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• 2017 Volume 26 Issue 3
  Published: 28 June 2017

    

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  Efficacy evaluation of β blockers on ventricular arrhythmias

  CAO Ke-Jiang

  2017, 26(3): 153-156. https://doi.org/10.13308/j.issn.2095-9354.2017.03.001

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  Ventricular arrhythmia is commonly seen in clinical practice. It is more common in patients with structural heart disease and can also occur in people without heart disease. Although more and more nondrug therapies have been emerging in recent years, antiarrhythmic drugs are still the basic and primary choice of treatment. Among the four major categories of antiarrhythmic drugs applied at present, β blockers is the only one which could reduce the total mortality rate. This paper evaluates its effectiveness on different kinds of ventricular arrhythmias.
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  Physicians group and management of ventricular arrhythmias

  DING Yan-Sheng

  2017, 26(3): 157-160. https://doi.org/10.13308/j.issn.2095-9354.2017.03.002

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  Cardiologists & Partners is a physicians group initiated and established by domestic authoritative experts in the field of cardiovascular medicine. By integrating and allocating the advanced medical technologies and topquality human resources of first class hospitals, it aims to help primary medical institutions of county level in personnel training and technical assistance. In order to make a detailed introduction to this innovative exploration in the field of cardiovascular medicine, and promote understanding of physicians group among more cardiovascular specialists, this paper focuses on the exploration and practice of physicians group from several aspects involving the epidemiology of ventricular arrhythmias, current situation of Cardiologists & Partners, its efforts in helping county hospitals, its predischarge management, inhospital appliance therapy and postdischarge management, clinical research data management, future development directions, etc.
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  ECG features and catheter ablation of ventricular arrhythmias originating from the coronary venous system

  ZHENG Zhi-Tao, LIU Xing-Peng

  2017, 26(3): 161-166. https://doi.org/10.13308/j.issn.2095-9354.2017.03.003

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  Ventricular arrhythmia originating from the coronary venous system(CVS) is not rare in clinical practice. However, the success rate of catheter ablation is low due to the complicated anatomical structure of CVS and its adjacent tissue. This paper reviews on the anatomical structure of CVS and its adjacent tissue, and the ECG features and catheter ablation of ventricular arrhythmia, aiming to elevate the success rate of catheter ablation of ventricular arrhythmia originating from this site.
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  The ECG scatterplot of interpolated premature beat: analysis on its features and formation principle

  JING Yong-Ming, PAN Yun-Ping, SUN Chao-Yang, JING Yan, SHEN Ji-Hong, ZHANG Fang-Fang, YANG Wei, LI Shi-Feng

  2017, 26(3): 167-174. https://doi.org/10.13308/j.issn.2095-9354.2017.03.004

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  Objective  To explore the features and formation principle of ECG scatterplot of interpolated premature beat, and thus to lay foundations for quickly analyzing ambulatory electrocardiography(AECG). Methods  Typical cases of interpolated premature beat were selected and morphological characteristics of their ECG scatterplots were analyzed. By dynamic mapping and trajectory tracking functions of “geometric sketchpad” software, the scatterplot model was established. We summarized the ECG scatterplot features of interpolated premature beat combining the characteristics of practically recorded ECG scatterplots and the mathematical model. Results  The actually recorded ECG scatterplots were very similar to the mathematical model. Conclusion  The ECG scatterplot of interpolated premature beat has obvious features and a very strong regularity. The joint application of Lorenz scatterplot and difference scatterplot is effective in rapidly recognizing interpolated premature beat and its frequency on AECG as well as finding the induced disruptive PR interval prolongation and the prolonged amount.
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  Application of ECG scatterplot in differential diagnosis of bigeminy of sinus arrhythmia

  XU Yi-De, XU Zhi-Yong

  2017, 26(3): 175-178. https://doi.org/10.13308/j.issn.2095-9354.2017.03.005

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  Objective  To make differential diagnosis of long and short bigeminy resulted from bigeminy of sinus premature beats, 3∶2 Wenckebach sinoatrial block and“longitudinal” dissociation of sinus node function. Methods  Twentysix patients diagnosed with bigeming of sinus arrhythmias underwent 24hour ambulatory electrocardiography examination in the department of electrocardiogram of Zhangzhou Municipal Hospital. With a combination of Lorenz scatterplot, timeRRinterval scatterplot(tRR scatterplot) and the reversal technique, the collected clinical data were analyzed and graphs were made by computer. Results  To make differential diagnosis of long and short bigeminy resulted from bigeminy of sinus premature beats, 3∶2 Wenckebach sinoatrial block and “longitudinal” dissociation of sinus node function, it is not recommended to simply rely on routine ECG. A combination of Lorenz scatterplot, tRR scatterplot and the reversal technique helps to make accurate differential diagnosis of these three kinds of bigeminy. Conclusion  It can effectively elevate the diagnostic accordance rate and reduce the rate of missed diagnosis to apply ECG scatterplot and the reversal technique in the differential diagnosis of bigeminy of sinus arrhythmia.
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  Relationship between grade Ⅲ ischemia of ECG and serum hs-cTnⅠ in patients with acute ST segment elevation myocardial infarction

