Angelo A V de Paola

Universidade Federal de São Paulo, San Paulo, São Paulo, Brazil

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Publications (126)328.83 Total impact

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    ABSTRACT: The sleep of patients admitted to coronary care unit (CCU) may be compromised. A feasible and cost-effective tool to evaluate sleep in this scenario could provide important data. The aim of this study was to evaluate sleep with a questionnaire developed specifically for the CCU and to validate it with polysomnography (PSG). Ninety-nine patients (68% male; 56 ± 10 years old) with acute coronary syndrome were included. PSG was performed within 36 h of admission. A specific 18-question questionnaire (CCU questionnaire) was developed and applied after the PSG. Cronbach's alpha test was used to validate the questionnaire. The Spearman test was used to analyze the correlation between the PSG variables and the questionnaire, and the Kruskal-Wallis test was used to compare the PSG variables among patients with good, regular, or poor sleep. The total sleep time was 265 ± 81 min, sleep efficiency 62 ± 18%, REM sleep 10 ± 7%, apnea/hypopnea index 15 ± 23, and the arousal index 24 ± 15. Cronbach's alpha test was 0.69. The CCU questionnaire showed correlation with the sleep efficiency evaluated by PSG (r: 0.52; p < 0.001). Sleep quality was divided into three categories according to the CCU questionnaire: patients with good sleep had a sleep efficiency of 72 ± 9%, better than those with a regular or poor sleep (60 ± 16% and 53 ± 20%, respectively; p < 0.01). The CCU questionnaire is a feasible and reliable tool to evaluate sleep in the CCU, showing correlation with the PSG sleep efficiency. Copyright © 2015 Elsevier B.V. All rights reserved.
    Sleep Medicine 04/2015; DOI:10.1016/j.sleep.2015.03.014 · 3.10 Impact Factor
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    ABSTRACT: BACKGROUND: EnSiteNavx electroanatomic mapping system is widely used in radiofrequency (RF) atrial fibrillation ablation, helping the creation of linear lesions. However, the correspondence of the virtual line created by EnSite with the pathological lesion has not yet been evaluated. OBJECTIVE: to assess the continuousness of Ensite-guided virtual lines in a swine model. METHODS: we performed RF ablation linear lesions (8mm and irrigated catheters tips) in both atria of 14 pigs (35Kg) guided by the EnSite. The animals were sacrificed 14 days post-ablation for macroscopic and histological analysis. RESULTS: a total of 23 lines in the right atrium and 21 lines in the left atrium were created in 14 animals. The medium power, impedance and temperature applications were 56 W, 54 ºC and 231 Ω for the 8mm tip, and 39W, 37ºC, 194 Ω for the irrigated tip catheter, respectively. All (100%) lines were identified on the epicardial and endocardial surfaces, denoting transmurality. At macroscopic examination, lesions were extensive and pale, continuous, with 3.61 cm long and 0.71 cm deep. The transmurality of the lesions was confirmed by microscopy. There was a correlation in the location of the lines at the virtual map and the anatomical lesions in 21 of 23 (91.3%) of the right atrium and 19/21 (90.4%) of the left atrium. CONCLUSION: In this model, the lines created in the virtual map by EnSiteNavX system correspond to continuous transmural linear lesions in anatomical specimen, suggesting that this method is suitable for linear ablation of atrial fibrillation.
