Case report
Inappropriate tachycardia at rest as a consequence of atrial preference pacing algorithm
Taquicardia inapropriada em repouso secundária a algoritmo de pacing auricular preferencial
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(B) Regular wide QRS complex tachycardia at 171 bpm. The absence of AV dissociation or precordial concordance, RS interval <100 ms and typical right bundle branch block morphology (identical to the baseline ECG) suggests a supraventricular origin. An adenosine test was performed, unmasking atrial flutter (not shown).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Kinán Rajjoub Al-Mahdi, Ez Alddin Rajjoub Al-Mahdi, Gonzalo Luis Alonso Salinas" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Kinán" "apellidos" => "Rajjoub Al-Mahdi" ] 1 => array:2 [ "nombre" => "Ez Alddin" "apellidos" => "Rajjoub Al-Mahdi" ] 2 => array:2 [ "nombre" => "Gonzalo Luis" "apellidos" => "Alonso Salinas" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204920304098?idApp=UINPBA00004E" "url" => "/21742049/0000003900000012/v1_202012240833/S2174204920304098/v1_202012240833/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2174204920304104" "issn" => "21742049" "doi" => "10.1016/j.repce.2020.07.009" "estado" => "S300" "fechaPublicacion" => "2020-12-01" "aid" => "1612" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "rev" "cita" => "Rev Port Cardiol. 2020;39:723-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Review article</span>" "titulo" => "Increased serum interleukin-6 level as a predictive biomarker for atrial fibrillation: A systematic review and meta-analysis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "723" "paginaFinal" => "728" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Nível sérico elevado de Interleucina-6 como biomarcador preditivo de fibrilhação auricular: uma revisão sistemática e meta-análise" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1847 "Ancho" => 2508 "Tamanyo" => 474152 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Association of IL-6 and other adverse events in atrial fibrillation (AF). (A) Forest plots of risk ratio (RR) and CI 95% for the association between IL-6 and major bleeding events in AF. (B) Forest plots of RR and CI 95% for the association between IL-6 and acute coronary syndrome events in AF. (C) Forest plots of RR and CI 95% for the association between IL-6 and all-cause mortality in AF.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Peng Zhou, Maieryemu Waresi, Yikai Zhao, Hung-Chen Lin, Bangwei Wu, Nanqing Xiong, Huiyang Li, Qingyu Huang, Xinping Luo, Jian Li" "autores" => array:10 [ 0 => array:2 [ "nombre" => "Peng" "apellidos" => "Zhou" ] 1 => array:2 [ "nombre" => "Maieryemu" "apellidos" => "Waresi" ] 2 => array:2 [ "nombre" => "Yikai" "apellidos" => "Zhao" ] 3 => array:2 [ "nombre" => "Hung-Chen" "apellidos" => "Lin" ] 4 => array:2 [ "nombre" => "Bangwei" "apellidos" => "Wu" ] 5 => array:2 [ "nombre" => "Nanqing" "apellidos" => "Xiong" ] 6 => array:2 [ "nombre" => "Huiyang" "apellidos" => "Li" ] 7 => array:2 [ "nombre" => "Qingyu" "apellidos" => "Huang" ] 8 => array:2 [ "nombre" => "Xinping" "apellidos" => "Luo" ] 9 => array:2 [ "nombre" => "Jian" "apellidos" => "Li" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204920304104?idApp=UINPBA00004E" "url" => "/21742049/0000003900000012/v1_202012240833/S2174204920304104/v1_202012240833/en/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>" "titulo" => "Inappropriate tachycardia at rest as a consequence of atrial preference pacing algorithm" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "729.e1" "paginaFinal" => "729.e4" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Baris Akdemir" "autores" => array:1 [ 0 => array:4 [ "nombre" => "Baris" "apellidos" => "Akdemir" "email" => array:1 [ 0 => "akdem002@umn.edu" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Division of Cardiology, Department of Electrophysiology, University of Minnesota, Minneapolis, MN, USA" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Division of Cardiology, Department of Electrophysiology, Bahcesehir University, Istanbul, Turkey" "etiqueta" => "b" "identificador" => "aff0010" ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Taquicardia inapropriada em repouso secundária a algoritmo de <span class="elsevierStyleItalic">pacing</span> auricular preferencial" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1862 "Ancho" => 2500 "Tamanyo" => 176223 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">EGM2 after P wave amplitude test device detected a PAC at CL of 752 ms and initiate APP.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Case report</span><p id="par0005" class="elsevierStylePara elsevierViewall">A 34-year-old female with a past medical history of atrial tachycardia ablations (five different foci were ablated in two different procedures) and sick sinus syndrome possibly due to secondary injury during ablation procedures, which required placement of a single chamber (atrial) permanent pacemaker (Medtronic, Minneapolis, MN, USA) at a different hospital. One year after pacemaker implantation, the patient reported exercise intolerance and palpitation at rest. Device was programed with a lower rate of 70 bpm, however on her resting electrocardiogram, rhythm was atrial paced, ventricular sensed with a heart rate of 94 bpm. Device interrogation (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>) during clinic visit revealed 99% atrial pacing and high atrial rate episodes (EGM<span class="elsevierStyleInf">1</span> and EGM<span class="elsevierStyleInf">2</span>; <a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a> and <a class="elsevierStyleCrossRef" href="#fig0015">Figure 3</a>). What is the mechanism for high atrial rate episodes which is causing exercise intolerance and palpitation at rest?