ALBERTO PEREIRA FERRAZ
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
5 resultados
Resultados de Busca
Agora exibindo 1 - 5 de 5
- Bipolar radiofrequency ablation of septal ventricular tachycardia in a patient with dilated cardiomyopathy using two 8-mm tip catheters-case report(2022) FERRAZ, Alberto Pereira; ANDERE, Tamer El; GONCALVES, Andre Luis Martins; CHOKR, Muhieddine Omar; MELO, Sissy Lara; HARDY, Carina; PISANI, Cristiano Faria; SCANAVACCA, Mauricio IbrahimSeptal ventricular tachycardiac exhibit high recurrence rates after radiofrequency ablation, which is mainly attributed to the deep intramyocardial circuits and the inability to create transmural lesions with the conventional unipolar ablation. Bipolar radiofrequency ablation is feasible and it has been reported as a valid technique in these cases, leading to deeper lesion formation, high non-inducibility rates, and acceptable recurrence rates during follow-up. Our goal is to report a successful case of bipolar ablation of a septal ventricular tachycardia using a simple bipolar ablation configuration with two 8-mm tip catheters.
- Myocardial Injury Progression after Radiofrequency Ablation in School-Age Children(2024) MELO, Sissy Lara de; FERRAZ, Alberto Pereira; LEMOUCHE, Stephanie Ondracek; DEVIDO, Marcela Santana; SOUSA, Gabriela Liberato de; ROCHITTE, Carlos E.; PISANI, Cristiano Faria; HACHUL, Denise Tessariol; SCANAVACCA, MauricioBackground: The past decades have seen the rapid development of the invasive treatment of arrhythmias by catheter ablation procedures. Despite its safety and efficacy being well-established in adults, to date there has been little data in pediatric scenarios. One of the main concerns is the possible expansion of the ablation procedure scar in this population and its consequences over the years. Objectives: This study aimed to analyze the risk of myocardial injury progression after radiofrequency catheter ablation in pediatric patients. Methods: This is a retrospective study of 20 pediatric patients with previous ablation for treatment of supraventricular arrhythmia that underwent cardiac magnetic resonance and coronary angiography for evaluation of myocardial fibrosis and the integrity of the coronary arteries during follow-up. Results: The median age at ablation procedure was 15.1 years (Q1 12.9, Q3 16.6) and 21 years (Q1 20, Q3 23) when the cardiac magnetic resonance was performed. Fourteen of them were women. Nodal reentry tachycardia and WolfParkinson-White Syndrome were the main diagnosis (19 patients), with one patient with atrial tachycardia. Three patients had ventricular myocardial fibrosis, but with a volume < 0.6 cm(3) . None of them developed ventricular dysfunction and no patient had coronary lesions on angiography. Conclusion: Radiofrequency catheter ablation did not show to increase the risk of myocardial injury progression or coronary artery lesions.
bookPart Síncope(2022) FERRAZ, Alberto Pereira; HACHUL, Denise TessariolconferenceObject Catheter ablation for ventricular tachycardia in Chagas disease(2020) KULCHETSCKI, R.; FERRAZ, A. P.; GOUVEA, F. C.; ALEXANDRE, F. K. B.; MAYRINK, M. P.; GONCALVES, A. L. M.; DIAS, V. H.; BALBO, C. P.; PAUCAR, A. D. R.; HARDY, C. A.; MELO, S. L.; CHOKR, M. O.; PISANI, C. F.; I, M. Scanavacca- Applicability of the PAINESD risk score for 30-day mortality prediction post ventricular tachycardia catheter ablation in Chagas disease(2021) KULCHETSCKI, R. M.; PISANI, C. F.; ALEXANDRE, F. K. B.; MAYRINK, M. P.; FERRAZ, A. P.; GOUVEA, F. C.; GONCALVES, A. L. M.; HARDY, C. A.; MELO, S. L.; CHOKR, M. O.; SCANAVACCA, M. I.Purpose The PAINESD risk score was developed in 2015 as a tool to stratify the risk of acute hemodynamic decompensation during ventricular tachycardia (VT) ablation in structural heart disease patients and further then used for post procedure 30-day mortality prediction. The original cohort however did not include Chagas disease (ChD) patients. We aim to evaluate the relevance of the score in a ChD population. Methods The PAINESD risk score gives weighted values for specific characteristics (chronic obstructive pulmonary disease, age > 60 years, ischemic cardiomyopathy, New York Heart Association [NYHA] functional class 3 or 4, ejection fraction less than 25%, VT storm, and diabetes). The score was applied in a retrospective cohort of ChD VT ablations in a single tertiary center in Brazil. Data were collected by VT study reports and patient record analysis at baseline and on follow-up. Results Between January 2013 and December 2018, 157 VT catheter ablation procedures in 121 ChD patients were analyzed. Overall, 30-day mortality was 9.0%. Multivariate analysis correlated NYHA functional class (HR 1.78, 95% CI 1.03-3.08, P 0.038) and the need for urgent surgery (HR 31.5, 95% CI 5.38-184.98, P < 0.001), as well as a tendency for VT storm at presentation (HR 2.72, 95% CI 0.87-8.50, P 0.084) as risk factors for the primary endpoint. The median PAINESD risk score in this population was 3 (3-8). The area under the receiver operating characteristic (ROC) curve was 0.64 (95% CI 0.479-0.814). Conclusions The PAINESD risk score did not perform well in predicting 30-day mortality in ChD patients. Pre-procedure NYHA functional class and the need for urgent surgery due to refractory pericardial bleeding were independently associated with increased 30-day mortality. Prospective studies are needed to take final conclusions in Chagas disease when using PAINESD score.