Brief reports
Cardiomyopathy induced by incessant fascicular ventricular tachycardia
Miocardiopatía inducida por taquicardia ventricular fascicular incesante
Enrique Velázquez-Rodrígueza,b,
, Horacio Rodríguez-Piñaa,b, Alex Pacheco-Bouthilliera,b, Luz María Deras-Mejíaa,b
Corresponding author
enve@prodigy.net.mx
Corresponding author at: Cuauhtémoc 330, col. Doctores CP 06725 México, D.F., Mexico. Tel.: +52(5)5627 6900x22076.
Corresponding author at: Cuauhtémoc 330, col. Doctores CP 06725 México, D.F., Mexico. Tel.: +52(5)5627 6900x22076.
a Unidad de Electrofisiología, División de Cardiología, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, DF, Mexico
b Curso de Posgrado de Alta Especialidad en Electrofisiología Cardiaca, Facultad de Medicina, Universidad Nacional Autónoma de México, México, DF, Mexico
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array:2 [ 0 => array:3 [ "entidad" => "Unidad de Electrofisiología, División de Cardiología, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, DF, Mexico" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Curso de Posgrado de Alta Especialidad en Electrofisiología Cardiaca, Facultad de Medicina, Universidad Nacional Autónoma de México, México, DF, Mexico" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author at: Cuauhtémoc 330, col. Doctores CP 06725 México, D.F., Mexico. Tel.: +52(5)5627 6900x22076." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Miocardiopatía inducida por taquicardia ventricular fascicular incesante" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2501 "Ancho" => 2917 "Tamanyo" => 386444 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">(A) Electrograms during VT showing recordings from distal to proximal sites (LV1–2, LV9–10) of decapolar mapping catheter located along the left ventricular septum. Earliest Purkinje potential (PP, arrows) was recorded at apical sites and activation sequence was toward the basal sites (long dotted arrow). (B) Fluoroscopic view showing catheter electrode positions. I, aVF, V1, V5 ECG leads; HIS; His bundle; RV, right ventricle; LAO, left anterior oblique.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Incessant or persistent tachycardia can lead to a clinical picture of dilated cardiomyopathy with left ventricular enlargement and impairment of systolic function. This phenomenon is particularly apparent in children with specific types of incessant supraventricular tachycardia as focal atrial tachycardia and permanent junctional reciprocating tachycardia.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–5</span></a> Reversibility of cardiac dysfunction has been shown after successful catheter ablation.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2,6–9</span></a> On the other hand, ventricular tachycardia (VT) is relatively uncommon in children, but, idiopathic is the most frequent form in the observed cases of pediatric VT and most had right bundle branch block (RBBB) configuration with left superior axis deviation (LSAD), VT usually occurs in young individuals with structurally normal hearts and generally carries a good prognosis.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> Idiopathic incessant VT leading to a tachycardia-mediated cardiomyopathy is a very rare form of clinical presentation. We report reversal of myocardial dysfunction after catheter ablation of an incessant fascicular VT.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Case report</span><p id="par0010" class="elsevierStylePara elsevierViewall">A 12-year-old girl was referred to the pediatric cardiology department for symptoms of fatigue, decreased exercise tolerance and progressive dyspnea (NYHA functional class III). She had a history of initially asymptomatic palpitations of undetermined date. A 12-lead electrocardiogram (12-lead ECG) (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>) showed a regular and sustained wide complex tachycardia (mean heart rate: 167<span class="elsevierStyleHsp" style=""></span>beats/min; QRS duration: 105<span class="elsevierStyleHsp" style=""></span>ms) with LSAD in the frontal plane and RBBB morphology in the horizontal plane with a pattern of qR in V1, R in V2–V3, RS transition in V4 and rS in V5–V6 interpreted initially as supraventricular tachycardia with aberrant conduction due to characteristic response to intravenous verapamil. At that time, the tachycardia had a clinical paroxystic pattern. Chest X-ray on admission revealed cardiomegaly and cephalization of pulmonary blood flow. Two-dimensional and Doppler echocardiography showed bi-ventricular dilatation, left ventricle dimensions: end-diastolic 60<span class="elsevierStyleHsp" style=""></span>mm; end-systolic 52.5<span class="elsevierStyleHsp" style=""></span>mm, severe global hypokinesis with mild mitral and tricuspid regurgitation, pulmonary arterial pressure 54<span class="elsevierStyleHsp" style=""></span>mmHg, and left ventricular ejection fraction (LVEF) 33% and fractional shortening 12.5% suggesting dilated cardiomyopathy.