  ZHANG Qin, YANG Su-Ping, QIN Guo-Wei, ZHANG Ya-Li, CHEN Xiao-Jie, LU Zhi-Hong, YANG Xia-Fang, HONG Ji-Ge, WU Jie

  2017, 26(3): 179-182. https://doi.org/10.13308/j.issn.2095-9354.2017.03.006

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  Objective  Based on the ischemia classification according to the change of QRS complex in ECG of patients with acute ST segment elevation myocardial infarction(STEMI), to explore the relationship between electrocardiographic ischemia and serum hscTnI. Methods  According to their ECGs on admission, 120 STEMI patients were divided into grade Ⅲ ischemia group(with QRS terminal distortion; n=81, accounting for 67.5%) and grade Ⅱis chemia group(without QRS terminal distortion; n=39, accounting for 32.5%). Coronary angiographic examination and hscTnI inspection were performed on both of the two groups. The relationship between the circumstances of coronary obstruction and serum hscTnI was compared between two groups. Results  (i) In grade Ⅲ ischemia group, there were 68 males(83.95%) and 13 females(16.05%); in grade Ⅱ ischemia group, there were 27 males(69.23%) and 12 females(30.77%). There was statistically significant difference in sex between the two groups(P<0.05). (ii) The incidence of lesion in left anterior descending artery among patients of grade Ⅲ ischemia group was higher than that in the other group(P＜0.05), however, the incidence of lesion in left circumflex artery was lower(P<0.001). (iii) The measured serum hscTnI was characterized by skew distribution with statistically significant difference(Z=-2.78, P<0.006). (iv) Compared two groups of patients with hs-cTnT level , grade II ischemia is lower than the levels grade III ischemia, the difference was statistically significant（P<0.05）. Conclusion  Grade Ⅲ ischemia in ECG of STEMI patients is associated with the concentration of serum hs-cTnI.
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  Application of noninvasive arteriosclerosis detection method and color ultrasound in diagnosing early arteriosclerosis of diabetics

  SU Gui-Zhu, QU Zhen-Peng

  2017, 26(3): 183-186. https://doi.org/10.13308/j.issn.2095-9354.2017.03.007

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  Objective  To explore the application of noninvasive arteriosclerosis detection method and color ultrasound in diagnosing early arteriosclerosis among patients with type 2 diabetes. Methods  One hundred and twenty patients with type 2 diabetes(diabetes group) and homochronous 100 healthy controls(control group) were enrolled in our study. Angeial color Doppler ultrasound technique was utilized in detecting the intimamedia thickness(IMT) of the common carotid arteries while arteriosclerosis detector was applied in measuring the brachialankle pulse wave velocity(baPWV) and toebrachial index(TBI). Analysis and evaluation of risk factors was made based on the measured data. Results  The differences of measured baPWV, TBI and IMT were all statistically significant between the two groups(P＜0.05). Multiple linear regression analysis showed that low(high)density lipoprotein cholesterol, uric acid and systolic blood pressure were risk factors for abnormal IMT; age, systolic blood pressure and blood sugar were risk factors for abnormal baPWV; age, systolic blood pressure and blood sugar were independent risk factors for abnormal TBI while highdensity lipoprotein cholesterol was a protective factor for TBI. Conclusion  The severity of early peripheral arteriosclerosis in patients with type 2 diabetes can be predicted with a combined application of noninvasive arteriosclerosis detection indexes and IMT measured by angeial ultrasound technique. It is fit for clinical promotion and application for its convenience, noninvasiveness and good repeatability.
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  The changes of Tp-, Tp-Tec and Tp-Te/QT in children with noncompaction of ventricular myocardium

