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CPC 2018
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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
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01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
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18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
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Clinical implications of cardiac rhythm and intraventricular conduction after transcatheter aortic valve
Session:
Posters 2 - Écran 02 - Intervenção não Coronária
Speaker:
Ines Rodrigues
Congress:
CPC 2018
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
25. Interventional Cardiology
Subtheme:
25.3 Non-coronary Cardiac Intervention
Session Type:
Posters
FP Number:
---
Authors:
Dra. Inês Rodrigues; Lino Patrício ; Ana Abreu; Duarte Cacela; Ruben Ramos; Hagen Kahlbau; Guilherme Portugal; Madalena Coutinho Cruz; Rita Ilhão Moreira; Tiago Mendonça; António Valentim Gonçalves; José Fragata; Rui Cruz Ferreira
Abstract
<p><strong>Background: </strong>Conduction abnormalities and rhythm disturbances are common in transcatheter aortic valve implantation (TAVI) patients (pts). Data pertaining to its clinical impact are controversial. </p> <p><strong>Objectiv</strong>e: The aim of this study was to evaluate the prognostic impact of cardiac rhythm and intraventricular conduction after TAVI.</p> <p><strong>Methods</strong>: Single-center study including consecutive pts undergoing TAVI between December 2009 and November 2017. Pts were divided into three subgroups – sinus rhythm (SR), atrial fibrillation (AF) group and pacemaker rhythm (PM) group according to last rhythm recorded in electrocardiograms after procedure and/or before hospital discharge. Mortality at 2 years was evaluated according to post-TAVI rhythm.</p> <p><strong>Results:</strong> 237 pts were included in the analysis, mean age 82±6 years, 44% male. SR group included 146 pts (61.6%), AF group 39 (15.2%) and PM group 52 (21.9%). The PM subgroup had significantly higher history of stroke, coronary artery disease and baseline creatinine levels. In SR group, 47.3% of patients had associated bundle branch block (BBB) (73.9% new BBB), and 56.4% had it in AF group (59.1% new). Pts were followed during a mean period of 22 months. Survival during the follow up was significantly lower in AF subgroup at two years (SR - 82±4%; AF - 56±9%; PM - 77±7%, p=0.02, figure), and also at four years of follow-up (SR – 62±7%; AF - 51±2%; PM - 76±7%, p=0.013). Univariate analysis indicated that PM and BBB were not predictors of mortality (HR: 0.98, 95% CI: 0.53-1.81, p=0.96, and HR: 0.94, 95% CI: 0.56-1.57, p=0.81). The presence of AF was associated with either higher mortality (HR: 2.36, 95% CI: 1.36 –4.08, p=0.02).</p> <p><strong>Conclusions: </strong>This study shows that AF in TAVI patients is associated with higher mortality during follow-up period. Between the cardiac rhythms and intraventricular conduction evaluated, AF was the only predictor of mid-term mortality.</p>
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