que se leu este artigo
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Last balloon inflation to 30<span class="elsevierStyleHsp" style=""></span>mm; (B) right coronary angiogram performed during angina and inferior ST-segment elevation; (C) left coronary angiogram performed during angina and inferior ST-segment elevation.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Juan Ruiz-García, Javier Soriano" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Juan" "apellidos" => "Ruiz-García" ] 1 => array:2 [ "nombre" => "Javier" "apellidos" => "Soriano" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255113000784?idApp=UINPBA00004E" "url" => "/08702551/0000003200000005/v1_201308021350/S0870255113000784/v1_201308021350/en/main.assets" ] "itemAnterior" => array:20 [ "pii" => "S0870255112003411" "issn" => "08702551" "doi" => "10.1016/j.repc.2012.06.018" "estado" => "S300" "fechaPublicacion" => "2013-05-01" "aid" => "236" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "Rev Port Cardiol. 2013;32:425-30" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 58941 "formatos" => array:3 [ "EPUB" => 315 "HTML" => 55911 "PDF" => 2715 ] ] "pt" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Caso clínico</span>" "titulo" => "Bloqueio completo de ramo esquerdo, bloqueio auriculoventricular, <span class="elsevierStyleItalic">torsade de pointes</span> e QT longo: será demasiado para uma rara miocardiopatia?" "tienePdf" => "pt" "tieneTextoCompleto" => "pt" "tieneResumen" => array:2 [ 0 => "pt" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "425" "paginaFinal" => "430" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Left bundle branch block, atrioventricular block, torsade de pointes and long QT syndrome: is this too much for a rare cardiomyopathy?" ] ] "contieneResumen" => array:2 [ "pt" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "pt" => true ] "contienePdf" => array:1 [ "pt" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0025" "etiqueta" => "Figura 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 682 "Ancho" => 901 "Tamanyo" => 67337 ] ] "descripcion" => array:1 [ "pt" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Ecocardiograma (esquerda): apical 4 câmaras revelando imagens compatíveis com VENC a nível apical; (direita): realce das trabeculações em ECO 3<span class="elsevierStyleHsp" style=""></span>D (seta).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Bruno Rodrigues, Emanuel Correia, Luís Ferreira Santos, Davide Moreira, Anne Delgado, Pedro Gama, António Costa, João Pipa, Oliveira Santos" "autores" => array:9 [ 0 => array:2 [ "nombre" => "Bruno" "apellidos" => "Rodrigues" ] 1 => array:2 [ "nombre" => "Emanuel" "apellidos" => "Correia" ] 2 => array:2 [ "nombre" => "Luís" "apellidos" => "Ferreira Santos" ] 3 => array:2 [ "nombre" => "Davide" "apellidos" => "Moreira" ] 4 => array:2 [ "nombre" => "Anne" "apellidos" => "Delgado" ] 5 => array:2 [ "nombre" => "Pedro" "apellidos" => "Gama" ] 6 => array:2 [ "nombre" => "António" "apellidos" => "Costa" ] 7 => array:2 [ "nombre" => "João" "apellidos" => "Pipa" ] 8 => array:2 [ "nombre" => "Oliveira" "apellidos" => "Santos" ] ] ] ] ] "idiomaDefecto" => "pt" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2174204913000846" "doi" => "10.1016/j.repce.2012.06.008" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204913000846?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255112003411?idApp=UINPBA00004E" "url" => "/08702551/0000003200000005/v1_201308021350/S0870255112003411/v1_201308021350/pt/main.assets" ] "en" => array:18 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>" "titulo" => "Simultaneous wide and narrow QRS complex tachycardia: what is the mechanism?" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "431" "paginaFinal" => "435" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Moisés Rodríguez-Mañero, Fatih Bayrak, Mehdi Namdar, Rubén Casado-Arroyo, Danilo Ricciardi, Gian-Battista Chierchia, Andrea Sarkozy, Carlo de Asmundis, Pedro Brugada" "autores" => array:9 [ 0 => array:4 [ "nombre" => "Moisés" "apellidos" => "Rodríguez-Mañero" "email" => array:1 [ 0 => "mrodrig3@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Fatih" "apellidos" => "Bayrak" ] 2 => array:2 [ "nombre" => "Mehdi" "apellidos" => "Namdar" ] 3 => array:2 [ "nombre" => "Rubén" "apellidos" => "Casado-Arroyo" ] 4 => array:2 [ "nombre" => "Danilo" "apellidos" => "Ricciardi" ] 5 => array:2 [ "nombre" => "Gian-Battista" "apellidos" => "Chierchia" ] 6 => array:2 [ "nombre" => "Andrea" "apellidos" => "Sarkozy" ] 7 => array:2 [ "nombre" => "Carlo" "apellidos" => "de Asmundis" ] 8 => array:2 [ "nombre" => "Pedro" "apellidos" => "Brugada" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Cardiovascular Division, UZ Brussel-VUB, Brussels, Belgium" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Corresponding author." ] ] ] ] "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" => 2340 "Ancho" => 3024 "Tamanyo" => 520595 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Left: result of pace-mapping; right: baseline PVC and spontaneous ventricular tachycardia.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We present the case of a 50-year-old patient with several episodes of syncope and documented simultaneous wide and narrow QRS complex tachycardia. We then review this tachyarrhythmia, focusing on electrophysiological findings and pathophysiology, diagnosis and treatment.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Case report</span><p id="par0010" class="elsevierStylePara elsevierViewall">A 50-year-old man presented to the emergency department due to an episode of palpitations and dizziness. He reported several episodes of sudden syncope. The standard 12-lead electrocardiogram (ECG) performed on admission showed a wide QRS complex tachycardia, which changed spontaneously into a narrow QRS complex tachycardia (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>) and vice versa. Blood pressure during the episode was 90/65mmHg. Due to the fact that the tachycardia was repetitive, bisoprolol was administered intravenously and sinus rhythm was restored. An emergency echocardiogram revealed no evidence of structural heart disease. An electrophysiological study (EPS) was subsequently performed. A bipolar catheter was placed initially in the right ventricular (RV) apex (afterwards withdrawn towards the His position) and a quadripolar catheter in the coronary sinus (CS). Ventricular stimulation performed from the right RV apex showed decremental retrograde conduction with a proximal to distal activation sequence in the CS. Programmed atrial stimulation revealed a dual AV nodal physiology with an AH jump and subsequent induction of atrioventricular nodal reentrant tachycardia (AVNRT). The diagnosis of AVNRT was based on the long postpacing interval (PPI) during entrainment of the tachycardia from the RV apex (PPI-TCL=180ms) (<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>A), septal VA interval of -10ms (<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>A), a stimulus-atrial (during pacing from the RV apex) minus ventriculo-atrial (during tachycardia) interval greater than 85ms, and absence of fusion during entrainment of the tachycardia. As in the baseline ECG, runs of wide QRS complex tachycardia with left bundle brunch morphology (LBBB) interacting with the narrow QRS tachycardia were also observed. The intracardiac signal during the latter confirmed that it was a ventricular tachycardia (VT) (<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>B) (VA dissociation, without anterograde His potential). Another interesting finding was the absence of atrial advancement by spontaneous single ventricular extrastimuli when the His bundle was refractory (<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>C). Transient entrainment of the AVNRT by non-sustained VT was also seen. During this phenomenon, the interval from the last beat of the VT to the first beat of the SVT minus the tachycardia cycle length (TCL) [(V<span class="elsevierStyleInf">VT</span> − V<span class="elsevierStyleInf">SVT</span>) − TCL] was longer than 115ms (<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>C and D), suggesting AVNRT, and making the diagnosis of an orthodromic septal tachycardia unlikely.