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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
G. Aortic Disease, Peripheral Vascular Disease, Stroke
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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
17. Myocardial Disease
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
36. Basic Science
37. Miscellanea
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Subclinical coronary artery disease in atrial fibrillation patients submitted to pulmonary vein isolation
Session:
Posters 1 - Écran 10 - Arritmologia
Speaker:
Mariana Gonçalves
Congress:
CPC 2019
Topic:
C. Arrhythmias and Device Therapy
Theme:
04. Arrhythmias, General
Subtheme:
04.2 Arrhythmias, General – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Mariana Gonçalves; Francisco Moscoso Costa; António Miguel Ferreira; Pedro Adragão; Pedro Lopes Do Carmo; Diogo Cavaco; Francisco Bello Morgado; João Abecasis; Carla Rodrigues Carvalho; Daniel Nascimento Matos; António Tralhão; Miguel Mendes
Abstract
<p><strong>Background:</strong> Coronary artery disease (CAD) has relevant implications for atrial fibrillation (AF) therapy both for oral anticoagulation (a significant risk factor in the CHADSVASC score) and for antiarrhythmic drugs eligibility. AngioCT is frequently performed before ablation to exclude intracardiac thrombus and collect left atrium anatomy</p> <p> </p> <p><strong>Aim:</strong> To evaluate the incidence of previously unknown coronary artery disease in a cohort of patients referred to AF ablation.</p> <p> </p> <p><strong>Methods: </strong>516 consecutive patients, admitted for AF ablation from October 2015 to October 2018, underwent angioCT to exclude intracardiac thrombus and were further evaluated for CAD. Obstructive CAD was defined by lesions >50%. Average age was 64 years old (±0,54), 39% were female, 61% hypertensive, 49% with dyslipidemia, 44% had previous or active smoking habits and 10% were diabetic. 10% of patients had previously known CAD (prior acute coronary syndrome or angioplasty). 121 (23%) were on AF during the exam. Coronary segments were not evaluated in 60 patients (12%) by technical reasons.</p> <p> </p> <p><strong>Results:</strong> Among patients without known CAD, 45% had no coronary disease. With the evaluation of the segments that was possible to achieve, 33% had non obstructive coronary disease, 10% had obstructive disease, and 20% (N=9) of these had a >70% coronary stenosis by angioCT. In this group of patients, CHA<sub>2</sub>DS<sub>2</sub>-VASc changed in 9,6% of patients (N=44), from which 31,8% (N=14) had a CHA<sub>2</sub>DS<sub>2</sub>-VASc of 0 or 1.</p> <p>When analyzing patients with every segment evaluable and obstructive coronary disease (N=33), angioCT allowed to identify CAD in the left main (12% of patients), left descending artery (73%), circumflex artery (24%) and right coronary artery (39%).</p> <p> </p> <p><strong>Conclusions:</strong> In this cohort of patients undergoing AF ablation, the prevalence of unknown significant coronary disease was in accordance with previous reported studies for the general asymptomatic population, similar in patients with or without AF (11%), of whom 20% had one stenosis >70%. Identification of higher risk patients by angioCT, may allow for more accurate classification of embolic risk with repercussion in anticoagulation decision and contraindication in class IC antiarrhythmic drugs.</p>
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