Summary:There is a limited experience with catheter ablation for treatment of ventricular tachycardia (VT) in Chagasic cardiomyopathy. A 30-year-old woman experienced episodes of palpitations and syncope due to attacks of VT. A diagnosis of Chagas disease was established on a biological basis. Twodimensional echo and contrast ventriculography showed an apical aneurysm with thrombus. Surgery was indicated to resect the aneurysm and ablate the VT. Ventricular tachycardia recurred 1 month later despite therapy, including amiodarone. Two clinical frequent and well-tolerated tachycardias were identified. The site of origin was located in the right ventricular apex and in the apical-lateral wall of the left ventricle, respectively. Catheter ablation was performed at two sites with DC shocks (total energy 600 J) after unsuccessful radiofrequency ablation. Holter recordings performed during the postoperative period showed only infrequent extrasystoles. After follow-up of 24 months the patient remains asymptomatic. Drug-refractory VT in Chagasic cardiomyopathy can be ablated by medium-energy DC shocks after failure of radiofiequency ablation.
Introducción: El estudio del papel de polimorfismos en genes de las vías metabólicas de la homocisteína-metionina y el ácido fólico en anomalías congénitas, es cada vez más importante debido a que sus efectos podrían ser modulados.Objetivo: Determinar si la presencia del polimorfismo C677T en el gen de la metilentetrahidrofolato reductasa (MTHFR) se asocia con el desarrollo de cardiopatías congénitas aisladas.Métodos: Se compararon las frecuencias alélicas y genotípicas del polimorfismo en 34 recién nacidos con cardiopatías congénitas aisladas y en 102 individuos sanos. La genotipificación se hizo mediante la reacción en cadena de la polimerasa (PCR) y se determinó el genotipo por medio de la técnica de polimorfismo de longitud de los fragmentos de restricción (RFLP).Resultados: No se encontraron diferencias estadísticamente significativas en las frecuencias alélicas ni genotípicas entre los grupos de casos y controles. Sin embargo, se observó una tendencia estadística para un posible efecto protector del genotipo TT.
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