Showing papers by "Alonso Pedrote published in 2017"

Repeated procedures at the generator pocket are a determinant of implantable cardioverter-defibrillator infection.

Abstract: Background Rates of cardiac-device infections have increased in recent years, but the current incidence and risk factors for infection in patients with implantable cardioverter-defibrillators (ICDs) are not well known. Hypothesis The increasing number of ICD infections is related to accumulated pocket manipulations over time. Methods This single-center, prospective study included patients that underwent ICD implantation from 2008 to 2015. The endpoint was time to infection. Multivariate analysis was performed to identify independent risk factors related to infection. Results The study included a total of 570 patients, of whom 419 (73.5%) underwent a first implantation. Mean age was 59 ± 14 years, and 80% were male. During a median follow-up of 36 months (interquartile range, 18–61 months; 1887 patient-years), infection was identified in 26 patients (4.56%), an incidence of 14.9 × 1000 patient-years. Median time to infection was 9.7 months (interquartile range, 1.35–23.4 months), and 38.5% were late infections (beyond 12 months of follow-up). In patients with replacement implants, the incidence was 3-fold higher than in first implantations (27.7 vs 9.1 × 1000 patient-years; P = 0.002). Cox regression identified 2 independent predictors of ICD infection: cumulative number of interventions at the generator pocket (hazard ratio: 1.92, 95% confidence interval: 1.42-2.6, P < 0.001) and pocket hematoma (hazard ratio: 7.0, 95% confidence interval: 2.7-17.9, P < 0.0001). Conclusions The incidence of infection in ICD patients is greater than previously reported, largely due to late infections. Each new cumulative intervention at the same generator pocket nearly doubles the risk of infection.

Paroxysmal atrial fibrillation ablation: Achieving permanent pulmonary vein isolation by point-by-point radiofrequency lesions

Abstract: Pulmonary vein isolation by point-by-point radiofrequency catheter ablation constitutes the cornerstone of catheter ablation strategies for the treatment of atrial fibrillation. However, despite advances in pulmonary vein isolation ablation strategies, long-term success rates after ablation remain suboptimal, which highlights the need to develop techniques to achieve more durable lesions. Strategies proposed to improve the durability of pulmonary vein isolation can be divided into two groups: Those addressed to improving the quality of the lesion and those that optimize the detection of acute PV reconnection during the ablation procedure. This manuscript reviews the role and potential benefits of these techniques according to current clinical evidence.

Leadless Pacemaker Implantation in a Patient With a Severe Thoracic Deformity

Abstract: regurgitation due to papillary muscle rupture. Circulation. 2008;118:1528–1534. 3. Navarro-Cuartero J, Córdoba-Soriano JG, Jiménez-Mazuecos J, Gutiérrez-Dı́ez A, Gallardo-López A, Melehi D. Incidence and prognosis of mechanical complications of STEMI after primary angioplasty: data from a single-center registry of an infarction code program. Rev Esp Cardiol. 2016;69:874–876. 4. Figueras J, Alcalde O, Barrabés JA, et al. Changes in hospital mortality rates in 425 patients with acute ST-elevation myocardial infarction and cardiac rupture over a 30-year period. Circulation. 2008;118:2783–2789. 5. Bouma W, Wijdh-den Hamer IJ, Klinkenberg TJ, et al. Mitral valve repair for postmyocardial infarction papillary muscle rupture. Eur J Cardiothorac Surg. 2013;44:1063–1069.

Implante de un marcapasos sin cables en un paciente con deformidad torácica grave

Abstract: l valve surgery for post-myocardial infarction papillary muscle rupture. J Cardiothorac Surg. 2015;10:11. 2. Russo A, Suri RM, Grigioni F, et al. Clinical outcome after surgical correction of mitral regurgitation due to papillary muscle rupture. Circulation. 2008;118: 1528–1534. 3. Navarro-Cuartero J, Córdoba-Soriano JG, Jiménez-Mazuecos J, Gutiérrez-Dı́ez A, Gallardo-López A, Melehi D. Incidence and prognosis of mechanical complications of STEMI after primary angioplasty: data from a single-center registry of an infarction code program. Rev Esp Cardiol. 2016;69:874–876.