array:24 [
  "pii" => "S0870255121005096"
  "issn" => "08702551"
  "doi" => "10.1016/j.repc.2021.12.001"
  "estado" => "S300"
  "fechaPublicacion" => "2022-01-01"
  "aid" => "1872"
  "copyright" => "Sociedade Portuguesa de Cardiologia"
  "copyrightAnyo" => "2021"
  "documento" => "simple-article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "dis"
  "cita" => "Rev Port Cardiol. 2022;41:27-9"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S0870255121003759"
    "issn" => "08702551"
    "doi" => "10.1016/j.repc.2021.03.010"
    "estado" => "S300"
    "fechaPublicacion" => "2022-01-01"
    "aid" => "1809"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Cardiol. 2022;41:31-40"
    "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">Original Article</span>"
      "titulo" => "Evaluating three biomarkers as prognostic factors of in-hospital mortality and severity in heart failure&#58; A prospective cohort"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "31"
          "paginaFinal" => "40"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Avalia&#231;&#227;o de tr&#234;s biomarcadores como fatores de progn&#243;stico de mortalidade intra-hospitalar e de gravidade da insufici&#234;ncia card&#237;aca&#58; coorte prospetiva"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "pt" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:6 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1951
              "Ancho" => 2500
              "Tamanyo" => 161712
            ]
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Pedro A&#46; Segura-Salda&#241;a, Diego Chambergo-Michilot, Javier E&#46; Alarc&#243;n-Santos, Cristian Aguilar, Mayita L&#46; Alvarez-Vargas, Marcos Padilla-Reyes, Rodrigo Leon-Vivar, Marcos Pariona-Javier"
          "autores" => array:8 [
            0 => array:2 [
              "nombre" => "Pedro A&#46;"
              "apellidos" => "Segura-Salda&#241;a"
            ]
            1 => array:2 [
              "nombre" => "Diego"
              "apellidos" => "Chambergo-Michilot"
            ]
            2 => array:2 [
              "nombre" => "Javier E&#46;"
              "apellidos" => "Alarc&#243;n-Santos"
            ]
            3 => array:2 [
              "nombre" => "Cristian"
              "apellidos" => "Aguilar"
            ]
            4 => array:2 [
              "nombre" => "Mayita L&#46;"
              "apellidos" => "Alvarez-Vargas"
            ]
            5 => array:2 [
              "nombre" => "Marcos"
              "apellidos" => "Padilla-Reyes"
            ]
            6 => array:2 [
              "nombre" => "Rodrigo"
              "apellidos" => "Leon-Vivar"
            ]
            7 => array:2 [
              "nombre" => "Marcos"
              "apellidos" => "Pariona-Javier"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255121003759?idApp=UINPBA00004E"
    "url" => "/08702551/0000004100000001/v1_202202030626/S0870255121003759/v1_202202030626/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S0870255121003747"
    "issn" => "08702551"
    "doi" => "10.1016/j.repc.2021.02.014"
    "estado" => "S300"
    "fechaPublicacion" => "2022-01-01"
    "aid" => "1808"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Cardiol. 2022;41:17-26"
    "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">Original Article</span>"
      "titulo" => "Efficacy of extended antrum ablation based on substrate mapping plus pulmonary vein isolation in the treatment of atrial fibrillation"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "17"
          "paginaFinal" => "26"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Efic&#225;cia da abla&#231;&#227;o antral alargada com base no mapeamento de substrato para al&#233;m do isolamento da veia pulmonar no tratamento da fibrilha&#231;&#227;o auricular"
        ]
      ]
      "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" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 694
              "Ancho" => 2917
              "Tamanyo" => 253274
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Representative examples of antrum ablation strategy&#46; A&#46; Electrophysiological substrate mapping showed target substrate according to EnSite NavX system&#59; B&#46; Radiofrequency ablation based on substrate mapping on Left pulmonary vein&#59; C&#46; Postablation substrate mapping to ensure the elimination of target substrate&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Lin Chen, Jian-Quan Chen, Tian Zou, Qian Chen, Liang-Hua Lian, Zhi-Ping Yang, Mei-Qiong Wu, Ya-Zhou Lin, Yi-Ming Peng, Wei Lin, Xue-Wen Liao, Qi-Lei Huang, Jian-Cheng Zhang"
          "autores" => array:13 [
            0 => array:2 [
              "nombre" => "Lin"
              "apellidos" => "Chen"
            ]
            1 => array:2 [
              "nombre" => "Jian-Quan"
              "apellidos" => "Chen"
            ]
            2 => array:2 [
              "nombre" => "Tian"
              "apellidos" => "Zou"
            ]
            3 => array:2 [
              "nombre" => "Qian"
              "apellidos" => "Chen"
            ]
            4 => array:2 [
              "nombre" => "Liang-Hua"
              "apellidos" => "Lian"
            ]
            5 => array:2 [
              "nombre" => "Zhi-Ping"
              "apellidos" => "Yang"
            ]
            6 => array:2 [
              "nombre" => "Mei-Qiong"
              "apellidos" => "Wu"
            ]
            7 => array:2 [
              "nombre" => "Ya-Zhou"
              "apellidos" => "Lin"
            ]
            8 => array:2 [
              "nombre" => "Yi-Ming"
              "apellidos" => "Peng"
            ]
            9 => array:2 [
              "nombre" => "Wei"
              "apellidos" => "Lin"
            ]
            10 => array:2 [
              "nombre" => "Xue-Wen"
              "apellidos" => "Liao"
            ]
            11 => array:2 [
              "nombre" => "Qi-Lei"
              "apellidos" => "Huang"
            ]
            12 => array:2 [
              "nombre" => "Jian-Cheng"
              "apellidos" => "Zhang"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255121003747?idApp=UINPBA00004E"
    "url" => "/08702551/0000004100000001/v1_202202030626/S0870255121003747/v1_202202030626/en/main.assets"
  ]
  "en" => array:12 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Editorial comment</span>"
    "titulo" => "Ablate and pace&#58; The ultimate treatment for atrial fibrillation&#63;"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "27"
        "paginaFinal" => "29"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "Pedro Carmo"
        "autores" => array:1 [
          0 => array:3 [
            "nombre" => "Pedro"
            "apellidos" => "Carmo"
            "email" => array:1 [
              0 => "p.lopescarmo@gmail.com"
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Hospital de Santa Cruz&#44; CHLO&#44; Carnaxide&#44; Portugal"
            "identificador" => "aff0005"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "pt" => array:1 [