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Medical therapy included digoxin, furosemide, spironolactone, enalapril, propranolol and amiodarone. Due to only mild clinical improvement, prednisone and azathioprine were indicated for possible diagnosis of dilated cardiomyopathy secondary to viral myocarditis. Immunosuppressive therapy was ineffective, thus, the patient was proposed to heart transplantation program.</p><p id="par0020" class="elsevierStylePara elsevierViewall">At 14 years of age due to an incessant tachycardia pattern and refractory to antiarrhythmic drugs she was referred for electrophysiological study. The 12-lead ECG analysis was at first sight considered as fascicular ventricular tachycardia based on atrioventricular dissociation and typical pattern of RBBB QRS configuration with LSAD (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>).</p><p id="par0025" class="elsevierStylePara elsevierViewall">After written informed consent, electrophysiological testing was performed in a fasting and sedated state, Two 6-Fr Josephson quadripolar catheters (Biosense-Webster, USA) were inserted into the right femoral vein and placed under fluoroscopic guidance in the His bundle position and right ventricular apex. Endocardial mapping was performed during VT using a 5-Fr 2–5–2<span class="elsevierStyleHsp" style=""></span>mm spaced decapolar catheter (Torqr, Medtronic, USA) introduced into the right femoral artery and advanced retrogradely into the postero-infero-apical septum of the left ventricle searching for the activation sequence and Purkinje potentials (Pp-QRS) during VT. Intracardiac mapping confirmed a reentry mechanism of tachycardia located in the posterior fascicle of the left bundle branch. Afterwards, the decapolar catheter was replaced with a 7-Fr, 4<span class="elsevierStyleHsp" style=""></span>mm tip radiofrequency (RF) catheter (Stinger M curve B, Bard, USA) for TV mapping and ablation. RF catheter ablation was performed guided by a Pp-QRS recording (-24<span class="elsevierStyleHsp" style=""></span>ms at successful site) during tachycardia and RF current was applied (Atakr II, Medtronic, USA) with an average power of 33 Watts and maximum temperature 51<span class="elsevierStyleHsp" style=""></span>°C. (<a class="elsevierStyleCrossRef" href="#fig0010">fig. 2</a>). After a second successful application of RF current, programmed ventricular and atrial stimulation were performed without VT reinduction. Intravenous heparin in a bolus of 50<span class="elsevierStyleHsp" style=""></span>U/kg and as an infusion of 1000<span class="elsevierStyleHsp" style=""></span>U/h was administered during the procedure.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">The patient was monitored for 2 days after catheter ablation and followed without any antiarrhythmic drugs. 24-hour Holter, chest x-ray, echocardiogram and treadmill exercise test were obtained in an outpatient basis at monthly intervals during the first three months. Follow-up showed progressive improvement until normalization of cardiac function by echocardiography with LVEF 68%. <a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a> shows the sequence of chest x-ray. The patient remained asymptomatic and tachycardia free after 2 years of follow-up.</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Discussion</span><p id="par0035" class="elsevierStylePara elsevierViewall">Tachycardia-mediated cardiomyopathy (TMC) is defined as atrial or ventricular dysfunction caused by persistent abnormal high rates, but is reversible with cure of tachyarrhythmia.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,3,6,7</span></a> Different tachyarrhythmias have been reported to result in ventricular dysfunction especially in the context of supraventricular tachycardias.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–4,8,9</span></a> Notably, the automatic atrial tachycardia, which is a common cause of incessant tachycardia in children, is resistant to pharmacologic therapy and represents one of the most common etiologies of cardiomyopathy.