    Arquivos brasileiros de cardiologia 06/2013; 101(2). DOI:10.5935/abc.20130127 · 1.12 Impact Factor
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    ABSTRACT: PURPOSE: Obstructive sleep apnea (OSA) is a risk factor for cardiovascular disease. Strong associations have been reported among sleep duration, hypertension, obesity, and cardiovascular mortality. The authors hypothesize that sleep duration may play a role in OSA severity. The aim of this study is to analyze sleep duration in OSA patients. METHODS: Patients who underwent overnight polysomnography were consecutively selected from the Sleep Clinic of Universidade Federal de São Paulo database between March 2009 and December 2010. All subjects were asked to come to the Sleep Clinic at 8:00 a.m. for a clinical evaluation and actigraphy. Anthropometric parameters such as weight, height, hip circumference, abdominal circumference, and neck circumference were also measured. RESULTS: One hundred thirty-three patients were divided into four groups based on total sleep time, sleep efficiency, sleep latency, and wake after sleep onset: very short sleepers (n = 11), short sleepers (n = 21), intermediate sleepers (n = 56), and sufficient sleepers (n = 45). Apnea-hypopnea index (AHI) was higher in very short sleepers (50.18 ± 30.86 events/h) compared with intermediate sleepers (20.36 ± 14.68 events/h; p = 0.007) and sufficient sleepers (23.21 ± 20.45 events/h; p = 0.02). Minimal and mean arterial oxygen saturation and time spent below 90 % oxygen saturation exhibited worse values in very short sleepers. After adjustment for gender, age, AHI, and body mass index, mean oxygen saturation was significantly associated to total sleep time (p = 0.01). CONCLUSIONS: In conclusion, the present study suggests that sleep duration may be associated to low mean oxygen saturation in OSA patients.
    Sleep And Breathing 10/2012; 17(2). DOI:10.1007/s11325-012-0774-3 · 2.87 Impact Factor
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    ABSTRACT: Invasive and non-invasive tests have been used to identify the risk of ventricular tachycardia (VT) in patients with chronic Chagas' heart disease (CCHD). Cardiac magnetic resonance imaging (CMRI) using the delayed enhancement (DE) technique can be useful to select patients with global or segmentary ventricular dysfunction, with high degree of fibrosis and at higher risk for clinical VT. To improve the identification of predictors of VT in patients with CCHD. This study assessed 41 patients with CCHD [30 (72%) males; mean age, 55.1 ± 11.9 years]. Twenty-six patients had history of VT (VT group), and 15 had no VT (NVT group). All patients enrolled had DE and segmentary ventricular dysfunction. In each case, the following variables were determined: left ventricular volume; percentage of ventricular wall thickness impairment in each segment; and DE distribution. No statistical difference regarding the DE volume between both groups was observed: VT group = 30.0 ± 16.2%; NVT group = 21.7 ± 15.7%; p = 0.118. The probability of VT was greater in the presence of two or more contiguous transmural fibrosis areas, and that was a predictive factor of clinical VT (RR 4.1; p = 0,04). Agreement between observers was 100% regarding that criterion (p < 0.001). The identification of two or more segments of transmural DE by use of CMRI is associated with the occurrence of clinical VT in patients with CCHD. Thus, CMRI improved risk stratification in the population studied.
    Arquivos brasileiros de cardiologia 03/2012; 98(5):421-30. DOI:10.1590/S0066-782X2012005000031 · 1.12 Impact Factor
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    ABSTRACT: To evaluate respiratory muscle strength, oxygenation and chest pain in patients undergoing off-pump coronary artery bypass (OPCAB) using internal thoracic artery grafts comparing pleural drain insertion site at the subxyphoid region versus the lateral region. Forty patients were randomized into two groups in accordance with the pleural drain site. Group II (n = 19) -pleural drain exteriorized in the intercostal space; group (SI) (n = 21) chest tube exteriorized at the subxyphoid region. All patients underwent assessment of respiratory muscle strength (inspiratory and expiratory) on the pre, 1, 3 and 5 postoperative days (POD). Arterial blood gas analysis was collected on the pre and POD1. The chest pain sensation was measured 1, 3 and 5 POD. A significant decrease in respiratory muscle strength (inspiratory and expiratory) was seen in both groups until POD5 (P <0.05). When compared, the difference between groups remained significant with greater decrease in the II (P <0.05). The blood arterial oxygenation fell in both groups (P <0.05), but the oxygenation was lower in the II (P <0.05). Referred chest pain was higher 1, 3 and 5 POD in the II group (P <0.05). The orotracheal intubation time and postoperative length of hospital stay were higher in the II group (P <0.05). Patients submitted to subxyphoid pleural drainage showed less decrease in respiratory muscle strength, better preservation of blood oxygenation and reduced thoracic pain compared to patients with intercostal drain on early OPCAB postoperative.
