Entity

Time filter

Source Type


Brenta G.,Cesar Milstein Hospital | Thierer J.,Cardiovascular Institute of Buenos Aires ICBA | Sutton M.,Cardiovascular Institute of Buenos Aires ICBA | Acosta A.,Cardiovascular Institute of Buenos Aires ICBA | And 6 more authors.
European Journal of Endocrinology | Year: 2011

Background: Low plasma triiodothyronine (T3) levels are considered a prognostic predictor of death in heart failure (HF) patients. Aim: To study an association between plasma T3 levels and several cardiac, neurohormonal, and metabolic markers of HF. Methods: A total of 133 ambulatory HF patients (114 males; mean age 63.2 years) with left ventricular ejection fraction <40% were enrolled. TSH, total tetraiodothyronine (T4) and T3, N-terminal pro-brain natriuretic peptide (NT-proBNP), and other cardiac and metabolic parameters were measured. The lowest tertile of T3 (group 1) was compared against the two upper ones (group 2). Results: In simple logistic regression, the lowest T3 tertile was associated with more advanced HF disease status: older (age: odds ratio (OR)=1.05; confidence interval (CI) 95% 1.01-1.09, P=0.004), lower functional capacity (walking test: OR=0.996; CI 95% 0.993-0.999, P=0.008), higher NT-proBNP (OR=1.64; CI 95% 1.19-2.27, P=0.003) and adiponectin levels (OR=1.07; CI 95% 1.02-1.11, P=0.004), lower DHEAS log-transformed (OR=0.50; CI 95% 0.31-0.80, P=0.004), and the presence of lower phase angle values as measured by body bioelectrical impedance analysis (OR=3.18; CI 95% 1.50-6.71, P=0.04) and worse renal function (OR=0.96; CI 95% 0.94-0.98, P=0.003). T3 levels in the lowest tertile were independently associated with low phase angle values (OR=2.95, CI 95% 1.16-7.50, P=0.02) and the log transformation of DHEAS (OR=0.56; CI 95% 0.32-0.97, P=0.04). Conclusion: We have demonstrated an association between plasma T3 levels in the lower range and other deranged hormonal and metabolic parameters in HF patients. © 2011 European Society of Endocrinology. Source


Rivera S.,Cardiovascular Institute of Buenos Aires ICBA | De La Paz Ricapito M.,Cardiovascular Institute of Buenos Aires ICBA | Espinoza J.,Cardiovascular Institute of Buenos Aires ICBA | Belardi D.,Cardiovascular Institute of Buenos Aires ICBA | And 5 more authors.
JACC: Clinical Electrophysiology | Year: 2015

Objectives This case series reports outcomes and complications of catheter cryoablation at the papillary muscles (PM) of the left ventricle (LV). Background Catheter radiofrequency ablation is an effective treatment for ventricular arrhythmias (VAs) arising from the PM of the LV. The use of cryoablation at PMs has not been described. Methods Ten patients (70% men; median age: 38 years [range: 34 to 45 years]) with drug-refractory premature ventricular contractions or ventricular tachycardia underwent catheter cryoablation. VAs were localized using 3-dimensional (3D) mapping, multidetector computed tomography, and intracardiac echocardiography, with arrhythmia foci being mapped at either the anterolateral PM or posteromedial papillary muscle (PMPM) of the LV. Focal ablation, up to 240 s with freeze-thaw-freeze cycles was performed using an 8-mm cryoablation catheter via a transmitral approach. Results Termination of ventricular arrhythmia was observed in all 10 patients during ablation. Median follow-up was 6 months after ablation. The PMPM had higher prevalence of clinical arrhythmias (100% PMPM VAs vs. 10% anterolateral PM VAs). The PM base was the most frequent site of origin of the arrhythmias (60% of patients). Pace-mapping showed >11/12 match in all treated PM at the site of effective lesion. All VAs arising from the base of the PM showed Purkinje potentials. There were no post-procedure complications. VA recurred in 1 patient. Conclusions Cryoablation for arrhythmias arising from the PMs of the LV can be performed, and is a safe and effective alternative energy source for ablation. © 2015 American College of Cardiology Foundation. Source


Rivera S.,Cardiovascular Institute of Buenos Aires ICBA | De La Paz Ricapito M.,Cardiovascular Institute of Buenos Aires ICBA | Tomas L.,Cardiovascular Institute of Buenos Aires ICBA | Parodi J.,Cardiovascular Institute of Buenos Aires ICBA | And 10 more authors.
Circulation: Arrhythmia and Electrophysiology | Year: 2016

Background - Catheter radiofrequency ablation of ventricular arrhythmias (VAs) arising from the left ventricle's papillary muscles has been associated with inconsistent results. The use of cryoenergy versus radiofrequency has not been compared yet. This study compares outcomes and complications of catheter ablation of VA from the papillary muscles of the left ventricle with either cryoenergy or radiofrequency. Methods and Results - Twenty-one patients (40±12 years old; 47% males; median ejection fraction 59±7.3%) with drug refractory premature ventricular contractions or ventricular tachycardia underwent catheter cryoablation or radiofrequency ablation. VAs were localized using 3-dimensional mapping, multidetector computed tomography, and intracardiac echocardiography, with arrhythmia foci being mapped at either the anterolateral papillary muscle or posteromedial papillary muscles of the left ventricle. Focal ablation was performed using an 8-mm cryoablation catheter or a 4-mm open-irrigated radiofrequency catheter, via transmitral approach. Acute success rate was 100% for cryoenergy (n=12) and 78% for radiofrequency (n=9; P=0.08). Catheter stability was achieved in all patients (100%) treated with cryoenergy, and only in 2 (25%) patients treated with radiofrequency (P=0.001). Incidence of multiple VA morphologies was observed in 7 patients treated with radiofrequency (77.7%), whereas none was observed in those treated with cryoenergy (P=0.001). VA recurrence at 6 months follow-up was 0% for cryoablation and 44% for radiofrequency (P=0.03). Conclusions - Cryoablation was associated with higher success rates and lower recurrence rates than radiofrequency catheter ablation, better catheter stability, and lesser incidence of polymorphic arrhythmias. © 2016 American Heart Association, Inc. Source

Discover hidden collaborations