The evolving treatment landscape of multiple myeloma in Portugal: A nation-wide retrospective cohort study of real-world clinical practice.

Objectives: To characterize variations in real-world treatment patterns in multiple myeloma (MM) in Portugal over a 5-year period.

Methods: A retrospective cohort multicenter study using secondary data of national hospital drug consumption database from 11 Portuguese public hospitals between 2017 and 2022.

Results: Number of MM-treated patients increased 53% over 5 years (from 825 to 1266 patients).

Converting an HLA-B27 flow assay from the BD FACSCanto to the BD FACSLyric.

HLA-B27 is a major histocompatibility complex (MHC) class I antigen which exhibits strong association (90%) with ankylosing spondylitis. HLA-B27 detection in patients by flow cytometry is a widely used clinical test, performed on many different flow cytometer models. We sought to develop and validate a test conversion protocol for the HLA-B27 test performed on the BD FACSCanto to BD's newer FACSLyric flow cytometers.

Automation in flow cytometry: Guidelines and review of systems.

Automation in flow cytometry has recently advanced from the partial laboratory automation and robotics islets, to more fully integrated systems. This article reviews three manufacturers' newest sample preparation systems: the Beckman CellMek, the Sysmex PS-10, and the BD FACSDuet. These three instruments are capable of performing many of the manual steps in flow cytometry sample processing (pipetting, staining, lysing, washing, fixing).

Impact of the COVID-19 lockdown in urgent pacemaker implantations: A cross-sectional study.

Aims: The COVID-19 pandemic resulted in a decrease in patients' follow-up and interventions with cardiovascular disease. In Portugal, the consequences on emergent pacemaker implantation rates are largely unknown. We sought to analyze the impact of the COVID-19 pandemic on emergent pacemaker implantation rate and patient profile.

Digoxin in Patients With Advanced Heart Failure and Sinus Rhythm Submitted to Cardiac Resynchronization Therapy-Is There Any Benefit?

Digoxin (DG) use in patients with heart failure with reduced ejection fraction (HFrEF) and sinus rhythm remains controversial. We aimed to assess the prognostic effect of DG in patients in sinus rhythm submitted to cardiac resynchronization therapy (CRT). Retrospective study including 297 consecutive patients in sinus rhythm, with advanced HFrEF submitted to CRT.

Improvement in circulating endothelial progenitor cells pool after cardiac resynchronization therapy: increasing the list of benefits.

Background: Recent studies suggest that circulating endothelial progenitor cells (EPCs) may influence the response to cardiac resynchronization therapy (CRT). The aim of this study was to evaluate the effect of CRT on EPC levels and to assess the impact of EPCs on long-term clinical outcomes.

Population And Methods: Prospective study of 50 patients submitted to CRT.

Pacemaker implantation in familial amyloid polyneuropathy: when and for whom?

Background: Despite the important role of cardiac pacing in preventing syncope and sudden cardiac death in familial amyloid polyneuropathy (FAP), we lack clear guidelines as to the ideal timing and indications for permanent pacemaker implantation.

Purpose: The purpose of this study was to evaluate the ideal timing for pacemaker implantation in FAP patients submitted to liver transplantation.

Methods: Retrospective study of 258 FAP patients submitted to liver transplantation between 1992 and 2012.

Unsafe Drug Use and Arrhythmic Events in Brugada Patients with ICD: Results of a Long-Term Follow-Up.

Purpose: Brugada syndrome is a hereditary disease linked with an increased risk of sudden death that may require an implantable cardioverter-defibrillator (ICD) in order to halt the arrhythmic events. The aim of this study was to identify possible triggers for appropriate ICD therapies in patients with Brugada syndrome, focusing on their past and current therapeutic profiles.

Methods: Thirty patients with high-risk Brugada syndrome, with ICD implanted at the Coimbra Hospital and University Center, were enrolled.

Who still remains at risk of arrhythmic death at time of implantable cardioverter-defibrillator generator replacement?

Background: Implantable cardioverter-defibrillator (ICD) is associated with reduction in arrhythmic mortality. However, at the time of generator replacement (GR) some patients had not experienced therapies and had a different clinical profile. Therefore, the risk-benefit ratio of ICD may have changed.

Initial international multicenter human experience with a novel epicardial access needle embedded with a real-time pressure/frequency monitoring to facilitate epicardial access: Feasibility and safety.

Background: Epicardial ablation is often necessary for the treatment of complex arrhythmias refractory to endocardial ablation. Conventional needle access to the pericardial space is considered quite challenging, and it is often associated with several potential complications, particularly inadvertent right ventricular puncture. The novel EpiAccess needle tip is embedded with a pressure sensor able to report the pressure waveform in real time when used with the EpiAccess System.

Transvenous removal of cardiac implantable electronic device leads.

Introduction And Objective: The number and complexity of cardiac implantable electronic devices (CIEDs) have increased, as has the number of related complications, often leading to removal of the implanted system. The aim of this study was to characterize transvenous explantation/extraction of CIED leads in a reference center.

Methods: This was a descriptive observational study of patients consecutively admitted from January 2009 to May 2014 for transvenous lead extraction.

Circulating endothelial progenitor cells as a predictor of response to cardiac resynchronization therapy: the missing piece of the puzzle?

Background: It would be important to better identify heart failure (HF) patients most likely to respond to cardiac resynchronization therapy (CRT). Because endothelial progenitor cells (EPCs) play a crucial role in the maintenance of vascular endothelium integrity, we hypothesize that patients who have higher circulating EPCs levels have greater neovascularization potential and are more prone to be responders to CRT.

Methods: Prospective study of 30 consecutive patients, scheduled for CRT.

[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.

Which echocardiographic definition should be used to define response to cardiac resynchronization therapy?

Introduction: The definition of response to cardiac resynchronization therapy (CRT) remains controversial, with different criteria being used to define a positive response. The PROSPECT trial recently demonstrated that echocardiography is not sufficiently accurate to identify responders to CRT. However, it is possible that the definition used in this study was not the most appropriate.

Cardiac resynchronization therapy is effective even in elderly patients with comorbidities.

Purpose: The purpose of this study was to compare the effects of cardiac resynchronization therapy (CRT) in elderly patients (> or =65 years) with younger patients and to assess the impact of comorbidities in CRT remodeling response.

Methods: This is a prospective study of 87 consecutive patients scheduled for CRT who underwent clinical and echocardiographic evaluation before and 6 months after CRT. A reduction in left ventricular end-systolic volume (LVESV) > or =15% after CRT defined remodeling responders, and a reduction of at least one New York Heart Association class defined clinical responders.

Identification of 'super-responders' to cardiac resynchronization therapy: the importance of symptom duration and left ventricular geometry.

Aims: Some patients show such an important clinical improvement and reverse remodelling after cardiac resynchronization therapy (CRT) that anatomy and function approach normal. These patients have been called 'super-responders'. The aim of our study was to identify predictors of becoming a super-responder after CRT.

Previous therapy with amiodarone increases the recurrence rate in successfully ablated patients with isthmus-dependent atrial flutter.

Ablation of isthmus-dependent atrial flutter in patients previously medicated with antiarrhythmic drugs may cause functional isthmus block during ablation, and subsequent discontinuation of therapy may lead to incomplete isthmus block (and recurrence). This may be particularly important if the drugs previously used have long plasma half-lives (and washout periods). The objective of this study was to evaluate whether the recurrence rate of isthmus-dependent atrial flutter was greater in patients previously medicated with antiarrhythmic drugs and whether there were differences in recurrence rate with different types of antiarrhythmic drugs.