MUHIEDDINE OMAR CHOKR

Índice h a partir de 2011
4
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Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/65, Hospital das Clínicas, Faculdade de Medicina

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Agora exibindo 1 - 10 de 27
  • 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
  • article 4 Citação(ões) na Scopus
    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, Mauricio
    Background 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.
  • article 0 Citação(ões) na Scopus
    Differential diagnosis and treatment of wide QRS tachycardia in an Ebstein anomaly patient
    (2021) MELO, S. Lara de; ROSA, X. F.; PISANI, C. F.; LOPES, H. B.; CHOKR, M. O.; SCANAVACCA, M. I.
  • 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.
  • article 2 Citação(ões) na Scopus
    Bipolar radiofrequency ablation of septal ventricular tachycardia in a patient with dilated cardiomyopathy using two 8-mm tip catheters-case report
    (2022) FERRAZ, Alberto Pereira; ANDERE, Tamer El; GONCALVES, Andre Luis Martins; CHOKR, Muhieddine Omar; MELO, Sissy Lara; HARDY, Carina; PISANI, Cristiano Faria; SCANAVACCA, Mauricio Ibrahim
    Septal ventricular tachycardiac exhibit high recurrence rates after radiofrequency ablation, which is mainly attributed to the deep intramyocardial circuits and the inability to create transmural lesions with the conventional unipolar ablation. Bipolar radiofrequency ablation is feasible and it has been reported as a valid technique in these cases, leading to deeper lesion formation, high non-inducibility rates, and acceptable recurrence rates during follow-up. Our goal is to report a successful case of bipolar ablation of a septal ventricular tachycardia using a simple bipolar ablation configuration with two 8-mm tip catheters.
  • article 1 Citação(ões) na Scopus
    Transatrial management of inadvertent puncture of the posterior wall during transseptal access for atrial fibrillation ablation: technical report
    (2022) CHOKR, Muhieddine Omar; SOUSA, Italo Bruno dos Santos; ANDERE, Tamer El; BRIGIDO, Alexandra Regia Dantas; GOUVEA FILHO, Luiz Fernando Fagundes de; SCANAVACCA, Mauricio Ibrahim
    Transseptal puncture for atrial fibrillation ablation is a safe and common procedure. However, complications, such as cardiac tamponade, may be fatal if not recognized and treated. Our goal is to report a bailout strategy, by which management of an inadvertent puncture of the posterior wall of the left atrium was possible. It was followed by successful pulmonary vein isolation, without the need for subsequent subxiphoid puncture.
  • 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.
  • conferenceObject
    Clinical Results of Scar Related Ventricular Tachycardia Ablation Performed in a South America School Hospital
    (2015) PISANI, Cristiano; HARDY, Carina; LARA, Sissy; CHOKR, Muhieddine; BELLOTTI, Hugo; HACHUL, Denise; DARRIEUX, Francisco; SOSA, Eduardo; SCANAVACCA, Mauricio
  • article 22 Citação(ões) na Scopus
    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, Mauricio
    BACKGROUND 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.
  • article 2 Citação(ões) na Scopus
    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, Mauricio
    Background: 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.