Objective To observe the incidence of pocket bleeding complication associated with pacemaker implantation in patients receiving antiplatelet agents not be interrupted. Methods The study population consisted of consecutive patients treated between 2010 and 2014 in our unit. Patients receiving oral anticoagulation or in whom periprocedural heparin derivates were administered were excluded. Patients were classified in three groups according to the presence of any antiplatelet treatment. Group A: no antiplatelet therapy; Group B: given aspirin only; Group C: on aspirin and clopidogrel.Bleeding complications were categorized as minor,moderate or serve complications. All patients were followed up for six weeks. Results Incidence of minor bleeding complication was higher in patients of Group B or Group C than those in Group A( 3. 7% vs 23. 3%,P = 0. 009; 3. 7% vs 34. 6%,P = 0. 000). The rate of minor bleeding complication was not significantly different between Group B and Group C( 23. 3% vs 34. 6%,P = 0. 388). There were no statistically differences among three groups regarding moderate bleeding complication incidence( 3. 7%,6. 7%,7. 7% respectively,P 0. 05). No severe bleeding complications occurred in three groups patients. Conclusions Only minor bleeding complication rate increases in patients receiving antiplatelet agents not be interrupted,antiplatelet therapy can be continued before pacemaker implantation.
Objective Observe the effect of flecainide,sodium channel blocker,on rabbit left ventricular about its electrical excitation activity of epicardial and endocardium myocardial cells. Methods Using the wedge tissue specimen of rabbit left ventricular and recording transmural electrocardiogram( ECG) with a silver- silver chloride electrode,recording action potential of myocardial cells with floating glass microelectrode,we observed the effects of flecainide( 10 μmol / L) on the action potential excitability of epicardium( Epi) and endocardium( Endo) myocardial cells under normal circumstances and case of increasing extracellular potassium concentration. Results The effects of flecainide on the action potential excitability of myocardial cells were different between Epi and Endo. Under normal circumstances,after adding flecainide,when stimulation frequency accelerated to 2. 8- 3. 8 Hz,in all nine preparations,we observed seven preparations' epicardial action potential droping out. Increasing extracellular potassium concentration,the same phenomenon was observed seven in nine preparations when stimulation frequency accelerated to 1. 3- 2. 1 Hz. Conclusion Our experimental results suggest,the excitability of myocardial cells is different between Epi and Endo of rabbit left ventricle,the differences between the two performance obviously after flecainide intervention. When the resting membrane potential decreases,the membrane potential depolarized,decreasing the excitability of myocardial cells,then blocking Na channel,the differences between Epi and Endo are more obviously.
Objective To investigate the differences of right ventricular ( RV) R wave amplitude,T wave amplitude and T/R ratio measurements among pacing system analyzer ( PSA) and implantable cardioverter defibrillators ( ICDs) from dif-ferent manufactures. Methods Thirteen patients scheduled for first ICD or cardiac resynchronization therapy-cardioverter defibrillator ( CRTD) implantation were enrolled in this study. After stable pacing parameters of RV defibrillator lead being measured by PSA, the defibrillator lead was connected in turn to ICD function demos from different manufactures with a regular RV active fixation pacing lead and a sterile extension wire used for PSA testing. Then RV R wave amplitude and lead impedance were measured by PSA and different ICDs and electrograms ( EGMs) on which R wave and T wave ampli-tude manually measured were printed out at the time of autonomous cardiac rhythm . Results Although R wave ampli-tude measurement was consistent among PSA and different ICDs(Kendall's W=0. 776), they showed significant differ-ence(P<0. 01). Compared to PSA measurement, only Medtronic (MDT) had lower R wave amplitude (P=0. 019). However, T wave amplitude measured by MDT ICDs were significantly higher than those of Boston Scientific ( BSC) and Biotronic (BTK) ICDs (P=0. 000). For T/R ratio, MDT ICDs also had a much higher T/R ratio than those of BSC, St. Jude Medical (SJM) and BTK ICDs (P=0. 000). For printed EGMs, only those from BSC and BTK ICDs were suitable for direct measurement of the R wave amplitude. Lead impedance measurement was consistent among PSA and different ICDs (Kendall's W=0. 869), but they showed significant difference. Compared with PSA, lead impedance measured by SJM ICDs (P=0. 000) was slightly lower as well as BTK ICDs(P=0. 035). Conclusions Differences of R wave amplitude and T/R ratio measured by ICDs from different manufactures do exist.
