The prevalence rate of cardiovascular diseases in China has been increasing, therefore the precise diagnosis and treatment of arrhythmias is particularly critical. ECG examination is the main basis for the diagnosis of arrhythmias. At present, artificial intelligence ECG analysis technology has brought new possibilities to improve the efficiency and accuracy of clinical diagnosis and treatment of arrhythmias. This paper reviews the latest progress in the application of artificial intelligence ECG analysis technology at home and abroad, and summarizes the prospects and challenges of the technology in the diagnosis of arrhythmias.

Objective To analyze initial and reexaminations of ECGs among enlisted male youths excluding functional changes due to various adverse influencing factors so as to prevent adverse cardiac events after enlistment and ensure the selection of physically and psychologically qualified candidates for the military. Methods Retrospective analysis was performed in the ECG examination results of 2 065 enlisted male youths. The age range of the examines was 18 to 22 years with a mean of (20.0±1.5) years. According to ECG diagnostic criteria, ECG changes of initial and reexaminations were analyzed. ResultsAmong the 2 065 enlisted male youths, abnormal ECGs were detected in 330 cases: sinus tachycardia in 30 cases (including 13 cases with concurrent ST-T changes), sinus bradycardia in 11 cases, premature beats in 19 cases, STT changes in 60 cases, early repolarization with elevated J point in 80 cases, right ventricular dominance in 12 cases, short PR interval in 56 cases, significant axis deviation in 10 cases, firstdegree atrioventricular block in 25 cases, seconddegree atrioventricular block in 1 case, left anterior fascicular block in 6 cases, atrial rhythm and atrial escape rhythm in 2 cases each, complete right bundle branch block in 12 cases, atrial fibrillation in 1 case, and ventricular preexcitation in 3 cases. A week later, reexamination was performed in the 330 cases with abnormal ECGs out of whom 277 cases turned to be normal, including sinus tachycardia (including 11 cases with concurrent ST-T changes) in 28 cases (93.33%), sinus bradycardia in 11 cases (100%), premature beats in 17 cases (89.47%), ST-T changes in 56 cases (93.33%), early repolarization with elevated J point in 68 cases (85.00%), right ventricular dominance in 11 cases (91.67%), short PR interval in 50 cases (89.29%), significant axis deviation in 8 cases (80.00%), firstdegree atrioventricular block in 22 cases(88.00%), left anterior fascicular block in 2 cases (33.33%), and atrial rhythm and atrial escape rhythm in 2 cases each (100%); the remaining cases were all unqualified in the reexamination. Except for seconddegree atrioventricular block, left anterior fascicular block, complete right bundle branch block, atrial fibrillation and ventricular preexcitation, there were statistically significant differences in the incidences of other ECG abnormalities between initial and reexaminations (all P<0.05). ConclusionBefore physical examinations of enlisted male youths, they should correct unhealthy living habits and keep a positive attitude in advance. ECG physicians should patiently recheck unqualified ECGs to exclude functional changes before confirming unqualified ECG results.

Based on a brief introduction to fetal electrocardiogram (FECG), this paper illustrates the clinical application of FECG technology in recent years in aspects such as detecting fetal arrhythmias and monitoring fetal intrauterine hypoxia in patients with pregnancyinduced hypertension syndrome. It sorts out the limitations of FECG itself. This paper also summarizes the progress of FECG signal processing techniques, and looks forward to the development prospect of FECG in the future.

