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• 2014 Volume 23 Issue 5
  Published: 28 October 2014

    

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  Rotor identification by body surface mapping and endocardial mapping：impact on atrial fibrillation ablation

  Karl-Heinz Kuck

  2014, 23(5): 305-318. https://doi.org/10.13308/j.issn.1008-0740.2014.05.001

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  Quadripolar left ventricular pacing in amplifying CRT benefits

  Dietmar Schmitz

  2014, 23(5): 319-325. https://doi.org/10.13308/j.issn.1008-0740.2014.05.002

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  Effect of amiodarone and perindopril on cardioversion in elderly patients with persistent atrial fibrillation

  2014, 23(5): 331-333. https://doi.org/10.13308/j.issn.1008-0740.2014.05.004

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  Objective  To investigate the effect of amiodarone and perindopril on cardioversion in elderly patients with persistent atrial fibrillation. Methods  A total of 92 elderly patients with persistent atrial fibrillation were randomly divided into two groups, conventional treatment group and combined treatment group, with 46 cases in each group. For restoration of sinus rhythm, conventional treatment group took amiodarone while combined treatment group received perindopril (4 mg/d) additionally. The rate and the average time of cardioversion within 4 weeks between the two groups was observed and compared. Results  The rate of cardioversion within 4 weeks in combined treatment group was significantly higher than that of conventional treatment group, with significantly shorter average cardioversion time, and both the differences were statistically significant(P<0.05).Conclusion  Amiodarone combined with perindopril can significantly improve cardioversion rates for elderly patients with persistent atrial fibrillation and shorten the average time of cardioversion.
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  Effect of levosimendan in treating severe heart failure: an observation report on 60 cases

  2014, 23(5): 334-337. https://doi.org/10.13308/j.issn.1008-0740.2014.05.005

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  Objective  To study the clinical effect on heart failure patients with intravenous use of levosimendan.Methods  We collected 60 cases of heart failure patients from January 2012 to January 2014, including 30 cases with ischemic cardiomyopathy and 30 with dilated cardiomyopathy. Since conventional drugs did not work, these patients were given intravenous injection of levosimendan. According to the instructions, the initial loading dose was 12 μg/kg in 10 minutes, and then continuous dose remained to be 0.1 μg·kg-1·min-1.For heart failure patients, the clinical efficacy of levosimendan was evaluated by comparing the improvements of some indexes 48 hours after the drug therapy and before. The indexes included left ventricular ejection fraction(LVEF), stroke volume(SV), and N-terminal brain natriuretic peptide(NT-BNP). Results  The mean value of LVEF increased by 6.41% 48 hours after the treatment than before, and the difference was statistically significant(P＜0.05). The increase of LVEF in ischemic cardiomyopathy group(increase by 8.32%) was significantly higher than that in dilated cardiomyopathy group(increase by 4.5%), and the difference was statistically significant(P＜0.05). The average increase of SV was 13.91 mL after the treatment, and the difference was statistically significant if (P＜0.05) if compared with SV value before the processing. The average increase of SV in ischemic cardiomyopathy group(17.56 mL) was significantly higher than that in dilated cardiomyopathy group(10.26 mL), and the difference was statistically significant(P＜0.05). The average decrease of NTBNP was 4 051 pg/mL after the treatment, and the difference was statistically significant if (P＜0.05) if compared with the value before the processing. With the use of levosimendan, dyspnea was relieved and the overall physical status of heart failure patients was improved significantly.Conclusion  Compared with routine treatment, intravenous use of levosimendan proves to be effective in patients with severe decompensated heart failure. It ameliorates hemodynamics indexes of ischemic cardiomyopathy patients better than those of dilated cardiomyopathy cases. 
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  Heart rate variability analysis of type 2 diabetes mellitus patients before and after treatment

  2014, 23(5): 338-340. https://doi.org/10.13308/j.issn.1008-0740.2014.05.006

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  Objective To observe the changes of heart rate variability(HRV) of patients with type 2 diabetes mellitus(T2DM) before and after treatment.MethodsDiabetes mellitus group enrolled 48 cases of T2DM patients and another 50 healthy volunteers participated in the control group. Before and after the treatment of T2DM patients, the changes of their HRV time domain indexes SDNN,SDANN,rMSSD and PNN50, and HRV frequency domain indexes LF,HF,LF/HF,VLF were observed and compared with those of control group.ResultsBefore the treatment, the HRV time domain and frequency domain indexes of diabetes mellitus group were all lower than those of control group(P＜0.05). Compared with situations before the treatment, the HRV time domain indexes of diabetes mellitus group such as SDNN, SDANN, rMSSD and PNN50 all improved in some extent after the treatment(P＜0.05)，so did the HRV frequency domain indexes of LF, HF and VLF(P＜0.05).ConclusionT2DM patients are usually found abnormity in regulation function of cardiac autonomic nerve, mainly vagus lesions. After proper treament, the regulation function of autonomic nerve could be recovered in some extent.
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  The application of ambulatory electrocardiography in acute arrhythmia monitoring