  SUN Dong-Ming, ZHANG Yong, WANG Rui-Geng, JIANG Xiao-Mei

  2017, 26(3): 187-189. https://doi.org/10.13308/j.issn.2095-9354.2017.03.008

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  Objective  To analyze the changes and clinical significance of T peakT end interval(Tp-Te), corrected Tp-Te(Tp-Tec), the ratio of Tp-Te and QT interval(Tp-Te/QT), and other myocardial repolarization indexes in children with noncompaction of ventricular myocardium(NVM). Methods  Thirty-four hospitalized children with NVM were enrolled in our study as NVM group while another 34 healthy children were randomly selected as the control group. We compared the heart rate measured from 12 lead surface electrocardiogram, corrected QT interval(QTc), Tp-Te, Tp-Tec, Tp-Te/QT and other indexes between the two groups. Results  Five(14.7%) out of the 34 NVM children were complicated by ventricular arrhythmia(4 cases of premature ventricular contraction and one case of ventricular tachycardia). The heart rate of children in NVM group was significantly higher than those in the control group, with statistically significant difference[(128.8±21.8) times/min vs. (113.1±17.5) times/min, P<0.05]. There was no significant difference in either QTc or TpTe between the two groups[(404.8±30.9) ms vs. (402.6±21.4) ms, (76.1±17.3) ms vs. (72.1±13.9) ms, P＞0.05]. In NVM group, Tp-Tec was prolonged and Tp-Te/QT increased significantly if compared with those indexes in the control group, with statistically significant differences[(112.7±26.8) ms vs. (98.6±16.6) ms, (0.27±0.06) vs. (0.23±0.04), P<0.05]. Conclusion  The abnormalities of transmural dispersion of repolarization in children with NVM easily lead to the occurrence of ventricular arrhythmia. Because of the influence of heart rate and other factors, the predictive value of Tp-Tec and Tp-Te/QT on ventricular arrhythmia in children with NVM is higher than that of Tp-Te.
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  Effectiveness of combined treatment of shensongyangxin capsule and metoprolol on atrial arrhythmia by ambulatory electrocardiography

  YIN Bing, XU Zhang-Hua

  2017, 26(3): 190-192. https://doi.org/10.13308/j.issn.2095-9354.2017.03.009

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  Objective  To observe and evaluate the effectiveness of the combined treatment of shensongyangxin capsule and metoprolol on atrial arrhythmia by ambulatory electrocardiography(AECG). Methods  Seventyeight patients with frequent atrial premature beats and paroxysmal atrial tachycardia were randomly divided into two groups, each with 39 cases. Patients in group A underwent a combined therapy of shensongyangxin capsule and metoprolol. They orally took 4 shensongyangxin capsules per time, 3 times per day and metoprolol at a dose of 12.5[CD*2]25 mg per time, 2 times per day. Patients in group B orally took metoprolol at a dose of 12.5[CD*2]25 mg per time, 2 times per day. After 4 weeks of treatment, AECG changes of the two groups were observed and compared. Results  The improvement rate of arrhythmia in group A and B was 97.44% and 64.10%, respectively, with statistically significant difference(P<0.05). Conclusion  It is obviously observed by AECG that the combined treatment of shensongyangxin capsule and metoprolol significantly strengthens the curative effect on frequent atrial premature beats and paroxysmal atrial tachycardia if compared with metoprolol alone.
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  Clinical analysis on ambulatory electrocardiography of sick sinus syndrome

  LIU Dan, 蓝Xin-Ping , CHEN Rui-Xing, TANG Qiong-Ru, CHEN Yan-Fen, YAO Shu-Zhen

  2017, 26(3): 193-195. https://doi.org/10.13308/j.issn.2095-9354.2017.03.010

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  Objective  To analyze the features of ambulatory electrocardiography(AECG) of patients with sick sinus syndrome(SSS). Methods  Holter inspection was carried out on 150 SSS patients(observation group) and 150 cases of healthy persons(control group). The 24hour total heart beat, and the average, the slowest and the highest ventricular rates were observed and analyzed between the two groups. And the detection rates of sinus bradycardia, sinus arrest, sinoatrial block and P′P interval after atrial premature beats >1 800 ms were also compared. Results  In the observation group, the 24hour total heart beat, and the average, the slowest and the highest ventricular rates were all lower than those in the control group, with statistically significant differences(P<0.05); the detection rates of sinus bradycardia, sinus arrest and sinoatrial block were all higher than those in the control group, with statistically significant differences(P<0.05); the detection rate of P′P interval after atrial premature beats >1 800 ms was higher than that in the control group, with statistically significant difference(P<0.01). Conclusion  P′P interval after atrial premature beats >1 800 ms can serve as a diagnosis basis of SSS.
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  Analysis of electrocardiogram and vectorcardiogram when R/S＞1 in lead V1

  GENG Xu-Hong, WANG Yong-Quan

  2017, 26(3): 196-202. https://doi.org/10.13308/j.issn.2095-9354.2017.03.011

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  In the electrocardiogram of normal adults, lead V1 has type rS morphology. Predominant R wave or R/S＞1 in lead V1 is clinically observed in various circumstances such as complete right bundle branch block, posterior wall myocardial infarction, right ventricular hypertrophy, hypertrophic cardiomyopathy, dextrocardia, type A ventricular preexcitation and normal variant. This paper analyzes and summarizes several electrocardiographic and vectorcardiographic manifestations when R/S＞1 in lead V1.
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  The advantages of vectorcardiogram in diagnosing left anterior fascicular block complicating old inferior wall myocardial infarction