        "titulo" => "<span class="elsevierStyleItalic">Pace</span> e abla&#231;&#227;o&#58; o tratamento derradeiro para a fibrilha&#231;&#227;o auricular&#63;"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Atrial fibrillation &#40;AF&#41; has become a major epidemic and is associated with increased morbidity and mortality&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Pacemaker treatment combined with atrioventricular junction &#40;AVJ&#41; ablation is an effective treatment in patients with atrial arrhythmias and symptoms due to high ventricular rate refractory to pharmacological treatment&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">1</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Another group that benefits from AVJ ablation are patients with heart failure &#40;HF&#41;&#44; AF and cardiac resynchronization therapy &#40;CRT&#41; with a low percentage of biventricular pacing&#46; AVJ ablation has been shown to increase the percentage of biventricular pacing and thus increase the therapeutic effects of CRT&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">2</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">However&#44; AVJ ablation is not without risks&#46; Right ventricular pacing induces left ventricle dyssynchrony that in turn impairs cardiac function&#46; There is also an increased risk of sudden death after AVJ ablation&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">3</span></a> On the other hand&#44; the long-term performance of pacing devices is not flawless&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">4</span></a> Hence the pertinence of long-term results after use of the ablate and pace strategy&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The article by Manuel et al&#46; in this issue of the Journal<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">5</span></a> illustrates the retrospective experience of a Portuguese tertiary center and the longest follow-up ever published after AVJ ablation&#46; The authors followed a very heterogeneous population of 123 patients who underwent AVJ ablation for a median period of 8&#46;5 years &#40;8&#46;8-11&#46;8&#41;&#46; Most of the patients presented uncontrolled supraventricular tachycardia that resulted in HF&#44; tachycardiomyopathy&#44; implantable cardioverter defibrillator &#40;ICD&#41; inappropriate shocks and other severe symptoms related to tachycardia&#46; Ten &#40;8&#37;&#41; patients were treated due to low biventricular pacing percentage&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The most common arrythmia was AF &#40;65&#37;&#41;&#46; All AVJ ablation procedures were successful without major complications&#46; 13 &#40;11&#37;&#41; patients had previous devices implanted and all the others were implanted at the time of AVJ ablation&#46; At the end&#44; device distribution was as follows&#58; pacemaker &#40;82&#37;&#41;&#44; CRT pacemaker &#40;6&#37;&#41;&#44; CRT-defibrillator &#40;8&#37;&#41; and ICD &#40;4&#37;&#41;&#46; Unexpectedly&#44; there were no device-related complications during this long follow-up&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">They report an improvement in HF functional class&#44; a reduction of hospitalizations and of unplanned emergency department visits due to HF&#46; There were no differences in left ventricular ejection fraction &#40;LVEF&#41; and LV end-diastolic diameter before and after the procedure&#46; The authors do not clarify the timeframe for these clinical and echocardiographic changes&#46; For that reason&#44; we are unable to gauge the magnitude and the pattern of the benefits&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">At the end of the follow-up&#44; mortality was 23&#37;&#46; There is no information regarding the causes of death&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Despite these gaps&#44; this article reinforces the importance of AVJ ablation&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">In a meta-analysis of randomized trials comparing the ablate and pace strategy with drug therapy&#44; overall mortality at one year was 3&#46;5&#37; among the ablate and pace group&#44;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">6</span></a> similar to the findings of Manuel et al&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">5</span></a> We need to keep in mind that no robust data support survival benefit after the ablate and pace strategy&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Clarification of the causes of death is of paramount importance&#46; AVJ ablation is associated with a small &#40;2&#37;-4&#37;&#41; risk of sudden death&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">7</span></a> It is important to note that the vast majority of those who experienced sudden cardiac death had a significant number of risk factors&#44; including reduced left ventricular function&#44; advanced HF&#44; and a history of ventricular arrhythmias&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Programming the pacemaker at a higher ventricular pacing rate &#40;minimum of 90 bpm&#41; for the first one to two months following ablation has been a way to mitigate the risk of proarrhythmic bradycardia&#46; Sudden death can be due to proarrhythmic bradycardia but pacemaker disfunction is another possible cause&#46; With that concern in mind&#44; many centers postpone AVJ ablation until pacemaker electronics are reassessed&#46; Otherwise&#44; a simultaneous procedure such as that used by Manuel et al&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">5</span></a> would be less burdensome&#46; Vascular access for the ablation catheter could even be the same as the pacemaker&#46; This article fails to clarify the important issue of the unreported causes of death&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">The assessment of symptoms and ventricular function improvement and reduction in hospitalization and emergency department visits is a matter of debate&#46; Most studies including the one by Manuel et al&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">5</span></a> included patients with and without reduced LVEF&#46; We are able to predict that patients with reduced LVEF may improve due to tachycardiomyopathy reversibility or increased biventricular pacing percentage&#46; On the other hand&#44; patients without reduced LVEF could worsen because of pacing induced desynchrony&#46; One mechanism could lead to an improvement in some patients and a worsening in others&#46; The final outcome would be hard to predict&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">In general&#44; several retrospective studies&#44; randomized control studies&#44; and meta-analysis reported beneficial demonstrate that ablate and pace is a valuable palliative therapy for highly symptomatic&#44; drug-refractory AF patients&#46; Many retrospective studies have documented significant acute and long-term improvement in left ventricular function&#44; symptoms&#44; cardiac performance&#44; exercise tolerance&#44; clinical outcomes&#44; and quality of life&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">There were several randomized controlled trials comparing an ablate and pace strategy with medical therapy&#46; Ablate and pace was effective at controlling symptoms and improving quality of life but showed no benefit regarding death and left ventricular function&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Some meta-analyses have reported improvements in symptomatic&#44; drug-refractory AF patients&#46; Wood et al&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">8</span></a> found that exercise duration&#44; ejection fraction&#44; quality of life&#44; symptoms&#44; and hospital admissions improved significantly&#46; Chatterjee et al<span class="elsevierStyleItalic">&#46;</span><a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">9</span></a> found