Objective To investigate the deceleration capacity of rate ( DC) and its possible application in patients with acute hemorrhagic cerebral vascular disease. Methods A total of 128 patients with acute cerebral hemorrhage and pri-mary subarachnoid hemorrhage ( SAH ) who were divided into SAH group ( 48 cases ) , right basal ganglia hemorrhage group(30 cases ), left basal ganglia hemorrhage group (28 cases) ), non basal ganglia hemorrhage group( 22 cases) and 80 normal control subjects underwent 24-hour dynamic electrocardiogram recordings at the first day they were in hospital. The computer automatically calculated the DC values and the values of heart rate variability ( HRV) . Average heart rate, arrhythmic events, the changes of ST-T, cTnT increased, left ventricular ejection fraction ( EF) and the clinical outcome and other clinical indicators were analyzed in each group of DC≤2. 5 ms, DC 2. 6 ~ 4. 5 ms, DC > 4. 5 ms of Selected stroke patients. The incidence of DC ≤4. 5 ms and DC > 4. 5 ms were analyzed in each stroke group. The patients were followed up for 6 months and the mortality rate was calculated. Results Compared with the normal group, DC and HRV were significantly reduced in each stroke group (P<0. 01), and there is no significant difference among the stroke groups . Compared with group of DC>4. 5 ms , 24 h average heart rate, arrhythmic events, cTnT increased, the mortality rate had significantly difference (P<0. 01) in the group of DC≤2. 5 ms. There was no significant difference of the incidence of DC≤4. 5 ms and DC > 4. 5 ms among each stroke group. Conclusion DC≤2. 5 ms is expected to become early warning index of malignant arrhythmia and sudden death in patients with acute hemorrhagic cerebral vascular disease.
Objective To explore the cardiac protective effect of galanin receptor antagonist M40 in rats with heart fail-ure. Methods SD rats were randomly assigned to 3 groups: M40 group, saline group and sham-operation group. Left anterior descending of M40 and saline group was ligated to establish heart failure model, and sham-operation group was lia-gated loosely. The success of heart failure model was testified by echocardiography. M40 group was injected with M40 solu-tion, the other two groups were injected with saline for 4 weeks. Then, cardiac function was tested by echocardiography, serum brain natriuretic peptide(BNP), tumor necrosis factor-αand interleukin-6(IL-6) was tested by ELISA, the ratio of heart weight and body weight was measured, Masson stain was used to observe the morphologic change. Results Com-pared with sham-operation group (n=10), cardiac function of M40 group (n=9) and saline group (n=8) was decreased significantly, BNP and IL-6 was increased significantly (P<0. 05), the ratio of heart weight and body weight and the per-cent of collagen fiber area was also increased significantly (P<0. 05). Compared with saline group, cardiac function of M40 group was improved significantly,BNP and IL-6 was decreased significantly[(331. 43±38. 26) pg/ml vs (406. 26± 68. 25) pg/ml, (71. 71±9. 36) pg/ml vs (93. 82±19. 18) pg/ml, P<0. 05], meanwhile, the ratio of heart weight and body weight and the percent of collagen fiber area was also decreased [(0. 34±0. 024) vs (0. 39±0. 026), (0. 32±0. 092) vs (0. 44±0. 110), P<0. 05]. Conclusion The galanin receptor antagonist M40 can improve cardiac systolic function, decrease serum BNP and IL-6, and attenuate myocardial remodeling.