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">11,12</span></a> Another common arrhythmia is the permanent junctional reciprocating tachycardia (Coumel) that is commonly incessant in infancy, even though it may not be recognized until adulthood and its persistent nature may lead to TMC.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Few reports have described TMC secondary to ventricular tachycardias, mostly related with idiopathic right ventricular outflow tract tachycardia.<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">13–15</span></a> Idiopathic fascicular ventricular tachycardia characterized by a pattern of QRS with RBBB and LSAD has a typical clinical presentation as paroxysmal and recurrent episodes and is intravenous verapamil-sensitive and is associated with good long-term prognosis.<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">16,17</span></a> Clinical picture as an unusual incessant form is extremely rare and symptoms of congestive heart failure have been published in only some pediatric cases with normalization of left ventricular function after treatment with catheter ablation in a 17-year-old boy,<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> 15-months-old infant,<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> 12-year-old boy<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> and 12-month-old baby<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> all with a behavior similar to our case.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Several pathological changes have been described but it remains unclear as to whether they play an etiologic role or they arise as a consequence of the tachycardia. Sustained VTs are more common in structural heart disease, such as primary cardiomyopathy and cause-effect relationship may be confusing. Others, such as scar VTs after congenital heart disease repair, may compromise ventricular function. Sustained VT originating in the left ventricle in patients without detectable heart disease has been widely recognized and it has been demonstrated that the underlying mechanism is a reentry circuit that includes an anterograde slow conduction area with passive retrograde activation along the posterior fascicle during idiopathic left VT.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> A focal fibrosis not related with ischemia or myocarditis in close proximity to the left posterior fascicle was presumed to be the possible cause of the incessant behavior in an isolated case of fascicular ventricular tachycardia.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Pathological changes include intense neurohormonal activation, high energy myocardial stores depletion, decreased beta-adrenergic responsiveness, abnormal calcium channel activity and sarcoplasmic reticulum calcium response.<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">24,25</span></a> Histological changes include distortion of myocyte geometry, changes in myocyte contractile and relaxation properties and finally increased left ventricular wall stress and decreased left ventricular performance and myocardial fibrosis.<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> TMC is a curable disease and should be suspected in any patient with decreased ventricular function in the setting of incessant tachycardia. As arrhythmias are frequently the result of cardiomyopathy, they are easily overlooked as the potential cause and it is difficult to determine whether the tachycardia is the cause or the result of cardiomyopathy, consequently, these patients can be easily misdiagnosed and potentially leading to inappropriate treatments. A high index of suspicion derived from history and clinical features remains the only available tool to diagnose a tachycardiomyopathy.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conclusion</span><p id="par0055" class="elsevierStylePara elsevierViewall">From a practical standpoint, the presence of a tachycardiomyopathy should be suspected in any patient with congestive heart failure and persistent or incessant tachycardia.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Funding</span><p id="par0060" class="elsevierStylePara elsevierViewall">No sponsorship of any kind was received to conduct this paper.