Myocardial Infarction with ST Elevation and Reperfusion Therapy in Brazil: Data from the ACCEPT Registry.

Background: There is a lack of information from Brazil regarding therapies used and outcomes in patients with acute coronary syndrome with ST elevation (STEMI).

Objectives: To evaluate evidence-based therapies, occurrence of outcomes, reperfusion use, and predictors of not receiving reperfusion in patients with STEMI in a national multicenter registry.

Methods: Patients with STEMI from the ACCEPT registry, with up to 12 hours of symptoms, were followed for 1 year for the occurrence of major adverse cardiovascular events.

Twelve-lead ambulatory ECG recording using a seven-electrode recorder: An alternative method for electrophysiological evaluation.

Introduction: Conventional three-lead ambulatory electrocardiogram recording (3L-AECG) is used for the quantitative diagnosis of arrhythmias. However, the lack of crucial information, such as QRS morphology and orientation, renders the 3L-AECG incomplete for planning electrophysiological interventions. The 12-lead AECG (12L-AECG) merges the temporal resolution 3L-AECG with the spatial resolution of the standard electrocardiogram (S-ECG).

Amiodarone or Implantable Cardioverter-Defibrillator in Chagas Cardiomyopathy: The CHAGASICS Randomized Clinical Trial.

Importance: Over 10 000 people with Chagas disease experience sudden cardiac death (SCD) annually, mostly caused by ventricular fibrillation. Amiodarone hydrochloride and the implantable cardioverter-defibrillator (ICD) have been empirically used to prevent SCD in patients with chronic Chagas cardiomyopathy.

Objective: To test the hypothesis that ICD is more effective than amiodarone therapy for primary prevention of all-cause mortality in patients with chronic Chagas cardiomyopathy and moderate to high mortality risk, assessed by the Rassi score.

Refining ECG interpretation: From false assumptions to evidence-based precision.

Introduction: Electrocardiography (ECG) remains a fundamental tool in cardiovascular diagnostics, frequently relying on System 1 thinking-rapid, intuitive pattern recognition (PR). However, this approach can be insufficient when dealing with complex cases where diagnostic precision is essential. This article emphasizes the importance of integrating System 2 thinking-a more deliberate, evidence-based approach-into ECG interpretation to enhance diagnostic accuracy and avoid clinical errors.

EPM algorithm: A stepwise approach to accessory pathway localization in ventricular pre-excitation.

Background: Accurate estimation of accessory pathway (AP) localization in patients with ventricular pre-excitation or Wolff-Parkinson-White (WPW) syndrome remains a diagnostic challenge. Existing algorithms have contributed significantly to this area, but alternative algorithms can offer additional perspectives and approaches to AP localization.

Objective: This study introduces and evaluates the diagnostic accuracy of the EPM algorithm in AP localization, comparing it with established algorithms Arruda and EASY.

A Nationwide Initiative to Improve Cardiology Quality: The Best Practice in Cardiology Program in Brazil.

Background: A Nationwide Initiative to Improve Cardiology Quality: The Best Practice in Cardiology Program in Brazil ACEI/ARB: angiotensin-converting enzyme inhibitor/angiotensin receptor blocker; LVEF: left ventricular ejection fraction; LVSD: left ventricular systolic dysfunction; AF: atrial fibrillation; PT/INR: prothrombin time/international normalized ratio.

Background: Despite significant progress in improving the quality of cardiovascular care, persistent gaps remain in terms of inconsistent adherence to guideline recommendations.

Objective: This study evaluates the effects of implementing a quality improvement program adapted from the American Heart Association's Get with the Guidelines™ initiative on adherence to guideline-directed medical therapy for acute coronary syndrome (ACS), atrial fibrillation (AF), and heart failure (HF).

Neurological symptoms and comorbidity profile of hospitalized patients with COVID-19.

Background: The neurological manifestations in COVID-19 adversely impact acute illness and post-disease quality of life. Limited data exist regarding the association of neurological symptoms and comorbid individuals.

Objective: To assess neurological symptoms in hospitalized patients with acute COVID-19 and multicomorbidities.

Epicardial mapping complicated by multi-vessel coronary spasm and electrical storm.

The case report describes a severe multi-vessel coronary spasm complicating the epicardial mapping in a patient with chronic Chagas cardiomyopathy.

Pacemaker lead-related macroreentrant atrial tachycardia.

Macroreentrant atrial circuits are frequently associated with scarring. Previous reports have shown the possible development of scar tissue that is adjacent to pacemaker (PM) leads. However, reports of PM lead-related reentrant tachycardia are scarce.

Economy- and Social-Based Strategies for Anticoagulation of Patients with Atrial Fibrillation.