    Brazilian Journal of Cardiovascular Surgery 03/2012; 27(1):103-9. DOI:10.5935/1678-9741.20120015
  • International journal of cardiology 11/2011; 154(2):221-2. DOI:10.1016/j.ijcard.2011.10.041 · 6.18 Impact Factor
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    ABSTRACT: We sought to assess the effect of naproxen versus placebo on prevention of atrial fibrillation after coronary artery bypass graft (CABG) surgery. In this randomized, double-blind, placebo-controlled, single-center trial of 161 consecutive patients undergoing CABG surgery, patients received naproxen 275 mg every 12 hours or placebo at the same dosage and interval over 120 hours immediately after CABG surgery. The primary outcome was the occurrence of atrial fibrillation in the first 5 postoperative days. The incidence of postoperative atrial fibrillation was 15.2% (12/79) in the placebo versus 7.3% (6/82) in the naproxen group (P=.11). The duration of atrial fibrillation episodes was significantly lower in the naproxen (0.35 hours) versus placebo group (3.74 hours; P=.04). There was no difference in the overall days of hospitalization between placebo (17.23±7.39) and naproxen (18.33±9.59) groups (P=.44). Intensive care unit length of stay was 4.0±4.57 days in the placebo and 3.23±1.25 days in the naproxen group (P=.16). The trial was stopped by the data monitoring committee before reaching the initial target number of 200 patients because of an increase in renal failure in the naproxen group (7.3% vs 1.3%; P=.06). Postoperative use of naproxen did not reduce the incidence of atrial fibrillation but decreased its duration, in a limited sample of patients after CABG surgery. There was a significant increase in acute renal failure in patients receiving naproxen 275 mg twice daily. Our study does not support the routine use of naproxen after CABG surgery for the prevention of atrial fibrillation.
    The American journal of medicine 11/2011; 124(11):1036-42. DOI:10.1016/j.amjmed.2011.07.026 · 5.30 Impact Factor
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    ABSTRACT: Rate control is an acceptable alternative to rhythm control in patients with chronic atrial fibrillation (AF). The aim of this study of AF patients was to understand the correlation between their exercise capacity and both heart rate (HR) and HR variation index during exercise. The exercise capacity of 85 male patients with chronic AF was measured using a cardiopulmonary exercise test (CPX). Within this population, we compared the exercise tolerance of patients with a normal chronotropic response (maximal HR 85%-115% that of the maximal age-predicted HR during CPX) to those whose HR response exceeded this range. Two similar comparisons were made by dividing the subject population according to (1) whether or not their HR variation index (HRVI) during CPX exceeded 10 bpm/min, and (2) whether their HR during the 6-minute walk test exceeded 110 bpm. Patients with an HRVI not over 10 bpm/min showed higher maximal oxygen uptake compared to patients with a higher HRVI (26.7 ± 6.1 vs 22.8 ± 4.8 mL O(2) /kg/min, P = 0.002) and a longer distance walked during CPX (705.6 ± 200.3 vs 520.9 ± 155.5 m, P<0.001). No other significant influence on exercise capacity was seen. Multivariate regression analysis revealed that both the body mass index and the HRVI during CPX were independent predictors of the maximal oxygen uptake. Better HRVI control on CPX was correlated with better exercise capacity in patients with chronic AF.