in their meta-analysis that in the therapeutic management of refractory AF&#44; AVJ ablation was associated with improvement in symptoms and quality of life&#46; In addition&#44; patients with reduced LVEF demonstrated an improved echocardiographic outcome relative to medical therapy alone&#46; However&#44; there was no survival advantage&#46; For the subgroup of patients with CRT and low pacing percentage&#44; the benefit is beyond any doubt&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">10</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">The debate about the effect on left ventricular function and clinical outcomes of HF is ongoing&#46; Indeed&#44; the effect on left ventricular function and clinical outcomes of HF are not consistent in the literature&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Meanwhile&#44; in order to avoid the deleterious effects of long-term right ventricular pacing on left ventricular function&#44; biventricular pacing has been proposed as an alternative to right ventricular pacing&#46; CRT significantly reduces hospitalizations for HF&#44; and significantly improves functional capacity&#44; and left ventricular function&#44; volumes and diameter in comparison with right ventricular pacing&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">11</span></a> The PAVE study<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">12</span></a> randomized 184 patients with a mean LVEF of 46&#37; to biventricular pacing or right ventricular pacing post AVJ ablation&#46; Both groups showed an improvement in the six minute walk distance compared with baseline&#46; Of interest is that the two pacing modalities did not differ until six months after the procedure&#44; when a small deterioration in the right ventricular pacing group resulted in a significant difference between the two groups&#46; The right ventricular pacing group showed a significant fall in LVEF within six weeks&#44; which persisted at six months&#46; On the other hand&#44; the LVEF in the biventricular pacing group did not change from baseline values&#46; Patients with impaired LVEF at baseline who underwent biventricular pacing showed the greatest improvement&#46; Furthermore&#44; patients with class II or III HF who received biventricular pacing improved significantly more than those who received right ventricular pacing&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Therefore&#44; the current guidelines recommend CRT in patients with AF and left ventricular dysfunction who are candidates for AVJ ablation with a IIa level of evidence B indication&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">13</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">Huang et al<span class="elsevierStyleItalic">&#46;</span><a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">14</span></a> demonstrated that permanent His bundle pacing is safe and stable in HF patients with AF who had narrow QRS and underwent AVJ ablation&#46; They observed a significant improvement in functional class and echocardiographic LVEF&#44; and reduction in the utilization of diuretics in HF therapeutic management&#46; Current results make His bundle pacing an attractive pace modality before AVJ ablation preserving ventricular synchrony&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Patients with AVJ ablation become chronotropic incompetent&#46; This condition may be corrected by rate-adaptive pacing&#46; While rate-responsive pacing can help these patients to adapt during exercise&#44; it can also elicit an excessive increment in heart rate with possible deleterious effects&#46; Device programming must be meticulous&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">A less radical alternative to AVJ ablation is AVJ modulation&#46; Although the outcome is less predictable&#44; it avoids the need for a pacemaker and can be thought as a step between drugs and AVJ ablation&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">15</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">Ablate and pace is a useful and easy therapy but should be regarded as a final resort&#46; It makes patients dependent on pacemakers and thereafter prone to pacing induced desynchrony&#44; pacemaker disfunction and infection&#46; Although the markers for a worse prognosis after ablate and pace are not completely clear&#44; care must be taken when choosing the pacing device&#44; particular in patients with impaired systolic function and HF&#46; For these patients&#44; a more physiologic pace modality such as biventricular pacing or His bundle pacing should be considered&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0120" class="elsevierStylePara elsevierViewall">The author has no conflicts of interest to declare&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:2 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Conflicts of interest"
        ]
        1 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:15 [
            0 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The ablate and pace trial&#58; a prospective study of catheter ablation of the AV conduction system and permanent pacemaker implantation for treatment of atrial fibrillation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "G&#46;N&#46; Kay"
                            1 => "K&#46;A&#46; Ellenbogen"
                            2 => "M&#46; Giudici"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1023/A: 1009795330454"
                      "Revista" => array:2 [
                        "tituloSerie" => "J Interv Card Electrophysiol"
                        "fecha" => "1998"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Benefit of cardiac resynchronization therapy in atrial fibrillation patients vs&#46; patients in sinus rhythm&#58; the role of atrioventricular junction ablation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46;M&#46; Ferreira"
                            1 => "P&#46; Adrag&#227;o"
                            2 => "D&#46;M&#46; Cavaco"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/europace/eun135"
                      "Revista" => array:6 [
                        "tituloSerie" => "Europace"
                        "fecha" => "2008"
                        "volumen" => "10"
                        "paginaInicial" => "809"
                        "paginaFinal" => "815"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18511438"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sudden death after radiofrequency ablation of the atrioventricular node in patients with atrial fibrillation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "C&#46; Ozcan"
                            1 => "A&#46; Jahangir"
                            2 => "P&#46;A&#46; Friedman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2016.02.054"
                      "Revista" => array:3 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2002"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27151352"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Complications after cardiac implantable electronic device implantations&#58; an analysis of a complete&#44; nationwide cohort in Denmark"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "R&#46;E&#46; Kirkfeldt"
                            1 => "J&#46;B&#46; Johansen"
                            2 => "E&#46;A&#46; Nohr"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/eht511"
