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[This corrects the article DOI: 10.1371/journal.pntd.0012114.].

Prognosis of Chronic Chagasic Cardiomyopathy (CCC) patients depends on functional and clinical factors. Bradyarrhythmia requiring pacemaker is a common complication. Prognosis of these patients is poorly studied, and mortality risk factors are unknown. We aimed to identify predictors of death and to define a risk score for mortality in a large cohort of CCC patients with pacemaker. It was an observational, unicentric and prospective study. The endpoint was all-cause mortality. Cox regression was used to identify predictors of death and to define a risk score. Bootstrapping method was used to internal score validation. We included 555 patients and after a mean follow-up of 3.7±1.5 years, 100 (18%) deaths occurred. Predictors of death were: right ventricular dysfunction (HR [hazard ratio] 2.24; 95%CI 1.41-3.53; P = 0.001); heart failure class III or IV (HR 2.16; 95% confidence interval [95%CI] 1.16-4.00; P = 0.014); renal disease (HR 2.14; 95%CI 1.24-3.68; P = 0.006); left ventricular end-systolic diameter > 44mm (HR 1.97; 95%CI 1.26-3.05; P = 0.003); atrial fibrillation (HR 1.94; 95%CI 1.25-2.99; P = 0.003) and cardiomegaly on X-ray (HR 1.87; 95%CI 1.10-3.17; P = 0.020). The score identified patients with: low (0-20 points), intermediate (21-30 points) and high risk (>31points). The optimism-corrected C-statistic of the predictive model was 0.751 (95% CI 0.696-0.806). Internal validation with bootstrapping revealed a calibration slope of 0.946 (95% CI 0.920-0.961), reflecting a small degree of over-optimism and C-statistic of 0.746 (95% CI 0.692-0.785). This study identified predictors of mortality in CCC patients with pacemaker defining a simple, validated and specific risk score.

Remote monitoring is beneficial for the management of patients with cardiovascular implantable electronic devices by impacting morbidity and mortality. With increasing numbers of patients using remote monitoring, keeping up with higher volume of remote monitoring transmissions creates challenges for device clinic staff. This international multidisciplinary document is intended to guide cardiac electrophysiologists, allied professionals, and hospital administrators in managing remote monitoring clinics. This includes guidance for remote monitoring clinic staffing, appropriate clinic workflows, patient education, and alert management. This expert consensus statement also addresses other topics such as communication of transmission results, use of third‐party resources, manufacturer responsibilities, and programming concerns. The goal is to provide evidence‐based recommendations impacting all aspects of remote monitoring services. Gaps in current knowledge and guidance for future research directions are also identified.

A importância da taquicardia ventricular no mecanismo da morte súbita cardíaca é bastante conhecida. A presença de disfunçao ventricular esquerda (FEVE < 35 a 40%) identifica pacientes de risco, independentemente da cardiopatia de base. Contudo, a associaçao entre a FEVE e a cardiopatia chagásica crônica ainda precisa ser melhor compreendida, uma vez que a arritmogenicidade dessa doença pode ocorrer mesmo em pacientes com funçao ventricular esquerda preservada ou pouco alterada. Relata-se o caso de uma paciente jovem com cardiopatia chagásica e que, a despeito de apresentar FEVE preservada e nao ter sintomas de insuficiência cardíaca (NYHA), evoluiu com taquicardias ventriculares sustentadas de diferentes morfologias, refratárias à terapêutica farmacológica com amiodarona e procainamida e à ablaçao por radiofrequência. Durante a evoluçao, apresentou bloqueio atrioventricular transitório avançado como efeito colateral da terapia antiarrítmica.

A importância da taquicardia ventricular no mecanismo da morte súbita cardíaca é bastante conhecida. A presença de disfunçao ventricular esquerda (FEVE < 35 a 40%) identifica pacientes de risco, independentemente da cardiopatia de base. Contudo, a associaçao entre a FEVE e a cardiopatia chagásica crônica ainda precisa ser melhor compreendida, uma vez que a arritmogenicidade dessa doença pode ocorrer mesmo em pacientes com funçao ventricular esquerda preservada ou pouco alterada. Relata-se o caso de uma paciente jovem com cardiopatia chagásica e que, a despeito de apresentar FEVE preservada e nao ter sintomas de insuficiência cardíaca (NYHA), evoluiu com taquicardias ventriculares sustentadas de diferentes morfologias, refratárias à terapêutica farmacológica com amiodarona e procainamida e à ablaçao por radiofrequência. Durante a evoluçao, apresentou bloqueio atrioventricular transitório avançado como efeito colateral da terapia antiarrítmica.

A importância da taquicardia ventricular no mecanismo da morte súbita cardíaca é bastante conhecida. A presença de disfunçao ventricular esquerda (FEVE < 35 a 40%) identifica pacientes de risco, independentemente da cardiopatia de base. Contudo, a associaçao entre a FEVE e a cardiopatia chagásica crônica ainda precisa ser melhor compreendida, uma vez que a arritmogenicidade dessa doença pode ocorrer mesmo em pacientes com funçao ventricular esquerda preservada ou pouco alterada. Relata-se o caso de uma paciente jovem com cardiopatia chagásica e que, a despeito de apresentar FEVE preservada e nao ter sintomas de insuficiência cardíaca (NYHA), evoluiu com taquicardias ventriculares sustentadas de diferentes morfologias, refratárias à terapêutica farmacológica com amiodarona e procainamida e à ablaçao por radiofrequência. Durante a evoluçao, apresentou bloqueio atrioventricular transitório avançado como efeito colateral da terapia antiarrítmica.

Sesamoiditis secondary to gout is an extremely rare condition with few case reports in the literature. It is an important differential diagnosis because the treatment depends on targeted therapy, unlike the main causes of sesamoiditis that often involves immobilization with special orthoses and prescription of anti-inflammatory drugs. We report here a case of a 38-year-old male, athlete, with bipartite medial sesamoid, who had insidious pain in the base of the left hallux. Laboratory tests showed no alterations, and imaging examinations demonstrated sesamoiditis with suspicion of stress fracture. The patient was initially prescribed an immobilization boot and analgesic and anti-inflammatory drugs, but he did not respond to the measures taken. After the onset of the same condition in the contralateral foot and getting the same imaging findings, we began an investigation of systemic disease, focusing on gout, because of a positive family history, which was confirmed by dual-energy computed tomography.