Portuguese National Registry on Cardiac Electrophysiology, 2017 and 2018.

Introduction: The authors present the results of the national cardiac electrophysiology registry of the Portuguese Association of Arrhythmology, Pacing and Electrophysiology (APAPE) and the Portuguese Institute of Cardiac Rhythm (IPRC) for 2017 and 2018.

Methods: The registry is annual, voluntary, and observational. Data are collected retrospectively.

Portuguese National Registry of Cardiac Electrophysiology (2015/2016).

Introduction: Knowledge of the activity performed in a country enables it to be positioned within the community of which it is part.

Objective: We present the results of the National Registry of Cardiac Electrophysiology of the Portuguese Association for Arrhythmology, Pacing and Electrophysiology (APAPE) for 2015 and 2016.

Methods: This is a voluntary, observational, annual registry collected retrospectively.

Real-life data on heart failure before and after implantation of resynchronization and/or defibrillation devices - the Síncrone study.

Introduction: The aim of this study was to document clinical practice in Portugal regarding the use of electronic cardiac devices in patients with heart failure (HF) and reduced left ventricular ejection fraction (LVEF).

Methods: The Síncrone study was an observational prospective multicenter registry conducted in 16 centers in Portugal between 2006 and 2014. It included adult patients with a diagnosis of HF, LVEF <35% and indication for implantable cardioverter-defibrillator (ICD) and/or cardiac resynchronization therapy (CRT) devices, according to the recommendations of the European Society of Cardiology at the beginning of the study.

Portuguese National Registry on Cardiac Electrophysiology, 2013 and 2014.

The authors present the results of the national registry of electrophysiology of the Portuguese Association for Arrhythmology, Pacing and Electrophysiology (APAPE) for 2013 and 2014. The registry is annual and voluntary, and data are collected retrospectively. Data for electrophysiological studies, ablations and cardioverter-defibrillator implantations for 2013 and 2014 are presented.

National registry on cardiac electrophysiology (2012).

Based on a survey sent to Portuguese centers that perform diagnostic and interventional electrophysiology and/or implantable cardioverter-defibrillator (ICD) implantations, the authors analyze the number and type of procedures performed during 2012 and compare these data with previous years. In 2012, a total of 2561 diagnostic electrophysiologic studies were performed, which were followed by ablation in 2017 cases, representing a steady situation compared with the previous year. There was a 12% increase in the number of ablation procedures for atrial fibrillation, making it for the first time the most frequent indication for ablation, overtaking atrioventricular nodal reentrant tachycardia.

[National registry on cardiac electrophysiology (2010 and 2011)].

Based on a survey sent to Portuguese centers that perform diagnostic and interventional electrophysiology and/or implant cardioverter-defibrillators (ICDs), the authors analyze the number and type of procedures performed during 2010 and 2011 and compare these data with previous years. In 2011, a total of 2533 diagnostic electrophysiologic procedures were performed, which were followed by ablation in 2013 cases, a steady increase over previous years. The largest share of this increase compared to 2010 was in atrial fibrillation, which is now the second most frequent indication for ablation, after atrioventricular nodal reentrant tachycardia.

National Registry on Cardiac Electrophysiology 2009.

The authors analyze the number and type of electrophysiologic procedures (diagnostic and ablation, and implantation of defibrillators and biventricular pacemakers with defibrillator backup) that were performed during 2009 in all Portuguese electrophysiology centers. A total of 2669 diagnostic electrophysiologic procedures were performed during the year, of which 62% were followed by ablation, amounting to 1668 ablations. The authors describe the type of ablations performed by the various centers, and analyze the distribution and type of ablation procedures in the light of recent data from published international studies.

[Epidemiology of atrial fibrillation].

Atrial fibrillation (AF) is the most frequent maintained arrhythmia and constitutes a major morbidity cause, especially because of its associated risk of ischemic stoke. Additionally, it represents an independent risk factor for global mortality. The incidence of AF varies, according to different studies, between a minimum of 0.

Prevalence of atrial fibrillation in the Portuguese population aged 40 and over: the FAMA study.

Introduction: Atrial fibrillation (AF) is the most frequently encountered arrhythmia in clinical practice, and is an important cause of morbidity and an independent risk factor for overall mortality and sudden death. This study aims to assess the prevalence of AF in individuals aged 40 and over in order to characterize the situation in Portugal and improve the detection and management of this arrhythmia.