                      "Revista" => array:5 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2014"
                        "paginaInicial" => "1186"
                        "paginaFinal" => "1194"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24347317"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long-term outcomes after radiofrequency catheter ablation of the atrioventricular node&#58; the experience of a Portuguese tertiary center"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46;M&#46; Manuel"
                            1 => "J&#46;F&#46;P&#46; Almeida"
                            2 => "P&#46; Fonseca"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:3 [
                        "tituloSerie" => "Rev Port Cardiol"
                        "fecha" => "2021"
                        "volumen" => "40"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Atrioventricular junction ablation combined with either right ventricular pacing or cardiac resynchronization therapy for atrial fibrillation&#58; the need for large-scale randomized trials"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46;J&#46; Bradley"
                            1 => "W&#46;K&#46; Shen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.hrthm.2006.10.016"
                      "Revista" => array:2 [
                        "tituloSerie" => "Hear Rhythm"
                        "fecha" => "2007"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sudden death and its risk factors after atrioventricular junction ablation and pacemaker implantation in patients with atrial fibrillation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "R&#46;X&#46; Wang"
                            1 => "H&#46;C&#46; Lee"
                            2 => "J&#46;P&#46; Li"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/clc.22600"
                      "Revista" => array:3 [
                        "tituloSerie" => "Clin Cardiol"
                        "fecha" => "2017"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19006111"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical outcomes after ablation and pacing therapy for atrial fibrillation&#58; a meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46;A&#46; Wood"
                            1 => "C&#46; Brown-Mahoney"
                            2 => "G&#46;N&#46; Kay"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/01.CIR.101.10.1138"
                      "Revista" => array:3 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2000"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33201741"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Atrioventricular nodal ablation in atrial fibrillation a meta-analysis and systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "N&#46;A&#46; Chatterjee"
                            1 => "G&#46;A&#46; Upadhyay"
                            2 => "K&#46;A&#46; Ellenbogen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCEP.111.967810"
                      "Revista" => array:2 [
                        "tituloSerie" => "Circ Arrhythmia Electrophysiol"
                        "fecha" => "2012"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cardiac resynchronization therapy in patients with atrial fibrillation - Worth the effort&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46;M&#46; Ferreira"
                            1 => "P&#46; Carmo"
                            2 => "P&#46; Adrag&#227;o"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4022/jafib.435"
                      "Revista" => array:2 [
                        "tituloSerie" => "J Atr Fibrillat"
                        "fecha" => "2012"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cardiac resynchronization therapy after atrioventricular junction ablation for symptomatic atrial fibrillation&#58; a meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46; Stavrakis"
                            1 => "P&#46; Garabelli"
                            2 => "D&#46;W&#46; Reynolds"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/europace/eus193"
                      "Revista" => array:2 [
                        "tituloSerie" => "Europace"
                        "fecha" => "2012"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Left ventricular-based cardiac stimulation post AV nodal ablation evaluation &#40;The PAVE study&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "R&#46;N&#46; Doshi"
                            1 => "E&#46;G&#46; Daoud"
                            2 => "C&#46; Fellows"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1540-8167.2005.50062.x"
                      "Revista" => array:2 [
                        "tituloSerie" => "J Cardiovasc Electrophysiol"
                        "fecha" => "2005"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "2013 ESC guidelines on cardiac pacing and cardiac resynchronization therapy&#58; the Task Force on cardiac pacing and resynchronization therapy of the European Society of Cardiology &#40;ESC&#41;&#46; Developed in collaboration with the European Heart Rhythm Association &#40;EHRA&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46; Brignole"
                            1 => "A&#46; Auricchio"
                            2 => "G&#46; Baron-Esquivias"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/europace/eut206"
                      "Revista" => array:2 [
                        "tituloSerie" => "Europace"
                        "fecha" => "2013"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Benefits of permanent his bundle pacing combined with atrioventricular node ablation in atrial fibrillation patients with heart failure with both preserved and reduced left ventricular ejection fraction"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "W&#46; Huang"
                            1 => "L&#46; Su"
                            2 => "S&#46; Wu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/JAHA.116.005309"
                      "Revista" => array:2 [
                        "tituloSerie" => "J Am Heart Assoc"
                        "fecha" => "2017"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bimodal RR interval distribution in chronic atrial fibrillation&#58; impact of dual atrioventricular nodal physiology on long-term rate control after catheter ablation of the posterior atrionodal input"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46; Tebbenjohanns"
                            1 => "B&#46; Schumacher"
                            2 => "T&#46; Korte"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1540-8167.2000.tb00001.x"
                      "Revista" => array:2 [
                        "tituloSerie" => "J Cardiovasc Electrophysiol"
                        "fecha" => "2000"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/08702551/0000004100000001/v1_202202030626/S0870255121005096/v1_202202030626/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "92834"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original Articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/08702551/0000004100000001/v1_202202030626/S0870255121005096/v1_202202030626/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255121005096?idApp=UINPBA00004E"
]
Partilhar
Informação da revista

Estatísticas

Siga este link para acessar o texto completo do artigo

Editorial comment
Ablate and pace: The ultimate treatment for atrial fibrillation?
Pace e ablação: o tratamento derradeiro para a fibrilhação auricular?