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Based on these observations, radiofrequency catheter ablation of the slow pathway region was performed using a 4-mm non-irrigated bidirectional catheter (Biosense Webster, Diamond Bar, CA). Post-ablation programmed atrial and ventricular stimulation failed to induce any supraventricular tachycardia even under isoproterenol infusion. However, premature ventricular complexes (PVC) and a wide QRS complex tachycardia identical to the initial one were induced. Because the patient was extremely symptomatic, the decision was taken to ablate the ventricular focus. The twelve-lead ECG suggested a septal origin of the tachycardia in the right ventricular outflow tract (RVOT) with a predominant R and small S wave in I and tall S waves in V1/V2, with transition in the precordial leads (R/S≥1 by V4). Furthermore, the PVC precordial transition occurred later than the sinus rhythm transition, excluding a left ventricular outflow tract origin.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">1</span></a> The ablation catheter was then placed in the subpulmonary septal RVOT for mapping and ablation. The PVC and the VT could not be further induced, perhaps due to mechanical pressure (“bump termination”). As conventional local activation mapping was not possible, pace-mapping was performed from this stable septal RVOT, which revealed 12/12 lead concordance with the PVC/VT (<a class="elsevierStyleCrossRef" href="#fig0015">Figure 3</a>). Moreover, ablation at this point unleashed runs of PVC and non-sustained tachycardia with QRS morphology similar to that seen during spontaneous VT, which terminated during radio frequency application with 50W and 55<span class="elsevierStyleHsp" style=""></span>°C. Thirty minutes after ablation, no tachycardia was induced either with or without isoproterenol and there was no recurrence during 12 months of follow-up.</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Discussion</span><p id="par0020" class="elsevierStylePara elsevierViewall">We describe the fascinating electrophysiological interplay between a narrow and a wide QRS tachycardia. Interestingly, the two different tachycardias did not occur simply by coincidence, but showed a degree of mutual interdependence in inducing, resetting and terminating each other.</p><p id="par0025" class="elsevierStylePara elsevierViewall">This association (RVOT VT/AVNRT) is a case of double tachycardia.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> It is reported to occur more often in patients with poor left ventricular function or in association with digoxin treatment,<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">1,3</span></a> but it has also been described in patients without known structural heart disease<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>; in fact, Kautzner et al<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> reported that 15% of patients with clinically documented idiopathic outflow tract VT were also found to have reproducibly inducible AVNRT at the time of the EPS. Additionally, it has also been postulated that concealed retrograde engagement of the AV node could occur, allowing the next anterograde impulse to depolarize the ventricle via the slow pathway and thus initiate tachycardia.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> Finally, RVOT tachycardia is a triggered arrhythmia, whose induction would be favored by the high catecholamine levels which can occur during AVNRT.