    Clinical Cardiology 09/2011; 34(9):533-6. DOI:10.1002/clc.20948 · 2.23 Impact Factor
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    Circulation Arrhythmia and Electrophysiology 02/2011; 4(1):112-4. DOI:10.1161/CIRCEP.110.957571 · 5.42 Impact Factor
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    ABSTRACT: Corticosteroids attenuate late growth of radiofrequency (RF) lesions in the thigh muscle of infant rats. We sought to assess the impact of these drugs on the late growth of RF lesions in immature swine myocardium and to determine the electroanatomical mapping (EAM) characteristics of these lesions. Radiofrequency (60°C; 60 s) lesions were created in the right atrium (n = 2) and ventricle (n = 2) of 14 piglets (age 65 days; weight 5 kg) and 3 adults. Piglets were divided into: controls (n = 7) and treated (n = 7), receiving hydrocortisone (10 mg/kg iv after RF) and prednisone (1 mg/kg/day) for 29 days. After 8 months, animals were sacrificed for histological analysis. In four piglets, endocardial and epicardial voltage EAM were performed. In infant groups, the dimensions of atrial (11 ± 5 vs. 13 ± 7 mm) and ventricular (12 ± 3 vs. 11 ± 3 mm) lesions were similar. In adults, atrial (6 ± 1 mm) and ventricular (6 ± 1 mm) lesions were smaller. In controls, ventricular lesions depicted dense fibrosis and multiple strands of fibrous tissue extending from the lesion into normal muscle. Treated piglets revealed scars exhibiting less dense fibrosis with predominance of fibroadipose tissue and less collagen proliferation. Large atrial and ventricular low-voltage areas corresponding to the macroscopic lesions were identified in all animals. Radiofrequency lesions in infant pigs reveal late growth and invasion of normal muscle by intense collagen proliferation. Corticosteroids do not prevent late enlargement of the lesions but modulate the fibrotic proliferation. The expressive growth of the lesion may generate low-voltage areas detectable by EAM.
    Europace 10/2010; 13(1):121-8. DOI:10.1093/europace/euq391 · 3.05 Impact Factor
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    ABSTRACT: We report the association between heart disease associated with noncompaction of the left ventricular myocardium (NCLVM) and chronic Chagas' heart disease (CCHD) in a patient with heart failure, ischemic stroke and cardiac arrhythmia. Images typical of NCLVM and CCHD were documented by cardiac magnetic resonance imaging (CMRI).
    Arquivos brasileiros de cardiologia 07/2010; 95(1):e4-6. · 1.12 Impact Factor
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    ABSTRACT: Stricto sensu post-graduation in Brazil was implemented in 1965 to increase university professors' teaching quality and to prepare full, independent researchers. The brazilian share in ISI publications has increased significantly since then, but little information is available on postgraduate quality. To review 29 years of the postgraduate programs in cardiology at the Federal University of São Paulo and to analyze master and doctorate graduates' characteristics regarding their origin, publications and subsequent career. We developed a questionnaire to evaluate 168 postgraduates who produced 196 theses (116 master's and 80 doctorate) over the period 1975-2004 and contacted 95.9% of them. Information on publications were obtained through the usual science databases. 30% of graduates came from the North-Northeast-Central West regions and only 50% returned to their original area. Mean age at admission was 32.5 and 34.9 years old for master and doctorate students, respectively; average program duration was, respectively, 39.0 and 43.2 months and approximately 50% went through it without any grants. Thesis publications throughout these 29 years averaged 36.5% for master's and 61.9% for doctorate, but any publishing afterwards occurred in 70.2 and 90.6% of the cases. The average impact factor of the published theses was 1.3 for master's degree and 3.1 for doctorate programs with 65.5% and 87.5% of Qualis A, respectively. Currently, there are graduates in 17 states of the country and 12 have became full professors. Although the stricto sensu program, especially the master's degree program, has many areas that need improvement, they seem to be contributing to improve professional quality and the number of brazilian indexed publications.