Pedro Carmo
Hospital de Santa Cruz, CHLO, Carnaxide, Portugal
Lido
2812
Vezes
que se leu este artigo
1170
Total PDF
1642
Total HTML
Compartilhar estatísticas
 array:24 [
  "pii" => "S0870255121005096"
  "issn" => "08702551"
  "doi" => "10.1016/j.repc.2021.12.001"
  "estado" => "S300"
  "fechaPublicacion" => "2022-01-01"
  "aid" => "1872"
  "copyright" => "Sociedade Portuguesa de Cardiologia"
  "copyrightAnyo" => "2021"
  "documento" => "simple-article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "dis"
  "cita" => "Rev Port Cardiol. 2022;41:27-9"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S0870255121003759"
    "issn" => "08702551"
    "doi" => "10.1016/j.repc.2021.03.010"
    "estado" => "S300"
    "fechaPublicacion" => "2022-01-01"
    "aid" => "1809"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Cardiol. 2022;41:31-40"
    "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">Original Article</span>"
      "titulo" => "Evaluating three biomarkers as prognostic factors of in-hospital mortality and severity in heart failure&#58; A prospective cohort"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "31"
          "paginaFinal" => "40"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Avalia&#231;&#227;o de tr&#234;s biomarcadores como fatores de progn&#243;stico de mortalidade intra-hospitalar e de gravidade da insufici&#234;ncia card&#237;aca&#58; coorte prospetiva"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "pt" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:6 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1951
              "Ancho" => 2500
              "Tamanyo" => 161712
            ]
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Pedro A&#46; Segura-Salda&#241;a, Diego Chambergo-Michilot, Javier E&#46; Alarc&#243;n-Santos, Cristian Aguilar, Mayita L&#46; Alvarez-Vargas, Marcos Padilla-Reyes, Rodrigo Leon-Vivar, Marcos Pariona-Javier"
          "autores" => array:8 [
            0 => array:2 [
              "nombre" => "Pedro A&#46;"
              "apellidos" => "Segura-Salda&#241;a"
            ]
            1 => array:2 [
              "nombre" => "Diego"
              "apellidos" => "Chambergo-Michilot"
            ]
            2 => array:2 [
              "nombre" => "Javier E&#46;"
              "apellidos" => "Alarc&#243;n-Santos"
            ]
            3 => array:2 [
              "nombre" => "Cristian"
              "apellidos" => "Aguilar"
            ]
            4 => array:2 [
              "nombre" => "Mayita L&#46;"
              "apellidos" => "Alvarez-Vargas"
            ]
            5 => array:2 [
              "nombre" => "Marcos"
              "apellidos" => "Padilla-Reyes"
            ]
            6 => array:2 [
              "nombre" => "Rodrigo"
              "apellidos" => "Leon-Vivar"
            ]
            7 => array:2 [
              "nombre" => "Marcos"
              "apellidos" => "Pariona-Javier"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255121003759?idApp=UINPBA00004E"
    "url" => "/08702551/0000004100000001/v1_202202030626/S0870255121003759/v1_202202030626/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S0870255121003747"
    "issn" => "08702551"
    "doi" => "10.1016/j.repc.2021.02.014"
    "estado" => "S300"
    "fechaPublicacion" => "2022-01-01"
    "aid" => "1808"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Cardiol. 2022;41:17-26"
    "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">Original Article</span>"
      "titulo" => "Efficacy of extended antrum ablation based on substrate mapping plus pulmonary vein isolation in the treatment of atrial fibrillation"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "17"
          "paginaFinal" => "26"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Efic&#225;cia da abla&#231;&#227;o antral alargada com base no mapeamento de substrato para al&#233;m do isolamento da veia pulmonar no tratamento da fibrilha&#231;&#227;o auricular"
        ]
      ]
      "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" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 694
              "Ancho" => 2917
              "Tamanyo" => 253274
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Representative examples of antrum ablation strategy&#46; A&#46; Electrophysiological substrate mapping showed target substrate according to EnSite NavX system&#59; B&#46; Radiofrequency ablation based on substrate mapping on Left pulmonary vein&#59; C&#46; Postablation substrate mapping to ensure the elimination of target substrate&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Lin Chen, Jian-Quan Chen, Tian Zou, Qian Chen, Liang-Hua Lian, Zhi-Ping Yang, Mei-Qiong Wu, Ya-Zhou Lin, Yi-Ming Peng, Wei Lin, Xue-Wen Liao, Qi-Lei Huang, Jian-Cheng Zhang"
          "autores" => array:13 [
            0 => array:2 [
              "nombre" => "Lin"
              "apellidos" => "Chen"
            ]
            1 => array:2 [
              "nombre" => "Jian-Quan"
              "apellidos" => "Chen"
            ]
            2 => array:2 [
              "nombre" => "Tian"
              "apellidos" => "Zou"
            ]
            3 => array:2 [
              "nombre" => "Qian"
              "apellidos" => "Chen"
            ]
            4 => array:2 [
              "nombre" => "Liang-Hua"
              "apellidos" => "Lian"
            ]
            5 => array:2 [
              "nombre" => "Zhi-Ping"
              "apellidos" => "Yang"
            ]
            6 => array:2 [
              "nombre" => "Mei-Qiong"
              "apellidos" => "Wu"
            ]
            7 => array:2 [
              "nombre" => "Ya-Zhou"
              "apellidos" => "Lin"
            ]
            8 => array:2 [
              "nombre" => "Yi-Ming"
              "apellidos" => "Peng"
            ]
            9 => array:2 [
              "nombre" => "Wei"
              "apellidos" => "Lin"
            ]
            10 => array:2 [
              "nombre" => "Xue-Wen"
              "apellidos" => "Liao"
            ]
            11 => array:2 [
              "nombre" => "Qi-Lei"
              "apellidos" => "Huang"
            ]
            12 => array:2 [
              "nombre" => "Jian-Cheng"
              "apellidos" => "Zhang"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255121003747?idApp=UINPBA00004E"
    "url" => "/08702551/0000004100000001/v1_202202030626/S0870255121003747/v1_202202030626/en/main.assets"
  ]
  "en" => array:12 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Editorial comment</span>"
    "titulo" => "Ablate and pace&#58; The ultimate treatment for atrial fibrillation&#63;"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "27"
        "paginaFinal" => "29"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "Pedro Carmo"
        "autores" => array:1 [
          0 => array:3 [
            "nombre" => "Pedro"
            "apellidos" => "Carmo"
            "email" => array:1 [
              0 => "p.lopescarmo@gmail.com"
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Hospital de Santa Cruz&#44; CHLO&#44; Carnaxide&#44; Portugal"
            "identificador" => "aff0005"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "pt" => array:1 [
