J. Cristovao

Ablação de taquicardia auricular em cardiopatia congénita operada

The authors describe the case of a 57-year-old woman with surgically treated superior vena cava sinus-venosus atrial septal defect who underwent an electrophysiology study with the CARTO ® 3 mapping system (Biosense Webster, J&J) due to recurrent episodes of tachycardia. The patient was found to be in narrow QRS-complex tachycardia, with a cycle length of 310 ms and concentric activation sequence in the coronary sinus (Figure 1A and 1B), suggesting atrial tachycardia (AT) originating from the right atrium (RA). High-density electroanatomical mapping of the RA was performed using the PentaRay catheter (Figure 2C). The AT activation map (Figure 2B) indicated microreentry and centrifugal activation mainly on the lateral RA wall (Figure 2B), coinciding with the border zone of the scar (Figure 2C) and reveals ≥75% of the tachycardia cycle on the PentaRay catheter (Figure 2A). Radio frequency was applied with the SmartTouch ablation catheter in the initial activation region, resulting in conversion to sinus rhythm (SR).

Who still remains at risk of arrhythmic death at time of implantable cardioverter-defibrillator generator replacement?: MADEIRA et al.

Implantable cardioverter‐defibrillator (ICD) is associated with reduction in arrhythmic mortality. However, at the time of generator replacement (GR) some patients had not experienced therapies and had a different clinical profile. Therefore, the risk‐benefit ratio of ICD may have changed. Our aim was to determine the proportion of patients with ICD implanted in primary prevention that maintain guideline‐derived indications at the time of GR and assess predictors of therapies in the postreplacement period. We evaluate the long‐term benefit of ICD after GR in nonischemic cardiomyopathy (NICM) versus ischemic cardiomyopathy (ICM).