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conflicts of interest</span><p id="par0065" class="elsevierStylePara elsevierViewall">The authors declare having no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:2 [ "identificador" => "xres274860" "titulo" => "Abstract" ] 1 => array:2 [ "identificador" => "xpalclavsec256741" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres274861" "titulo" => "Resumen" ] 3 => array:2 [ "identificador" => "xpalclavsec256742" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Case report" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Conclusion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Funding" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Conflicts of interest" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2012-10-11" "fechaAceptado" => "2013-04-30" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec256741" "palabras" => array:5 [ 0 => "Fascicular ventricular tachycardia" 1 => "Idiopathic left ventricular tachycardia" 2 => "Verapamil-sensitive ventricular tachycardia" 3 => "Tachycardia-mediated cardiomyopathy" 4 => "Mexico" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec256742" "palabras" => array:5 [ 0 => "Taquicardia ventricular fascicular" 1 => "Taquicardia ventricular izquierda idiopática" 2 => "Taquicardia ventricular sensible a verapamil" 3 => "Miocardiopatía mediada por taquicardia" 4 => "México" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A 12-year-old girl with symptoms of fatigue, decreased exercise tolerance and progressive dyspnea (New York Heart Association functional class III) with a possible diagnosis of dilated cardiomyopathy secondary to viral myocarditis. Because of incessant wide QRS tachycardia refractory to antiarrhythmic drugs, she was referred for electrophysiological study. The diagnosis was idiopathic left ventricular tachycardia involving the posterior fascicle of the left bundle branch. After successful treatment with radiofrequency catheter ablation guided by a Purkinje potential radiological and echocardiographic evaluation showed complete reversal of left ventricular function in the first 3 months and no recurrence of arrhythmia during 2 years of follow up.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Niña de 12 años de edad con síntomas por fatiga, disminución de la tolerancia al ejercicio y disnea progresiva (clase funcional III de la New York Heart Association) con un posible diagnóstico de miocardiopatía dilatada secundaria a miocarditis viral. Debido a taquicardia con QRS ancho de comportamiento incesante refractaria a diversos fármacos antiarrítmicos fue referida para estudio electrofisiológico. El diagnóstico final fue taquicardia ventricular izquierda idiopática con participación del fascículo posterior de la rama izquierda. Después del tratamiento exitoso con ablación transcatéter con radiofrecuencia guiado por un potencial de Purkinje la evaluación radiológica y ecocardiográfica demostró reversión completa de la función ventricular izquierda en los primeros 3 meses y sin recurrencia de la arritmia durante 2 años de seguimiento.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1144 "Ancho" => 2520 "Tamanyo" => 259996 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">12-lead ECG. Wide complex tachycardia (QRS 105<span class="elsevierStyleHsp" style=""></span>ms, heart rate, 167<span class="elsevierStyleHsp" style=""></span>beats per minute) with right bundle branch block morphology in the horizontal plane and left superior axial deviation in the frontal plane. Posterior fascicular ventricular tachycardia based on atrioventricular dissociation (arrows).</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2501 "Ancho" => 2917 "Tamanyo" => 386444 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">(A) Electrograms during VT showing recordings from distal to proximal sites (LV1–2, LV9–10) of decapolar mapping catheter located along the left ventricular septum. Earliest Purkinje potential (PP, arrows) was recorded at apical sites and activation sequence was toward the basal sites (long dotted arrow). (B) Fluoroscopic view showing catheter electrode positions. I, aVF, V1, V5 ECG leads; HIS; His bundle; RV, right ventricle; LAO, left anterior oblique.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 677 "Ancho" => 2464 "Tamanyo" => 144812 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Sequence of chest X-ray. (A) Cardiomegaly and cephalization of pulmonary blood flow before catheter ablation. (B) One month and (C) three months after successful catheter ablation.