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">From the electrophysiological point of view it is worth analyzing the response after the transient “entrainment” of the AVNRT by the non-sustained ventricular tachycardia. During the latter, the atrial cycle length accelerated to the VT cycle length and the narrow tachycardia resumed after the VT spontaneously stopped. We suggest that similar information to that obtained during the ventricular entrainment of SVT could also be inferred from spontaneous transient entrainment of an AVNRT by a VT [(V<span class="elsevierStyleInf">VT</span><span class="elsevierStyleHsp" style=""></span>−<span class="elsevierStyleHsp" style=""></span>VSVT)<span class="elsevierStyleHsp" style=""></span>−<span class="elsevierStyleHsp" style=""></span>TCL], to the best of our knowledge never previously described. This is in favor of an AVNRT rather than orthodromic tachycardia (AVRT) due to the long [(V<span class="elsevierStyleInf">VT</span><span class="elsevierStyleHsp" style=""></span>−<span class="elsevierStyleHsp" style=""></span>V<span class="elsevierStyleInf">SVT</span>)<span class="elsevierStyleHsp" style=""></span>−<span class="elsevierStyleHsp" style=""></span>TCL] interval (140ms-160ms), similar to the PPI-TCL measurement, which is also supported by the absence of atrial advancement by the spontaneous occurring PVC when the His bundle was refractory. The VAV response also helps to rule out an atrial tachycardia. In this regard, during the VT runs and the subsequent SVT, the first VA after the narrow QRS tachycardia was always fixed, regardless of the different cycle lengths of the RVOT-VT, another clue that helps to rule out an atrial tachycardia (<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>D and E).</p><p id="par0035" class="elsevierStylePara elsevierViewall">The fact that the syncope disappeared after ablation is interesting. As is known, syncope often has multiple contributory factors. In the present case, the high heart rate during orthostatism and a possible inadequacy of vascular compensation could have contributed to the syncope episodes. However, this is only supposition and the exact mechanism cannot be completely explained.</p><p id="par0040" class="elsevierStylePara elsevierViewall">To summarize, in such situations, in which during tachycardia there is intermittent widening of the QRS, care should be taken to not classify it as a simple transient aberrancy. Subsequent analysis looking for clues pointing towards the presence of a double tachycardia should be taken into account.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Ethical disclosures</span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Protection of human and animal subjects</span><p id="par0045" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Confidentiality of data</span><p id="par0050" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data and that all the patients included in the study received sufficient information and gave their written informed consent to participate in the study.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Right to privacy and informed consent</span><p id="par0055" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Conflicts of interest</span><p id="par0060" class="elsevierStylePara elsevierViewall">Dr. Moisés Rodríguez-Mañero is funded by a post-residency grant on clinical electrophysiology from the European Society of Cardiology.