CARINA ABIGAIL HARDY
Índice h a partir de 2011
10
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
5 resultados
Resultados de Busca
Agora exibindo 1 - 5 de 5
- A novel treatment for esophageal lesions following atrial fibrillation ablation(2021) RIVAROLA, Esteban W. R.; MOURA, Eduardo; CHOU, Marco; SEABRA, Luciana Feitosa; HARDY, Carina; SCANAVACCA, MauricioThis study presents a novel technique for the treatment of a deep esophageal ulcer after ablation of paroxysmal atrial fibrillation (AF). Pulmonary vein isolation was performed using a radiofrequency irrigated tip catheter. On Day 5 of follow-up, a deep esophageal ulcer was observed. No significant visual improvement was observed after conventional treatment. Endoscopic negative pressure therapy in the esophagus was then applied for 5 days. A significant decrease in diameter and depth of the lesion was observed, possibly preventing perforation. Endoscopic negative pressure therapy can be used to heal thermal lesions after AF ablation procedures.
- Percutaneous Epicardial Access as an Alternative Approach for Catheter Ablation of a Posteroseptal Accessory Pathway Related to the Coronary Venous System(2016) FAUSTINO, Mariana; BELLOTTI, Hugo; HARDY, Carina; SCANAVACCA, Mauricio Ibrahim
- Young Woman With Wide QRS Tachycardia and No Structural Heart Disease: Do We Need to Look for Something Else?(2016) CHOKR, Muhieddine Omar; PISANI, Cristiano F.; HARDY, Carina; SCANAVACCA, Mauricio I.
- Catheter ablation of the parahisian accessory pathways from the aortic cusps-Experience of 20 cases-Improving the mapping strategy for better results(2020) CHOKR, Muhieddine O.; MOURA, Lucas G. de; AIELLO, Vera D.; SOUSA, Italo B. dos Santos; LOPES, Hugo B.; CARMO, Andre A. L. do; PISANI, Cristiano F.; HARDY, Carina A.; MELO, Sissy L. de; SCANAVACCA, Mauricio I.Introduction Catheter ablation of the parahisian accessory pathways (PHAP) has been established as the definitive therapy for this type of arrhythmia. However, the PHAP proximity to the normal atrioventricular conduction system makes the procedure technically challenging. Here, we have reported a case series of 20 patients with PHAP who underwent aortic access ablation to evaluate the safety and efficacy of this approach in the PHAP ablation. Methods and Results The ablation through the aortic cusps was the successful approach in 13 of 20 (65%) of the cases. In 11 patients, the aortic approach was the initial strategy for ablation, and the accessory pathway was eliminated in seven (63.6%) of them. The aortic approach followed a failed right-sided attempt in nine patients. In six (66.7%) patients, the ablation was successful with the aortic approach. The only independent predictor for the successful ablation with each approach was the earliest ventricular activation before delta wave (predelta time) and a right-sided earliest ventricular activation of more than 23 ms had high sensitivity and specificity for right-sided success. Systematically using the two strategies (right and left approaches), the ablation of the PHAP was successful in 18 (90%) patients. Conclusion The aortic approach seems to be a safe and effective strategy for the ablation of PHAP. It can be used when the right-sided approach fails or even considered as an initial strategy when the predelta time is less than 23 ms in the right septal region. When combining the right- and left-sided approaches, the success rate is high. We believe that the retrograde aortic approach remains a key tool for this challenging ablation.
- Comparative study of strategies to prevent esophageal and periesophageal injury during atrial fibrillation ablation(2020) OLIVEIRA, Barbara D. de; OYAMA, Helena; HARDY, Carina A.; MELO, Sissy L. de; PISANI, Cristiano F.; CHOKR, Muhieddine O.; BALBO, Conrado; DARRIEUX, Francisco C. Costa; HACHUL, Denise T.; CHAVES, Dalton M.; ARTIFON, Everson L. de Almeida; CESTARI, Idagene A.; SAKAI, Paulo; I, Mauricio ScanavaccaObjective To compare the prevalence of esophageal and periesophageal thermal injury in patients undergoing radiofrequency (RF) atrial fibrillation (AF) ablation using 8 mm tip catheters during three different esophageal protection strategies. Methods Forty-five consecutive patients with paroxysmal or persistent AF underwent first ablation procedure, besides esophagogastroduodenoscopy (EGD) combined with radial endosonography (EUS) performed before and after the pulmonary vein (PV) isolation. Before the procedure, patients were randomly assigned to one of three esophageal lesion protection strategies: group I-without any protective or monitoring dispositive and limiting RF applications to 30 W for 20 seconds, in left atrium posterior wall (LAPW); group II-power and time of RF delivery, up to 50 W for 20 seconds at LAPW, limited by esophageal temperature monitoring; group III-applications of RF in LAPW with fixed power application of 50 W for 20 seconds during continuous esophageal cooling. Results Baseline characteristics of patients were similar in all groups. The four PVs were isolated in 14 (93.3%), 13 (86.7%), and 15 (100%) patients, respectively in groups I, II, and III. The mean RF power was significantly higher (P < .001) in the posterior side of PVs in group III. Post-AF ablation EGD and EUS revealed two esophageal wall ulcerations and two periesophageal mediastinal edemas only in the esophageal cooling group (P = .008). Conclusion Esophageal cooling balloon strategy resulted in a higher RF power energy delivery when ablating at the LA posterior wall, using 8 mm nonirrigated tip catheters under temperature mode control. Despite that, patients presented a relatively low incidence of esophageal and periesophaeal injuries.