<HTML><BODY style="word-wrap: break-word; -khtml-nbsp-mode: space; -khtml-line-break: after-white-space; "><FONT class="Apple-style-span" face="Arial">Español - Portugués</FONT><DIV><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">Español</FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Nuestro grupo informó en 1991 la incidencia de arritmias SV en pacientes con DAVD obvia.</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Se observó en un 25% de nuestra cohorte de pacientes retrospectivos.</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Desde entonces observamos que estas arritmias pueden ser los primeros síntomas en presentarse en pacientes con DAVD.</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Algunos de estos pacientes no tienen dilatación ventricular y tampoco regurgitación tricuspídea. </FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Por lo tanto, es posible sugerir que la enfermedad pueda haberse extendido a la aurícula. La histología del VD no es clara porque contiene fibrosis y adiposidad fisiológicamente. Aún no estudiamos la alteración de los “gap junction” en el músculo auricular en la DAVD.</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Las arritmias auriculares también son causas de descargas inapropiadas en pacientes con DAVD con dispositivo, especialmente aquellos con conducción AV rápida (Wenckebach de más de 200 lpm)</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Sugiero no dejar pasar un EEF completo que evalúe la conducción AV y la vulnerabilidad auricular.</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Am J Cardiol. 1991 May 15;67(13):1153.</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Frequency of supraventricular tachyarrhythmias in arrhythmogenic right ventricular dysplasia.</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Tonet JL, Castro-Miranda R, Iwa T, Poulain F, Frank R, Fontaine GH.</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Service de Rytmologie et de Stimulation Cardiaque, Hopital Jean Rostand, Ivry, France.</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Guy Hugues Fontaine</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">-------------</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">A incidência de arritmias SV em pacientes com DAVD óbvia foi relatada pelo nosso grupo em 1991.</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; line-height: 19px; "><FONT class="Apple-style-span" face="Arial">Esta foi observada em 25% da nossa coorte retrospectiva de pacientes.</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; line-height: 19px; "><FONT class="Apple-style-span" face="Arial">Desde então nós observamos que estas arritmias podem ser o primeiro sintoma a se apresentar nos pacientes com DAVD</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; line-height: 19px; "><FONT class="Apple-style-span" face="Arial">Alguns destes pacientes não têm dlatação ventricular e nem regurgitação tricúspide, Portanto, é possível sugerir que a doença pode ter alguma extensão para o átrio. A hitologia do VD não é clara porque contem fisiologicamente gordura e fibrose. Nós ainda não temos estudado alterações nas gap juntions no músculo atrial na DAVD. </FONT></DIV><P style="margin: 0.0px 0.0px 0.0px 0.0px; line-height: 19.0px"><FONT class="Apple-style-span" face="Arial"> </FONT></P><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; line-height: 19px; "><FONT class="Apple-style-span" face="Arial">Arritmias atriais também são causa de choques inapopriados nos pacientes com DAVD com dispositivo, especialmente aqueles com rápida condução AV (Wenebach abaixo se 200bpm).</FONT></DIV><P style="margin: 0.0px 0.0px 0.0px 0.0px; line-height: 19.0px"><FONT class="Apple-style-span" face="Arial"> </FONT></P><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; line-height: 19px; "><FONT class="Apple-style-span" face="Arial">Eu tenho sugerido não deixar de fazer avaliação completa da condução AV e da vulnerabilidade atrial.</FONT></DIV><P style="margin: 0.0px 0.0px 0.0px 0.0px; line-height: 19.0px"><FONT class="Apple-style-span" face="Arial"> </FONT></P><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; line-height: 19px; "><FONT class="Apple-style-span" face="Arial">Am J Cardiol. 1991 May 15;67(13):1153.</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; line-height: 19px; "><FONT class="Apple-style-span" face="Arial">Frequency of supraventricular tachyarrhythmias in arrhythmogenic right</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; line-height: 19px; "><FONT class="Apple-style-span" face="Arial">ventricular dysplasia.</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; line-height: 19px; "><FONT class="Apple-style-span" face="Arial">Tonet JL, Castro-Miranda R, Iwa T, Poulain F, Frank R, Fontaine GH. </FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; line-height: 19px; "><FONT class="Apple-style-span" face="Arial">Serviço de Ritmologia e de Estimulação Cardíaca, Hospital Jean Rostand, Ivry,</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; line-height: 19px; "><FONT class="Apple-style-span" face="Arial">França.</FONT></DIV><P style="margin: 0.0px 0.0px 0.0px 0.0px; line-height: 19.0px"><FONT class="Apple-style-span" color="#002269"><FONT class="Apple-style-span" face="Arial"> </FONT></FONT></P><P style="margin: 0.0px 0.0px 0.0px 0.0px; line-height: 19.0px"><FONT class="Apple-style-span" color="#002269"><FONT class="Apple-style-span" face="Arial"> </FONT></FONT></P><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; line-height: 19px; "><FONT class="Apple-style-span" color="#002269"><FONT class="Apple-style-span" face="Arial">Guy Hugues Fontaine </FONT></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial"><BR></FONT><DIV> <SPAN class="Apple-style-span" style="border-collapse: separate; border-spacing: 0px 0px; color: rgb(0, 0, 0); font-family: Helvetica; font-size: 12px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; text-align: auto; -khtml-text-decorations-in-effect: none; text-indent: 0px; -apple-text-size-adjust: auto; text-transform: none; orphans: 2; white-space: normal; widows: 2; word-spacing: 0px; "><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">--</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Dr.</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">Sergio</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">Dubner</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">President</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">of</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">Scientific</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">Committee</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; font: normal normal normal 13px/normal Lucida Grande; min-height: 16px; ; font-family: Lucida Grande; font-size: 13px; "><FONT class="Apple-style-span" face="Arial" size="3"><SPAN class="Apple-style-span" style="font-size: 12px;"><BR style="font-family: Lucida Grande; font-size: 13px; "></SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Dr.</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">Edgardo</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">Schapachnik</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">President</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">of</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">Steering</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">Committee</FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></DIV><FONT class="Apple-style-span" face="Arial"><BR class="Apple-interchange-newline"></FONT></SPAN><FONT class="Apple-style-span" face="Arial"> </FONT></DIV><FONT class="Apple-style-span" face="Arial"><BR></FONT></DIV></BODY></HTML>