Hypertension and LAD are independent pre-procedural predictors of AF recurrence after CPVA to treat AF. These data may help in patient selection for AF ablation.

Accumulated lifetime physical activity, height, and left atrial size are risk factors for LAF in healthy middle-aged individuals.

Patients with idiopathic AF showed larger left atria when compared with controls, there being no differences between patients with a first episode or a recurrence. This suggests the presence of an enhanced substrate to develop idiopathic lone AF.

Background: There is close association between maltreatment during pregnancy and child abuse after birth. Aim: To compare anthropometric growth and use of health services of children whose mothers suffered maltreatment with children coming from families without domestic violence. Subjects and methods: A longitudinal study of two cohorts. An index groups formed by 76 children whose mothers experienced maltreatment and control group of 46 children coming from families without domestic violence. Data was obtained from patient files in private health centers. Results: Respiratory diseases were the most prevalent cause of consultation and hospital admission. Children in the index group had a 2.8 times higher risk of bronchopneumonia in the post natal period and a poor attendance to health care controls. In four children, cerebral contusion was registered as the cause of hospital admission. Conclusions: Domestic violence is associated with a higher risk of respiratory diseases and hospital admissions in children. New strategies are necessary to detecte and prevent child abuse and neglect (Rev Méd Chile 2003; 131: 1454-62). (

We investigated breathing patterns and the occurrence of arrhythmias and ST-segment changes during sleep in patients with Brugada Syndrome. Patients with Brugada Syndrome are more likely to die from ventricular arrhythmias during sleep. ST-segment changes have been correlated with risk of SCD. Whether sleep disturbances may contribute to arrhythmogenesis is unknown. Patients with Brugada Syndrome underwent an overnight polysomnography (PSG) with simultaneous 12-lead ECG recording. A control group matched by age, gender and BMI also underwent PSG. Twenty patients were included (50 ± 15 yo, 75% male). Despite their normal BMI (24.7 ± 2.7 kg/m2), 45% had sleep disordered breathing (SDB), with a mean AHI of 17.2 ± 14 events/hour. Amongst patients with a high risk of arrhythmias, 5 (63%) had SDB. In the control group, 27% had SDB. Atrial or ventricular arrhythmias were not observed. Spontaneous ST-segment changes occurred in 2 patients over 45 different time-points. The majority of the ST changes was observed either during REM sleep (31%) or within one minute of arousals (44%). Regarding the respiratory events, 25 (56%) ST changes were related to the occurrence of apnea or hypopnea. In conclusion, patients with Brugada Syndrome have a high prevalence of SDB even in the setting of normal BMI. The higher incidence of nocturnal death in patients with Brugada Syndrome may be conceivably related to comorbid SDB. Moreover, autonomic instability encountered in REM sleep and arousals could potentiate the risk of arrhythmias.

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Aims Brugada syndrome is characterized by typical ECG features, ventricular arrhythmias and sudden cardiac death (SCD), more frequent during nighttime. Autonomic cardiovascular control has been implicated in triggering the ventricular arrhythmias. Sleep-disordered breathing (SDB) elicits marked autonomic changes during sleep and it is associated with an increased risk of nighttime SCD. Brugada patients may have a higher likelihood of SDB compared to controls. However, no data are available on cardiac autonomic control in Brugada patients, particularly with regard to the comorbidity of SDB. Methods We evaluated autonomic cardiovascular control in Brugada patients with SDB (BRU-SDB, n=9), without SDB (BRU, n= 9), in controls (CON, n=8) and in non-Brugada patients with SDB (n=6), during wakefulness and sleep (N2, N3 and REM). Linear spectral and entropy-derived measures of heart rate variability (HRV) were performed during apnea-free stable breathing epochs. Results Total HRV was attenuated in BRU-SDB compared to CON and BRU. During N2 and REM, in BRU-SDB patients sympathetic modulation decreased compared to BRU and CON, while during REM, they showed an increased parasympathetic modulation, compared to the other two groups. BRU-SDB and SDB were similar in terms of spectral components. Entropy-derived indices showed preserved dynamic changes in Brugada patients compared to controls through the different sleep stages. Conclusion Brugada syndrome per se does not appear associated with an altered autonomic cardiovascular control during wakefulness and sleep. The comorbidity with SDB may contribute to disrupted autonomic cardiovascular regulation during sleep, possibly predisposing to the increased likelihood of sleep-related ventricular tachyarrhythmias and SCD.

PV stenosis is a potential complication of SSOA not seen in CPVA. The study confirms than MRA is useful for identifying patients with asymptomatic PV stenosis.