Introduction: The implantable cardiodefibrillator (ICD) the best available treatment for patients with hypertrophic cardiomyopathy (HCM), survivors or at high risk sudden cardiac death (SCD). The incidence of SCD HCM has decreased significantly since the advent of ICD. We report our 25-year experience with its use in a public hospital. Materials and methods: A retrospective analysis of 630 patients with HCM from 1999 to 2024 was made, including 26 patients with ICD implantation. Risk factors, ICD indication, functional class, discharges, echo-cardiographic measurements, and ICD-related and non-interventional complications were analyzed. Results: The mean age was 42.5 +/- 15.5 years, with 11 patients being women (42.3%). A total 25 patients (96.1%) were in primary prevention and 1 in secondary prevention. The maximum left ventricular wall thickness was 26 +/- 5.9 mm. The risk factors for SCD that motivated implantation were family history of SCD (42.3%), non-sustained ventricular tachycardia (61.5%) and massive left ventricular hypertrophy (LVH) (50%). Fourteen ICD therapies were recorded, 8 being appropriate (1.18%/ year) and 6 inappropriate (0.85%/year). The complication rate was 15.4% (0.57%/year), and no deaths were reported. Conclusion: There is very little information on the evolution of treatment of HCM with ICD in our country. We present here the results of a 25-year follow-up with a median of 10 years, in which the ICD, implanted in most cases in primary prevention, allowed excellent long-term survival with a low rate of complications.
INTRODUCTION:The COVID-19 pandemic exposed inequalities in mortality across territories. Northern Argentina, characterized by high social vulnerability and active international borders, despite formal closures, may have favored the spread of the virus. OBJECTIVE:To identify high-mortality clusters (HMC) due to COVID-19 among older adults (≥60 years) between 2020-2022, in relation to socioeconomic conditions and the border strip (FF). MATERIALS AND METHODS:A population-based ecological study of COVID-19 deaths was conducted in provinces with international border strips. Spatial and space-time scan analyses were applied to detect highmortality clusters (HMC). The relationship between these clusters, socioeconomic indicators, and location within the border strip was evaluated. RESULTS:Between 2020 and 2022, 12 968 deaths were recorded among older adults. In 2020, HMC were located in Salta and Jujuy (RR=3.6). In 2021, clusters shifted to Chaco and Formosa, in areas bordering Paraguay. In 2022, they concentrated in Corrientes and Misiones (RR=1.6-1.8). Population density was associated with clusters in 2020. Over the entire period, 41% of HMC were located within the FF. CONCLUSION:In 2020, the departments connected to Bolivia through road corridors showed higher mortality, and the expansion observed in 2021 coincided with the increase in deaths in Paraguay. Several studies have reported the persistence of informal or illegal border crossings, which may have sustained active cross-border circulation. These findings highlight the importance of regional cooperation and the need to strengthen epidemiological surveillance in border areas.