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:9 [ 0 => array:2 [ "identificador" => "xres251425" "titulo" => "Abstract" ] 1 => array:2 [ "identificador" => "xpalclavsec239024" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres251426" "titulo" => "Resumo" ] 3 => array:2 [ "identificador" => "xpalclavsec239025" "titulo" => "Palavras-chave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Case report" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Discussion" ] 6 => array:3 [ "identificador" => "sec0015" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0020" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0030" "titulo" => "Right to privacy and informed consent" ] ] ] 7 => array:2 [ "identificador" => "sec0035" "titulo" => "Conflicts of interest" ] 8 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2011-11-18" "fechaAceptado" => "2012-06-04" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec239024" "palabras" => array:4 [ 0 => "Atrioventricular nodal reentrant tachycardia" 1 => "Right ventricular outflow tract tachycardia" 2 => "Double tachycardia" 3 => "Spontaneous entrainment" ] ] ] "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec239025" "palabras" => array:4 [ 0 => "Taquicardia de reentrada nodal auriculoventricular" 1 => "Taquicardia do tracto de saída do ventrículo direito" 2 => "Taquicardia dupla" 3 => "Arrastamento espontâneo" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">We present the case of a 50-year-old patient with several episodes of syncope and documented simultaneous wide and narrow QRS complex tachycardia. We then review this tacharrhythmia, focusing on electrophysiological findings and pathophysiology, diagnosis and treatment.</p>" ] "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Apresentamos um caso de um doente de 50 anos com diversos episódios de síncope e documentação de taquicardia com complexo QRS simultaneamente largo e estreito. Fazemos uma revisão desta taquiarritmia tendo em especial atenção achados electrofisiológicos e fisiopatologia, diagnóstico e tratamento.</p>" ] ] "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" => 2250 "Ancho" => 2985 "Tamanyo" => 939424 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Twelve-lead ECG. In the first part of the tracing a broad QRS tachycardia is shown, with LBBB inferior axis morphology and negative QRS complex in aVL. After this run there is a change to a narrow QRS complex. Surface leads (I, II, III, aVF, V1 and V6), and electrograms recorded from the right ventricular apex and the coronary sinus.</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" => 2375 "Ancho" => 3167 "Tamanyo" => 524637 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">(A): The long postpacing interval (PPI-TCL>180ms) after tachycardia entrainment from the right ventricular apex and the tachycardia cycle length are shown; (B): intracardiac recordings during the tachycardia. The first two beats correspond to an AVNRT, and the last three to the ventricular tachycardia. Note the absence of His bundle deflection and variable retrograde conduction during the runs of broad complexes; (C): absence of atrial advancement by spontaneous extrastimulus when the His bundle was refractory; (D and E): transient entrainment of the AVNRT by the spontaneous non-sustained ventricular tachycardia is observed, at different cycle lengths (290 and 310ms respectively). The long interval after the last beat of the broad QRS complex tachycardia and the first beat of the narrow QRS complex tachycardia can also be seen, with VAV response and a fixed VA interval after the ventricular tachycardia (see text).</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" => 2340 "Ancho" => 3024 "Tamanyo" => 520595 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Left: result of pace-mapping; right: baseline PVC and spontaneous ventricular tachycardia.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:7 [ 0 => array:3 [ "identificador" => "bib0010" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The V(2) transition ratio: a new electrocardiographic criterion for distinguishing left from right ventricular outflow tract tachycardia origin" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "B.P. 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Ano/Mês | Html | Total | |
---|---|---|---|
2024 Novembro | 9 | 6 | 15 |
2024 Outubro | 57 | 42 | 99 |
2024 Setembro | 73 | 24 | 97 |
2024 Agosto | 90 | 40 | 130 |
2024 Julho | 51 | 33 | 84 |
