Nestor Lopez Cabanillas - Academia.edu (original) (raw)

Papers by Nestor Lopez Cabanillas

Research paper thumbnail of Efficacy and Safety of Epicardial Access on Uninterrupted Anticoagulation Using the SAFER Epicardial Approach

Research paper thumbnail of Single/Dual Chamber vs. Cardiac Resynchronization Pacemakers for Cardiac Resynchronization – Results from the SYNCHRONY Collaborative Group

Heart Rhythm, Dec 31, 2023

Research paper thumbnail of 50-W vs 40-W During High-Power Short-Duration Ablation for Paroxysmal Atrial Fibrillation

JACC: Clinical Electrophysiology, Nov 30, 2023

Research paper thumbnail of 157. Implicaciones quirúrgicas de la teoría de torrent-guasp en el tratamiento mediante restauración ventricular de la insuficiencia cardíaca de origen isquémico

Cirugía Cardiovascular, Apr 1, 2012

Research paper thumbnail of Left Bundle Branch Versus Biventricular Pacing as the Initial Implant Strategy for Cardiac Resynchronization Therapy

Research paper thumbnail of Propagación eléctrica en los mecanismos de torsion y succión en un corazón de tres tiempos

Revista Argentina de Cardiología, Oct 1, 2015

Research paper thumbnail of Electrophysiological Activation and Times of Propagation in the Ventricular Muscle Band. First Study in Humans

Argentine Journal of Cardiology, Dec 20, 2016

Research paper thumbnail of 685Hemodinamic evaluation of univentricular versus biventricular stimulation in left endocardial cardiac resynchronization therapy

Research paper thumbnail of Evaluación hemodinámica no invasiva a largo plazo de la terapia de resincronización cardiaca endocárdica izquierda

Revista Argentina de Cardiologia, 2019

Introducción: La terapia de resincronización cardíaca presenta una tasa de un 25%-30% de paciente... more Introducción: La terapia de resincronización cardíaca presenta una tasa de un 25%-30% de pacientes "no respondedores". La resincronización endocárdica, en la que el catéter del ventrículo izquierdo se implanta en el endocardio, sería una alternativa para estos pacientes, aunque su evolución a largo plazo no ha sido investigada. Objetivos: Evaluación hemodinámica no invasiva a largo plazo de la resincronización endocárdica en respondedores clínicos. Métodos: Se incluyeron pacientes implantados según los criterios para resincronización, usando la técnica Jurdham, con más de 6 meses desde el implante. Todos eran respondedores clínicos. La respuesta hemodinámica se evaluó con un analizador de la función cardíaca, que mide los intervalos sistólicos (períodos preeyectivo y eyectivo) del ventrículo izquierdo y calcula automáticamente un índice de función sistólica y estimar la fracción de eyección (Systocor mod ÍS100). Para determinar la eficacia mecánica de la TRCe se comparó la función cardíaca durante el modo biventricular con el bloqueo completo de la rama izquierda, espontáneo o por estimulación única del ventrículo derecho; los pacientes fueron sus propios controles. Se promediaron al menos 20 latidos en cada modo de estimulación y se consideraron solo los cambios >1% con valor p < 0,01 como clínicamente relevantes y estadísticamente significativos. Resultados: Se incluyeron 17 pacientes, con mediana de seguimiento de 43 meses, rango 9 a 78 meses. La resincronización endocárdica, en comparación con la activación ventricular con BCRI, demostró que todos los pacientes acortaron el período preeyectivo en un promedio de 31 ms (15%), indicativo de disminución de la disincronía interventricular causada por el BCRI. En todos aumentó el índice de función sistólica en 0,3 (23%) y la FE en el 8,3%. En 12/17 (71%) aumentó el período eyectivo en promedio 8,7 mseg (2,9%), lo que sugiere un aumento del volumen sistólico. En todos los cambios el valor de p fue menor de 0,01. Conclusiones: La TRCe ofrece mejoría hemodinámica significativa a largo plazo, detectada por intervalos sistólicos.

