https://jca.emnuvens.com.br/jca/issue/feed 2025-03-24T09:32:06-03:00 Juan Carlos Zerpa Acosta jczerpaacosta@gmail.com Open Journal Systems <p>Journal of Cardiac Arrhythmias (JCA) is an official publication of the Associação Brasileira de Arritmia, Eletrofisiologia e Estimulação Cardíaca Artificial/Departamento de Estimulação Cardíaca Artificial da Sociedade Brasileira de Cirurgia Cardiovascular and Sociedade Brasileira</p> https://jca.emnuvens.com.br/jca/article/view/3561 2025-03-24T09:32:06-03:00 Gala Caixal caixalgala@gmail.com Victor Garcia-Hernando garcia@tauli.cat Jordi Punti punti@tauli.cat Maria Soledad Ascoeta-Ortiz soledad@tauli.cat Gabriel Gusi gusi@tauli.cat Antonio Martinez-Rubio martinez@tauli.cat

<p>An 81-year-old woman was referred to Parc Taulí Hospital Universitari with complete atrioventricular block and a dual-chamber pacemaker was implanted. She subsequently presented an episode of ventricular tachycardia that degenerated into ventricular fibrillation requiring cardiopulmonary resuscitation. After review of the device, as well as the electrocardiogram and chest X-ray, displacement of the atrial lead into the right ventricle was confirmed. Contrary to expectations, the ventricular event was not secondary to endocardial irritation by the displaced lead, so the hypothesis of a possible depolarization-repolarization heterogeneity as a cause of the increased arrhythmogenicity was raised.</p>

2025-03-24T00:00:00-03:00 Copyright (c) 2025 Gala Caixal, Victor Garcia-Hernando, Jordi Punti, Maria Soledad Ascoeta-Ortiz, Gabriel Gusi, Antonio Martinez-Rubio https://jca.emnuvens.com.br/jca/article/view/3562 2025-01-08T06:19:21-03:00 João Lins de Araújo Neto joaolinsneto@yahoo.com.br Eduardo Arrais Rocha eduardoa@cardiol.br

<p><strong>Introduction:</strong> Postoperative atrial fibrillation is the most common sustained arrhythmia after cardiac surgeries that occurs in approximately 30-50% of patients postoperatively. Because of the substantial evidence recommending prophylactic treatment and the lack of clear indications for commencing treatment, this study aimed to develop a new predictive score for atrial fibrillation after cardiac surgery that represents well the pathophysiology of the disease. <strong>Methods:</strong> This is a retrospective cohort study, involving two public teaching hospitals. The study included 989 adult patients who underwent cardiac surgery, except for heart transplantation or the implantation of a ventricular assist device. Patients with previous atrial fibrillation or those requiring amiodarone were excluded. The variables (age ≥60 years, echocardiographic LA enlargement, inotrope use within 24 hours of surgery, and the need for reoperation) were subjected to univariate analysis of the occurrence of postoperative atrial fibrillation and multivariate analysis using logistic regression. This was then used for developing a risk score. <strong>Results:</strong> Statistically significant variables in the multivariate analysis were age ≥60 years (<em>P</em>&lt;.001), left atrial enlargement based on echocardiography (<em>P</em>=.025), inotrope use within 24 hours after surgery (<em>P</em>=.002), and the need for reoperation within 24 hours after surgery (<em>P</em>=.016). The score comprises these four variables and has an accuracy of 77% for predicting outcomes. Scores ≥3 were related to a 34% risk of postoperative atrial fibrillation. <strong>Conclusions:</strong> The proposed score represents the disease pathophysiology well and has good accuracy for predicting the main outcome.</p>

2025-01-08T00:00:00-03:00 Copyright (c) 2025 João Lins de Araújo Neto, Eduardo Arrais Rocha