR, M. O.; SCANAVACCA, M. I.
    Purpose The PAINESD risk score was developed in 2015 as a tool to stratify the risk of acute hemodynamic decompensation during ventricular tachycardia (VT) ablation in structural heart disease patients and further then used for post procedure 30-day mortality prediction. The original cohort however did not include Chagas disease (ChD) patients. We aim to evaluate the relevance of the score in a ChD population. Methods The PAINESD risk score gives weighted values for specific characteristics (chronic obstructive pulmonary disease, age > 60 years, ischemic cardiomyopathy, New York Heart Association [NYHA] functional class 3 or 4, ejection fraction less than 25%, VT storm, and diabetes). The score was applied in a retrospective cohort of ChD VT ablations in a single tertiary center in Brazil. Data were collected by VT study reports and patient record analysis at baseline and on follow-up. Results Between January 2013 and December 2018, 157 VT catheter ablation procedures in 121 ChD patients were analyzed. Overall, 30-day mortality was 9.0%. Multivariate analysis correlated NYHA functional class (HR 1.78, 95% CI 1.03-3.08, P 0.038) and the need for urgent surgery (HR 31.5, 95% CI 5.38-184.98, P < 0.001), as well as a tendency for VT storm at presentation (HR 2.72, 95% CI 0.87-8.50, P 0.084) as risk factors for the primary endpoint. The median PAINESD risk score in this population was 3 (3-8). The area under the receiver operating characteristic (ROC) curve was 0.64 (95% CI 0.479-0.814). Conclusions The PAINESD risk score did not perform well in predicting 30-day mortality in ChD patients. Pre-procedure NYHA functional class and the need for urgent surgery due to refractory pericardial bleeding were independently associated with increased 30-day mortality. Prospective studies are needed to take final conclusions in Chagas disease when using PAINESD score.