Research paper thumbnail of Electrical Propagation in the Mechanisms of Torsion and Suction in a Three-phase Heart

Revista Argentina de Cardiología, 2015

Background: The hypothesis of Torrent Guasp considers that the ventricular myocardium consists of... more Background: The hypothesis of Torrent Guasp considers that the ventricular myocardium consists of a continuous muscular bandthat begins at the level of the pulmonary valve and ends at the level of the aortic root, limiting both ventricular chambers. Thisanatomy would provide the interpretation for two fundamental aspects of left ventricular dynamics: the mechanism of left ventriculartorsion and rapid diastolic filling due to the suction effect.Objectives: The aim of this study was to investigate the electrical activation of the endocardial and epicardial bands to understandventricular torsion, the mechanism of active suction during the diastolic isovolumic phase and the significance of the residual volume.Methods: Five patients underwent three-dimensional electroanatomic mapping. As the descending band is endocardial and theascending band is epicardial, two sites of puncture were used.Results: Three-dimensional endo-epicardial mapping demonstrates an electrical activation sequence i...

Research paper thumbnail of 2023 HRS/APHRS/LAHRS guideline on cardiac physiologic pacing for the avoidance and mitigation of heart failure

Journal of Arrhythmia

Cardiac physiologic pacing (CPP), encompassing cardiac resynchronization therapy (CRT) and conduc... more Cardiac physiologic pacing (CPP), encompassing cardiac resynchronization therapy (CRT) and conduction system pacing (CSP), has emerged as a pacing therapy strategy that may mitigate or prevent the development of heart failure (HF) in patients with ventricular dyssynchrony or pacing‐induced cardiomyopathy. This clinical practice guideline is intended to provide guidance on indications for CRT for HF therapy and CPP in patients with pacemaker indications or HF, patient selection, pre‐procedure evaluation and preparation, implant procedure management, follow‐up evaluation and optimization of CPP response, and use in pediatric populations. Gaps in knowledge, pointing to new directions for future research, are also identified.

Research paper thumbnail of Comparison of Left Bundle Branch Pacing Versus Left Ventricular Septal/Biventricular Pacing for Cardiac Resynchronization Therapy

Research paper thumbnail of Left Bundle Branch Area Pacing Versus Biventricular Pacing as Initial Strategy for Cardiac Resynchronization

JACC: Clinical Electrophysiology

Research paper thumbnail of LB-456088-3 Left Bundle Branch Area Versus Coronary Venous Lead Placement as the Initial Implant Strategy for Cardiac Resynchronization Therapy - Results from the Synchrony Collaborative Group

Research paper thumbnail of 2023 HRS/EHRA/APHRS/LAHRS expert consensus statement on practical management of the remote device clinic

Research paper thumbnail of Abordaje de la pared lateral del ventrículo izquierdo a través de una vena posterior para terapia de resincronización cardiaca

Revista Costarricense de Cardiología, Oct 1, 2018

Research paper thumbnail of Outcomes of Chlorhexidine Scrubbing without Capsulectomy vs. Complete Capsulectomy After Lead Extraction for the Treatment of Cardiac Implantable Device Infection

Introduction: Capsulectomy is recommended in patients with cardiac implantable electronic device ... more Introduction: Capsulectomy is recommended in patients with cardiac implantable electronic device (CIED) infection after transvenous lead extraction (TLE) but is time-consuming and requires extensive tissue debridement. In this study, we describe the outcomes of chlorhexidine gluconate (CHG) scrubbing in lieu of capsulectomy for the treatment of CIED infections. Methods: This retrospective observational study included patients who underwent TLE for CIED-related infections. In the capsulectomy group, complete capsulectomy was performed after hardware removal. In the CHG group, thorough scrubbing of the generator pocket with 20 cc of 2% CHG followed by irrigation with approximately 500 cc of sterile normal saline (SNS) was performed. The primary outcomes included reinfection and hematoma formation in the generator pocket. Secondary outcomes included any adverse reaction to chlorhexidine, the need for reintervention, infection-related mortality, and total procedural time. Results: A total of 102 patients (mean age 67.2±13 years, 32.4% female) underwent CIED extraction with either total capsulectomy (n=54) or CHG (n=48) scrubbing. Hematoma formation was significantly higher in the capsulectomy group vs. the CHG group (13% vs. 0%, p=0.014), with no significant differences in the reinfection rate. Capsulectomy was associated with longer procedural time (133.7±78.5vs. 89.9±51.8 minutes, p=0.002). No adverse reactions to CHG were found. Four patients (4.3%) died from worsening sepsis: 3 in the capsulectomy group and 1 in the CHG group (p=0.346). Conclusions: In patients with CIED infections, the use of CHG without capsulectomy resulted in a lower risk of hematoma formation and shorter procedural times without an increased risk of reinfection or adverse events associated with CHG use.

