In rural China, where healthcare relies on village doctors (nonspecialized practitioners who work exclusively in their village clinics), delivering integrated atrial fibrillation (AF) management poses challenges. We developed a telemedicine-based, village doctor-led integrated care model and conducted a cluster randomized clinical trial to assess its efficacy compared to usual care. A total of 30 village clinics were randomly assigned (1:1) to the intervention or control group, with 1,039 village residents aged >= 65 years with AF (44.3% women) recruited. The primary outcome in stage 1 is adherence to integrated AF care at 12 months. In stage 2, the primary outcome is a composite of cardiovascular death, all strokes, heart failure or acute coronary syndrome hospitalization, and AF emergency visits over 36 months. Both primary outcomes were met. At 12 months, 33.1% in the telemedicine-based, village doctor-led care group and 8.7% in the usual care group met all criteria for integrated AF care (between-group difference, 24.4% (95% confidence interval (CI), 18.3-30.5%); P < 0.001). Over 34.0 months, 41.8% in the telemedicine-based, village doctor-led care group and 10.3% in the usual care group met all criteria for integrated AF care (P < 0.001). The rate of the composite cardiovascular event outcome was lower in the telemedicine-based, village doctor-led care group than in the usual care group (6.2% versus 9.6% per year; hazard ratio, 0.64 (95% CI, 0.50-0.82); P < 0.001). Our trial intervention by this telemedicine-based integrated care delivery model of AF care in rural villages demonstrates better adherence and improved clinical outcomes compared to usual care. ClinicalTrials.gov registration: NCT04622514.

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a progressive disease characterized by adipose and fibrous replacement of the myocardium. While elevated testosterone levels have been implicated in the pathological process of ARVC, its exact contribution to cardiac fibrosis in ARVC remains unclear. In this study, we analyzed the potential contribution of gender-based differences on the distribution of the low-voltage area in an ARVC cohort undergoing an electrophysiological study, which was indicated by feature selection. Additionally, we established engineered cardiac spheroid models in vitro using patient-specific induced pluripotent stem cell (iPSC)-derived cardiomyocytes (iPSC-CMs) and iPSC-derived cardiac fibroblasts (icFBs). We elucidated the pathogenicity of abnormal splicing in the plakophilin-2 (PKP2) gene caused by an intronic mutation. Additionally, pathogenic validation of the desmoglein-2 (DSG2) point mutation further confirms the reliability of the models. Moreover, testosterone exacerbated the DNA damage in the mutated cardiomyocytes and further activated myofibroblasts in a chain reaction. In conclusion, we designed and constructed an in vitro three-dimensionally-engineered cardiac spheroid model of ARVC based on clinical findings and provided direct evidence of the fibrotic role of testosterone in ARVC.

Background This study aimed to investigate the predictive value of parameters of every precordial lead and their combinations in differentiating between idiopathic ventricular arrhythmias (IVAs) from the right ventricular outflow tract and aortic sinus of Valsalva (ASV). Methods and Results Between March 1, 2018, and December 1, 2021, consecutive patients receiving successful ablation of right ventricular outflow tract or ASV IVAs were enrolled. The amplitude and duration of the R wave and S wave were measured in every precordial lead during IVAs. These parameters were either summed, subtracted, multiplied, or divided to create different indexes. The index with the highest area under the curve to predict ASV IVAs was developed, compared with established indexes, and validated in an independent prospective multicenter cohort. A total of 150 patients (60 men; mean age, 45.3±16.4 years) were included in the derivation cohort. The RV1+RV3 index (summed R‐wave amplitude in leads V1 and V3) had the highest area under the curve (0.942) among the established indexes. An RV1+RV3 index >1.3 mV could predict ASV IVAs with a sensitivity of 95% and a specificity of 83%. Its predictive performance was maintained in the validation cohort (N=109). In patients with V3 R/S transition, an RV1+RV3 index >1.3 mV could predict ASV IVAs, with an area under the curve of 0.892, 93% sensitivity, and 75% specificity. Conclusions The RV1+RV3 index is a simple and novel criterion that accurately differentiates between right ventricular outflow tract and ASV IVAs. Its performance outperformed established indexes, making it a valuable tool in clinical practice.