2024 Junho | 64 | 32 | 96 |
2024 Maio | 75 | 38 | 113 |
2024 Abril | 54 | 40 | 94 |
2024 Maro | 59 | 31 | 90 |
2024 Fevereiro | 54 | 21 | 75 |
2024 Janeiro | 53 | 26 | 79 |
2023 Dezembro | 49 | 22 | 71 |
2023 Novembro | 70 | 43 | 113 |
2023 Outubro | 53 | 14 | 67 |
2023 Setembro | 62 | 19 | 81 |
2023 Agosto | 46 | 24 | 70 |
2023 Julho | 47 | 11 | 58 |
2023 Junho | 40 | 16 | 56 |
2023 Maio | 62 | 29 | 91 |
2023 Abril | 42 | 8 | 50 |
2023 Maro | 50 | 23 | 73 |
2023 Fevereiro | 42 | 18 | 60 |
2023 Janeiro | 34 | 13 | 47 |
2022 Dezembro | 45 | 24 | 69 |
2022 Novembro | 66 | 32 | 98 |
2022 Outubro | 62 | 25 | 87 |
2022 Setembro | 43 | 44 | 87 |
2022 Agosto | 85 | 30 | 115 |
2022 Julho | 79 | 44 | 123 |
2022 Junho | 64 | 42 | 106 |
2022 Maio | 65 | 34 | 99 |
2022 Abril | 53 | 45 | 98 |
2022 Maro | 65 | 51 | 116 |
2022 Fevereiro | 65 | 35 | 100 |
2022 Janeiro | 69 | 23 | 92 |
2021 Dezembro | 51 | 42 | 93 |
2021 Novembro | 56 | 40 | 96 |
2021 Outubro | 74 | 48 | 122 |
2021 Setembro | 56 | 29 | 85 |
2021 Agosto | 51 | 41 | 92 |
2021 Julho | 38 | 27 | 65 |
2021 Junho | 53 | 25 | 78 |
2021 Maio | 46 | 33 | 79 |
2021 Abril | 102 | 63 | 165 |
2021 Maro | 110 | 25 | 135 |
2021 Fevereiro | 114 | 22 | 136 |
2021 Janeiro | 80 | 23 | 103 |
2020 Dezembro | 60 | 27 | 87 |
2020 Novembro | 61 | 20 | 81 |
2020 Outubro | 56 | 32 | 88 |
2020 Setembro | 114 | 28 | 142 |
2020 Agosto | 70 | 20 | 90 |
2020 Julho | 75 | 23 | 98 |
2020 Junho | 85 | 22 | 107 |
2020 Maio | 70 | 14 | 84 |
2020 Abril | 70 | 20 | 90 |
2020 Maro | 96 | 25 | 121 |
2020 Fevereiro | 207 | 50 | 257 |
2020 Janeiro | 119 | 27 | 146 |
2019 Dezembro | 105 | 15 | 120 |
2019 Novembro | 90 | 8 | 98 |
2019 Outubro | 92 | 6 | 98 |
2019 Setembro | 176 | 27 | 203 |
2019 Agosto | 81 | 14 | 95 |
2019 Julho | 69 | 18 | 87 |
2019 Junho | 95 | 22 | 117 |
2019 Maio | 101 | 10 | 111 |
2019 Abril | 69 | 17 | 86 |
2019 Maro | 81 | 13 | 94 |
2019 Fevereiro | 85 | 15 | 100 |
2019 Janeiro | 101 | 17 | 118 |
2018 Dezembro | 120 | 18 | 138 |
2018 Novembro | 113 | 15 | 128 |
2018 Outubro | 218 | 31 | 249 |
2018 Setembro | 113 | 17 | 130 |
2018 Agosto | 140 | 124 | 264 |
2018 Julho | 69 | 8 | 77 |
2018 Junho | 78 | 11 | 89 |
2018 Maio | 93 | 18 | 111 |
2018 Abril | 93 | 10 | 103 |
2018 Maro | 104 | 10 | 114 |
2018 Fevereiro | 59 | 5 | 64 |
2018 Janeiro | 77 | 6 | 83 |
2017 Dezembro | 106 | 12 | 118 |
2017 Novembro | 74 | 7 | 81 |
2017 Outubro | 44 | 8 | 52 |
2017 Setembro | 62 | 10 | 72 |
2017 Agosto | 56 | 25 | 81 |
2017 Julho | 65 | 16 | 81 |
2017 Junho | 62 | 17 | 79 |
2017 Maio | 101 | 16 | 117 |
2017 Abril | 52 | 8 | 60 |
2017 Maro | 103 | 53 | 156 |
2017 Fevereiro | 125 | 13 | 138 |
2017 Janeiro | 31 | 6 | 37 |
2016 Dezembro | 48 | 10 | 58 |
2016 Novembro | 62 | 15 | 77 |
2016 Outubro | 123 | 21 | 144 |
2016 Setembro | 92 | 11 | 103 |
2016 Agosto | 38 | 7 | 45 |
2016 Julho | 35 | 14 | 49 |
2016 Junho | 20 | 9 | 29 |
2016 Maio | 1 | 10 | 11 |
2016 Abril | 63 | 1 | 64 |
2016 Maro | 78 | 13 | 91 |
2016 Fevereiro | 74 | 22 | 96 |
2016 Janeiro | 52 | 9 | 61 |
2015 Dezembro | 79 | 12 | 91 |
2015 Novembro | 77 | 8 | 85 |
2015 Outubro | 117 | 21 | 138 |
2015 Setembro | 79 | 10 | 89 |
2015 Agosto | 90 | 12 | 102 |
2015 Julho | 86 | 8 | 94 |
2015 Junho | 65 | 3 | 68 |
2015 Maio | 77 | 13 | 90 |
2015 Abril | 103 | 11 | 114 |
2015 Maro | 79 | 9 | 88 |
2015 Fevereiro | 81 | 7 | 88 |
2015 Janeiro | 51 | 8 | 59 |
2014 Dezembro | 67 | 12 | 79 |
2014 Novembro | 71 | 15 | 86 |
2014 Outubro | 87 | 16 | 103 |
2014 Setembro | 62 | 20 | 82 |
2014 Agosto | 73 | 20 | 93 |
2014 Julho | 61 | 9 | 70 |
2014 Junho | 70 | 12 | 82 |
2014 Maio | 61 | 11 | 72 |
2014 Abril | 69 | 7 | 76 |
2014 Maro | 91 | 18 | 109 |
2014 Fevereiro | 110 | 17 | 127 |
2014 Janeiro | 94 | 14 | 108 |
2013 Dezembro | 108 | 20 | 128 |
2013 Novembro | 99 | 13 | 112 |
2013 Outubro | 81 | 17 | 98 |
2013 Setembro | 88 | 20 | 108 |
2013 Agosto | 95 | 20 | 115 |
2013 Julho | 97 | 37 | 134 |
2013 Junho | 55 | 35 | 90 |