Research paper thumbnail of Terapia de ressincronizaçao cardíaca: superando desafios anatômicos

Research paper thumbnail of 2018 Joint European consensus document on the management of antithrombotic therapy in atrial fibrillation patients presenting with acute coronary syndrome and/or undergoing percutaneous cardiovascular interventions : a joint consensus document of the European Heart Rhythm Association (EHRA), Euro...

Europace, Feb 1, 2019

In 2014, a joint consensus document dealing with the management of antithrombotic therapy in atri... more In 2014, a joint consensus document dealing with the management of antithrombotic therapy in atrial fibrillation (AF) patients presenting with acute coronary syndrome (ACS) and/or undergoing percutaneous coronary or valve interventions was published, which represented an effort of the European Society of Cardiology Working Group on Thrombosis, European Heart Rhythm Association (EHRA), European Association of Percutaneous Cardiovascular Interventions (EAPCI), and European Association of Acute Cardiac Care (ACCA) endorsed by the Heart Rhythm Society (HRS) and Asia-Pacific Heart Rhythm Society (APHRS). Since publication of this document, additional data from observational cohorts, randomized controlled trials, and percutaneous interventions as well as new guidelines have been published. Moreover, new drugs and devices/interventions are also available, with an increasing evidence base. The approach to managing AF has also evolved towards a more integrated or holistic approach. In recognizing these advances since the last consensus document, EHRA, WG Thrombosis, EAPCI, and ACCA, with additional contributions from HRS, APHRS, Latin America Heart Rhythm Society (LAHRS), and Cardiac Arrhythmia Society of Southern Africa (CASSA), proposed a focused update, to include the new data, with the remit of comprehensively reviewing the available evidence and publishing a focused update consensus document on the management of antithrombotic therapy in AF patients presenting with ACS and/or undergoing percutaneous coronary or valve interventions, and providing up-to-date consensus recommendations for use in clinical practice.

Research paper thumbnail of 2018 Joint European consensus document on the management of antithrombotic therapy in atrial fibrillation patients presenting with acute coronary syndrome and/or undergoing percutaneous cardiovascular interventions: a joint consensus document of the European Heart Rhythm Association (EHRA), Europ...

In 2014, a joint consensus document dealing with the management of antithrombotic therapy in atri... more In 2014, a joint consensus document dealing with the management of antithrombotic therapy in atrial fibrillation (AF) patients presenting with acute coronary syndrome (ACS) and/or undergoing percutaneous coronary or valve interventions was published, which represented an effort of the European Society of Cardiology Working Group on Thrombosis, European Heart Rhythm Association (EHRA), European Association of Percutaneous Cardiovascular Interventions (EAPCI), and European Association of Acute Cardiac Care (ACCA) endorsed by the Heart Rhythm Society (HRS) and Asia-Pacific Heart Rhythm Society (APHRS). Since publication of this document, additional data from observational cohorts, randomized controlled trials, and percutaneous interventions as well as new guidelines have been published. Moreover, new drugs and devices/interventions are also available, with an increasing evidence base. The approach to managing AF has also evolved towards a more integrated or holistic approach. In recognizing these advances since the last consensus document, EHRA, WG Thrombosis, EAPCI, and ACCA, with additional contributions from HRS, APHRS, Latin America Heart Rhythm Society (LAHRS), and Cardiac Arrhythmia Society of Southern Africa (CASSA), proposed a focused update, to include the new data, with the remit of comprehensively reviewing the available evidence and publishing a focused update consensus document on the management of antithrombotic therapy in AF patients presenting with ACS and/or undergoing percutaneous coronary or valve interventions, and providing up-to-date consensus recommendations for use in clinical practice.