        "titulo" => "<span class="elsevierStyleItalic">Pace</span> e abla&#231;&#227;o&#58; o tratamento derradeiro para a fibrilha&#231;&#227;o auricular&#63;"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Atrial fibrillation &#40;AF&#41; has become a major epidemic and is associated with increased morbidity and mortality&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Pacemaker treatment combined with atrioventricular junction &#40;AVJ&#41; ablation is an effective treatment in patients with atrial arrhythmias and symptoms due to high ventricular rate refractory to pharmacological treatment&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">1</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Another group that benefits from AVJ ablation are patients with heart failure &#40;HF&#41;&#44; AF and cardiac resynchronization therapy &#40;CRT&#41; with a low percentage of biventricular pacing&#46; AVJ ablation has been shown to increase the percentage of biventricular pacing and thus increase the therapeutic effects of CRT&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">2</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">However&#44; AVJ ablation is not without risks&#46; Right ventricular pacing induces left ventricle dyssynchrony that in turn impairs cardiac function&#46; There is also an increased risk of sudden death after AVJ ablation&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">3</span></a> On the other hand&#44; the long-term performance of pacing devices is not flawless&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">4</span></a> Hence the pertinence of long-term results after use of the ablate and pace strategy&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The article by Manuel et al&#46; in this issue of the Journal<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">5</span></a> illustrates the retrospective experience of a Portuguese tertiary center and the longest follow-up ever published after AVJ ablation&#46; The authors followed a very heterogeneous population of 123 patients who underwent AVJ ablation for a median period of 8&#46;5 years &#40;8&#46;8-11&#46;8&#41;&#46; Most of the patients presented uncontrolled supraventricular tachycardia that resulted in HF&#44; tachycardiomyopathy&#44; implantable cardioverter defibrillator &#40;ICD&#41; inappropriate shocks and other severe symptoms related to tachycardia&#46; Ten &#40;8&#37;&#41; patients were treated due to low biventricular pacing percentage&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The most common arrythmia was AF &#40;65&#37;&#41;&#46; All AVJ ablation procedures were successful without major complications&#46; 13 &#40;11&#37;&#41; patients had previous devices implanted and all the others were implanted at the time of AVJ ablation&#46; At the end&#44; device distribution was as follows&#58; pacemaker &#40;82&#37;&#41;&#44; CRT pacemaker &#40;6&#37;&#41;&#44; CRT-defibrillator &#40;8&#37;&#41; and ICD &#40;4&#37;&#41;&#46; Unexpectedly&#44; there were no device-related complications during this long follow-up&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">They report an improvement in HF functional class&#44; a reduction of hospitalizations and of unplanned emergency department visits due to HF&#46; There were no differences in left ventricular ejection fraction &#40;LVEF&#41; and LV end-diastolic diameter before and after the procedure&#46; The authors do not clarify the timeframe for these clinical and echocardiographic changes&#46; For that reason&#44; we are unable to gauge the magnitude and the pattern of the benefits&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">At the end of the follow-up&#44; mortality was 23&#37;&#46; There is no information regarding the causes of death&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Despite these gaps&#44; this article reinforces the importance of AVJ ablation&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">In a meta-analysis of randomized trials comparing the ablate and pace strategy with drug therapy&#44; overall mortality at one year was 3&#46;5&#37; among the ablate and pace group&#44;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">6</span></a> similar to the findings of Manuel et al&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">5</span></a> We need to keep in mind that no robust data support survival benefit after the ablate and pace strategy&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Clarification of the causes of death is of paramount importance&#46; AVJ ablation is associated with a small &#40;2&#37;-4&#37;&#41; risk of sudden death&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">7</span></a> It is important to note that the vast majority of those who experienced sudden cardiac death had a significant number of risk factors&#44; including reduced left ventricular function&#44; advanced HF&#44; and a history of ventricular arrhythmias&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Programming the pacemaker at a higher ventricular pacing rate &#40;minimum of 90 bpm&#41; for the first one to two months following ablation has been a way to mitigate the risk of proarrhythmic bradycardia&#46; Sudden death can be due to proarrhythmic bradycardia but pacemaker disfunction is another possible cause&#46; With that concern in mind&#44; many centers postpone AVJ ablation until pacemaker electronics are reassessed&#46; Otherwise&#44; a simultaneous procedure such as that used by Manuel et al&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">5</span></a> would be less burdensome&#46; Vascular access for the ablation catheter could even be the same as the pacemaker&#46; This article fails to clarify the important issue of the unreported causes of death&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">The assessment of symptoms and ventricular function improvement and reduction in hospitalization and emergency department visits is a matter of debate&#46; Most studies including the one by Manuel et al&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">5</span></a> included patients with and without reduced LVEF&#46; We are able to predict that patients with reduced LVEF may improve due to tachycardiomyopathy reversibility or increased biventricular pacing percentage&#46; On the other hand&#44; patients without reduced LVEF could worsen because of pacing induced desynchrony&#46; One mechanism could lead to an improvement in some patients and a worsening in others&#46; The final outcome would be hard to predict&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">In general&#44; several retrospective studies&#44; randomized control studies&#44; and meta-analysis reported beneficial demonstrate that ablate and pace is a valuable palliative therapy for highly symptomatic&#44; drug-refractory AF patients&#46; Many retrospective studies have documented significant acute and long-term improvement in left ventricular function&#44; symptoms&#44; cardiac performance&#44; exercise tolerance&#44; clinical outcomes&#44; and quality of life&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">There were several randomized controlled trials comparing an ablate and pace strategy with medical therapy&#46; Ablate and pace was effective at controlling symptoms and improving quality of life but showed no benefit regarding death and left ventricular function&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Some meta-analyses have reported improvements in symptomatic&#44; drug-refractory AF patients&#46; Wood et al&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">8</span></a> found that exercise duration&#44; ejection fraction&#44; quality of life&#44; symptoms&#44; and hospital admissions improved significantly&#46; Chatterjee et al<span class="elsevierStyleItalic">&#46;</span><a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">9</span></a> found in their meta-analysis that in the therapeutic management of refractory AF&#44; AVJ ablation was associated with improvement in symptoms and quality of life&#46; In addition&#44; patients with reduced LVEF demonstrated an improved echocardiographic outcome relative to medical therapy alone&#46; However&#44; there was no survival advantage&#46; For the subgroup of patients with CRT and low pacing percentage&#44; the benefit is beyond any doubt&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">10</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">The