Implantable neuroelectronic interfaces have gained significant importance in long-term brain-computer interfacing and neuroscience therapy. However, due to the mechanical and geometrical mismatches between the electrode-nerve interfaces, personalized and compatible neural interfaces remain serious issues for peripheral neuromodulation. This study introduces the stretchable and flexible electronics class as a self-rolled neural interface for neurological diagnosis and modulation. These stretchable electronics are made from liquid metal-polymer conductors with a high resolution of 30 mu m using microfluidic printing technology. They exhibit high conformability and stretchability (over 600% strain) during body movements and have good biocompatibility during long-term implantation (over 8 weeks). These stretchable electronics offer real-time monitoring of epileptiform activities with excellent conformability to soft brain tissue. The study also develops self-rolled microfluidic electrodes that tightly wind the deforming nerves with minimal constraint (160 mu m in diameter). The in vivo signal recording of the vagus and sciatic nerve demonstrates the potential of self-rolled cuff electrodes for sciatic and vagus neural modulation by recording action potential and reducing heart rate. The findings of this study suggest that the robust, easy-to-use self-rolled microfluidic electrodes may provide useful tools for compatible neuroelectronics and neural modulation.

ABSTRACT Background New-onset atrial fibrillation (NeAF) is common after cavotricuspid isthmus-dependent counterclockwise atrial flutter (CCW-AFL) ablation. This study aimed to investigate a simple predictive model of NeAF after CCW-AFL ablation. Methods and Results From January 2013 to December 2017, consecutive patients receiving CCW-AFL ablation were enrolled from three centers. Clinical, echocardiographic, and electrocardiographic data were collected and followed. Patients from two centers and another center were assigned into the derivation and validation cohorts, respectively. In the derivation cohort, logistic regression was performed to evaluate the ability of parameters to discriminate those with and without NeAF. A score system was developed and then validated. Two hundred seventy-one patients (mean 59.7±13.6 age; 205 male) were analyzed. During follow-up (73.0±6.5 months), 107 patients (39.5%) had NeAF. 190 and 81 patients were detected in the derivation and validation cohorts, respectively. Hypertension, age ≥70 years, left atrial diameter ≥42 mm, P wave duration ≥120 ms and the negative component of flutter wave in lead II ≥120 ms were selected as the final parameters. A weighted score was used to develop the HAD-AF score ranging from 0 to 9. In the derivation cohort, area under the receiver operating characteristic curve (AUC) was 0.938 (95% CI 0.902-0.974), superior to those of currently used CHA2DS2-VAS C (0.679, 95% CI 0.600-0.757) and HATCH scores (0.651, 95% CI 0.571-0.730) (P<0.001). Performance maintained in the validation cohort. Conclusions 39.5% of patients developed NeAF in 6 years after CCW-AFL ablation. HAD-AF score can reliably identify patients likely to develop NeAF after CCW-AFL ablation. Clinical Perspective What Is New? During a follow-up period of more than 6 years after CCW-AFL ablation, 107 of 271 (39.5%) patients developed NeAF. HAD-AF score, based on easily obtainable clinical, echocardiographic and electrocardiographic parameters, could better predict development of NeAF after CCW-AFL ablation (area under the receiver operating characteristics curve [AUC], 0.938), compared with currently used HATCH score (AUC, 0.651) and CHA2DS2-VAS C score (AUC, 0.679) (P<0.001). What Are the Clinical Implications? In CCW-AFL patients with a HAD-AF score >4, close postoperative follow-up for earlier detection of AF should be recommended, or the option of concomitant AF ablation could be considered during the shared decision-making process.

Substantial advancements have been achieved in the realm of cardiac tissue repair utilizing functional hydrogel materials. Additionally, drug-loaded hydrogels have emerged as a research hotspot for modulating adverse microenvironments and preventing left ventricular remodeling after myocardial infarction (MI), thereby fostering improved reparative outcomes. In this study, diacrylated Pluronic F127 micelles were used as macro-cross-linkers for the hydrogel, and the hydrophobic drug α-tocopherol (α-TOH) was loaded. Through the in situ synthesis of polydopamine (PDA) and the incorporation of conductive components, an injectable and highly compliant antioxidant/conductive composite FPDA hydrogel was constructed. The hydrogel exhibited exceptional stretchability, high toughness, good conductivity, cell affinity, and tissue adhesion. In a rabbit model, the material was surgically implanted onto the myocardial tissue, subsequent to the ligation of the left anterior descending coronary artery. Four weeks postimplantation, there was discernible functional recovery, manifesting as augmented fractional shortening and ejection fraction, alongside reduced infarcted areas. The findings of this investigation underscore the substantial utility of FPDA hydrogels given their proactive capacity to modulate the post-MI infarct microenvironment and thereby enhance the therapeutic outcomes of myocardial infarction.