Research paper thumbnail of Efficacy and Safety of Epicardial Access on Uninterrupted Anticoagulation Using the SAFER Epicardial Approach

Research paper thumbnail of Single/Dual Chamber vs. Cardiac Resynchronization Pacemakers for Cardiac Resynchronization – Results from the SYNCHRONY Collaborative Group

Heart Rhythm, Dec 31, 2023

Research paper thumbnail of 50-W vs 40-W During High-Power Short-Duration Ablation for Paroxysmal Atrial Fibrillation

JACC: Clinical Electrophysiology, Nov 30, 2023

Research paper thumbnail of 157. Implicaciones quirúrgicas de la teoría de torrent-guasp en el tratamiento mediante restauración ventricular de la insuficiencia cardíaca de origen isquémico

Cirugía Cardiovascular, Apr 1, 2012

Research paper thumbnail of Left Bundle Branch Versus Biventricular Pacing as the Initial Implant Strategy for Cardiac Resynchronization Therapy

Research paper thumbnail of Propagación eléctrica en los mecanismos de torsion y succión en un corazón de tres tiempos

Revista Argentina de Cardiología, Oct 1, 2015

Research paper thumbnail of Electrophysiological Activation and Times of Propagation in the Ventricular Muscle Band. First Study in Humans

Argentine Journal of Cardiology, Dec 20, 2016

Research paper thumbnail of 685Hemodinamic evaluation of univentricular versus biventricular stimulation in left endocardial cardiac resynchronization therapy

Research paper thumbnail of Evaluación hemodinámica no invasiva a largo plazo de la terapia de resincronización cardiaca endocárdica izquierda

Revista Argentina de Cardiologia, 2019

Introducción: La terapia de resincronización cardíaca presenta una tasa de un 25%-30% de paciente... more Introducción: La terapia de resincronización cardíaca presenta una tasa de un 25%-30% de pacientes "no respondedores". La resincronización endocárdica, en la que el catéter del ventrículo izquierdo se implanta en el endocardio, sería una alternativa para estos pacientes, aunque su evolución a largo plazo no ha sido investigada. Objetivos: Evaluación hemodinámica no invasiva a largo plazo de la resincronización endocárdica en respondedores clínicos. Métodos: Se incluyeron pacientes implantados según los criterios para resincronización, usando la técnica Jurdham, con más de 6 meses desde el implante. Todos eran respondedores clínicos. La respuesta hemodinámica se evaluó con un analizador de la función cardíaca, que mide los intervalos sistólicos (períodos preeyectivo y eyectivo) del ventrículo izquierdo y calcula automáticamente un índice de función sistólica y estimar la fracción de eyección (Systocor mod ÍS100). Para determinar la eficacia mecánica de la TRCe se comparó la función cardíaca durante el modo biventricular con el bloqueo completo de la rama izquierda, espontáneo o por estimulación única del ventrículo derecho; los pacientes fueron sus propios controles. Se promediaron al menos 20 latidos en cada modo de estimulación y se consideraron solo los cambios >1% con valor p < 0,01 como clínicamente relevantes y estadísticamente significativos. Resultados: Se incluyeron 17 pacientes, con mediana de seguimiento de 43 meses, rango 9 a 78 meses. La resincronización endocárdica, en comparación con la activación ventricular con BCRI, demostró que todos los pacientes acortaron el período preeyectivo en un promedio de 31 ms (15%), indicativo de disminución de la disincronía interventricular causada por el BCRI. En todos aumentó el índice de función sistólica en 0,3 (23%) y la FE en el 8,3%. En 12/17 (71%) aumentó el período eyectivo en promedio 8,7 mseg (2,9%), lo que sugiere un aumento del volumen sistólico. En todos los cambios el valor de p fue menor de 0,01. Conclusiones: La TRCe ofrece mejoría hemodinámica significativa a largo plazo, detectada por intervalos sistólicos.

Research paper thumbnail of Electrical Propagation in the Mechanisms of Torsion and Suction in a Three-phase Heart

Revista Argentina de Cardiología, 2015

Background: The hypothesis of Torrent Guasp considers that the ventricular myocardium consists of... more Background: The hypothesis of Torrent Guasp considers that the ventricular myocardium consists of a continuous muscular bandthat begins at the level of the pulmonary valve and ends at the level of the aortic root, limiting both ventricular chambers. Thisanatomy would provide the interpretation for two fundamental aspects of left ventricular dynamics: the mechanism of left ventriculartorsion and rapid diastolic filling due to the suction effect.Objectives: The aim of this study was to investigate the electrical activation of the endocardial and epicardial bands to understandventricular torsion, the mechanism of active suction during the diastolic isovolumic phase and the significance of the residual volume.Methods: Five patients underwent three-dimensional electroanatomic mapping. As the descending band is endocardial and theascending band is epicardial, two sites of puncture were used.Results: Three-dimensional endo-epicardial mapping demonstrates an electrical activation sequence i...

Research paper thumbnail of 2023 HRS/APHRS/LAHRS guideline on cardiac physiologic pacing for the avoidance and mitigation of heart failure

Journal of Arrhythmia

Cardiac physiologic pacing (CPP), encompassing cardiac resynchronization therapy (CRT) and conduc... more Cardiac physiologic pacing (CPP), encompassing cardiac resynchronization therapy (CRT) and conduction system pacing (CSP), has emerged as a pacing therapy strategy that may mitigate or prevent the development of heart failure (HF) in patients with ventricular dyssynchrony or pacing‐induced cardiomyopathy. This clinical practice guideline is intended to provide guidance on indications for CRT for HF therapy and CPP in patients with pacemaker indications or HF, patient selection, pre‐procedure evaluation and preparation, implant procedure management, follow‐up evaluation and optimization of CPP response, and use in pediatric populations. Gaps in knowledge, pointing to new directions for future research, are also identified.

Research paper thumbnail of Comparison of Left Bundle Branch Pacing Versus Left Ventricular Septal/Biventricular Pacing for Cardiac Resynchronization Therapy

Research paper thumbnail of Left Bundle Branch Area Pacing Versus Biventricular Pacing as Initial Strategy for Cardiac Resynchronization

JACC: Clinical Electrophysiology

Research paper thumbnail of LB-456088-3 Left Bundle Branch Area Versus Coronary Venous Lead Placement as the Initial Implant Strategy for Cardiac Resynchronization Therapy - Results from the Synchrony Collaborative Group

Research paper thumbnail of 2023 HRS/EHRA/APHRS/LAHRS expert consensus statement on practical management of the remote device clinic

Research paper thumbnail of Abordaje de la pared lateral del ventrículo izquierdo a través de una vena posterior para terapia de resincronización cardiaca

Revista Costarricense de Cardiología, Oct 1, 2018

Research paper thumbnail of Outcomes of Chlorhexidine Scrubbing without Capsulectomy vs. Complete Capsulectomy After Lead Extraction for the Treatment of Cardiac Implantable Device Infection

Introduction: Capsulectomy is recommended in patients with cardiac implantable electronic device ... more Introduction: Capsulectomy is recommended in patients with cardiac implantable electronic device (CIED) infection after transvenous lead extraction (TLE) but is time-consuming and requires extensive tissue debridement. In this study, we describe the outcomes of chlorhexidine gluconate (CHG) scrubbing in lieu of capsulectomy for the treatment of CIED infections. Methods: This retrospective observational study included patients who underwent TLE for CIED-related infections. In the capsulectomy group, complete capsulectomy was performed after hardware removal. In the CHG group, thorough scrubbing of the generator pocket with 20 cc of 2% CHG followed by irrigation with approximately 500 cc of sterile normal saline (SNS) was performed. The primary outcomes included reinfection and hematoma formation in the generator pocket. Secondary outcomes included any adverse reaction to chlorhexidine, the need for reintervention, infection-related mortality, and total procedural time. Results: A total of 102 patients (mean age 67.2±13 years, 32.4% female) underwent CIED extraction with either total capsulectomy (n=54) or CHG (n=48) scrubbing. Hematoma formation was significantly higher in the capsulectomy group vs. the CHG group (13% vs. 0%, p=0.014), with no significant differences in the reinfection rate. Capsulectomy was associated with longer procedural time (133.7±78.5vs. 89.9±51.8 minutes, p=0.002). No adverse reactions to CHG were found. Four patients (4.3%) died from worsening sepsis: 3 in the capsulectomy group and 1 in the CHG group (p=0.346). Conclusions: In patients with CIED infections, the use of CHG without capsulectomy resulted in a lower risk of hematoma formation and shorter procedural times without an increased risk of reinfection or adverse events associated with CHG use.