debate about the effect on left ventricular function and clinical outcomes of HF is ongoing&#46; Indeed&#44; the effect on left ventricular function and clinical outcomes of HF are not consistent in the literature&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Meanwhile&#44; in order to avoid the deleterious effects of long-term right ventricular pacing on left ventricular function&#44; biventricular pacing has been proposed as an alternative to right ventricular pacing&#46; CRT significantly reduces hospitalizations for HF&#44; and significantly improves functional capacity&#44; and left ventricular function&#44; volumes and diameter in comparison with right ventricular pacing&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">11</span></a> The PAVE study<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">12</span></a> randomized 184 patients with a mean LVEF of 46&#37; to biventricular pacing or right ventricular pacing post AVJ ablation&#46; Both groups showed an improvement in the six minute walk distance compared with baseline&#46; Of interest is that the two pacing modalities did not differ until six months after the procedure&#44; when a small deterioration in the right ventricular pacing group resulted in a significant difference between the two groups&#46; The right ventricular pacing group showed a significant fall in LVEF within six weeks&#44; which persisted at six months&#46; On the other hand&#44; the LVEF in the biventricular pacing group did not change from baseline values&#46; Patients with impaired LVEF at baseline who underwent biventricular pacing showed the greatest improvement&#46; Furthermore&#44; patients with class II or III HF who received biventricular pacing improved significantly more than those who received right ventricular pacing&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Therefore&#44; the current guidelines recommend CRT in patients with AF and left ventricular dysfunction who are candidates for AVJ ablation with a IIa level of evidence B indication&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">13</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">Huang et al<span class="elsevierStyleItalic">&#46;</span><a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">14</span></a> demonstrated that permanent His bundle pacing is safe and stable in HF patients with AF who had narrow QRS and underwent AVJ ablation&#46; They observed a significant improvement in functional class and echocardiographic LVEF&#44; and reduction in the utilization of diuretics in HF therapeutic management&#46; Current results make His bundle pacing an attractive pace modality before AVJ ablation preserving ventricular synchrony&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Patients with AVJ ablation become chronotropic incompetent&#46; This condition may be corrected by rate-adaptive pacing&#46; While rate-responsive pacing can help these patients to adapt during exercise&#44; it can also elicit an excessive increment in heart rate with possible deleterious effects&#46; Device programming must be meticulous&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">A less radical alternative to AVJ ablation is AVJ modulation&#46; Although the outcome is less predictable&#44; it avoids the need for a pacemaker and can be thought as a step between drugs and AVJ ablation&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">15</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">Ablate and pace is a useful and easy therapy but should be regarded as a final resort&#46; It makes patients dependent on pacemakers and thereafter prone to pacing induced desynchrony&#44; pacemaker disfunction and infection&#46; Although the markers for a worse prognosis after ablate and pace are not completely clear&#44; care must be taken when choosing the pacing device&#44; particular in patients with impaired systolic function and HF&#46; For these patients&#44; a more physiologic pace modality such as biventricular pacing or His bundle pacing should be considered&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0120" class="elsevierStylePara elsevierViewall">The author has no conflicts of interest to declare&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:2 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Conflicts of interest"
        ]
        1 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:15 [
            0 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The ablate and pace trial&#58; a prospective study of catheter ablation of the AV conduction system and permanent pacemaker implantation for treatment of atrial fibrillation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "G&#46;N&#46; Kay"
                            1 => "K&#46;A&#46; Ellenbogen"
                            2 => "M&#46; Giudici"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1023/A: 1009795330454"
                      "Revista" => array:2 [
                        "tituloSerie" => "J Interv Card Electrophysiol"
                        "fecha" => "1998"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Benefit of cardiac resynchronization therapy in atrial fibrillation patients vs&#46; patients in sinus rhythm&#58; the role of atrioventricular junction ablation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46;M&#46; Ferreira"
                            1 => "P&#46; Adrag&#227;o"
                            2 => "D&#46;M&#46; Cavaco"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/europace/eun135"
                      "Revista" => array:6 [
                        "tituloSerie" => "Europace"
                        "fecha" => "2008"
                        "volumen" => "10"
                        "paginaInicial" => "809"
                        "paginaFinal" => "815"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18511438"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sudden death after radiofrequency ablation of the atrioventricular node in patients with atrial fibrillation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "C&#46; Ozcan"
                            1 => "A&#46; Jahangir"
                            2 => "P&#46;A&#46; Friedman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2016.02.054"
                      "Revista" => array:3 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2002"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27151352"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Complications after cardiac implantable electronic device implantations&#58; an analysis of a complete&#44; nationwide cohort in Denmark"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "R&#46;E&#46; Kirkfeldt"
                            1 => "J&#46;B&#46; Johansen"
                            2 => "E&#46;A&#46; Nohr"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/eht511"
                      "Revista" => array:5 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2014"
                        "paginaInicial" => "1186"
                        "paginaFinal" => "1194"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24347317"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long-term outcomes after radiofrequency catheter ablation of the atrioventricular node&#58; the experience of a Portuguese tertiary center"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46;M&#46; Manuel"
                            1 => "J&#46;F&#46;P&#46; Almeida"
                            2 => "P&#46; Fonseca"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:3 [
                        "tituloSerie" => "Rev Port Cardiol"
                        "fecha" => "2021"
