To the Editor, We read with great interest the article by Ternes et al., recently published in the Arquivos Brasileiros de Cardiologia, with its accompanying insightful editorial., This multicentre prospective cohort study of consecutive patients across three centres in Brazil provided valuable insights into the predictors of atrial arrhythmia recurrence following first-time catheter ablation. It highlighted its clinical setting in a middle-income country and reported outcomes similar to those in high-income countries. However, the results must be interpreted cautiously, and […]

Introduction Atrial fibrillation (AF), the most common sustained cardiac arrhythmia, significantly impacts global healthcare due to its association with increased morbidity, mortality, and healthcare utilization., Catheter ablation has emerged as a cornerstone treatment for AF, offering rhythm control and symptomatic relief., Among contemporary ablation strategies, very high-power short-duration (vHPSD) radiofrequency (RF) ablation is valued for its efficiency and precision, while pulsed field ablation (PFA), a non-thermal technique utilizing electroporation, has gained attention for its potential to minimize collateral tissue damage.– […]

Abstract Background Alcohol septal ablation (ASA) is an alternative to surgical myectomy for patients with symptomatic hypertrophic obstructive cardiomyopathy (HOCM) and significant left ventricular (LV) outflow tract (LVOT) obstruction. Although widely studied worldwide, data on ASA outcomes in Brazil are still limited. Objective To assess the safety and effectiveness of ASA in symptomatic HOCM patients receiving optimal medical therapy using current techniques across multiple centers in Brazil. Methods Patients with HOCM and angina (classified by the Canadian Cardiovascular Society [CCS]) […]

To the editor Anticoagulation is a standard therapeutic approach for patients with atrial fibrillation (AF), requiring careful consideration of the balance between antithrombotic efficacy and the risk of hemorrhagic complications. The authors examined the rate of anticoagulant prescriptions among patients admitted to the emergency department with symptomatic AF, revealing a higher prevalence of non-prescription in women compared to men. This observation raises several important concerns. […]

Heart failure with reduced ejection fraction (HFrEF) is a complex clinical syndrome characterized by symptoms of dyspnea and worsening functional capacity resulting from reduced cardiac output in patients with left ventricular ejection fraction (LVEF) ≤40%. HFrEF represents an important public health problem, being one of the main causes of hospital admission, with high morbidity and mortality rates. Based on large randomized clinical trials, the standard treatment for patients with HFrEF until the late 1990s consisted of angiotensin-converting enzyme inhibitors (ACEIs) […]

Abstract Background Atrial-esophageal fistula following AF ablation remains a concern. There is no standardized approach to minimize its risk and morbidity. Objective To present the seven-year experience of a systematic endoscopic surveillance of esophageal injury after AF catheter ablation. Methods This is a retrospective single center registry of systematic endoscopic evaluation after AF ablation in consecutive procedures performed from 2016 to 2022. A p-value of <0.05 was considered statistically significant. Results 823 AF ablation with controlled esophagogastroduodenoscopy (EGD) were analyzed. […]

Abstract Background In patients with persistent atrial fibrillation (AF), addition of posterior wall isolation (PWI) to pulmonary vein isolation (PVI) is controversial. Objective Compare PVI plus PWI versus PVI alone in patients with persistent AF. Methods We searched PubMed (by MEDLINE), Embase, LILACS, CENTRAL (by Cochrane Library), and Clinicaltrials.gov databases for randomized trials comparing PVI + PWI and PVI alone in persistent AF. The outcomes were: (i) AF recurrence; (ii) composite of recurrent atrial arrhythmias (i.e., AF, atrial tachycardia, or […]