Atrial fibrillation ablation in systolic dysfunction: clinical and echocardiographic outcomes.

Background: Heart failure and atrial fibrillation (AF) often coexist in a deleterious cycle.

Objective: To evaluate the clinical and echocardiographic outcomes of patients with ventricular systolic dysfunction and AF treated with radiofrequency (RF) ablation.

Methods: Patients with ventricular systolic dysfunction [ejection fraction (EF) <50%] and AF refractory to drug therapy underwent stepwise RF ablation in the same session with pulmonary vein isolation, ablation of AF nests and of residual atrial tachycardia, named "background tachycardia".

In vitro assessment of the Apico Aortic Blood Pump: anatomical positioning, hydrodynamic performance, hemolysis studies, and analysis in a hybrid cardiovascular simulator.

The Apico Aortic Blood Pump (AABP) is a centrifugal continuous flow left ventricular assist device (LVAD) with ceramic bearings. The device is in the initial development phase and is being designed to be attached directly to the left ventricular apex by introducing an inlet cannula. This paper reports results from in vitro experiments.

Sepsis in the postoperative period of cardiac surgery: problem description.

Background: In spite of the advances in sepsis diagnosis and treatment in the last years, the morbidity and mortality are still high.

Objective: To assess the prevalence, in-hospital evolution and prognosis of patients that presented sepsis in the postoperative period of cardiac surgery.

Methods: This is a prospective study that included patients (n = 7,332) submitted to cardiac surgery (valvular or coronary) between January 1995 and December 2007.

Risk factors for stroke after coronary artery bypass grafting.

Background: Stroke is a feared complication after coronary artery bypass grafting surgery (CABG), with an incidence between 1.3 and 4.3%.

Prevalence and surgical approach of supravalvular pulmonary stenosis after Jatene operation for transposition of great arteries.

Background: The Transposition of the Great Arteries is the most frequent congenital cyanogenic cardiopathy in the neonatal period, corresponding to 7% of all congenital cardiopathies. Among the operations for surgical treatment, the Jatene operation, with arterial correction, is the treatment of choice. During the late postoperative evolution, some problems were observed, with the most common being the occurrence of supravalvular stenosis at the neopulmonary, regardless of the type of surgical technique used.

Coronary artery bypass grafting using both internal mammary arteries in patients with diabetes mellitus.

Objective: We sought to describe the use of both internal mammary arteries (IMA) in patients with diabetes mellitus (DM) submitted to coronary artery bypass grafting (CABG).

Method: Between January of 1995 to August of 2005, 4.569 patients received isolated CABG in our institution, of these, 1.

Radiofrequency catheter ablation of atrial fibrillation guided by spectral mapping of atrial fibrillation nests in sinus rhythm.

Background: Two types of myocardia can be observed through the endocardial spectral mapping (SM) in sinus rhythm: the compact type with a smooth spectrum and the fibrillar type with a segmented spectrum (atrial fibrillation nests). During the atrial fibrillation (AF), the compact type has an organized activation and low frequency (passive), whereas the fibrillar type has a rather disorganized activation and high frequency (active/resonant), with both being activated by high-frequency sustained tachycardia--the background tachycardia (BT).

Objective: To describe the treatment of AF by the ablation of the AF nests and BT.

Postoperative atrial fibrillation following coronary artery bypass graft: clinical factors associated with in-hospital death.

Objective: To identify factors associated with a higher likelihood of in-hospital death in patients submitted to coronary artery bypass graft surgery (CABG) who developed atrial fibrillation (AF) postoperatively.

Methods: The authors analyzed data from 397 consecutive patients submitted to CABG that developed AF postoperatively between 2000 and 2003. The patients were divided into 2 groups: group 1 (G1) comprised patients who survived (n=369); and group 2 (G2) comprised patients who died during hospital stay (n=28).

Prevalence and risk factors for combined coronary artery disease and aortic aneurysm.