Methods: This was a cross-sectional study of a representative sample of the Portuguese population including subjects of both genders aged 40 and over, resident in Portugal.

National Registry on Cardiac Electrophysiology 2007 and 2008.

Clinical electrophysiology remains one of the most dynamic areas of cardiology, with continuing developments in equipping centers with more modern mapping and navigation systems. This has enabled an increase in the number and variety of interventions, resulting in significant improvements in results of therapeutic ablation of arrhythmias and prevention of sudden cardiac death. In this phase of transition towards implementation of a computerized national registry with nationwide data transmitted via the internet, publication of the registry in its previous form, although requiring more work, still seems justified, in order to appraise and disseminate qualitative and quantitative developments in this activity and enable comparisons with what is being done internationally, assess the centers' training capacity and inform national and European health authorities of the activities and real needs in this sector.

Atrial fibrillation ablation: importance of cavotricuspid isthmus block.

Introduction And Objective: Maintenance of atrial fibrillation (AF) depends on the presence of multiple reentrant circuits in the atria. In AF ablation, after pulmonary vein (PV) isolation, substrate modification can be increased by performing linear lesions in the left atrium that reduce the fibrillatory surface. A cavotricuspid isthmus (CTI) block may be an easier and safer alternative to left atrial lines for this purpose.

Five years of catheter ablation procedures in South-Western Europe: meta-analysis of National Registries.

Background: Radiofrequency catheter ablation is a well-established approach to treating several types of cardiac arrhythmias. The aim of our study was to provide data on the diffusion of catheter ablation procedures in clinical practice through a meta-analysis of National Registries of electrophysiological procedures performed over a 5-year period, from 2000 to 2005.

Methods: We found only two national registries of catheter ablation procedures published in the journals indexed in PubMed: The Spanish Catheter Ablation Registry and the Portuguese National Registry on Cardiac Electrophysiology.

National Registry on Cardiac Electrophysiology--2006.

Clinical electrophysiology is one of the areas of cardiology that has seen most growth in Portugal, particularly in interventional cardiology, which includes ablation of arrhythmias and prevention of sudden cardiac death. The annual publication of a national registry enables us to assess qualitative and quantitative progress, compare our results with international data, assess the centers' training capabilities and inform health authorities of the activities and needs of the sector. The authors analyze the number and type of procedures performed during 2006 based on a survey sent to 19 national centers (15 public and 4 private) that performed diagnostic and interventional electrophysiology (15 centers) and/or implanted cardioverter-defibrillators (ICDs) (19 centers) in that year.

Ventricular tachycardia ablation in patients with coronary heart disease: beyond the reentry circuit.

Introduction: Patients with coronary heart disease and left ventricular dysfunction are at increased risk for the development of ventricular tachycardia (VT) related to areas of myocardial fibrosis. Although the mechanism and the circuit of this arrhythmia are well understood, little is known about the triggers that precipitate VT episodes. Purkinje fiber potentials may be responsible for idiopathic VT, and recent studies have related them to polymorphic VT and ventricular fibrillation.

Atrial flutter ablation: correlation between isthmic activation times and flutter cycle.

Background: Ablation of typical atrial flutter relies on the suppression of electrical conduction along the cavo-tricuspid isthmus. Bidirectional isthmus block is a criterion of successful ablation and is associated with the presence of different activation times on each side of the ablation line.

Objective: The aim of this study was to determine whether the difference in isthmic activation times correlates with the length of the atrial flutter cycle.

Atrial tachycardia ablation in a patient with double outlet right ventricle corrected by surgery.

The development of surgical and percutaneous techniques for treatment or palliation of congenital heart disease has prolonged survival in these patients and has increased late complications, particularly arrhythmias. Such arrhythmias are more frequently refractory to medical therapy, requiring percutaneous ablation. We present the clinical case of a 14-year-old child with complex congenital heart disease (double outlet right ventricle) who underwent two corrective surgeries (Rastelli operation and subsequent replacement of the homograft in the conduit connecting the right ventricle to the pulmonary artery; ventricular septal defect closure and tricuspid valve repair).