PURPOSE:To investigate the role of radiomics features in thrombus age identification and establish a CT-based radiomics model for predicting thrombus age of large vessel occlusion stroke patients. METHODS:We retrospectively reviewed patients with middle cerebral artery occlusion receiving mechanical thrombectomy from July 2020 to March 2022 at our center. The retrieved clots were stained with Hematoxylin and Eosin (H&E) and determined as fresh or older thrombi based on coagulation age. Clot-derived radiomics features were selected by least absolute shrinkage and selection operator (LASSO) regression analysis, by which selected radiomics features were integrated into the Rad-score via the corresponding coefficients. The prediction performance of Rad-score in thrombus age was evaluated with the area under the curve (AUC) of receiver operating characteristic (ROC) curve analysis. RESULTS:A total of 104 patients were included in our analysis, with 52 in training and 52 in validation cohort. Older thrombi were characterized with delayed procedure time, worse functional outcome and marginally associated with more attempts of device. We extracted 982 features from NCCT images. Following T test and LASSO analysis in training cohort, six radiomics features were selected, based on which the Rad-score was generated by the linear combination of features. The Rad-score showed satisfactory performance in distinguishing fresh with older thrombi, with the AUC of 0.873 (95 %CI: 0.777-0.956) and 0.773 (95 %CI: 0.636-0.910) in training and validation cohort, respectively. CONCLUSION:This study established and validated a CT-based radiomics model that could accurately differentiate fresh with older thrombi for stroke patients receiving mechanical thrombectomy.

Objective:To assess the concerns about oral anticoagulants (OAC) in patients with nonvalvular atrial fibrillation (NAF) receiving anticoagulant therapy and find the education target in the use of OAC.Methods:It was a cross-sectional study. From December 2018 to October 2019, patients with NAF receiving OAC treatment in Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University were included. The questionnaire survey containing 10 questions was conducted to evaluate each patient's degree of concerns about OAC. A score of 0-10 indicated a level of concern ranging from none to very serious, with 0-3 considered as mild concern, 4-7 considered as moderate concern, and 8-10 considered as serious concern.Results:A total of 115 patients [mean age (65.9±12.5) years and 71 males] were selected in this study. The mean CHA 2DS 2-VASc score was 2.87±1.80. Fifty-six patients (48.7%, 56/115) took warfarin, 36 patients (31.3%, 36/115) took rivaroxaban, and 23 patients (20.0%, 23/115) took dabigatran. There were 89 (77.4%, 89/115) urban residents (urban group) and 26 (22.6%, 26/115) rural residents (rural group) . It had no significant difference in the types of OAC between urban and rural groups ( P=0.828) . Compared to urban patients, rural patients were more concerned about the risk of bleeding (4.1±3.6 vs.6.9±3.0, P=0.003) and the absence of antagonist after OAC overdose (3.6±3.8 vs.5.8±3.7, P=0.039) . There was no significant difference in drug cost between rural and urban population ( P=0.349) . Both of the two groups showed little concern about OAC's interaction with other drugs (66.1%, 76/115) or food (42.6%, 49/115) , while much concern about the potential impairment of liver and kidney functions by OAC (36.5%, 42/115) . Conclusion:Patients with NAF who received OAC treatment had little economic concerns. However, their knowledge of OAC remained lacking. Proper scientific education and optimized out-patient management of OAC should be further strengthened to improve the adherence to OAC.

Biophysical cues can facilitate the cardiac differentiation of human pluripotent stem cells (hPSCs), yet the mechanism is far from established. One of the binary colloidal crystals, composed of 5 μm Si and 400 nm poly(methyl methacrylate) particles named 5PM, has been applied as a substrate for hPSCs cultivation and cardiac differentiation. In this study, cell nucleus, cytoskeleton, and epigenetic states of human induced pluripotent stem cells on the 5PM were analyzed using atomic force microscopy, molecular biology assays, and the assay for transposase-accessible chromatin sequencing (ATAC-seq). Cells were more spherical with stiffer cell nuclei on the 5PM compared to the flat control. ATAC-seq revealed that chromatin accessibility decreased on the 5PM, caused by the increased entry of histone lysine methyltransferase SETDB1 into the cell nuclei and the amplified level of histone H3K9me3 modification. Reducing cytoskeleton tension using a ROCK inhibitor attenuated the nuclear accumulation of SETDB1 on the 5PM, indicating that the effect is cytoskeleton-dependent. In addition, the knockdown of SETDB1 reversed the promotive effects of the 5PM on cardiac differentiation, demonstrating that biophysical cue-induced cytoskeletal tension, cell nucleus deformation, and then SETDB1 accumulation are critical outside-in signal transformations in cardiac differentiation. Human embryonic stem cells showed similar results, indicating that the biophysical impact of the 5PM surfaces on cardiac differentiation could be universal. These findings contribute to our understanding of material-assistant hPSC differentiation, which benefits materiobiology and stem cell bioengineering.