Background: Atrial fibrillation is a public health problem associated with a fivefold increased risk of stroke or death. Analyzing costs is important when introducing new therapies and must be reconsidered in special situations, such as the novel coronavirus pandemic of 2020.

Objective: This study aimed to evaluate the costs related to anticoagulant therapy in a one-year period, and the quality of life of atrial fibrillation patients treated in a public university hospital.

Long-term clinical outcomes of patients with nonsignificant transplanted renal artery stenosis.

Background: Transplant renal artery stenosis (TRAS) is the main vascular complication of kidney transplantation. For research and treatment purposes, several authors consider critical renal artery stenosis to be greater than 50%, and percutaneous intervention is indicated in this scenario. However, there are no reports in the current literature on the evolution of patients with less than 50% stenosis.

Epicardial and Endocardial Ablation Based on Channel Mapping in Patients With Ventricular Tachycardia and Chronic Chagasic Cardiomyopathy: Importance of Late Potential Mapping During Sinus Rhythm to Recognize the Critical Substrate.

Background Ventricular tachycardia (VT) in patients with chronic chagasic cardiomyopathy (CCC) is associated with considerable morbidity and mortality. Catheter ablation of VT in patients with CCC is very complex and challenging. The main goal of this work was to assess the efficacy of VT catheter ablation guided by late potentials (LPs) in patients with CCC.

Evaluation of 1-Year Follow-up of Patients Included in the Registry of Clinical Practice in Patients at High Cardiovascular Risk (REACT).

Background: In clinical practice, there is evidence of failure to prescribe evidence-based therapies for patients at high cardiovascular risk. However, in Brazil, data on 1-year outcomes of these patients remain insufficient.

Objectives: To describe the use of evidence-based therapies and the occurrence of major cardiovascular outcomes and their major predictors in a 12-month follow-up of a Brazilian multicenter registry of patients at high cardiovascular risk.

One year follow-up Assessment of Patients Included in the Brazilian Registry of Acute Coronary Syndromes (ACCEPT).

Background There is lack of prospective data on evolution within one year of acute coronary syndromes (ACS) in a representative population of Brazilian patients. Objectives To assess the prescription of evidence-based therapies, the incidence of severe outcomes and the predictors for these outcomes in a multicenter Brazilian registry of ACS patients. Methods The ACCEPT is a prospective observational study, which included patients hospitalized with a diagnostic of ACS in 47 Brazilian hospitals.

Implementation of a Best Practice in Cardiology (BPC) Program Adapted from Get With The Guidelines®in Brazilian Public Hospitals: Study Design and Rationale.

Background There are substantial opportunities to improve the quality of cardiovascular care in developing countries through the implementation of a quality program. Objective To evaluate the effect of a Best Practice in Cardiology (BPC) program on performance measures and patient outcomes related to heart failure, atrial fibrillation and acute coronary syndromes in a subset of Brazilian public hospitals. Methods The Boas Práticas em Cardiologia (BPC) program was adapted from the American Heart Association's (AHA) Get With The Guidelines (GWTG) Program for use in Brazil.

Ventricular arrhythmias in the Chagas disease are not random phenomena: Long-term monitoring in Chagas arrhythmias.

Background: Variability of ventricular arrhythmias among days in patients with Chagas disease is not detected by 24 hours of Holter monitoring.

Objective: To analyze whether ventricular arrhythmias are a random phenomenon or have a reproducible behavior in patients with Chagas cardiomyopathy.

Method: Holter monitoring was recorded in 16 subjects with a mean age of 52 ± 8 years.

Catheter entrapment in Chiari network: Extraction with radiofrequency.

We report a challenging case of a duodecapolar mapping catheter entrapment in Chiari network and its release by radiofrequency energy application with an ablation catheter.

Clinical value of myocardial performance index in patients with isolated diastolic dysfunction.

Aims: The Doppler-derived myocardial performance index (MPI) has been considered as a diagnostic and prognostic Doppler marker for many different clinical conditions. The purpose of this study was to determine the diagnostic accuracy of traditional Pulsed-wave Doppler (PWD-MPI) and Pulsed-wave tissue Doppler imaging (TDI-MPI) and the degree of agreement between these methods in patients with grade-I diastolic dysfunction (DDI) and a normal ejection fraction.

Methods: Forty-seven consecutive ambulatory patients with DDI were compared to 51 healthy subjects with normal echocardiograms.

Prevalence of atrial fibrillation and stroke risk assessment based on telemedicine screening tools in a primary healthcare setting.

Background: Worldwide atrial fibrillation (AF) prevalence varies between 0.1% and 4.0%, and has been increasing.

Radiofrequency ablation of a middle cardiac vein inserted accessory pathway resulting in posterolateral coronary artery occlusion: A case report.

Introduction: Posteroseptal accessory pathways account for 34.5% of the total. Of these, 36% are located within the coronary sinus (CS).