Objective: To evaluate CAD prevalence in patients with aortic aneurysm, as well as differences related to aneurysm topographies. To describe the primary risk factors for CAD related to this association and their occasional differences according to AA topographies.

Methods: This was an open, prospective, nonrandomized study that evaluated 95 patients (66 men and 33 women, mean age 63 +/- 11.

Late outcome of sirolimus-eluting stents: comparison of multidetector computed tomography with quantitative coronary angiography and intravascular ultrasound.

Objective: To assess the performance of multidetector computed tomography in determining late clinical outcomes of patients undergoing sirolimus-eluting stent implantation.

Methods: Thirty patients, successfully submitted to sirolimus-eluting stent implantation for more than six months, were selected to participate in the study. All underwent invasive angiography and intravascular ultrasound following CT angiography using iodinated contrast medium at a dose of 1.

Syncopal high-degree AV block treated with catheter RF ablation without pacemaker implantation.

A 23-year-old-female patient had undergone a very successful gastric banding surgery to treat obesity. Six months later she began to present recurrent syncope due to very frequent, intermittent high-degree AV block referred to as pacemaker implantation. The electrophysiological study showed impaired AV nodal conduction but the His-Purkinje conduction was preserved.

Five-year outcomes after coronary stenting versus bypass surgery for the treatment of multivessel disease: the final analysis of the Arterial Revascularization Therapies Study (ARTS) randomized trial.

Objectives: The long-term (five-year) comparative results of treatment of multivessel coronary artery disease with stenting or coronary artery bypass grafting (CABG) is at present unknown.

Background: The Arterial Revascularization Therapies Study (ARTS) was designed to compare CABG and stenting in patients with multivessel disease.

Methods: A total of 1,205 patients with the potential for equivalent revascularization were randomly assigned to CABG (n = 605) or stent implantation (n = 600).

Five year clinical effect of coronary stenting and coronary artery bypass grafting in renal insufficient patients with multivessel coronary artery disease: insights from ARTS trial.

Aims: To compare coronary stent implantation and bypass surgery for multivessel coronary disease in patients with renal insufficiency.

Methods And Results: In the ARTS trial, 142 moderate renal insufficient patients (Ccr<60 mL/min) with multivessel coronary disease were randomly assigned to stent implantation (n=69) or CABG (n=73). At 5 years, there was no significant difference between the two groups in terms of mortality (14.

"Cardioneuroablation"--new treatment for neurocardiogenic syncope, functional AV block and sinus dysfunction using catheter RF-ablation.

Cardiac neuroablation is a new technique for management of patients with dominantly adverse parasympathetic autonomic influence. The technique is based on radiofrequency (RF) ablation of autonomic connections in the three main ganglia around the heart. Their connections are identified by Fast-Fourier Transforms (FFTs) of endocardial signals: sites of autonomic nervous connections show fractionated signals with FFTs shifted to the right.

A new treatment for atrial fibrillation based on spectral analysis to guide the catheter RF-ablation.

Background: By studying the spectrum of atrial potentials by fast Fourier transform (FFT) we have found two types of atrial muscle: the compact (CM) and the fibrillar (FM) myocardium. The former presents normal in-phase conduction inferring a great number of cellular connections, long-lasting refractoriness and leftward FFT-shift. The latter shows anisotropic out-of-phase conduction, fewer cellular connections, short refractoriness and a segmented right-FFT-shift.

Risk factors for acute myocardial infarction during the postoperative period of myocardial revascularization.

Objective: To identify risk factors for acute myocardial infarction during the postoperative period after myocardial revascularization.

Methods: This was a case-control study paired for sex, age, number, type of graft used, coronary endarterectomy, type of myocardial protection, and use of extracorporeal circulation. We assessed 178 patients (89 patients in each group) undergoing myocardial revascularization, and the following variables were considered: dyslipidemia, systemic hypertension, smoking, diabetes mellitus, previous myocardial revascularization surgery, previous coronary angioplasty, and acute myocardial infarction.