    Arquivos brasileiros de cardiologia 03/2010; 94(4):500-6. DOI:10.1590/S0066-782X2010005000015 · 1.12 Impact Factor
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    ABSTRACT: Current criteria for rate control in atrial fibrillation (AF) treatment are empirical and based on a small amount of scientific data. This study was designed to analyze the influence of heart rate (HR, measured by the 6-minute walk test [6MWT] and 24-hour Holter monitoring) on quality of life (QoL). A total of 89 male patients with chronic atrial fibrillation (AF) and resting HR < 90 bpm were included. QoL (assessed by the Short Form-36 Health Survey [SF-36] questionnaire) was compared among 3 groups of patients classified by HR testing results: group 1 had HR < or = 110 bpm on 6MWT and < or = 80 bpm on Holter monitor; group 2 had HR in the target area by 1 but not both tests; and group 3 had HR > 110 bpm on 6MWT and > 80 bpm on Holter monitor. There were significant differences among the 3 groups in physical and mental component summary scores (285.9 +/- 73.9; 276.6 +/- 80.8; 230.3 +/- 91.0, P = .035; and 319.8 +/- 70.2; 294.7 +/- 76.0; 255.0 +/- 107.1, P = .026, respectively).When the methods were analyzed separately, there was a significant difference on QoL in physical and mental summary scores in patients with maximal HR < or = 110 bpm on 6MWT in comparison with HR > 110 bpm (P = .04 and P = .01, respectively) and in the physical summary score in patients with average HR < or = 80 bpm on Holter monitor in comparison with HR > 80 bpm (P = .02). Holter monitoring and 6MWT should be performed as complementary methods to better predict QoL.
    Clinical Cardiology 01/2010; 33(4):E28-32. DOI:10.1002/clc.20528 · 2.23 Impact Factor
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    Arquivos Brasileiros de Cardiologia 01/2010; 95(1). DOI:10.1590/S0066-782X2010001100022 · 1.12 Impact Factor
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    ABSTRACT: The Doppler-derived myocardial performance index (MPI) has been used in the evaluation of left ventricular (LV) function in several diseases. In patients with isolated diastolic dysfunction, the diagnostic utility of this index remains unclear. The aim of this study was to determine the diagnostic utility of MPI in patients with systemic hypertension, impaired LV relaxation, and normal ejection fraction. Thirty hypertensive patients with impaired LV relaxation were compared to 30 control subjects. MPI and its components, isovolumetric relaxation time (IRT), isovolumetric contraction time (ICT), and the ejection time (ET), were measured from LV outflow and mitral inflow Doppler velocity profiles. MPI was higher in patients than in control subjects (0.45 +/- 0.13 vs 0.37 +/- 0.07 P < 0.0029). The increase in MPI was due to the prolongation of IRT without significant change of ICT and ET. MPI cutoff value of > or =0.40 identified impaired LV relaxation with a sensitivity of 63% and specificity of 70% while an IRT >94 ms had a sensitivity of 67% and specificity of 80%. Multivariate analysis identified relative wall thickness, mitral early filling wave velocity (E), and systolic myocardial velocity (Sm) as independent predictors of MPI in patients with hypertension. MPI was increase in patients with hypertension, diastolic dysfunction, and normal ejection fraction but was not superior to IRT to detect impaired LV relaxation.