ObjectiveTo investigate the effect of comprehensive geriatric assessment (CGA) nursing on the prognosis of elderly patients with coronary heart disease (CHD) and angina pectoris after percutaneous coronary intervention (PCI). MethodsA total of 86 elderly patients with CHD and angina pectoris were selected, and all treated by PCI. They were divided into routine nursing group and CGA nursing group, with 43 cases in each group. The routine nursing group was given routine nursing while the CGA nursing group was given CGA nursing on the basis of routine nursing. We compared the improvement of cardiac function ［left ventricular enddiastolic volume (LVEDV), LVEF, NTproBNP and 6minute walking distance］, self-care ability ［coronary artery disease selfmanagement behavior scale (CSMS)］, mental state ［selfrating anxiety scale (SAS)］ and quality of life ［China questionnaire of quality of life in patients with cardiovascular diseases (CQQC)］, the occurrence of major adverse cardiovascular events (MACE), and nursing satisfaction between the two groups. ResultsAfter intervention, LVEF, LVEDV and 6minute walking distance in the CGA nursing group were all higher than those in the routine nursing group, while NT-proBNP level was lower than that in the routine nursing group (P<0.05). After intervention, CSMS and CQQC scores in the CGA nursing group were higher than those in the routine nursing group, while SAS score was lower than that in the routine nursing group (P<0.05). During the intervention, the incidence of MACE in the CGA nursing group was significantly lower than that in the routine nursing group (4.65% vs. 18.60%, P<0.05). Nursing satisfaction in the CGA nursing group was higher than that in the routine nursing group (95.35% vs. 81.40%, P<0.05). ConclusionAmong elderly patients with CHD and angina pectoris after PCI, CGA nursing could improve their negative emotional state, enhance self-management ability, promote the improvement of cardiac function, reduce the occurrence of MACE, and improve their quality of life and nursing satisfaction.

Objective To investigate the factors influencing the decrease of heart rate variability (HRV) in patients with type 2 diabetes mellitus (T2DM). Methods Seventyone inpatients with T2DM were selected as research subjects. According to whether HRV was reduced, these T2DM patients were divided into HRV normal group (39 cases) and HRV reduction group (32 cases). The general data, random blood glucose, HbA1c, triglycerides, cholesterol, LDLC, HDLC, creatinine, uric acid, beta2 microglobulin, urea, and HRV indexes of the two groups were collected. Multivariate Logistic regression analysis was used to study the influencing factors of HRV reduction in T2DM patients. ResultsCompared with the HRV normal group, the patients in the HRV reduction group had longer course of disease, higher levels of random blood glucose, HbA1c, systolic blood pressure, cholesterol and LDLC, and higher proportions of coronary heart disease, diabetic nephropathy, decreased left ventricular diastolic function, STT changes and positive urine glucose as well, all with statistically significant differences (all P<0.05). The values of SDNN, SDANN, rMSSD, pNN50, HRVindex, LF and HF in the HRV reduction group were lower than those in the HRV normal group, and the differences were all statistically significant (all P<0.01). The course of disease, random blood glucose, HbA1c, and coronary heart disease in T2DM patients were independent influencing factors for HRV reduction (P<0.05). Conclusion Timely monitoring and control of the influencing factors for HRV reduction in T2DM patients is conducive to improving the cardiac autonomic function and also has positive significance for improving their prognosis.

ObjectiveTo retrospectively explore the efficacy of felodipine combined with bisoprolol in the treatment of hypertension complicating coronary heart disease (CHD), and their effect on hemorheology, inflammationrelated indicators and vascular endothelial function. MethodsWe selected 100 patients with hypertension complicated by CHD, and collected related clinical data. They were divided into two groups according to different treatment plans, with 50 cases in each group: the control group was treated with bisoprolol while the combination group was treated with bisoprolol plus felodipine. The efficacy, adverse reactions, blood pressure ［including systolic blood pressure (SBP) and diastolic blood pressure (DBP)］ and heart rate levels, vascular endothelial function ［endothelin-1 (ET-1), vascular endothelial growth factor (VEGF) and nitric oxide (NO)］, inflammationrelated indicators ［lipoproteinassociated phospholipase A2 (LpPLA2), vascular cell adhesion molecule 1 (VCAM-1) and homocysteine (Hcy)］, and hemorheology ［hematocrit (HCT), platelet count (PLT), plasma viscosity (PV) and whole blood viscosity (WBV)］ were compared between the two groups. ResultsThe total effective rate of the combination group was higher than that of the control group (P<0.05). After treatment, SBP, DBP and heart rate in the combination group were all lower than those in the control group (P<0.05); VEGF and NO levels in the combination group were both higher than those in the control group, however HCT, PLT, PV, WBV, ET1, LpPLA2, VCAM1 and Hcy levels were all lower than those in the control group (P<005). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). ConclusionFelodipine combined with bisoprolol has significant efficacy for hypertension complicating CHD, which could relieve vascular endothelial injury, inhibit inflammatory response, improve hemorheology, and decrease blood pressure and heart rate. It serves as a safe and reliable medication therapy.

