Cardioneuroablation: a new era for vagal syncope?

42 years old male athlete Bradycardia and vagal syncope episodes ECGs showed sinus rhythm with bradycardia (40-44 bpm) Transthoracic Echocardiogram: normal TILT test: positive - 2b cardio inhibitory response and 20s asystoleN/

ARC-HBR SCORE PREDICTS BETTER THAN HAS-BLED THE RISK OF MAJOR BLEEDING IN PATIENTS WITH ATRIAL FIBRILLATION

Neste estudo unicêntrico retrospetivo com doentes hospitalizados por fibrilhação auricular, o score ARC-HBR critérios major tem um desempenho superior ao HAS-BLED e semelhante ao HEMORR2HAGES na previsão do risco de hemorragiaN/

PrOgnosis in Pulmonary Embolism (PoPE): 30-Day mortality risk score based on five admission parameters

Introduction and objective: Several scoring systems have been developed for risk stratification in patients with acute pulmonary embolism (PE). The Pulmonary Embolism Severity Index (PESI) and its simplified version (sPESI) are among the most used, however the high number of variables hinder its application. Our aim was to derive an easy-to-perform score based on simple parameters obtained at admission to predict 30-day mortality in acute PE patients. Methods: Retrospective study in 1115 patients with acute PE from two institutions (derivation cohort n=835, validation cohort n=280). The primary endpoint was all-cause mortality at 30 days. Statistically and clinically relevant variables were selected for multivariable Cox regression analysis. We derived and validated a multivariable risk score model and compared to other established scores. Results: The primary endpoint occurred in 207 patients (18.6%). Our model included five variables weighted as follows: modified shock index ≥1.1 (hazard ratio [HR] 2.57, 1.68–3.92, p1,1 (HR 2,57, 1,68-3,92, p<0,001), neoplasia ativa (HR 2,27, 1,45-3,56, p<0,001), alteração do estado de consciência (HR 3,82, 2,50-5,83, p<0,001), concentração de lactato sérica ≥2,50 mmol/L (HR 5,01, 3,25-7,72, p<0,001) e idade ≥80 anos (HR 1,95, 1,26-3,03, p=0,003). O desempenho prognóstico foi superior a outros scores (AUC 0,83 [0,79-0,87] versus 0,72 [0,67-0,79] no PESI e (0,70 [0,62-0,75]) no sPESI, p<0,001) e a sua performance na cohort de validação foi boa (73 eventos em 280 doentes, 26,1%, AUC 0,76, 0,71-0,82, p<0,0001) e superior aos outros scores (p<0,05). Conclusões: O score PoPE (https://tinyurl.com/ybsnka8s) é um instrumento fácil com performance superior para prever mortalidade precoce em doentes admitidos com EP de baixo risco

PrOgnosis in Pulmonary Embolism (PoPE): 30-day mortality risk score based on five admission parameters

Existem vários sistemas de pontuação para a estratificação de doentes com tromboembolismo pulmonar (TEP). As taxas de mortalidade no TEP agudo dependem principalmente da gravidade da disfunção cardiopulmonar na apresentação e das comorbidades associadas.N/