Research paper thumbnail of Terapia de ressincronizaçao cardíaca: superando desafios anatômicos

Research paper thumbnail of 2018 Joint European consensus document on the management of antithrombotic therapy in atrial fibrillation patients presenting with acute coronary syndrome and/or undergoing percutaneous cardiovascular interventions : a joint consensus document of the European Heart Rhythm Association (EHRA), Euro...

Europace, Feb 1, 2019

In 2014, a joint consensus document dealing with the management of antithrombotic therapy in atri... more In 2014, a joint consensus document dealing with the management of antithrombotic therapy in atrial fibrillation (AF) patients presenting with acute coronary syndrome (ACS) and/or undergoing percutaneous coronary or valve interventions was published, which represented an effort of the European Society of Cardiology Working Group on Thrombosis, European Heart Rhythm Association (EHRA), European Association of Percutaneous Cardiovascular Interventions (EAPCI), and European Association of Acute Cardiac Care (ACCA) endorsed by the Heart Rhythm Society (HRS) and Asia-Pacific Heart Rhythm Society (APHRS). Since publication of this document, additional data from observational cohorts, randomized controlled trials, and percutaneous interventions as well as new guidelines have been published. Moreover, new drugs and devices/interventions are also available, with an increasing evidence base. The approach to managing AF has also evolved towards a more integrated or holistic approach. In recognizing these advances since the last consensus document, EHRA, WG Thrombosis, EAPCI, and ACCA, with additional contributions from HRS, APHRS, Latin America Heart Rhythm Society (LAHRS), and Cardiac Arrhythmia Society of Southern Africa (CASSA), proposed a focused update, to include the new data, with the remit of comprehensively reviewing the available evidence and publishing a focused update consensus document on the management of antithrombotic therapy in AF patients presenting with ACS and/or undergoing percutaneous coronary or valve interventions, and providing up-to-date consensus recommendations for use in clinical practice.

Research paper thumbnail of 2018 Joint European consensus document on the management of antithrombotic therapy in atrial fibrillation patients presenting with acute coronary syndrome and/or undergoing percutaneous cardiovascular interventions: a joint consensus document of the European Heart Rhythm Association (EHRA), Europ...

In 2014, a joint consensus document dealing with the management of antithrombotic therapy in atri... more In 2014, a joint consensus document dealing with the management of antithrombotic therapy in atrial fibrillation (AF) patients presenting with acute coronary syndrome (ACS) and/or undergoing percutaneous coronary or valve interventions was published, which represented an effort of the European Society of Cardiology Working Group on Thrombosis, European Heart Rhythm Association (EHRA), European Association of Percutaneous Cardiovascular Interventions (EAPCI), and European Association of Acute Cardiac Care (ACCA) endorsed by the Heart Rhythm Society (HRS) and Asia-Pacific Heart Rhythm Society (APHRS). Since publication of this document, additional data from observational cohorts, randomized controlled trials, and percutaneous interventions as well as new guidelines have been published. Moreover, new drugs and devices/interventions are also available, with an increasing evidence base. The approach to managing AF has also evolved towards a more integrated or holistic approach. In recognizing these advances since the last consensus document, EHRA, WG Thrombosis, EAPCI, and ACCA, with additional contributions from HRS, APHRS, Latin America Heart Rhythm Society (LAHRS), and Cardiac Arrhythmia Society of Southern Africa (CASSA), proposed a focused update, to include the new data, with the remit of comprehensively reviewing the available evidence and publishing a focused update consensus document on the management of antithrombotic therapy in AF patients presenting with ACS and/or undergoing percutaneous coronary or valve interventions, and providing up-to-date consensus recommendations for use in clinical practice.