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:26 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Catheter ablation treatment of supraventricular tachycardia-induced cardiomyopathy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A.G. Lashus" 1 => "C.L. Case" 2 => "P.C. Gillette" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Pediatr Adolesc Med" "fecha" => "1997" "volumen" => "151" "paginaInicial" => "264" "paginaFinal" => "266" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9080934" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tachycardiomyopathy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Y. Nakazato" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Indian Pacing Electrophysiol J" "fecha" => "2002" "volumen" => "2" "paginaInicial" => "104" "paginaFinal" => "113" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16951726" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Reversible symptomatic dilated cardiomyopathy in older children and young adolescents due to primary non-sinus supraventricular tachyarrhythmias" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "M.S. Horenstein" 1 => "E. Saarel" 2 => "M. Dick II" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00246-002-0274-5" "Revista" => array:7 [ "tituloSerie" => "Pediatr Cardiol" "fecha" => "2003" "volumen" => "24" "paginaInicial" => "274" "paginaFinal" => "279" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12545317" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0735109707024825" "estado" => "S300" "issn" => "07351097" ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Permanent junctional re-entry tachycardia. A multicentre long-term follow-up study in infants, children and young adults" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "A. Lindinger" 1 => "G. Heisel" 2 => "T. von Bernuth" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur Heart J" "fecha" => "1998" "volumen" => "19" "paginaInicial" => "936" "paginaFinal" => "942" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9651719" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Permanent junctional reciprocating tachycardia in children: a multicentre study on clinical profile and outcome" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "G. Vaksmann" 1 => "C. D’Hoinne" 2 => "V. Lucet" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/hrt.2004.054163" "Revista" => array:6 [ "tituloSerie" => "Heart" "fecha" => "2006" "volumen" => "92" "paginaInicial" => "101" "paginaFinal" => "104" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15831598" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Recovery pattern of left ventricular dysfunction following radiofrequency ablation of incessant supraventricular tachycardia in infants and children" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "J.V. De Giovanni" 1 => "A.M. Dindar" 2 => "J. Griffith" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Heart" "fecha" => "1998" "volumen" => "79" "paginaInicial" => "588" "paginaFinal" => "592" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10078086" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rapid recovery of cardiac function after catheter ablation of persistent junctional reciprocating tachycardia in children" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "P. Noë" 1 => "V. Van Driel" 2 => "F. Wittkampf" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Pacing Clin Electrophysiol" "fecha" => "2002" "volumen" => "25" "paginaInicial" => "191" "paginaFinal" => "194" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11915986" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Reversibility of tachycardia-induced cardiomyopathy after radiofrequency ablation of incessant supraventricular tachycardia in children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C. Sánchez Fernández-Bernal" 1 => "F. Benito-Bartolomé" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Esp Cardiol" "fecha" => "1997" "volumen" => "50" "paginaInicial" => "643" "paginaFinal" => "649" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9380934" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Disfunción ventricular izquierda inducida por taquicardia: regresión postablación con catéter" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R.E. Velázquez" 1 => "H.J.A. Morales" 2 => "Z.F. Solórzano" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Mex Cardiol" "fecha" => "1998" "volumen" => "9" "paginaInicial" => "121" "paginaFinal" => "133" "itemHostRev" => array:3 [ "pii" => "S0735109704012471" "estado" => "S300" "issn" => "07351097" ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical spectrum and prognostic factors of pediatric ventricular tachycardia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "K. Song Mi" 1 => "J-S. Baek" 2 => "S. Kwon Bo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Circ J" "fecha" => "2010" "volumen" => "74" "paginaInicial" => "1951" "paginaFinal" => "1958" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20668351" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dilated cardiomyopathy induced by ectopic atrial tachycardia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R.E. Velázquez" 1 => "E.A. Martínez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Inst Cardiol Mex" "fecha" => "2000" "volumen" => "70" "paginaInicial" => "292" "paginaFinal" => "300" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10959459" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Electrophysiologic studies and radiofrequency catheter ablation of ectopic atrial tachycardia in children" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "K. Toyohara" 1 => "H. Fukuhara" 2 => "J. Yoshimoto" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00246-010-9809-3" "Revista" => array:6 [ "tituloSerie" => "Pediatr Cardiol" "fecha" => "2011" "volumen" => "32" "paginaInicial" => "40" "paginaFinal" => "46" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20936469" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Reversal of tachycardia induced cardiomyopathy following ablation of repetitive monomorphic right ventricular outflow tract tachycardia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "W. Grimm" 1 => "V. Menz" 2 => "J. Hoffman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Pacing Clin Electrophysiol" "fecha" => "2001" "volumen" => "24" "paginaInicial" => "166" "paginaFinal" => "171" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11270695" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ventricular tachycardia induced cardiomyopathy: improvement with radiofrequency ablation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "N.S. Jaggarao" 1 => "A.S. Nanda" 2 => "J.P. Daubert" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Pacing Clin Electrophysiol" "fecha" => "1996" "volumen" => "19" "paginaInicial" => "505" "paginaFinal" => "508" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8848402" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tachycardia induced cardiomyopathy secondary to right ventricular outflow tract ventricular tachycardia: improvement of left ventricular systolic function after radiofrequency catheter ablation of the arrhythmia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "J. Vigen" 1 => "P. Hill" 2 => "L.A. Biblo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "J Cardiovasc Electrophysiol" "fecha" => "1997" "volumen" => "8" "paginaInicial" => "445" "paginaFinal" => "450" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9106431" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0735109707035759" "estado" => "S300" "issn" => "07351097" ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Idiopathic sustained left ventricular tachycardia in pediatric patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "K. Yasui" 1 => "T. Shibata" 2 => "U. Yokoyama" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Pediatr Int" "fecha" => "2001" "volumen" => "43" "paginaInicial" => "42" "paginaFinal" => "47" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11207998" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0735109705007473" "estado" => "S300" "issn" => "07351097" ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0085" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Idiopathic left ventricular tachycardia in children" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "M. Suesaowalak" 1 => "A. Khongphatthanayothin" 2 => "B. Sunsaneewttayakul" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Med Assoc Thai" "fecha" => "2008" "volumen" => "91" "paginaInicial" => "1732" "paginaFinal" => "1738" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19127797" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0090" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Reversibility of tachycardia induced cardiomyopathy following the cure of idiopathic left ventricular tachycardia using radiofrequency energy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "B. Singh" 1 => "U. Kaul" 2 => "K.K. Talwar" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Pacing Clin Electrophysiol" "fecha" => "1996" "volumen" => "19" "paginaInicial" => "1391" "paginaFinal" => "1392" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8880807" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0095" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Reversibilidad de la miocardiopatía tras curación de la taquicardia