</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Discussion</span><p id="par0010" class="elsevierStylePara elsevierViewall">After careful examination of device interrogation (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>), which shows that the atrial preference pacing (APP) feature was turned on with an internal decrement of 100 ms, which is nominally off. This feature was designed to suppress atrial arrhythmias, but in this case, interrogation of electrograms revealed that high atrial rate episodes as a consequence of APP were causing palpitation at rest and exercise (EGM<span class="elsevierStyleInf">1</span> and EGM<span class="elsevierStyleInf">2</span>; <a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>).</p><p id="par0015" class="elsevierStylePara elsevierViewall">Atrial tachycardia is not a life-threatening arrhythmia and usually patients present with symptoms such as shortness of breath and palpitation, etc. In patients with permanent pacemakers, some studies have shown that atrial pacing reduces the incidence of atrial tachyarrhythmias.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1–3</span></a> It has been described that an increased number of premature atrial contractions, by causing a dispersion of atrial refractoriness and conduction velocities, may play a role in initiation of atrial tachyarrhythmias.<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4–7</span></a> The APP algorithm developed by Medtronic Inc. (Minneapolis, MN, USA) allows the pacemaker to maintain the pacing rates slightly higher than the sinus rates and was designed to achieve a high percentage of atrial pacing to prevent atrial ectopic activity and premature atrial contractions. Several studies have assessed the efficacy of the APP algorithm but did not reveal consistent results and in some patients, APP activation is associated with a reduction in atrial tachyarrhythmias, but not in others not.<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">8,9</span></a> In another study, APP off with APP on with three different search interval settings was compared and demonstrated that APP search interval setting should be tailored to the individual to obtain the greatest benefit from the algorithm to suppress atrial tachyarrhythmias instead of using nominal numbers.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> A case report also showed the onset of a life-threatening monomorphic ventricular tachycardia due to the APP algorithm.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> In our case, high atrial rate episodes, APP, as a consequence of APP were causing palpitation at rest and exercise intolerance. Symptoms were resolved by turning the APP algorithm off.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclusion</span><p id="par0020" class="elsevierStylePara elsevierViewall">APP algorithm is a promising method for preventing atrial tachyarrhythmia in patients with an implanted pacemaker. However, instead of using nominal search interval settings, which may not benefit patients, we should individually tailor the programming, identifying the most effective search interval and also be aware of any possible pro-arrhythmic effects such as, high atrial rates, life-threatening arrhythmia ventricular arrhythmias, etc.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conflicts of interest</span><p id="par0025" class="elsevierStylePara elsevierViewall">The author has no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:9 [ 0 => array:3 [ "identificador" => "xres1440326" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1314605" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1440327" "titulo" => "Resumo" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0010" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1314604" "titulo" => "Palavras-chave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Case report" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Discussion" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Conclusion" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Conflicts of interest" ] 8 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-06-03" "fechaAceptado" => "2020-05-05" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1314605" "palabras" => array:3 [ 0 => "Preferential headset pacing" 1 => "Permanent pacemaker" 2 => "Ear tachyarrhythmias" ] ] ] "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec1314604" "palabras" => array:3 [ 0 => "<span class="elsevierStyleItalic">Pacing</span> auricular preferencial" 1 => "<span class="elsevierStyleItalic">Pacemaker</span> permanente" 2 => "Taquiarritmias auriculares" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A 34-year-old female with a past medical history of sick sinus syndrome which requiring placement of single chamber (atrial) permanent pacemaker (Medtronic, Minneapolis, MN, USA). One year after pacemaker implantation, the patient reported exercise intolerance and palpitation at rest. Device interrogation during clinic visit revealed 99% atrial pacing and high atrial rate episodes. What is the mechanism for high atrial rate episodes? Atrial preference pacing (algorithm is a promising method for preventing atrial tachyarrhythmia in patients with an implanted pacemaker. However, instead of using nominal search interval settings, which may not benefit patients, we should individually tailor the programming, identifying the most effective search interval and be aware of possible pro-arrhythmic effects.