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2013027

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  • 1. IDENTIFICAÇÃOArtigo n ᄎ : 2013027Tipo de Artigo : Artigos OriginaisPortugu?TERAPIA DE RESSINCRONIZA?O CARD?CA COM ESTIMULA?O TRANSVENOSA VERSUS EPIC?DICA DOVENTR?ULO ESQUERDO -ESTUDO COMPARATIVO-Resumo:Introdu?o: A insufici?cia card?ca ?respons?el por uma grande taxa de morta/morbilidadecardiovasculares e elevados custos em sa?e. O seu tratamento recorrendo ?terapia de ressincroniza?ocard?ca tem benef?ios comprovados, sendo o grau de resposta condicionado pela condi?o cl?ica basal eposicionamento do electrocat?er ventricular esquerdo. A via de estimula?o epic?dica surge com oobjectivo de garantir o sucesso da terapia e reduzir a percentagem de insucesso. Objectivos: Avaliar seas vari?eis varia?o da frac?o de ejec?o do ventr?ulo esquerdo, classe funcional de NYHA, dura?o dointervalo QRS e par?etros de pacing s? id?ticos nas duas vias de estimula?o do ventr?ulo esquerdo.Metodologia: Seleccionaram-se 36 indiv?uos na consulta de pacemaker do Centro Hospitalar do AltoAve e divididiram-se: grupo transvenoso (n=25) e epic?dico (n=11) e caracterizaram-se em termos desexo, idade, etiologia, classe de insufici?cia card?ca e electrocardiograma. Com o teste de MannWhitney avaliou-se a varia?o da frac?o de ejec?o do ventr?ulo esquerdo, classe funcional de NYHA,dura?o do intervalo QRS e par?etros de pacing. Discuss?/conclus?s: O pacing biventricular foi respons?elpor melhorias cardiovasculares e cl?icas. N? se p?e concluir que as vari?eis: varia?o da frac?o de ejec?odo ventr?ulo esquerdo, classe funcional de NYHA, dura?o do intervalo QRS, amplitude da onda R,imped?cia do electrocat?er, limiar de estimula?o e dura?o do est?ulo ventricular esquerdo que n? eramid?ticas nas duas vias de estimula?o (com p=0.971, p=0.568, p=0.365, p=0.365, p =0.359, p=0.131 ep=0.441, respectivamente, α=0.05). Os resultados s? suportados por um estudo publicado pelaSociedade Europeia de Cardiologia.Palavras chave:Insufici?cia card?ca, terapia de ressincroniza?o card?ca,frac?o de ejec?o do ventr?ulo esquerdoIngl?CARDIAC RESYNCRONIZATION THERAPY WITH LEFT VENTRICULAR TRANSVENOUS VERSUS EPICARDIALSTIMULATION ROUTE -A COMPARATIVE STUDY-Abstract:Introduction: Heart メ s failure is responsible for a high rate of cardiovascular morbidity, mortality andsubstantial health costs. The treatment by cardiac resynchronization therapy has largely provenbenefits. The degree of the response is largely conditioned by the initial clinical status, and also theposition of left ventricular electrocatheter. The epicardial route tries to reduce the 20% of failure.Objectives: To evaluate and analyze if the variation of ejection fraction of left ventricle, NYHA class,duration of QRS interval and pacing parameters were identical in the two stimulation routes.Methodology: Thirty six patients were selected from the Centro Hospitalar do Alto Ave pacemakerfollow up and divided: transvenous group (n = 25) and epicardial group (n = 11). Both werecharacterized in terms of sex, age, class and aetiology of heart failure, rhythm and conduction systemdisturbances. Mann-Whitney test was used to evaluate the variation of the fraction left ventricularejection, NYHA class, duration of QRS interval and pacing parameters. Discussion/conclusions: It was