    Echocardiography 05/2009; 26(8):907-15. DOI:10.1111/j.1540-8175.2009.00896.x · 1.25 Impact Factor
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    ABSTRACT: Atrial fibrillation (AF) is the most common sustained arrhythmia in clinical practice, and has major impact on health-related quality of life, thus, there is a need for a specific instrument to assess AF symptoms and quality of life. We developed and validated a specific questionnaire for quality of life in AF patients (QLAF) based on clinical manifestations (palpitation, breathlessness, dizziness and chest pain), and the usual treatments (medication, cardioversion and ablation). For validation, the new questionnaire was compared with the generic SF-36 questionnaire. Reproducibility was tested using 40 questionnaires administered by two different observers at distinct times and places. Responsiveness was evaluated based on variation of the QLAF score over time. There were a total of 462 questionnaires (231 SF-36 and 231 QLAF) administered at baseline, 3, 6, 9 and 12 months. Construct validity was demonstrated by the negative correlation between QLAF and SF-36 scores that was observed over the follow-up period. Analysis of internal consistency for reproducibility showed excellent Cronbach's alpha coefficients (inter- and intraobserver coefficients of 0.98 and 0.96, respectively). QLAF was responsive as indicated by significant differences in mean domain scores from the beginning to the end of follow-up. It took much less time to administer the QLAF than the SF-36 (3:08±0:33 min vs. 9:25±1:14 min, p<0.001). The QLAF questionnaire is easy to understand and can be administered rapidly in the outpatient setting. Furthermore, the QLAF score is valid and reproducible and responsive to a change in clinical status.
    International journal of cardiology 04/2009; 143(3):391-8. DOI:10.1016/j.ijcard.2009.03.087 · 6.18 Impact Factor
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    ABSTRACT: Myocardial ischemia may occur during an exercise session in cardiac rehabilitation programs. However, it has not been established whether it is elicited when exercise prescription is based on heart rate corresponding to the anaerobic threshold as measured by cardiopulmonary exercise testing. Our objective was to determine the incidence of myocardial ischemia in cardiac rehabilitation programs according to myocardial perfusion SPECT in exercise programs based on the anaerobic threshold. Thirty-nine patients (35 men and 4 women) diagnosed with coronary artery disease by coronary angiography and stress technetium-99m-sestamibi gated SPECT associated with a baseline cardiopulmonary exercise test were assessed. Ages ranged from 45 to 75 years. A second cardiopulmonary exercise test determined training intensity at the anaerobic threshold. Repeat gated-SPECT was obtained after a third cardiopulmonary exercise test at the prescribed workload and heart rate. Myocardial perfusion images were analyzed using a score system of 6.4 at rest, 13.9 at peak stress, and 10.7 during the prescribed exercise (P < 0.05). The presence of myocardial ischemia during exercise was defined as a difference > or = 2 between the summed stress score and summed rest score. Accordingly, 25 (64%) patients were classified as ischemic and 14 (36%) as nonischemic. MIBI-SPECT showed myocardial ischemia during exercise within the anaerobic threshold. The 64% prevalence of ischemia observed in the study should not be looked on as representative of the whole population of patients undergoing exercise programs. Changes in patient care and exercise programs were implemented as a result of our finding of ischemia during the prescribed exercise.
    Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas / Sociedade Brasileira de Biofisica ... [et al.] 04/2009; 42(3):272-8. DOI:10.1590/S0100-879X2009000300008 · 1.08 Impact Factor
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    ABSTRACT: Left ventricular hypertrophy (LVH) and obesity are important cardiovascular risk factors. This study evaluates the influence of obesity on the diagnostic performance of the most used electrocardiographic criteria for LVH in hypertensive patients. One thousand two hundred four outpatients from the Hypertensive Unit of the Hospital São Paulo, São Paulo, SP, Brazil, were studied. All underwent 12-lead electrocardiogram and echocardiogram. The most known electrocardiographic criteria for LVH were assessed and compared with the left ventricular mass index obtained by echocardiogram in obese and nonobese groups of hypertensive patients. The population's mean age was 57.4 +/- 4.7 years; 351 were men (29.1%) and 853 women (70.8%). Cornell voltage, Cornell duration, Sokolow-Lyon voltage, Romhilt-Estes criteria, and R wave in aVL 11 mm or higher showed a positive correlation with left ventricular mass index (P < .05). Notwithstanding, there were no changes regarding specificity for obese or nonobese characteristics. However, sensitivity had a statistically significant decrease in obese patients in regard to Sokolow-Lyon voltage and Romhilt-Estes criteria and strain pattern (P < .05). Cornell voltage and Cornell duration criteria, Perugia score, R wave in aVL, and QTc variable had no significant changes in diagnostic sensitivity in the obese patients.