  FENG Xia, NA Zhi-Ying, LI Bo, HAN Xue

  2014, 23(5): 341-344. https://doi.org/10.13308/j.issn.1008-0740.2014.05.007

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  Objective To evaluate the clinical value of ambulatory electrocardiography(AECG) on acute arrhythmia monitoring.MethodsWe collected routine electrocardiogram(ECG) and AECG results of inpatients and outpatients in our hospital from July 2012 to December 2013, and compared the detection rates of acute arrhythmia by the two methods.ResultsBy AECG, acute arrhythmias were detected in 41 patients and required immediate treatment, including 1 case with paroxysmal supraventricular tachycardia, 8 cases with paroxysmal atrial fibrillation complicating rapid ventricular rate, 5 cases with polymorphic and torsade de pointes, 5 cases with incessant ventricular tachycardia, 10 cases with sinus arrest, 3 cases with 2︰1 atrioventricular block, and 9 cases with high degree and paroxysmal complete atriventricular block. However, routine ECG failed to detect any arrhythmia in those patients. ConclusionAECG monitoring is capable of finding acute arrhythmia requiring emergency treatment and providing clinicians reports to diagnose and treat the patients in time.
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  Crossing the threshold of myocardial infarction vectorcardiogram via measuring method of electrocardiogram

  WEI Ying, SHI Na, WANG Qian, MA Li-Ning

  2014, 23(5): 351-357. https://doi.org/10.13308/j.issn.1008-0740.2014.05.009

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  Myocardial infarction is a risk factor for sudden cardiac death, and thus it is particularly important to improve the accuracy of the diagnosis of myocardial infarction. There are limitations of diagnosing the disease by electrocardiogram(ECG), however, vectorcardiogram(VCG) can make up for ECGs deficiency. From the composition principle of myocardial infarction VCG, this paper carries out a case analysis of clinically typical VCGs of myocardial infarction in the measuring method of ECG, and proposes a simple, quick, practical and intelligible technique of reading the VCG of myocardial infarction. In this method, we can easily cross the threshold of VCG.
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  Dronedarone in treating atrial fibrillation: the prospects and evidences

  LIU Yu-Ping, ZHAO Wen-Ting, ZOU Cao, LI Xun, YANG Xiang-Jun

  2014, 23(5): 358-363. https://doi.org/10.13308/j.issn.1008-0740.2014.05.010

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  Dronedarone is one of the new drugs for the treatment of atrial fibrillation. This paper briefly introduces the pharmacological characteristics of dronedarone and 6 phase Ⅲ clinical trials, aiming to guide clinical medication.
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  The diagnostic value of ambulatory electrocardiography for acute transient myocardial ischemia: a report of one case

  ZHANG Zhao-Guo, MA Hong-Yan

  2014, 23(5): 364-368. https://doi.org/10.13308/j.issn.1008-0740.2014.05.011

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  Ambulatory electrocardiography(AECG) can completely record the process of myocardial ischemia and provide certain evidence for the disease.Through correlation analysis of typical case and AECG recordings, this paper illustrates the roles AECG plays in identifying the process of acute transient myocardial ischemia, which is clinically significant in diagnosing acute coronary syndrome. Therefore, clinicians should pay more attention on the diagnostic value of AECG for acute transient myocardial ischemia, especially silent myocardial ischemia.
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  The application and improvement of electrocardiogram teaching methodology for resident physicians standardized training

  CHEN Wei-Wen, WANG Hui-Xin, LIN Jing-Yu

  2014, 23(5): 369-370. https://doi.org/10.13308/j.issn.1008-0740.2014.05.012

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  The operation and diagnosis of ECG is one of the important skills to be examined in resident physicians standardized training program. Due to the special requirements of the skill and tight training schedule, our department took full advantages of teachers and abundant practical resources, and laid emphasis on ECG theory plus manipulative skill in resident physicians ECG training program. We focused on the diagnosis of ECG, strengthened onetoone teaching, and thus achieved success in the training.