Antonio Asso

Spanish Implantable Cardioverter-defibrillator Registry. Eleventh Official Report of the Spanish Society of Cardiology Electrophysiology and Arrhythmias Section (2014).

INTRODUCTION AND OBJECTIVES We present the results of the Spanish Implantable Cardioverter-defibrillator Registry for 2014, as compiled by the Electrophysiology and Arrhythmia Section of the Spanish Society of Cardiology. METHODS Data collection sheets were voluntarily completed by each implantation team and prospectively sent to the Spanish Society of Cardiology. RESULTS The number of reported implantations was 4911 (82% of the estimated total number of implantations). The implantation rate was 106 per million population while the estimated rate was 128. First implantations comprised 72.2%. Data were obtained from 162 hospitals (8 more than in 2013). Most implantations (82%) were performed in men. The mean patient age was 61.8±13.7 years. Most patients showed severe or moderate-to-severe ventricular dysfunction and were in New York Heart Association functional class II. The most frequent cardiac condition was ischemic heart disease, followed by dilated cardiomyopathy. Implantations for primary prevention indications comprised 58.5%. Electrophysiologists performed 85.6% of the implantations. CONCLUSIONS The 2014 Spanish Implantable Cardioverter-defibrillator Registry received information on 82% of the implantations performed in Spain. The number of implantations has increased from previous years and the percentage of implantations for primary prevention indications has increased from the previous year.

Guías de práctica clínica de la Sociedad Española de Cardiología sobre requerimientos y equipamiento en electrofisiología

.La evolucion, tanto cualitativa como cuantitativa, experimentada por la electrofisiologia en los ultimos anos ha llevado a la necesidad de crear unidades especificas dedicadas al manejo de los pacientes con arritmias cardiacas. En estas guias se consideran las necesidades materiales y humanas minimas con las que debe contar una unidad de arritmias.

Utilidad en la práctica clínica del tratamiento antiarrítmico tras cardioversión eléctrica en pacientes sin cardiopatía estructural

Introduccion y objetivos Conocer en la practica clinica el uso de antiarritmicos tras cardioversion electrica en pacientes sin cardiopatia y su repercusion en el mantenimiento del ritmo sinusal. Metodos Se realizo un seguimiento a un ano de 528 pacientes con fibrilacion auricular persistente sin cardiopatia significativa tras una cardioversion electrica efectiva en 96 hospitales espanoles, con controles clinicos 1, 3, 6 y 12 meses despues. Se analizo el uso y la utilidad de los farmacos antiarritmicos en la prevencion de recurrencias de fibrilacion auricular persistente. Resultados Se trato al alta con farmacos antiarritmicos al 80% de los pacientes, y el mas utilizado fue la amiodarona. Ningun factor clinico se relaciono con un mayor uso de antiarritmicos. El 37% de los pacientes siguio en ritmo sinusal en todos los controles. En el control a los 12 meses, se mantuvo el tratamiento antiarritmico al 59% de los pacientes que seguian en ritmo sinusal. En el analisis multivariable de la regresion de Cox, el peso (hazard ratio [HR] por cada kilo = 1,01; p = 0,04) y la ausencia de tratamiento antiarritmico (HR = 1,59; p = 0,001) fueron factores independientes relacionados con la recurrencia de fibrilacion auricular persistente. La amiodarona tendia a ser superior a los otros antiarritmicos. Conclusiones En la practica clinica habitual, tras una cardioversion electrica efectiva, la gran mayoria de los pacientes sin cardiopatia estructural recibe farmacos antiarritmicos, especialmente amiodarona, que es el principal factor relacionado con el mantenimiento del ritmo sinusal 1 ano mas tarde.

Spanish Catheter Ablation Registry. 17th Official Report of the Spanish Society of Cardiology Working Group on Electrophysiology and Arrhythmias (2017)

INTRODUCTION AND OBJECTIVES This report describes the findings of the 2017 Spanish Catheter Ablation Registry. METHODS Data collection was retrospective. A standardized questionnaire was completed by each of the participating centers. RESULTS A total of 15 284 ablation procedures were performed by 98 institutions (the highest number of ablations and institutions historically reported in this registry), with a mean of 156±126 and a median of 136 procedures per center. For the first time, the most frequently treated ablation target was atrial fibrillation (n=3457; 22.6%), followed by cavotricuspid isthmus (n=3449; 22.5%) and atrioventricular nodal re-entrant tachycardia (n=3429; 22.4%). The overall success rate was 87%. The rate of major complications was 2.6%, and the mortality rate was 0.09%. The percentage of procedures performed without fluoroscopic support increased to 6% of all ablations, and 2.3% of all ablations were performed in pediatric patients. CONCLUSIONS The Spanish Ablation Catheter Registry systematically and uninterruptedly collects data on the ablation procedures performed in Spain, revealing that both the number of ablations and the number of centers performing them has progressively increased, while maintaining a high success rate and a low percentage of complications.

Polymorphic ventricular arrhythmia triggered by temporary epicardial right ventricular stimulation after cardiac surgery

Introduction Temporary epicardial pacing is commonly used for rhythmic support in the acute postoperative period after cardiac surgery. Clinical studies suggest that pacing in the left ventricular epicardium during resynchronization therapy may be proarrhythmic in a minority of patients. The epicardial pacing increases transmural heterogeneity of repolarization. This could prolong the QT and JT intervals on the electrocardiogram (ECG), with subsequent proarrhythmic effects. The following case describes polymorphic ventricular arrhythmias after temporary epicardial ventricular stimulation.