No abstract

No abstract

In patients with advanced HF and severe systolic dysfunction: (1) a significant reduction of MSNA (at rest and during handgrip) occurred after CRT, and this behavior was significantly superior to HF patients receiving only medical therapy; (2) MSNA reduction after CRT had an inverse correlation with O2 consumption outcomes.

BackgroundThe recording of arrhythmic events (AE) in renal transplant candidates (RTCs) undergoing dialysis is limited by conventional electrocardiography. However, continuous cardiac rhythm monitoring seems to be more appropriate due to automatic detection of arrhythmia, but this method has not been used.ObjectiveWe aimed to investigate the incidence and predictors of AE in RTCs using an implantable loop recorder (ILR).MethodsA prospective observational study conducted from June 2009 to January 2011 included 100 consecutive ambulatory RTCs who underwent ILR and were followed-up for at least 1 year. Multivariate logistic regression was applied to define predictors of AE.ResultsDuring a mean follow-up of 424 ± 127 days, AE could be detected in 98% of patients, and 92% had more than one type of arrhythmia, with most considered potentially not serious. Sustained atrial tachycardia and atrial fibrillation occurred in 7% and 13% of patients, respectively, and bradyarrhythmia and non-sustained or sustained ventricular tachycardia (VT) occurred in 25% and 57%, respectively. There were 18 deaths, of which 7 were sudden cardiac events: 3 bradyarrhythmias, 1 ventricular fibrillation, 1 myocardial infarction, and 2 undetermined. The presence of a long QTc (odds ratio [OR] = 7.28; 95% confidence interval [CI], 2.01–26.35; p = 0.002), and the duration of the PR interval (OR = 1.05; 95% CI, 1.02–1.08; p < 0.001) were independently associated with bradyarrhythmias. Left ventricular dilatation (LVD) was independently associated with non-sustained VT (OR = 2.83; 95% CI, 1.01–7.96; p = 0.041).ConclusionsIn medium-term follow-up of RTCs, ILR helped detect a high incidence of AE, most of which did not have clinical relevance. The PR interval and presence of long QTc were predictive of bradyarrhythmias, whereas LVD was predictive of non-sustained VT.

FILHO, M.M., ET AL.: Probability of Occurrence of Life-Threatening Ventricular Arrhythmias in Chagas' Disease versus Non-Chagas' Disease. The implantable cardioverter defibrillator (ICD) is highly effective in the treatment of ventricular arrhythmias (VA) responsible for sudden cardiac death. However, the prob ability of occurrence of these arrhythmic events in presence of cardiomyopathy remains uncertain. The aim of this study was to compare the probability of nonoccurrence of life-threatening VA in ICD recipients with Chagas' versus non-Chagas' heart disease. Over a mean follow-up of 10.5 months, 53 ICD recipients (mean age = 50.1 years, 48 male) were evaluated. Eleven patients had Chagas' heart disease, 19 had idiopathic dilated cardiomyopathy and 23 had ischémie cardiomyopathy. Ventricular tachyarrhythmias with a cycle length < 315 ms were considered life-threatening. The cumulative probability of nonoccur rence of life-threatening VA was examined by Kaplan-Meyer method and the outcomes were submitted to the log rank test. At 2 years, the cumulative probability of life-threatening VA nonoccurrence was 0 in the Chagas' heart disease group versus 40% up to 55 months of follow-up in the non-Chagas' disease group (P = 0.0097). Among patients with cardiomyopathies of different etiologies, those with Chagas' heart dis ease had the lowest cumulative probability of nonoccurrence of life-threatening VA, confirming its unfa vorable prognosis and the importance of preventive measures against sudden death in this disease. (PACE 2000; 23[Pt. II]:1944-1946 Chagas' heart disease, sudden death, implantable cardioverter defibrillator