                        "volumen" => "40"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Atrioventricular junction ablation combined with either right ventricular pacing or cardiac resynchronization therapy for atrial fibrillation&#58; the need for large-scale randomized trials"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46;J&#46; Bradley"
                            1 => "W&#46;K&#46; Shen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.hrthm.2006.10.016"
                      "Revista" => array:2 [
                        "tituloSerie" => "Hear Rhythm"
                        "fecha" => "2007"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sudden death and its risk factors after atrioventricular junction ablation and pacemaker implantation in patients with atrial fibrillation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "R&#46;X&#46; Wang"
                            1 => "H&#46;C&#46; Lee"
                            2 => "J&#46;P&#46; Li"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/clc.22600"
                      "Revista" => array:3 [
                        "tituloSerie" => "Clin Cardiol"
                        "fecha" => "2017"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19006111"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical outcomes after ablation and pacing therapy for atrial fibrillation&#58; a meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46;A&#46; Wood"
                            1 => "C&#46; Brown-Mahoney"
                            2 => "G&#46;N&#46; Kay"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/01.CIR.101.10.1138"
                      "Revista" => array:3 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2000"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33201741"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Atrioventricular nodal ablation in atrial fibrillation a meta-analysis and systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "N&#46;A&#46; Chatterjee"
                            1 => "G&#46;A&#46; Upadhyay"
                            2 => "K&#46;A&#46; Ellenbogen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCEP.111.967810"
                      "Revista" => array:2 [
                        "tituloSerie" => "Circ Arrhythmia Electrophysiol"
                        "fecha" => "2012"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cardiac resynchronization therapy in patients with atrial fibrillation - Worth the effort&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46;M&#46; Ferreira"
                            1 => "P&#46; Carmo"
                            2 => "P&#46; Adrag&#227;o"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4022/jafib.435"
                      "Revista" => array:2 [
                        "tituloSerie" => "J Atr Fibrillat"
                        "fecha" => "2012"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cardiac resynchronization therapy after atrioventricular junction ablation for symptomatic atrial fibrillation&#58; a meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46; Stavrakis"
                            1 => "P&#46; Garabelli"
                            2 => "D&#46;W&#46; Reynolds"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/europace/eus193"
                      "Revista" => array:2 [
                        "tituloSerie" => "Europace"
                        "fecha" => "2012"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Left ventricular-based cardiac stimulation post AV nodal ablation evaluation &#40;The PAVE study&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "R&#46;N&#46; Doshi"
                            1 => "E&#46;G&#46; Daoud"
                            2 => "C&#46; Fellows"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1540-8167.2005.50062.x"
                      "Revista" => array:2 [
                        "tituloSerie" => "J Cardiovasc Electrophysiol"
                        "fecha" => "2005"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "2013 ESC guidelines on cardiac pacing and cardiac resynchronization therapy&#58; the Task Force on cardiac pacing and resynchronization therapy of the European Society of Cardiology &#40;ESC&#41;&#46; Developed in collaboration with the European Heart Rhythm Association &#40;EHRA&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46; Brignole"
                            1 => "A&#46; Auricchio"
                            2 => "G&#46; Baron-Esquivias"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/europace/eut206"
                      "Revista" => array:2 [
                        "tituloSerie" => "Europace"
                        "fecha" => "2013"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Benefits of permanent his bundle pacing combined with atrioventricular node ablation in atrial fibrillation patients with heart failure with both preserved and reduced left ventricular ejection fraction"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "W&#46; Huang"
                            1 => "L&#46; Su"
                            2 => "S&#46; Wu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/JAHA.116.005309"
                      "Revista" => array:2 [
                        "tituloSerie" => "J Am Heart Assoc"
                        "fecha" => "2017"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bimodal RR interval distribution in chronic atrial fibrillation&#58; impact of dual atrioventricular nodal physiology on long-term rate control after catheter ablation of the posterior atrionodal input"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46; Tebbenjohanns"
                            1 => "B&#46; Schumacher"
                            2 => "T&#46; Korte"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1540-8167.2000.tb00001.x"
                      "Revista" => array:2 [
                        "tituloSerie" => "J Cardiovasc Electrophysiol"
                        "fecha" => "2000"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/08702551/0000004100000001/v1_202202030626/S0870255121005096/v1_202202030626/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "92834"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original Articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/08702551/0000004100000001/v1_202202030626/S0870255121005096/v1_202202030626/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255121005096?idApp=UINPBA00004E"
]
Informação do artigo
ISSN: 08702551
Idioma original: Inglês
Dados atualizados diariamente
Ano/Mês Html Pdf Total
2024 Novembro 15 4 19
2024 Outubro 122 45 167
2024 Setembro 81 38 119
2024 Agosto 108 70 178
2024 Julho 53 46 99
2024 Junho 48 20 68
2024 Maio 37 22 59
2024 Abril 84 30 114
2024 Maro 59 22 81
2024 Fevereiro 37 17 54
2024 Janeiro 40 29 69
2023 Dezembro 30 23 53
2023 Novembro 45 42 87
2023 Outubro 25 21 46
2023 Setembro 18 36 54
2023 Agosto 24 16 40
2023 Julho 41 10 51
2023 Junho 43 14 57
2023 Maio 36 28 64
2023 Abril 29 7 36
2023 Maro 39 33 72
2023 Fevereiro 35 28 63
2023 Janeiro 29 27 56
2022 Dezembro 49 29 78
2022 Novembro 60 37 97
2022 Outubro 50 36 86
2022 Setembro 39 53 92
2022 Agosto 38 46 84
2022 Julho 32 47 79
2022 Junho 37 36 73
2022 Maio 33 32 65
2022 Abril 31 46 77
2022 Maro 49 57 106
2022 Fevereiro 119 91 210
2022 Janeiro 27 32 59
Mostrar tudo

Siga este link para acessar o texto completo do artigo

Idiomas
Revista Portuguesa de Cardiologia
en pt

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos

Ao assinalar que é «Profissional de Saúde», declara conhecer e aceitar que a responsável pelo tratamento dos dados pessoais dos utilizadores da página de internet da Revista Portuguesa de Cardiologia (RPC), é esta entidade, com sede no Campo Grande, n.º 28, 13.º, 1700-093 Lisboa, com os telefones 217 970 685 e 217 817 630, fax 217 931 095 e com o endereço de correio eletrónico revista@spc.pt. Declaro para todos os fins, que assumo inteira responsabilidade pela veracidade e exatidão da afirmação aqui fornecida.