80 años las T fueron de 32,4 y 43,7/10.000 H respectivamente (P<0,0001). En las regiones I-II-III, las T no presentaron variaciones, pero en las regiones X-XII-XII las T aumentaron gradualmente en el periodo estudiado (2,3 y 3,5 /10.000 H los años 2002 y 2007, respectivamente). Conclusiones: Este trabajo muestra que en nuestro país, las H por FA muestran una tendencia creciente, con un incremento de 27% en el periodo estudiado, especialmente en > 65 años, y en las regiones del sur del país. Se requiere profundizar en las causas de este aumento.]]>
Efecto de la terapia de resincronización ventricular en los parámetros de disfunción endotelial y función sistólica izquierda en pacientes con insuficiencia cardíaca crónica y bloqueo completo de rama izquierda
Results of intraventricular resynchronization in patients with severe cardiac failure Background: Intraventricular resynchronization with pacemakers is a promising therapy for patients with refractory cardiac failure and intraventricular conductions delay. However its long term effects are not well known. Aim: To report the results of this therapy in patients with cardiac failure. Patients and methods: Fourteen patients (11 male), whose mean age was 68 years, with a severe and refractory cardiac failure, have been treated in our unit using intraventricular resynchronization with pacemakers. Eight had a coronary heart disease and six a dilated myocardiopathy. The pacemaker was implanted transvenously, with conventional stimulation in atrium and right ventricle. The left ventricle was stimulated through an epicardial vein, accessed through the coronary sinus. Results: In one patient the high thresholds did not allow a left ventricular stimulation. In the other 13 patients, a clinical improvement was observed in 11 (85%), that has been sustained for a mean of 8.2 months. The ejection fraction improved form 23.5 to 32.4% (p <0.001), the 6 min walking test improved from 347 to 437 m (p=0.003) and the functional capacity changes from 3.3 to 2.7 (p <0.001). Three patients died during follow up. One was the patient in whom the stimulation failed and two had a sudden death. No complications of the procedure were observed. Conclusions: In this series, intraventricular resynchronization with pacemakers was effective in 11 of 13 patients, improving functional capacity and ejection fraction. Sudden death could be avoided adding a defibrillator to the pacemaker system (
FPPI variability may differentiate SMVT from AT and ST. This criterion is potentially useful in implantable devices that use a single ventricular lead.
Objective: Previously, reports have shown that women experience a higher mortality rate than men after elective open (OAR) and endovascular (EVAR) repair of abdominal aortic aneurysm (AAA). With recent improvements in overall AAA repair outcomes, this study aimed to identify whether sex specific disparity has been ameliorated by modern practice, and to define sex specific differences in peri-and post-operative complications and pre-operative status; factors which may contribute to poor outcome.Methods: This was a systematic review, meta-analysis, and meta-regression of sex specific differences in 30 day mortality and complications conducted according to PRISMA guidance (Prospero registration CRD42020176398). Papers with $ 50 women, reporting sex specific outcomes, following intact primary AAA repair, from 2000 to 2020 worldwide were included; with separate analyses for EVAR and OAR. Data sources were Medline, Embase, and CENTRAL databases 2005 e 2020 searched using ProQuest Dialog.Results: Twenty-six studies (371 215 men, 65 465 women) were included. Meta-analysis and meta-regression indicated that sex specific odds ratios (ORs) for 30 day mortality were unchanged from 2000 to 2020. Mortality risk was higher in women for OAR and more so for EVAR (OR [95% CI] 1.49 [1.37 e 1.61]; 1.86 [1.59 e 2.17], respectively) and this remained following multivariable risk adjustment. Transfusion, pulmonary complications, and bowel ischaemia were more common in women after OAR and EVAR
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