ventricular incesante mediante ablación con radiofrecuencia en el lactante" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "F. Benito Bartolomé" 1 => "C. Sánchez Fernández-Bernal" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "An Esp Pediatr" "fecha" => "2000" "volumen" => "53" "paginaInicial" => "156" "paginaFinal" => "158" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11083958" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0100" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Resolution of tachycardia-induced cardiomyopathy following ablation of verapamil-sensitive idiopathic left ventricular tachycardia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "A. Arya" 1 => "M. Haghjoo" 2 => "P. Davari" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00246-005-1091-4" "Revista" => array:6 [ "tituloSerie" => "Pediatr Cardiol" "fecha" => "2006" "volumen" => "27" "paginaInicial" => "146" "paginaFinal" => "148" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16391993" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0105" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Curative ablation in a 12-month-old baby with severe ventricular systolic dysfunction and incessant ventricular tachycardia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "P. De Filippo" 1 => "P. Ferrero" 2 => "R. Brambilla" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/europace/eur054" "Revista" => array:6 [ "tituloSerie" => "Europace" "fecha" => "2011" "volumen" => "13" "paginaInicial" => "1052" "paginaFinal" => "1055" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21421576" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0110" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Electroanatomic substrate of idiopathic left ventricular tachycardia: unidirectional block and macroreentry within the Purkinje network" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "F. Ouyang" 1 => "R. Cappato" 2 => "S. Ernst" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "2002" "volumen" => "105" "paginaInicial" => "462" "paginaFinal" => "469" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11815429" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0115" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A case of focal fibrosis near the fascicle as a possible cause of incessant ventricular tachycardia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "D-W. Lee" 1 => "I-Y. Oh" 2 => "J-W. Seo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1540-8159.2011.03140.x" "Revista" => array:6 [ "tituloSerie" => "Pacing Clin Electrophysiol" "fecha" => "2012" "volumen" => "35" "paginaInicial" => "e131" "paginaFinal" => "e135" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21651588" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0120" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Alterations in serum sodium in relation to atrial natriuretic factor and other neuroendocrine variables in experimental pacing-induced heart failure" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "G.W. Moe" 1 => "T.P. Stopps" 2 => "C. Angus" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "J Am Coll Cardiol" "fecha" => "1989" "volumen" => "13" "paginaInicial" => "173" "paginaFinal" => "179" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2521228" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0735109702017266" "estado" => "S300" "issn" => "07351097" ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0125" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Myocardial Na, K-ATPase in tachycardia induced cardiomyopathy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "F.G. Spinale" 1 => "C. Clayton" 2 => "R. Tanaka" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Mol Cell Cardiol" "fecha" => "1992" "volumen" => "24" "paginaInicial" => "277" "paginaFinal" => "289" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1320703" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0130" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Increased number of cardiomyocytes in cross sections from tachycardia induced cardiomyopathy hearts" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "S. Jovanovic" 1 => "A.J. Grantham" 2 => "J.E. Tarara" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Int J Mol Med" "fecha" => "1999" "volumen" => "3" "paginaInicial" => "153" "paginaFinal" => "155" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9917522" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/14059940/0000008300000003/v1_201309150141/S1405994013000748/v1_201309150141/en/main.assets" "Apartado" => array:4 [ "identificador" => "9824" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Comunicaciones breves" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/14059940/0000008300000003/v1_201309150141/S1405994013000748/v1_201309150141/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1405994013000748?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 7 | 1 | 8 |
