Hello. Well, we are going to have the privilege here, through Dr. Roberto Kigam and the one who speaks of Dr. Llorente, of presenting the second Latin American record of speech by catheter. Please, how can I do the next one? We will do it quickly for time and because the fact that it goes to the clinical case informs right away. Well, I'm going to do a part of what is the preamble, of what this is here. The importance of making a record, as you know, is to determine the evolution of invasive treatment of arrhythmias in Latin America, as well as providing reliable and comparable information on the activity and staffing of the units of arrhythmia in Latin America. We already had a first approach, already in 2012, thanks to the push that Dr. Roberto Kigam had with several doctors at the South American level, in which they were included more or less in 13 countries, with 120 centers, with 15,000 patients, in the first Latin American registry of catheter speaking, given through of the previous LARS, which was first the only S, in which they included electrophysiologists from the entire region, mainly from Argentina, Brazil and Mexico, but there was a sample at the level of South America, where we also made conversations at the same level. What was intended to be done with this first record? It was to determine the spoken substrates, from substrates simple to more complex substrates. At that time we were doing more simple substrates. We saw what the success rate of speech is, both in the supraventricular as in the ventricular. This is acute rate success. And they also saw the rates of complications, which is important, as we advance in the substrates, they increased the risk of complications, but when we went to see the type of complications, we saw that the complications are relatively, mainly due to hematomas at the puncture site, However, serious complications, such as blockages, tamponades with or without the need for pericardium or fistulas or pericarditis, resulting from the procedures, were relatively low. Then, going to what are the records at the level of everything that is the world, we have to not forget that since 2012 the Spanish Society of Arrhythmias and the Spanish Society of Gariology generates records year after year to try to determine the technical endowments they have and what personnel they include throughout the entire time of the evolution of their arrhythmic pathologies in treatment of the same. And they saw that in 2012, in service provision as personnel, they had 3.3 full-time physicians 2 and that they had more or less the same nursing staff, nursing assistants or technicians at the same level. Unlike what happens in Latin America, in Spain The services are mainly public, but they have a large supply of three-dimensional mapping systems, they have several electrophysiology rooms, more than one room, Almost 20, 30% and they also have facilities like us, such as intracardiac echocardiography, cryoablation and we have laser ablation. And this here, well, marks the step that we do not use. What is important in them is that despite the main arrhythmia that they cause, that we also do, I think it is atrial fibrillation, we see that the growth was exponential over time. There was a decline due to COVID in 2020, but it is is recovering almost 18,000 patients already in 2021, which is the data of the ablation rate. And like us, the complication rates were in simple substrates relatively low, less than 1% and as we begin to implement or increase the substrate, will increase the rate of complications mainly also at the level of the site or the puncture access. Something more current, localized and determined At the country level, it is the Argentine registry of ablation. This was published this year, if I am not mistaken, in which 18 centers were included, mainly at the level of Buenos Aires. Aires, the federal capital, but they included centers from Tucumán, Misiones, Corrientes, La Pampa, El Chanco and Córdoba. What was seen, this is 2019-2020, were 1,600 patients more or less registered in these 18 centers and it was seen that, in contrast, in January there was a slight increase of the ablation rate, but later in 2020, the years of COVID, they went down substantially and could not be recovered at the level of what is the time of what is the ablations. When they went to see the type of substrate, again the tachycarias, the atrial flutters or nodal reentrant tachycariasis, were the most common, followed by ablation by atrial fibrillation, atrial tachycardia or reentrant tachycardia. A fact important is that they made the location, like the 2012 record, of the location of the accessory pathways, whether at the level of the lateral wall, posterior wall, left wall, right wall or anterocentral level. Then, through LARS, there was also a symposium this year at HRS in which they wanted to determine the endowments we had at the South American level. to see the shortcomings in health systems and it is a fact that at the HRS summit everything intervened what is America and Latin America to try to determine how we were in terms of facilities, rooms and procedures. And again we begin, this is a sample of We did 786 patients, the substrates were mainly simple ones followed by FAO, flutters, bradycardia with pacemaker implants, ventricular abutments and here We discussed what the appendage closure is. What we saw in this center We had two