Objective To explore the feasibility, safety of laser-assisted lead extraction. Methods Consecutive la-ser-assisted lead extraction in 5 patients from Department of Cardiac Electrophysiology,Peking University People' s Hospi-tal. The clinical characteristics including reason for lead removal,lead characteristic,and complicaton were summarized. Results Eight leads in 5 patients were extracted successfully by lase sheah without complication. Four patients had Class I indications for lead extraction, 1 patient for Ⅱa indications. Conclusions Pacing and implantable cardioverter-defib-rillator leads can safely, effectively, and predictablybe extracted by lasersheath.
Objective This study evaluated the usefulness of fluorodesoxyglucose marked by fluorine-18( 18F-FDG)positron emission tomography( PET) and computed tomography( CT) in patients with suspected cardiovascular implantable electronic device( CIED) infection. Methods From Jan 2013 to Jun 2014,patients treated for CIED infection in our center were enrolled. The patients,suspected as CIED infection without confirm evidence from symptom,blood culture,echocardiography,underwent 18F-FDG PET / CT. Post 1 year follow up,analysis the accuracy of diagnosis depended on18F-FDG PET / CT. Result From Jan 2013 to Jun 2014,there were 227 patients treated for CIED infection in our center. 10 of 227 cases was suspected as CIED infection without confirm evidence from symptom,blood culture,echocardiography. Eight were suspected as infective endocarditis( IE),2 as pocket infection. The results of 18F-FDG PET / CT suggested no infection in 2 patients with suspected pocket infection,1 with suspected IE. One patient with suspected IE was diagnosed as bacteremia. 1 patient with vegetation,suspected IE,was diagnosed as no infection. All of the cases received standard treatment based on 18F-FDG PET / CT. Post follow up of 1 year,there were no recurrence and new infection ca-ses. Conclusions PET / CT is useful in diagnosis of CIED infection and classification
Category: 27. Clinical Electrophysiology—Ventricular ArrhythmiasSession-Poster Board Number: 1057-381 Authors: Yoshihiro Yamashina, Tetsuo Yagi, Akio Namekawa, Akihiko Ishida, Hirokazu Sato, Takashi Nakagawa, Manjirou Sakuramoto, Eiji Sato, Tomoyuki Yambe, Sendai City Hospital, Sendai, Japan, Tohoku University School of Medicine, Sendai, Japan Background: The relationship between J waves during sinus rhythm and idiopathic ventricular tachycardia (VT) or premature ventricular complexes (PVCs) originating from the right ventricular outflow tract (RVOT) has not been reported. The aim of this study was to investigate the prevalence and characteristics of idiopathic RVOT-VT/PVCs associated with J waves. Methods: The study enrolled 121 consecutive idiopathic RVOT-VT/PVC patients (mean age 45 ± 16 years, 46 males) undergoing radiofrequency catheter ablation (RFCA). The prevalence of J waves was assessed. The clinical and electrophysiological data were compared between the patients with J waves (J-wave group) and those without (Non-J-wave group). Results: J waves were present in 53 (43.8%) idiopathic RVOT-VT/PVC patients. The distribution of the J waves was as follows: Inferior leads = 62%, inferior-lateral leads = 24.5% and lateral leads = 13.2%. The J-wave group had a higher incidence of sustained VT (22.6% vs. 3.5%, P<0.01), shorter VT cycle length (303 ± 56 msec vs. 351 ± 62 msec, P<0.01) and more episodes of syncope (16% vs. 3%, P<0.05) than did the Non-J-wave group. There were no significant differences between the 2 groups in terms of the success rate of RFCA (90.9% vs. 88.8%, P= 0.72) or clinical outcome: No ventricular fibrillation, syncope or cardiac sudden death were observed in any patients during the follow up period. Conclusions: There was a high prevalence of J waves in the idiopathic RVOT-VT/PVC patients. J waves may play an important arrhythmogenic role in high risk idiopathic RVOT-VT patients.