Objective:To investigate the distribution of the trough activated partial thromboplastin time (APTT) level in patients with nonvalvular atrial fibrillation (NVAF) treated with dabigatran and the associated clinical variables. Furthermore, to explore whether the trough APTT level was different under different status of blood flow in the left atrial.Methods:This was a cross-sectional study. NVAF patients treated with dabigatran in Department of Cardiology, The First Affiliated Hospital with Nanjing Medical University were consecutively enrolled from August 2018 to October 2020. All the patients had taken dabigatran regularly for at least three weeks before enrollment. Plasma samples were collected, and APTT levels were measured when the plasma dabigatran concentration was at the trough. Creatinine clearance rate (CCR) was calculated using the Cockcroft-Gault equation. The associated clinical variables of APTT levels were identified using multiple linear regression analysis. The difference in APTT levels under different status of blood flow in the left atrial was analyzed using analysis of variance (ANOVA) .Results:A total of 584 patients were enrolled. The mean age was (60.3±10.7) years and 397 (68.0%, 397/584) patients were men. The average CHA 2DS 2-VASc score and HAS-BLED score of patients was 1.7±1.4 and 1.2±0.9, respectively. A total of 581 patients received dabigatran 110 mg bid, and another 3 patients received dabigatran 150 mg bid. The normal range of APTT in our hospital was 25.0-31.3 s. There were 1 patient with APTT level <25.0 s, 106 (18.2%, 106/584) patients with APTT levels ranging from 25.0 s to 31.3 s, 476 (81.5%, 476/584) patients with APTT levels ranging from 31.4 s to 62.6 s, and 1 patient with APTT level >62.6 s at the trough level of dabigatran. Multiple linear regression analysis revealed that CCR was significantly associated with the trough APTT levels of dabigatran ( P<0.001). There was no difference in APTT levels under different status of blood flow in the left atrial ( P=0 .535) . Conclusion:The trough-APTT levels of dabigatran in NVAF patients generally did not exceed twice the normal upper limit of 62.6 s. More attention should be paid to the changes of renal function in patients treated with dabigatran. APTT levels cannot accurately reflect the therapeutic effect of dabigatran.

A 55-year-old woman visited our hospital with paroxysmal atrial flutter ) and two episodes of abdominal pain which were found to be renal infarction. She had no cardiac history before the first thromboembolic (TE). The TE was she 20 mg for 20 days. Her 2 2 -VASc TEs to the her (LA) was mildly

目的:评估因前循环大血管闭塞导致的急性缺血性脑卒中合并房颤的老年患者取栓治疗的临床结局及影响因素.方法:2019年1月—2021年7月,前循环大血管闭塞且合并房颤的老年患者(≥80岁)被纳入研究.主要终点为90 d改良Rankin评分(modified Rankin scale,mRS).次要终点包括全因死亡率、血管再通等级(modified thrombolysis in cerebral infarc-tionscale,mTICI)和颅内出血转化.采用多因素Logistic回归分析影响临床预后的因素.结果:最终纳入74例患者.良好预后(90 d mRS 0～2分)率为21.6％,血流良好再通(mTICI 2b-3级)比例为77％,全因死亡率为36.4％,颅内出血转化率为35.1％.多因素Logistic回归分析显示,非阵发性心房颤动(OR=18.35,95％CI:1.98～169.77,P=0.010)、基线美国国立卫生研究院卒中量表(NI-HSS)评分(OR=1.42,95％CI:1.15～1.75,P＜0.001)、总流程时长(OR=1.01,95％CI:1.00～1.02,P=0.030)是老年房颤患者机械取栓预后的独立危险因素.结论:老年房颤患者前循环急性缺血性脑卒中时,如合并基线NIHSS评分高和域非阵发性房颤时,选择取栓治疗要更慎重.也需进一步提高老年房颤患者的抗凝率预防脑卒中.

