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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)
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15. Valvular Heart Disease
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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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Abstract
Slides
Vídeo
Report
CLEAR FILTERS
ATRIAL FIBRILLATION ABLATION USING HIGH-DENSITY VOLTAGE MAPPING WITH A SIMPLIFIED SINGLE TRANSSEPTAL PUNCTURE APPROACH: LONG-TERM OUTCOME OF A SINGLE-CENTER EXPERIENCE
Session:
Posters - C. Arrhythmias and Device Therapy
Speaker:
Mário Martins Oliveira
Congress:
CPC 2021
Topic:
C. Arrhythmias and Device Therapy
Theme:
05. Atrial Fibrillation
Subtheme:
05.4 Atrial Fibrillation - Treatment
Session Type:
Posters
FP Number:
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Authors:
Mário Martins Oliveira; Pedro Silva Cunha; Bruno Valente; Guilherme Portugal; Ana Lousinha; Madalena Cruz; Vera Ferreira; Alexandra Castelo; Pedro Brás; Ana s Delgado; Catia Guerra; Rui c Ferreira
Abstract
<p style="text-align:justify"><span style="font-size:12pt"><span style="background-color:white"><span style="font-family:"Times New Roman",serif"><span style="background-color:white"><span style="font-family:"Calibri",sans-serif"><span style="color:#212121">For atrial fibrillation (AF) ablation, two transseptal sheaths are often positioned in the left atrium. Furthermore, in recent years, h</span></span></span><span style="font-family:"Calibri",sans-serif"><span style="color:#333333">igh-density mapping has become often used in AF ablation. <strong>Aim:</strong> to assess the feasibility, safety and long-term efficacy of a simplified single-puncture technique using high-resolution mapping to guide pulmonary veins isolation (PVI) in AF ablation. <strong>Methods:</strong> 88 consecutive AF patients (P) [58% women, age 57.8±12.2 yrs, 61% paroxysmal AF, mean left ventricular ejection fraction 55%, mean left atrium volume 43 ml/m2, mean CHADSVASC score 1.75] with >1-year follow-up post-AF ablation were included. A specified protocol was applied: segmentation of the cardiac CT scan, placement of a 10-pole catheter in the coronary sinus (CS), His location, single transseptal puncture using a defectable sheath, left atrium high-density catheter voltage mapping (PentaRay, Biosense or HD Grid, Abbott). Mapping was done during sinus rhythm (paroxysmal AF) or in AF (persistent AF) with the following settings: <em>LAT stability: 5ms; position stability: 5mm; density: 1mm; voltage scale: <0,2 mV. </em>After voltage map, the high-density mapping catheter changed with the irrigated ablation catheter to perform PVI with a wide area of circumferential ablation</span></span><span style="font-size:12.5pt"><span style="font-family:"interstateregular",serif"><span style="color:#333333">. </span></span></span><span style="font-family:"Calibri",sans-serif"><span style="color:#333333">Remapping was performed to analyze signals, possible gaps and low-voltage areas. Ablation of gaps, followed by remap to confirm homogeneous low-voltage and PVI, was done. PVI was confirmed by bi-directional block and low voltage homogeneity of PV and antrum in all P. </span></span><strong><span style="font-size:12.5pt"><span style="font-family:"interstateregular",serif"><span style="color:#333333">Results:</span></span></span></strong> <span style="font-family:"Calibri",sans-serif"><span style="color:#333333">Mean procedure duration was 169±20min, X-ray time was 18±4 min and RF time 22±10 min. The average number of mapping points and acquisition times were: MAP 1 - 1009 points (388-2200), MAP 2 (90% of the P) – 1000 points (244-2617), and MAP 3 (29,5% of the P) - 299 points (135-1019). There were 1 pericardial effusion, 2 temporary right phrenic palsy and 1 bradypnea during the procedure. All P were in sinus rhythm after ablation. During a mean follow-up of 24 months, 62P (70,5%) remained free from AF. <strong>Conclusion: </strong>A simplified single-puncture approach using high-density multi-electrode mapping is a safe and accurate technique for AF ablation, with good long-term results.</span></span></span></span></span></p>
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