Objective Catheter ablation for atrial fibrillation(AF) patients with atrial septalocclude(ASO) is challenging,this study is to evaluate the feasibility and safety of catheter ablation in these patients. Methods Sixteen patients [age(56 ± 12)years,10 male] with drug-refractory AF(10 paroxysmal,6 persistent) and previously implanted ASO device underwent ablation. The transseptal puncture was performed under the guidance of RAO 45° fluoroscopy. Balloon dilation of the closure device was performed if the native septum passage could not be achieved. For paroxysmal AF,the ablation strategy was circumferential pulmonary vein isolation(CPVI) and for persistent AF,atrial linear ablation was performed combined with CPVI. Results Transseptal access was achieved through the native septum in 11 patients(group A) and through the ASO in 5 patents(group B) with the aid of balloon dilatation. Pulmonary vein isolation was achieved in all the 16 patients and linear block was achieved in all the persistent patients except mitral isthmus block could not achieved in one patient. The transseptal,total fluoroscopy,procedural duration was(38 ± 8) min vs(5 ± 3)min,(54± 15) min vs(31 ± 11) min and(224 ± 36) min vs(165 ± 35) min in group B and A,respectively. No shunt at atrial level was detected by transthoracic echocardiography at 3-month follow up. During a follow-up of(16 ± 6) months,sinus rhythm was maintained in 12(75%) patients. No severe complications were observed. Conclusions In patients implanted ASO,catheter ablation of AF is feasible,safe,and effective. Balloon dilatation technique can facilitate transseptal access through the ASO.
Objective To analyze causes of reversible increase of pacing threshold during later period of follow-up in patients with permanent pacemaker implantation. Methods One thousand one hundred and forty-three patients were enrolled in this study,7 patients had reversible increase of pacing threshold during later period of follow-up. The clinical data were analyzed. Results In the seven patients,4 cases had clinical symptoms with amaurosis,brief loss of consciousness and loss of capture in ECG; 1 patient having atrial loss of captrue had no clinial symptoms beacause the ventrical capture's function was all right; 2 patients had no clinical symptoms benefited from the function of AutoCapture. Atrial pacing threshold in the baseline were between 0. 5-0. 75 V,ventricular pacing threshold in the baseline were between 0. 5-0. 75 V. When acute illness happened,ventricular threshold exceed 2. 5 V in 6 patients,and atrial threshold exceed 2. 5 V in 1patient. The 7 patients had different acute illness included large area of burns,acute exacerbation of chronic renal insufficiency,acute heart failure with respiratory failure,which could cause metabolic acidosis,hyperpotassaemia,myocardial ischemia and hypoxia. After the acute illness were relieved,pacing threshold became decreasing. Atrial pacing thresholds were between 0. 5-1. 0 V,ventricular pacing thresholds were between 0. 5-1. 5 V. Pacemaker could work normally again.Conclusions With the diseases such as heart failure,respiratory failure and renal insufficiency deteriorating,external environment of myocardial cells will be changed,and the pacing threshold will suddenly increase. The problem can be resolved by increase output voltage,implant the pacemaker with function of AutoCapture
Objective To investigate effects and mechanism of probucol to atrial electrophysiological properties and structure remodeling of chronic atrial pacing canine. Methods ①Twenty-one dogs were randomly divided into sham-operation group( n = 7),pacing-group( n = 7),and probucol group( n = 7). Dogs in pacing-group and probucol group were underwent right atrial pacing at 400 beats per minute for 6 weeks,the dogs in probucol group received probucol( 100 mg· kg- 1·d- 1) 1 week before rapid atrial pacing until pacing stop. ②Atrial electrophysiological index in dogs were observed. TUNEL technique was used to detect the atrial cell apoptosis. Fibrosis degree in the atrial were investigated by masson method. The indexes of oxidative stress were also measured by color comparison. The expressions of poly ADP-riboses polymerase-1( PARP-1) and apoptosis inducing factor( AIF) were observed by using the immunohistochemistry and westernblot. Results ①Compared with the sham-operation group,the inducibility and duration of atrial fibrillation( AF) increased significantly( P 0. 01),the expressions of PARP-1 and AIF increased dramatically( P 0. 001),and the apoptosis index and fibrosis degree increased dramatically in atria of the pacing-group( P 0. 01) ②Compared with pacinggroup,the inducibility of AF significantly decreased and the duration of AF was significantly shorten in the probucol group( P 0. 05). Probucol could significantly decrease expressions of PARP-1 and AIF,and significantly decrease the apoptosis index and firosis degree. The indexes of oxidative stress in probucol group were lower than the level in pacing-group. Conclusion Antioxidant probucol may downregulate expresion PARP-1 by reducing oxidative stress,and attenuate atrial electrophysiological and structural remodeling in atrial rapid pacing canine. [Chinese Journal of Cardiac Pacing and Electrophysiology,2014,28( 1) : 45- 49]