angiography rooms, mainly rotational angiography, we had the systems mapping, we have the crankcase and what is the ensayex, we have the cryoconsole, the ecotransesophageal, intracardiac echo. We have three professionals and we always had the support of anesthesiologists, radio technicians, nurses, as I was talking about what the Spanish registry is and the Argentine registry of electrophysiology. It is also another center, more simple substrate, less AFA and more pacemaker implants that we also have. And the technologies that we can use, Here we are two electrophysiologists, we have a rotational angiography, we have two rooms and We have anesthesia, a room is for electrophysiology and we have surgery support. So from now on Next comes Dr. Kiham to talk about what the registry is, a registry to try to elucidate for us in the future what lies ahead for our registry. and determine what we are doing in South America. Well, after what Jose showed you, we have some data on this technique in some places. from Latin America, but the idea of the registry is to update and give continuity to that registry that we did a few years ago and that we published. And the idea of this second record is to update Not only data, but based on everything that has evolved in the last 10 years, so we incorporate data that we believe are important to know today in Latin America. Well, the record is going to be structured as follows. The first thing that is going to happen, Let's say, in the stages of registration it will be the researcher's registration. There we will register Some variables that will also help us to know the status of our electrophysiologists in Latin America. There you can see the demographic data of this country and fundamentally what I was telling you, years of experience, skills, ablations per year, let's say, the expertise of electrophysiologists, the memberships to which they belong and fundamentally the certifications. This has to do with the researcher. This is going to be the first step, registering as a researcher. Once registered, you will have an ID and a password. The ID will always be the email and one when you continue In the process you will have to use this same email to register data from the centers where we work. It is clear that many of us work in more than one center, so The idea is that each researcher registers each of the centers where he or she works. And of the centers we are going to record these variables to know all these types of data that we consider today important updates in Latin America. And finally, once the centers are registered, The centers have this data, there will be a codification of the centers so that in the next step, which is the final destination of the record, which is procedures, we register certain variables. I don't want to go on too long so as not to take up Ulysses' time. How are we? We are already there. The idea is that we register by procedure, not by patient. nor by substrate, by procedure. In each procedure we will be able to record data from different substrates, by procedure. As you can see there, I am not going to detail everything, You will see this, you will have it on the LARS website, it will begin to spread on social networks, but so that you can get an idea, and from a practical point of view Here, there will be little work to be done, so to speak, by whoever is doing the data loading. Why? Because most of the data will not be text, there will be no need to enter text. But it is important that you start to familiarize yourself there, checking the website, so that you can see what data you will need to have ready to load the procedures. Why am I telling you this? Because this is the start of the official data upload, it opens on the 1st of December, from December 1st we will be able to upload data. And from which procedures? Of all those carried out in the year 2023, from January 1st to December 31st, 2023, it will be to include this record. We will open it on December 1st and depending on the progress we will announce, in advance of course, when the data upload closes. I would just like to tell you that the registration presentation will obviously be on the website. and there will also be all the information regarding definitions, abbreviations, let's say, that we will consider in each of the variables that we will record. Once the data has been entered and closed, the analysis stage will begin later. But what It is important that you start to familiarize yourself and we are going to invite some colleagues to start to rehearse to have at this stage from now until December 1st a feedback that allows us correct things if they need to be corrected, some data that needs to be reviewed, the practicality of the system data entry systems that are web forms. So some will soon start to receive an email with the access links to the forms so that they can start registering data from now until December 1st. Later, starting on December 1st, we will begin with the data upload. We invite everyone to join and start spreading the word. It is important that we update our data and the more we are, the more and better information we will have. This is what we wanted to present to you and Jose and invite you to join the 2nd LARS Speech Registry. Thank you very much. Subtitles made by the Amara.org community

Latin America

arrhythmia treatment

electrophysiology registries

researchers

data entry