    Journal of electrocardiology 11/2008; 41(6):724-9. DOI:10.1016/j.jelectrocard.2008.05.010 · 1.36 Impact Factor
  • Carlos E B Balbão, Angelo A V de Paola, Guilherme Fenelon
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    ABSTRACT: Alcohol is the most consumed drug worldwide. Both acute and chronic alcohol use have been associated with cardiac arrhythmias, in particular atrial fibrillation, or so-called 'holiday heart syndrome'. Epidemiological, clinical and experimental studies have attempted to elucidate the mechanisms involved in this association. However, because most of these studies have shown conflicting results, the connection between ethanol and atrial arrhythmias remains controversial. Historical, epidemiological and pharmacological aspects of alcohol, as well as recent concepts on atrial fibrillation are reviewed. We then examine the literature and provide a critical point of view on the still elusive association between alcohol and atrial fibrillation.
    Therapeutic Advances in Cardiovascular Disease 09/2008; 3(1):53-63. DOI:10.1177/1753944708096380 · 2.13 Impact Factor
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    ABSTRACT: We explored the angiographic and pathological effects of corticosteroids on the long-term outcome of radiofrequency (RF) ablation lesions in the swine caval veins. Under fluoroscopy guidance, a single linear RF lesion (4-mm tip, 60 degrees C, 180 seconds) was created in each vena cava (from +/-2 cm into the vein to the venoatrial junction) of 20 anesthetized minipigs (35+/- 2 kg). Three groups were studied: acute (n = 4), killed 1 hour after RF; control (n = 8), sacrificed 83+/- 1 days after RF; and pigs (n = 8) receiving hydrocortisone (400 mg i.v. after RF) and prednisone (25 mg po for 30 days), killed 83+/- 1 days post-RF. Angiography was performed before, immediately after ablation, and at follow-up. Then, animals were sacrificed for histological analysis. Mild (<40%) or moderate (41-70%) acute luminal narrowing occurred in 19/20 (95%) inferior veins and in 13/20 (65%) superior veins. Severe (>70%) stenosis and occlusions were not noted. At follow-up, in both chronic groups, mean vessel diameters returned to baseline and progression of luminal narrowing did not occur in any vein. Of note, superior and inferior vena cava angiographic diameter for control and treated pigs did not differ. The same was observed for the cross-sectional luminal area. Acute lesions displayed transmural coagulative necrosis whereas chronic lesions revealed marked fibrosis. Histological findings were similar in controls and treated pigs. In this model, mild and moderate stenosis, occurring immediately after ablation, seems to resolve over time. Corticosteroids do not affect the long-term outcome of such RF lesions in the caval veins.
    Pacing and Clinical Electrophysiology 09/2008; 31(8):1010-9. DOI:10.1111/j.1540-8159.2008.01128.x · 1.25 Impact Factor

Publication Stats

546 Citations
328.83 Total Impact Points

Institutions

  • 1995–2013
    • Universidade Federal de São Paulo
      • School of Medicine
      San Paulo, São Paulo, Brazil
  • 2009
    • Universidade Estadual de Ciências da Saúde de Alagoas
      Maçayó, Alagoas, Brazil
  • 2007
    • Universidade do Oeste Paulista
      PPB, São Paulo, Brazil
  • 2004
    • Federal University of Pará
      Pará, Pará, Brazil
  • 1998
    • Senac São Paulo
      San Paulo, São Paulo, Brazil
  • 1996
    • Instituto Dante Pazzanese de Cardiologia - Fundação Adib Jatene
      San Paulo, São Paulo, Brazil
  • 1992
    • Mount Sinai Hospital
      New York, New York, United States
  • 1989–1992
    • Hospital Samaritano São Paulo
      San Paulo, São Paulo, Brazil
  • 1987
    • Philadelphia ZOO
      Filadelfia, Pennsylvania, United States