</p></span>" ] "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Mulher de 34 anos com história de doença do nódulo sinusal com implantação de <span class="elsevierStyleItalic">pacemaker</span> definitivo de câmara única (auricular) (Medtronic, Minneapolis, EUA). Um ano após a implantação do <span class="elsevierStyleItalic">pacemaker</span>, inicia queixas de intolerância ao esforço e palpitações em repouso. A análise ao equipamento durante a visita clínica revelou 99% de <span class="elsevierStyleItalic">pacing</span> auricular e episódios de frequência auricular rápida. Qual o mecanismo destes ritmos auriculares rápidos? O algoritmo de <span class="elsevierStyleItalic">pacing</span> auricular preferencial (EAP) é um método promissor para a prevenção da taquiarritmias auriculares em doentes com <span class="elsevierStyleItalic">pacemaker</span>. No entanto, em vez de aceitar as definições nominais dos intervalos de pesquisa destes algoritmos, que poderão não beneficiar os doentes, devemos individualizar a programação, identificando o intervalo de pesquisa mais eficaz e estando atentos a possíveis efeitos pró-arrítmicos.</p></span>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1794 "Ancho" => 2500 "Tamanyo" => 372007 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Device interrogation, AAIR 70/140 bpm, atrial pacing 99%, atrial pacing preference on with an internal decrement of 100 ms.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1853 "Ancho" => 2500 "Tamanyo" => 192141 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">EGM1. During searching period device detected a PAC at CL of 732 msec and initiate APP.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1862 "Ancho" => 2500 "Tamanyo" => 176223 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">EGM2 after P wave amplitude test device detected a PAC at CL of 752 ms and initiate APP.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long-term follow-up of patients from a randomized trial of atrial versus ventricular pacing for sick-sinus syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "H.R. Andersen" 1 => "J.C. Nielsen" 2 => "P.E. Thomsen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0140-6736(97)03425-9" "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "1997" "volumen" => "350" "paginaInicial" => "1210" "paginaFinal" => "1216" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9652562" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0060" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effects of physiologic pacing versus ventricular pacing on the risk of stroke and death due to cardiovascular causes Canadian Trial of Physiologic Pacing Investigators" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "S.J. Connolly" 1 => "C.R. Kerr" 2 => "M. Gent" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJM200005113421902" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2000" "volumen" => "342" "paginaInicial" => "1385" "paginaFinal" => "1391" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10805823" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0065" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ventricular pacing or dual-chamber pacing for sinus-node dysfunction" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "G.A. Lamas" 1 => "K.L. Lee" 2 => "M.O. Sweeney" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMoa013040" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2002" "volumen" => "346" "paginaInicial" => "1854" "paginaFinal" => "1862" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12063369" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0070" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Initiating mechanisms of paroxysmal atrial fibrillation" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "C. Dimmer" 1 => "T. Szili-Torok" 2 => "R. Tavernier" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1053/eupc.2002.0273" "Revista" => array:6 [ "tituloSerie" => "Europace" "fecha" => "2003" "volumen" => "5" "paginaInicial" => "1" "paginaFinal" => "9" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12504634" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0075" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Analysis of the cardiac rhythm preceding episodes of paroxysmal atrial fibrillation" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "K. Hnatkova" 1 => "J.E. Waktare" 2 => "F.D. Murgatroyd" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s0002-8703(98)70066-3" "Revista" => array:6 [ "tituloSerie" => "Am Heart J" "fecha" => "1998" "volumen" => "135" "paginaInicial" => "1010" "paginaFinal" => "1019" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9630105" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0080" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Variations of autonomic tone preceding onset of atrial fibrillation after coronary artery bypass grafting" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "C. Dimmer" 1 => "R. Tavernier" 2 => "N. Gjorgov" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s0002-9149(98)00231-8" "Revista" => array:6 [ "tituloSerie" => "Am J Cardiol" "fecha" => "1998" "volumen" => "82" "paginaInicial" => "22" "paginaFinal" => "25" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9671003" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0085" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Regional and functional factors determining induction and maintenance of atrial fibrillation in dogs" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "J. Wang" 1 => "L. Liu" 2 => "J. Feng" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1152/ajpheart.1996.271.1.H148" "Revista" => array:6 [ "tituloSerie" => "Am J Physiol" "fecha" => "1996" "volumen" => "271" "paginaInicial" => "H148" "paginaFinal" => "H158" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8760170" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0090" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Impact of consistent atrial pacing algorithm on premature atrial complexe number and paroxysmal atrial fibrillation recurrences in brady-tachy syndrome: a randomized prospective cross over study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "R. Ricci" 1 => "M. Santini" 2 => "A. Puglisi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1023/a:1009801706928" "Revista" => array:6 [ "tituloSerie" => "J Interv Card Electrophysiol" "fecha" => "2001" "volumen" => "5" "paginaInicial" => "33" "paginaFinal" => "44" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11248773" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0095" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effects of right atrial pacing preference in prevention of paroxysmal atrial fibrillation Atrial Pacing Preference Study (APP Study)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "H. Ogawa" 1 => "T. Ishikawa" 2 => "K. Matsushita" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1253/circj.72.700" "Revista" => array:6 [ "tituloSerie" => "Circ J" "fecha" => "2008" "volumen" => "72" "paginaInicial" => "700" "paginaFinal" => "704" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18441446" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0100" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "ICD proarrhythmia as a consequence of an interaction with an algorithm to prevent atrial arrhythmias" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "J. Martinez Sanchez" 1 => "A. Garcia Alberola" 2 => "J. Sanchez Munoz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1540-8159.2009.02444.x" "Revista" => array:6 [ "tituloSerie" => "PACE" "fecha" => "2009" "volumen" => "32" "paginaInicial" => "1096" "paginaFinal" => "1098" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19659632" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21742049/0000003900000012/v1_202012240833/S2174204920304177/v1_202012240833/en/main.assets" "Apartado" => array:4 [ "identificador" => "9914" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case report" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003900000012/v1_202012240833/S2174204920304177/v1_202012240833/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204920304177?idApp=UINPBA00004E" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 3 | 2 | 5 |
| 2024 October | 35 | 38 | 73 |
| 2024 September | 35 | 29 | 64 |
| 2024 August | 35 | 37 | 72 |
| 2024 July | 32 | 38 | 70 |
| 2024 June | 28 | 26 | 54 |
| 2024 May | 23 | 23 | 46 |
| 2024 April | 25 | 30 | 55 |
| 2024 March | 31 | 25 | 56 |
| 2024 February | 23 | 21 | 44 |
| 2024 January | 24 | 27 | 51 |
| 2023 December | 16 | 28 | 44 |
| 2023 November | 20 | 23 | 43 |
| 2023 October | 19 | 19 | 38 |
| 2023 September | 16 | 27 | 43 |
| 2023 August | 23 | 14 | 37 |
| 2023 July | 20 | 9 | 29 |
| 2023 June | 29 | 15 | 44 |
| 2023 May | 31 | 27 | 58 |
| 2023 April | 23 | 2 | 25 |
| 2023 March | 41 | 20 | 61 |
| 2023 February | 32 | 15 | 47 |
| 2023 January | 15 | 15 | 30 |
| 2022 December | 29 | 25 | 54 |
| 2022 November | 42 | 25 | 67 |
| 2022 October | 38 | 19 | 57 |
| 2022 September | 22 | 38 | 60 |
| 2022 August | 23 | 42 | 65 |
| 2022 July | 23 | 38 | 61 |
| 2022 June | 18 | 28 | 46 |
| 2022 May | 23 | 28 | 51 |
| 2022 April | 22 | 31 | 53 |
| 2022 March | 22 | 33 | 55 |
| 2022 February | 21 | 30 | 51 |
| 2022 January | 14 | 21 | 35 |
| 2021 December | 17 | 30 | 47 |
| 2021 November | 29 | 31 | 60 |
| 2021 October | 26 | 45 | 71 |
| 2021 September | 16 | 32 | 48 |
| 2021 August | 17 | 32 | 49 |
| 2021 July | 15 | 29 | 44 |
| 2021 June | 18 | 23 | 41 |
| 2021 May | 28 | 27 | 55 |
| 2021 April | 55 | 53 | 108 |
| 2021 March | 40 | 36 | 76 |
| 2021 February | 60 | 30 | 90 |
| 2021 January | 47 | 31 | 78 |
| 2020 December | 17 | 5 | 22 |
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