Nonsurgical transthoracic epicardial radiofrequency ablation An alternative in incessant ventricular tachycardia

AbstractObjectivesThe purpose of this study was to analyze the feasibility, efficacy, and safety of epicardial radiofrequency (RF) ablation in patients with incessant ventricular tachycardia (VT).BackgroundManagement of patients with incessant VT is a difficult clinical problem. Drugs and RF catheter ablation are not always effective. A nonsurgical transthoracic epicardial RF ablation can be an alternative in patients refractory to conventional therapy.MethodsEpicardial RF ablation was performed in 10 patients who presented with incessant VT despite the use of two or more intravenous antiarrhythmic drugs.ResultsIn eight patients, endocardial ablation (EdA) failed to control the tachycardia. In the remaining two patients, epicardial ablation (EpA) was first attempted because of left ventricular thrombus and severe artery disease, respectively. Eight patients had a diagnosis of coronary artery disease with healed myocardial infarction. One patient had dilated cardiomyopathy, and one patient had idiopathic, incessant VT. In patients with structural heart disease, the mean ejection fraction was 0.28 ± 0.10%. Four patients previously received an implantable defibrillator. The EpA effectively terminated the incessant tachycardia in eight patients, which represents a success rate of 80%. In them, after a follow-up of 18 ± 18 months, a single episode of a different VT was documented in one patient. No significant complications occurred related to the procedure.ConclusionsIn patients with incessant VT despite the use of drugs or standard EdA, the epicardial approach was very effective and should be considered as an alternative in this life-threatening situation

La enseñanza de la Historia y los estudiantes ingresantes: obstáculos y estrategias superadoras

Desde la primera reforma de los planes de estudio durante la etapa democrática, hasta el año 1992, la asignatura Introducción a la Historia de las Sociedades integró el Año Básico Común de las carreras de la Facultad de Humanidades de la Universidad Nacional de Salta, junto con otras materias, cuyos objetivos eran introducir a los estudiantes a los diferentes trayectos disciplinares y profesionales que ofrecía la Facultad de Humanidades