Objective Implantation of coronary sinus-left ventricular( CS-LV) lead is usually accomplished through CS long sheaths. This study observed sheathless technique,a simplified method of implanting CS-LV lead,and explored its feasibility and suitable vessel morphological characteristics in patents with cardiac resynchronization therapy( CRT). Methods Before the procedure of CRT,51 cases accepted anterograde cardiac venography during coronary angiography and were randomly divided into two groups,sheathless group( n = 26) and conventional group( n = 25). In the former group,CS long sheath was only used later if direct lead placement failed( unsuccessful subgroup). Results Eight patients were successfully placed CS-LV lead( successful subgroup). The success rate of sheathless group was 30. 8%,which was significantly lower than that of conventional group( 96%,P0. 001). Implanting duration and fluoroscopy time of CS-LV lead was significantly decreased in the successful subgroup,compared with conventional group [( 24. 1±5. 1) min vs( 45. 6 ±10. 1) min;( 9. 1±2. 5) min vs( 13. 3±2. 4) min,all P0. 001]. There were 2 cases( 8%) with CS dissection,3 cases( 12%) with instantaneous electrode dislocation when tearing the CS long sheath in the conventional group. Implanting duration and fluoroscopy time of CS-LV lead didn't significantly extend in the unsuccessful subgroup,compared with conventional patients,as well as perioperative complications( all P 0. 05). Successful subgroup had a significantly higher proportion of tubular CS than unsuccessful subgroup( 87. 5% vs 33. 3%,P0. 05). Meanwhile,CS diameter,target vessel diameter,angle between target vessel with proximal CS in the successful subgroup was significantly larger than that of unsuccessful group( all P0. 05). Conclusions Sheathless technique provides a kind of simplified,secure and economic method for implanting CS-LV lead,but the success rate is limited.
Oxidative stress injury plays an important role in the process of atrial remodeling. The mechanisms of oxidative stress injury in atrial by rapid pacing and the protective effects of resveratrol will be explored in this study. Thirty-two isolated rabbit hearts were produced by rapid atrial pacing. They were randomly divided into 4 groups: control group (Ctrl group), Rapid Atrial Pacing group (RAP group), Apocynin Pretreatment group (APO group) and Resveratrol Pretreatment group (RES group); each with 8 rabbits. At the end, the indexs of the oxdise stress were measured take advantage of the techniques of the immunohistochemistry, western blotting and reverse transcription PCR.
Objective To explore electrocardiographic characteristics and radiofrequency catheter ablation( RFCA)techniques of epicardial ventricular arrhythmias( VAs) from the great cardiac vein( GCV). Methods Twelve patients with VAs originating from epicardium were enrolled. Electrocardiographic features of VAs from GCV were compared with those from endocardium in control group. Evaluate the techniques and effect of RFCA. Results A total of 12 patients( 8males and 4 females) were enrolled in the study. Electrocardiogram( ECG) of all the patients showed a right bundle branch block morphology,and the R wave ratio of leadⅡ to Ⅲ( Ⅱ /Ⅲ) was about 1; all the precordial leads presented as an R-wave or Rs-wave,and all the R-wave in V1 were more than 75 ms. Pseudo-delta wave( PdW) 、duration of R wave and maximal deflection index( MDI) in epicardial VAs were significantly higher than those in control group( P0. 01).All the patients achieved acute success of ablation in GCV. Among them,9( 75%) could record late potential( LP) at the successful ablation sites during sinus rhythm. The distance from the successful ablation site to the closest coronary artery was( 8. 3±3. 3) mm. During the mean follow-up of( 10. 5±1. 2) months,only 1 patients had VAs recurred. Conclusion Recognition of the electrocardiographic and electrophysiological characteristics of VAs originating from epicardium is significant; RFCA through the GCV is an effective and secure strategy to cure VAs originating from epicardium.