  WANG Yan-Cai

  2017, 26(3): 203-206. https://doi.org/10.13308/j.issn.2095-9354.2017.03.012

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  Objective  To explore the advantages of vectorcardiogram(VCG) in diagnosing left anterior fascicular block(LAFB) complicating old inferior wall myocardial infarction. Methods  ECG and VCG of two typical patients with LAFB complicating old inferior wall myocardial infarction were collected and analyzed. Wilson and Frank lead systems were utilized in collecting ECG and VCG, respectively. Results  ECG can not lead to definitive diagnosis of LAFB. VCG showed distinctive manifestations. Frontal initial vector on VCG was located on the left or right at the bottom and then quickly turned to upper left, and the ring also developed to the upper left; the centrifugal limb ran in clockwise direction while the above afferent limb ran in counterclockwise direction. Conclusion  VCG proves to be obviously superior to ECG in diagnosing LAFB complicating old inferior wall MI.
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  Application of vectorcardiogram in the differential diagnosis of inferior wall myocardial infarction and left anterior fascicular block

  WANG Xiang-Tao, JIANG Yan-Liang, LIAN Xiao-Jing, ZHANG Hong-Yan

  2017, 26(3): 207-211. https://doi.org/10.13308/j.issn.2095-9354.2017.03.013

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  In this paper, three patients were selected whose inferior wall lead Ⅱ, Ⅲ and aVF had QS, rS and qrS type morphology, respectively in routine electrocardiogram (ECG). Through crosscheck analysis by ECG and vectorcardiogram(VCG), the three cases were specifically diagnosed with inferior wall myocardial infarction, left anterior fascicular block and inferior wall myocardial infarction complicating left anterior fascicular block. It indicates that VCG is clinically valuable in the differential diagnosis of inferior wall myocardial infarction and left anterior fascicular block.
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  The methodology and efficacy evaluation of “one-stop treatment of atrial fibrillation”

  DU Xian-Feng, CHU Hui-Min

  2017, 26(3): 212-217. https://doi.org/10.13308/j.issn.2095-9354.2017.03.014

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  Atrial fibrillation(AF) as one kind of arrhythmias has gained the most attention clinically and the greatest progress in evidencebased medicine at present. Besides the therapies such as anticoagulant therapy and ventricular rate control, catheter ablation(energy sources including radiofrequency and freezing) is the first choice of treatment recommended by guidelines at present from the perspective of symptom control. However, its effectiveness in preventing against cardiac apoplexy has not been authorized yet. The technique of percutaneous left atrial appendage occlusion fills the blank and becomes one of the better choices for AF patients who are highrisky of stroke and intolerance of permanent anticoagulant therapy. The derivative “onestop treatment of AF” thereof has become one of hot topics of current industry. This paper discusses the methodology of the “onestop treatment of AF” and advances of its curative effect.
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  The development of high-density mapping technique

  CHEN ErDong, ZHOU Jing

  2017, 26(3): 218-221. https://doi.org/10.13308/j.issn.2095-9354.2017.03.015

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   Highdensity mapping is a new technique coming out in recent years, which is based on three-dimensional electroanatomical mapping and multielectrode mapping. It is faster and more effective in diagnosing and treating arrhythmias including atrial fibrillation, atrial tachycardia and ventricular tachycardia than the previous techniques. Meanwhile, this technique also provides a new perspective of understanding the electrophysiological mechanism of these arrhythmias. This review intends to briefly introduce the present situation and future development of highdensity mapping technique.
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  Characteristics and clinical significance of ischemic J wave

  FAN Xue-Ting, HAN Meng-Jing, MAI Li-Dan-Mu-·Ai-Ke-Bai

  2017, 26(3): 222-225. https://doi.org/10.13308/j.issn.2095-9354.2017.03.016

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  Ischemic J wave is brought forward in recent years as an electrocardiographic phenomenon of myocardial ischemia in the hyperacute phase. It may appear under various clinical conditions and indicates tendencies of malignant arrhythmia and sudden cardiac death. Timely identification and diagnosis of ischemic J wave helps to diagnose and interfere in serious myocardial ischemia, and to reduce the incidence of sudden cardiac death. This paper retrospectively analyzes the related literature at home and abroad during the last five years, and roundly summarizes and further discusses the characteristics and clinical significance of ischemic J wave which appears under multiple clinical circumstances(myocardial ischemia in the hyperacute phase, variant angina, etc.).