PURPOSE:Anticoagulation (AC) is the main preventive strategy for ischemic stroke in atrial fibrillation (AF) patients. We aim to investigate the association of prior AC with thrombus composition and clinical outcome in AF patients with acute ischemic stroke (AIS).MATERIALS AND METHODS:From January 2019 to December 2020, consecutive AIS patients with AF treated with mechanical thrombectomy (MT) in our center were included in this analysis. Retrieved thrombi were stained with hematoxylin and eosin (H&E) and Martius Scarlet blue (MSB). The relative fractions of red blood cell (RBC), white blood cell (WBC), fibrin, and platelet were quantitatively analyzed. Procedural and clinical outcomes were compared between patients with and without prior AC.RESULTS:A total of 133 patients were enrolled in this study, with 39 in AC group and 94 in non-AC (NAC) group. Thrombi in AC group contained more fibrins (36% vs 20%, p<0.001), more platelets (36% vs 24%, p<0.001) and fewer RBCs (25% vs 54%, p<0.001). No difference was detected in terms of successful recanalization evaluated with modified Thrombolysis in Cerebral Infarction scale (mTICI 2b-3, 97% vs 86%, p=0.065), functional independence at 90 days with modified Rankin Score (mRS 0-2, 44% vs 33%, p=0.246).CONCLUSION:Thrombi retrieved from AF patients with prior AC contained more fibrins, more platelets and fewer RBCs compared with those of NAC patients. A trend of higher successful reperfusion rate was observed in AC patients but failed to reach statistical significance.

Background To assess the clinical outcomes after endovascular thrombectomy (EVT) in elderly large vessel occlusion (LVO)-related acute ischemic stroke (AIS) patients with atrial fibrillation (AF). Methods Between January 2019 and December 2020, consecutive AF patients who received EVT due to anterior-circulation stroke were enrolled. The primary outcome was modified Rankin scale (mRS) score at 90 days. Secondary outcomes included all-cause mortality, the recanalization status after EVT (assessed using modified thrombolysis in cerebral infarction scale, mTICI) and any intracranial hemorrhage (ICH). A multivariate logistic regression model was performed to identify predictors of the functional outcome. Results A total of 148 eligible patients were finally enrolled. Among them, 42 were ≥ 80 years old. Compared to their younger counterparts, patients aged ≥80 years had lower likelihood of good functional outcome (mRS score 0–2) at 90 days (26.2% vs. 48.1%, P = 0.015), less satisfied recanalization (mTICI, 2b-3) (78.6% vs. 94.3%, P = 0.004) and higher all-cause mortality rate (35.7% vs. 14.2%, P = 0.003). A multivariable logistic regression analysis showed that age ≥ 80 years at baseline were the significant predictors for a poor functional outcome (OR: 3.72, 95% CI: 1.17–11.89, p = 0.027). Intravenous thrombolysis (IVT) prior to EVT and longer time intervals from onset of symptoms to EVT tended to be associated with poor functional outcome in patients ≥80 years old. Conclusions Age ≥ 80 years was a significant predictor of unfavorable outcomes after EVT for AIS patients with AF. An increased risk of adverse events must be balanced against the benefit from EVT in elderly patients with AF.

To establish a nomogram incorporating pretreatment imaging parameters and clinical characteristics for predicting the thrombus composition of acute ischemic stroke (AIS) with large vessel occlusion (LVO). We retrospectively enrolled patients with occlusion of the Middle Cerebral Artery (MCA) who underwent Mechanical Thrombectomy (MT). Retrieved thrombi were stained with Hematoxylin and Eosin (H&E) and Martius Scarlet Blue (MSB). Thrombi are assigned to the Fibrin-rich or RBC-rich group based on the relative fractions of Red Blood Cells (RBC), fibrin, and platelet. The independent risk factors for Fibrin-rich clots were determined via univariate and multivariate logistic regression analysis and were then integrated to establish a nomogram. In total, 98 patients were included in this study. Patients with fibrin-rich clots had worse functional outcome [modified Rankin scale (mRS) 0–2, 34.7% vs 63.2%, p = 0.005], longer procedure time (76.8 min vs 50.8 min, p = 0.001), and increased maneuvers of MT (1.84 vs 1.46, p = 0.703) than those with RBC-rich clots. The independent risk factors for Fibrin-rich clots were lower perviousness measured by Non-Contrast Computer Tomography (NCCT) and CT Angiography (CTA), lower thrombus relative attenuation on NCCT, elevated Platelet-WBC ratio (PWR) of admission peripheral blood, and previous antithrombotic medication. The nomogram showed good discrimination with an area under the Receiver Operating Characteristic (ROC) curve (AUC) of 0.852 (95% CI: 0.778–0.926). The calibration curve and decision curve analysis also displayed satisfactory accuracy and clinical utility. This study has developed and internally validated an easy-to-use nomogram which can help predict clot composition and optimize therapeutic strategies for thrombectomy.