Objective To evalute the effect of intracoronary electrocardiogram( IC-ECG) in alcohol septal ablation( ASA) in patients with hypertrophic obstructive cardiomyopathy( HOCM). Methods IC-ECG were performed in ASA in seven patients with HOCM. The decrease of left ventricular outflow tract gradient( LVOTG) in ASA were measured by pigtail catheter. The CK and CK-MB in plasma were assayed at 0,6,12,24,48,and 72 hours after ASA. Results The dosage of alcohol in 7 patients was( 2. 11 ± 1. 27) ml; The elevation of ST-segment in IC-ECG immediately after ASA was( 6. 36 ± 3. 54) times higher than before( P 0. 05). The LVOTG at rest before and after ASA were( 85. 71 ± 43. 53) mmHg and( 41 ± 38. 30) mmHg respectively,which decreased by 57%( P 0. 05). The evoked LVOTG before and after ASA were( 163. 75 ± 31. 46) mmHg and( 86 ± 24. 98) mmHg respectively,which decreased by 48%( P 0. 05). The peak values of CK and CK-MB in plasma were( 917. 54 ± 327. 86) IU/ L and( 123. 46 ± 52. 46) IU/ L respectively. The area under curve of CK( CK-Area) and CK-MB-Area were( 32 544.17 ±13 723.28) IU·h/L and( 4 125.78 ±1 964.95) IU·h/L respectively. The correlation coefficients between the elevation of ST-segment and CK-Area,CK-MB-Area,the dosage of alcohol and the decrease of LVOTG were 0. 028( P 0. 05), 0. 609( P 0. 05),0. 846( P 0. 05) and 0. 115( P 0. 05) respectively. The correlation coefficient between the peak values of CK-MB and the dosage of alcohol was 0. 582( P 0. 05). Conclusions IC-ECG may be helpful to estimate the myocardial necrosis in ASA. [Chinese Journal of Cardiac Pacing and Electrophysiology,2014,28( 1) : 29-32]
Objective To analyze the electrocardiogram( ECG) changes and clinical significances of percutaneous transluminal septal myocardial ablation( PTSMA) in patients with hypertrophic obstruction cardiomyopathy( HOCM).Methods Comparisons of V1-Ptf(-mm·s),amplitude increasing cases of R wave in V1-3leads,left ventricular hypertrophy,ST-T segment depression in left ventricular leads,pathologic Q wave in anteroseptal or inferior leads,T-wave inversion in anterior leads in standard 12 leads ECG between HOCM group( n = 76) underwent PTSMA and HCM with non-obstruction( n = 29) group( control group); Compared the differences when patients arrived in hospital,immediate changes after operation,before operation and 6 months later in HOCM group,evolution trends in ECG of control group. Results1 amplitude increasing cases of R wave in V1-3leads were significantly less in HOCM group( 14.5% vs 41.4%,P0.01),T-wave inversions were also less( 51.3% vs 93.1%,P 0.001). 2typical STEMI changes and evolutions,diversified arrhythmias in ECG immediately after operation in HOCM group,V1-Ptf(-mm·s) in HOCM group 6 months later was significantly lower than before operation[( 0.036±0.012 vs 0.051±0.014),P0.001]; pathologic Q wave cases were significantly more( 94.7% vs 28.9%,P0.001); 3V1-Ptf(-mm·s) in control group 6 months after drug treatment was significantly lower than before[( 0.039±0.010) vs( 0.047±0.010),P0.001].Conclusion PTSMA is an effective methold for treating patients with HOCM with the left ventricular hypertrophy and ST-T chang getting better improvement; pathologic Q wave is one of the successful changes of PTSMA,V1-ptf is an indicator for long-term effects of PTSMA,and drugs are basic treatments for HCM.[Chinese Journal of Cardiac Pacing and Electrophysiology,2014,28( 3) : 223-226]