| 2024 October | 42 | 7 | 49 |
| 2024 September | 50 | 7 | 57 |
| 2024 August | 38 | 5 | 43 |
| 2024 July | 44 | 5 | 49 |
| 2024 June | 26 | 8 | 34 |
| 2024 May | 27 | 5 | 32 |
| 2024 April | 52 | 6 | 58 |
| 2024 March | 49 | 12 | 61 |
| 2024 February | 88 | 6 | 94 |
| 2024 January | 42 | 5 | 47 |
| 2023 December | 64 | 7 | 71 |
| 2023 November | 41 | 8 | 49 |
| 2023 October | 40 | 7 | 47 |
| 2023 September | 18 | 2 | 20 |
| 2023 August | 35 | 10 | 45 |
| 2023 July | 36 | 7 | 43 |
| 2023 June | 44 | 4 | 48 |
| 2023 May | 78 | 14 | 92 |
| 2023 April | 60 | 3 | 63 |
| 2023 March | 49 | 9 | 58 |
| 2023 February | 31 | 3 | 34 |
| 2023 January | 19 | 8 | 27 |
| 2022 December | 24 | 5 | 29 |
| 2022 November | 39 | 13 | 52 |
| 2022 October | 36 | 18 | 54 |
| 2022 September | 22 | 9 | 31 |
| 2022 August | 31 | 10 | 41 |
| 2022 July | 32 | 8 | 40 |
| 2022 June | 28 | 9 | 37 |
| 2022 May | 37 | 10 | 47 |
| 2022 April | 34 | 15 | 49 |
| 2022 March | 65 | 8 | 73 |
| 2022 February | 74 | 10 | 84 |
| 2022 January | 89 | 18 | 107 |
| 2021 December | 65 | 9 | 74 |
| 2021 November | 45 | 18 | 63 |
| 2021 October | 46 | 14 | 60 |
| 2021 September | 38 | 15 | 53 |
| 2021 August | 35 | 8 | 43 |
| 2021 July | 49 | 10 | 59 |
| 2021 June | 51 | 6 | 57 |
| 2021 May | 67 | 11 | 78 |
| 2021 April | 166 | 11 | 177 |
| 2021 March | 107 | 10 | 117 |
| 2021 February | 84 | 12 | 96 |
| 2021 January | 65 | 17 | 82 |
| 2020 December | 51 | 10 | 61 |
| 2020 November | 62 | 12 | 74 |
| 2020 October | 38 | 12 | 50 |
| 2020 September | 39 | 13 | 52 |
| 2020 August | 50 | 19 | 69 |
| 2020 July | 59 | 20 | 79 |
| 2020 June | 48 | 7 | 55 |
| 2020 May | 59 | 8 | 67 |
| 2020 April | 26 | 6 | 32 |
| 2020 March | 55 | 6 | 61 |
| 2020 February | 55 | 14 | 69 |
| 2020 January | 49 | 9 | 58 |
| 2019 December | 43 | 19 | 62 |
| 2019 November | 20 | 20 | 40 |
| 2019 October | 46 | 10 | 56 |
| 2019 September | 41 | 15 | 56 |
| 2019 August | 38 | 7 | 45 |
| 2019 July | 72 | 18 | 90 |
| 2019 June | 82 | 50 | 132 |
| 2019 May | 163 | 85 | 248 |
| 2019 April | 90 | 45 | 135 |
| 2019 March | 25 | 14 | 39 |
| 2019 February | 32 | 11 | 43 |
| 2019 January | 29 | 16 | 45 |
| 2018 December | 35 | 10 | 45 |
| 2018 November | 40 | 1 | 41 |
| 2018 October | 56 | 8 | 64 |
| 2018 September | 24 | 10 | 34 |
| 2018 August | 21 | 4 | 25 |
| 2018 July | 19 | 10 | 29 |
| 2018 June | 28 | 3 | 31 |
| 2018 May | 25 | 12 | 37 |
| 2018 April | 20 | 3 | 23 |
| 2018 March | 19 | 3 | 22 |
| 2018 February | 13 | 5 | 18 |
| 2018 January | 18 | 4 | 22 |
| 2017 December | 24 | 2 | 26 |
| 2017 November | 18 | 4 | 22 |
| 2017 October | 23 | 4 | 27 |
| 2017 September | 18 | 13 | 31 |
| 2017 August | 37 | 10 | 47 |
| 2017 July | 23 | 6 | 29 |
| 2017 June | 26 | 16 | 42 |
| 2017 May | 49 | 9 | 58 |
| 2017 April | 35 | 26 | 61 |
| 2017 March | 33 | 39 | 72 |
| 2017 February | 37 | 6 | 43 |
| 2017 January | 35 | 8 | 43 |
| 2016 December | 58 | 9 | 67 |
| 2016 November | 62 | 10 | 72 |
| 2016 October | 79 | 17 | 96 |
| 2016 September | 99 | 9 | 108 |
| 2016 August | 59 | 6 | 65 |
| 2016 July | 41 | 3 | 44 |
| 2016 June | 55 | 9 | 64 |
| 2016 May | 57 | 15 | 72 |
| 2016 April | 43 | 18 | 61 |
| 2016 March | 59 | 17 | 76 |
| 2016 February | 50 | 22 | 72 |
| 2016 January | 38 | 21 | 59 |
| 2015 December | 43 | 20 | 63 |
| 2015 November | 45 | 21 | 66 |
| 2015 October | 57 | 23 | 80 |
| 2015 September | 38 | 13 | 51 |
| 2015 August | 50 | 12 | 62 |
| 2015 July | 70 | 7 | 77 |
| 2015 June | 25 | 9 | 34 |
| 2015 May | 31 | 19 | 50 |
| 2015 April | 44 | 19 | 63 |
| 2015 March | 34 | 16 | 50 |
| 2015 February | 13 | 3 | 16 |
| 2015 January | 30 | 10 | 40 |
| 2014 December | 34 | 12 | 46 |
| 2014 November | 25 | 3 | 28 |
| 2014 October | 27 | 6 | 33 |
| 2014 September | 25 | 4 | 29 |
| 2014 August | 21 | 10 | 31 |
| 2014 July | 25 | 8 | 33 |
| 2014 June | 19 | 7 | 26 |
| 2014 May | 19 | 7 | 26 |
| 2014 April | 20 | 10 | 30 |
| 2014 March | 98 | 14 | 112 |
| 2014 February | 82 | 15 | 97 |
| 2014 January | 100 | 23 | 123 |
| 2013 December | 144 | 22 | 166 |
| 2013 November | 96 | 23 | 119 |
| 2013 October | 65 | 31 | 96 |
| 2013 September | 28 | 20 | 48 |
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