BACKGROUND:Epicardial adipose tissue (EAT) accumulation is associated with the progression of atrial fibrillation. However, the histological features of EATs are poorly defined and their correlation with atrial fibrosis is unclear.OBJECTIVE:The purpose of this study was to identify and characterize EAT subgroups in the persistent atrial fibrillation (PeAF) cohorts.METHODS:EATs and the corresponding left atrial appendage samples were obtained from patients with PeAF via surgical intervention. Adipocyte markers, that is, Uncoupling Protein 1, Transcription Factor 21, and CD137, were examined. On the basis of expression of adipocyte markers, patients with PeAF were categorized into subgroups by using unsupervised clustering analysis. Clinical characteristics, histological analyses, and outcomes were subsequently compared across the clusters. External validation was performed in a validation cohort.RESULTS:The ranking of feature importance revealed that the 3 adipocyte markers were the most relevant factors for atrial fibrosis compared with other clinical indicators. On the k-medoids analysis, patients with PeAF could be categorized into 3 clusters in the discovery cohort. The histological studies revealed that patients in cluster 1 exhibited statistically larger size of adipocytes in EATs and severe atrial fibrosis in left atrial appendages. Findings were replicated in the validation cohort, where severe atrial fibrosis was noted in cluster 1. Moreover, in the validation cohort, there was a high degree of overlap between the supervised classification results and the unsupervised cluster results from the k-medoids method.CONCLUSION:Machine learning-based cluster analysis could identify subtypes of patients with PeAF having distinct atrial fibrosis profiles. Additionally, EAT whitening (increased proportion of white adipocytes) may be involved in the process of atrial fibrosis.

Background: New-onset atrial fibrillation (AF) after ablation of typical atrial flutter (AFL) is not rare. This study aimed to investigate the predictive value of electrocardiographic parameters on new-onset AF post-typical AFL ablation. Methods: A total of 158 consecutive patients (79.1% males, mean age 57.8 ± 14.3 years) with typical AFL were enrolled between January 2012 and August 2017 in this single-center study. Patients with a history of AF before ablation were excluded. ECGs during sinus rhythm (SR) and AFL were collected. The duration of the negative component of flutter wave in lead II (DFNII), proportion of the DFNII of the total circle length of AFL (DFNII%), amplitude of the negative component of flutter wave in lead II (AFNII), duration (DPNV1), and amplitude (APNV1) of negative component of the P wave in lead V1, and P wave duration in lead II (DPII) during sinus rhythm were measured. Results: During a median follow-up of 26.9 ± 11.8 months, 22 cases (13.9%) developed new-onset AF. DFNII was significantly longer in patients with new-onset AF compared to patients without AF (114.7 ± 29.6 ms vs. 82.7 ± 12.8 ms, p < 0.0001). AFNII was significantly lower (0.118 ± 0.034 mV vs. 0.168 ± 0.051 mV, p < 0.0001), DPII (144.21 ± 23.77 ms vs. 111.46 ± 14.19 ms, p < 0.0001), and DPNV1 was significantly longer (81.07 ± 16.87 ms vs. 59.86 ± 14.42 ms, p < 0.0001) in patients with new-onset AF. In the multivariate analysis, DFNII [odds ratio (OR), 1.428; 95% CI, 1.039–1.962; p = 0.028] and DPII (OR, 1.429; 95% CI, 1.046–1.953; p = 0.025) were found to be independently associated with new-onset AF after typical AFL ablation. Conclusion: Parameters representing left atrial activation time under both the SR and AFL were independently associated with new-onset AF post-typical AFL ablation and may be useful in risk prediction, which needs to be confirmed by further prospective studies.

肥厚型心肌病(hypertrophic cardiomyopathy,HCM)是一种常见的常染色体显性遗传心脏病,全球患病率(200～500)/10万,是青少年、运动员猝死的主要原因,部分患者会出现心力衰竭、心房颤动、卒中等并发症[1].HCM主要以左心室肥厚病变为主,而以双心室肥厚并以右心功能不全为主要表现的病例较为少见.本文报道1例双心室HCM.