Objective To investigate the effect of atorvastatin on left atrium diameter( LAD) and pro-thrombotic state in hypertensive patients with paroxysmal atrial fibrillation. Methods With basic hypotensive drug,62 hypertensive patients with paroxysmal atrial fibrillation were treated with atorvastatin or aspirin,and divided to aspirin group,atorvastatin group and aspirin+atorvastatin group.LAD,C-reactive protein( CRP),D-dimer( DD),fibrinogen( FIB),low-density lipoprotein cholesterol( LDL-C),erythrocyte sedimentation rate( ESR) and hematocrit( Hct) would be recorded before and after treatment for 6 months,then compared the effect of atorvastatin or aspirin on LAD,and pro-thrombotic state. Results In aspirin group,FIB,ESR and Hct were reduced after treatment( P0.05). In atorvastatin group and atorvastatin+aspirin group,LAD,CRP,LDL-C,DD,FIB,ESR and Hct were reduced( P 0.05),the difference of DD,FIB,ESR and Hct between these two group after treatment had statistical significance( P0.05). Comparing with aspirin,atorvastatin was better in reducing LAD,CRP and LDL-C,and would have almost the same effect in reducing the level of DD,FIB,ESR and Hct.Conclusion In hypertensive patients with paroxysmal atrial fibrillation,atorvastatin could reduce the level of LAD and CRP,improve pro-thrombotic state and and hemorrheology indexes.
Objective To investigate the effects of coexistence of obstructive sleep apnea-hypopnea syndrome( OSAHS) on the success rate of catheter ablation for atrial fibrillation( AF). Methods A total of 101 paroxysmal AF patients who were admitted for catheter ablation and accepted free sleep monitoring were enrolled. All patients underwent circumferential pulmonary vein ablation with the guidance of 3-D electro-anatomical mapping system and were followed up for at least 6 months. Results Of the 101 patients,41 were diagnosed of OSAHS. The rate of male was significantly higher in the OSAHS group than the control group without OSAHS( 35 /41 vs 37 /60,P 0. 01). The rate of conversion to sinus rhythm during the ablation procedure and the long-term success rate( 41% vs 72%) were significantly lower in the OSAHS group than these in the control group( P 0. 05). The increase in left atrial diameter and coexistence of OSAHS could independently predict the recurrence of AF after ablation. Conclusion Coexistence of OSAHS with AF significantly decreases the success rate of catheter ablation for AF. [Chinese Journal of Cardiac Pacing and Electrophysiology,2014,28( 1) : 37- 39]
Objective To evaluate the effect of shen song yang xin( SSYX) on neural remodeling after myocardial infarction in rabbits. Methods New Zealand White rabbits were randomly assigned into myocardial infarction( MI) group and MI +( SSYX)( 0. 4g / Kg. d- 1) group after successful establishment of model of MI. Sham operation group were not ligated in the same part of heart. Eight weeks after treatment,rabbits were sacrificed and samples were obtained from peri-infarcted and non-infarcted area. Nerve density were assessed by GAP43 and TH immunohistochemical technique. The nuclear transcription factor( NF-κB),endothelin-l( ET-1),nerve growth factor( NGF),interleukin-1β( IL-1β),tumor necrosis factor- α( TNF-α) and p75-NTR mRNA expression were examined. Results Compared to sham operation group,the densities of immunostaining positive nerve fibers were significantly higher and expressions of NF-κB,ET-1,NGF,IL-1β,TNF-α and p75-NTR mRNA significantly increased in MI group( P 0. 05 for all). Compared to MI group,the densities of GAP43 and TH positive nerve fibers decreased and expression of NF-κB,ET-1,NGF,IL-1β,TNF-α and p75-NTR mRNA were lowered in MI +( SSYX) group( P 0. 05 for all). Conclusion SSYX inhabits neural remodeling,which may be correlated with the inhabition of proinflammatory response and NGF signaling.[Chinese Journal of Cardiac Pacing and Electrophysiology,2014,28( 1) : 59- 62]
