Publicaciones miembros SOMEEC

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Flecainide-induced incessant orthodromic atrioventricular reentrant tachycardia in Wolff-Parkinson-White syndrome

During orthodromic atrioventricular reentrant tachycardia (AVRT), ventricles are activated anterogradely through the atrioventricular node and retrogradely through an accessory
pathway (AP). Antiarrhythmic drugs are initially used to prevent recurrences of AVRT, whereas catheter ablation is frequently performed as a definitive treatment.
Occasion-ally, catheter ablation can be “proarrhythmic” if the AP is partially damaged but not completely eliminated.

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Paroxysmal tachycardias: How to address the clinical presentation of a patient with palpitations/tachycardia – Third in series

An article from the e-journal of the ESC Council for Cardiology Practice, Vol13 No24

Dr. Enrique Asensio-Lafuente

26 May 2015
As for any other cardiovascular symptom, palpitations must be carefully analysed when examining a patient. History taking will seek to uncover onset, termination, duration, contextual period(s), triggers, and whether palpitations are associated with signs and symptoms of a low cardiac output. Review here how to address the potential findings of the ten questions to include in anamnesis. Physical examination will follow. Important aspects regarding the timing of examination, arterial and jugular pulse, heart sounds and systolic blood pressure will also be reviewed for the reader.

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Registro Mexicano de Fibrilación Auricular (ReMeFa)

Fuente: Gaceta Médica de México.2014;150 Suppl 1:48-599

Susano Lara-Vaca(1*), Alejandro Cordero-Cabra(2), Enrique Martínez-Flores(3) y Pedro Iturralde-Torres(4) para el grupo de estudio ReMeFa

Introducción: El ReMeFa es el primer registro nacional multicéntrico con seguimiento clínico de un año sobre el tratamiento de la fibrilación auricular (FA) en pacientes recientemente diagnosticados.

Objetivo: Describir la demografía y modalidades de tratamiento para la estrategia de control del ritmo (CR) o control de la frecuencia cardíaca (CF) en pacientes diagnosticados con FA atendidos por cardiólogos. Además, evaluar de forma prospectiva el estado de la FA según la estrategia elegida; ritmo sinusal para el CR y frecuencia ventricular media (FVM) en reposo de ≤ 80 latidos por minuto (lpm) en el CF, y la incidencia de desenlaces clínicos a 12 meses.

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Adverse Effects of Long-Term Right Ventricular Apical Pacing and Identification of Patients at Risk of Atrial Fibrillation and Heart Failure

2012 Mar 27. doi: 10.1111/j.1540-8159.2012.03371.x.
Publicado en: Pacing and clinical electrophysiology : PACE

Con la participación del Dr. Manlio F. Márquez, del Departamento de Electrofisiología, Instituto Nacional de Cardiología Ignacio Chávez.

In patients needing a pacemaker (PM) for bradycardia indications, the amount of right ventricular (RV) apical pacing has been correlated with atrial fibrillation (AFib) and heart failure (HF) in both DDD and VVI mode. RV pacing was linked with left ventricular (LV) dyssynchrony in almost 50% of patients with PM implantation and atrioventricular (AV) node ablation for AFib. In patients with normal systolic function needing a PM, apical RV pacing resulted in LV ejection fraction (LVEF) reduction. These negative effects were prevented by cardiac resynchronization therapy (CRT). Algorithms favoring physiological AV conduction are possible useful tools able to maintain both atrial and ventricular support and limit RV pacing. However, when chronic RV pacing cannot be avoided, it appears necessary to reconsider the cut-off value of basic LVEF for CRT. In HF patients, RV pacing can induce greater LV dyssynchrony, enhanced by underlying conduction diseases. In this context, a more deleterious effect of RV pacing in implantable cardioverter-defibrillator (ICD) patients with low LVEF can be expected. In some major ICD trials, DDD mode was correlated with increased mortality/HF.

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Catheter Ablation of Accessory Pathway in the Treatment of Pacemaker-Mediated Tachycardia.

2011 Sep 28. doi: 10.1111/j.1540-8159.2011.03217.x.
PMID: 21954936

Con la participación de los doctores: Robledo-Nolasco R, Ortiz-Avalos M, Rodriguez-Diez G, Castro-Villacorta H.

Source: Electrophysiology Division, National Medical Center 20 de Noviembre, ISSSTE, Mexico D.F.


Pacemaker-mediated tachycardia (PMT) remains a clinical problem in patients with dual-chamber pacemaker despite technological advances. The onset mechanism of this tachycardia is sensing of retrograde atrial activation after ventricular stimulation. Repeated retrograde conduction perpetuates tachycardia. Postventricular atrial refractory period prolongation has been used for prevention of PMT, but this is not the solution in all cases. We present a case with PMT where the retrograde limb is a left accessory pathway, which is treated with radiofrequency ablation successfully. (PACE 2011; 1-3).

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Mutual information analysis reveals bigeminy patterns in Andersen–Tawil syndrome and in subjects with a history of sudden cardiac death

Physica A 391 (2012) 693–707

Con la participación del Dr. Manlio F. Márquez, del Departamento de Electrofisiología, Instituto Nacional de Cardiología Ignacio Chávez.


Herein we introduce the Mutual Information Function (MIF) as a mathematical method to analyze ventricular bigeminy in certain pathological conditions of the heart known to be associated with frequent ventricular arrhythmias. In particular, we show that the MIF is sensitive enough to detect the bigeminy pattern in symbolic series from patients with Andersen–Tawil syndrome as well as in a group of patients from the Sudden Cardiac Death Holter Databases. The results confirm that MIF is an adequate method to detect the autocorrelation between the appearance of sinus and ventricular premature beats resulting in a bigeminy pattern.

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