ObjectiveTo understand the performances of cardiac electrical activities in college students, and to analyze the detection and characteristics of ECG abnormalities among them, providing references for identifying those requiring further examinations and screening high risky population based on ECGs. MethodsWe collected the ECGs of 1 003 college students who had been enrolled in 2022 and had undergone physical examination. Descriptive statistical analysis was performed on the population distribution characteristics of ECGs and ECG parameters by different sexes and different ethnic groups. ResultsThere were 459 cases (45.8%) of normal ECGs while abnormal ones were detected in 544 cases (54.2%). The detection of abnormal ECGs was as follows: sinus arrhythmia accounted for 36.7%, sinus tachycardia accounted for 2.2%, sinus bradycardia with arrhythmia accounted for 5.5%, premature contraction accounted for 1.8%, bundle branch block accounted for 1.7%, and ST-T changes accounted for 2.5%. The detection rate of abnormal ECGs was higher in females than that in males, and the difference was statistically significant (P<0.01). Among the male and female college students, the differences of ECG related parameters including Pwave duration, QRS complex duration, QT interval, and RV5 and SV1 amplitudes were all statistically significant (all P<0.05). ConclusionThe detection rate of abnormal ECGs in college students physical examination was relatively high. Their ECG changes may be associated with autonomic nerve dysfunction and the boundary value settings of ECG parameters. Therefore, in diagnosing ECGs of physical examination, careful judgment of whether ECG changes are physiological or pathological is required in case of misdiagnosis, resulting in stress to examinees family members and wasting of medical resources. ECG related parameters differ less between sexes in college students, and thus the difference could be ignored in actual clinical operation.

With the gradual increase of the incidence of cardiovascular diseases, cardiac implantable electronic device (CIED) as an important means of treatment has been applied more and more widely in clinical practice, and the incidence of CIED infection has also increased. At present, international guidelines and consensus all recommend that the entire device system (including pulse generator and electrode) should be completely removed as soon as possible after infection. However, the technical difficulty and risk of electrode removal are relatively high, and some patients cannot complete relevant surgical treatment due to physiological or psychological factors. Therefore, a correct understanding of the pathogenesis, risk factors, and treatment and prevention of CIED infection is of great significance for clinicians to correctly deal with CIED infection. This article reviews the recent progress in the diagnosis and treatment of CIED infection.

ObjectiveTo study the effect of nifekaran combined with propafenone on heart rate variability (HRV) and inflammatory response in elderly patients with arrhythmia. MethodsEighty elderly patients with arrhythmia were selected as study objects. They were divided into control group and combination group according to treatment plan, each with 40 cases. The control group was treated with propafenone while the combination group was treated with nifekaran injection plus propafenone. We compared the clinical efficacy between the two groups. HRV indexes (SDNN, SDANN, rMSSD and PNN50), levels of hemorheological indexes ［fibrinogen (Fib), low shear rate blood viscosity (LBV), plasma viscosity (PV) and high shear rate blood viscosity (HBV)］, and serum inflammatory related factors ［hypersensitive Creactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), nuclear factor κB (NF-κB), polyadenylate diphosphoribose polymerase 1 (PARP1)］ before and after treatment as well as incidence of adverse reactions were also made comparison between the two groups. ResultsThe total clinical effective rate of the combination group was higher than that of the control group (95.00% vs. 77.50%, P＜0.05). After 14 days of treatment, the values of SDNN, SDANN, rMSSD and PNN50 in the combination group were significantly higher than those in the control group (P<0.05), while the levels of Fib, LBV, PV and HBV in the combination group were significantly lower than those in the control group (P<0.05). Compared with the control group, the levels of serum PARP1, TNF-α, hs-CRP and NF-κB in the combination group were lower after 14 days of treatment (P<0.05). The total incidence of adverse reactions between the two groups showed no statistically significant difference (P>0.05). ConclusionNifekaran combined with propafenone could improve HRV and hemorheology, relieve inflammation state, and improve efficacy with high safety in elderly patients with arrhythmia.

ObjectiveTo investigate the correlation of serum apolipoprotein A1 (ApoA1), apolipoprotein B (ApoB) and homocysteine (Hcy) levels with hypertension complicating coronary heart disease (CHD). MethodsWe selected 156 cases including patients with essential hypertension (EH), hypertensives with CHD who had undergone coronary CT or coronary angiography (CAG), and healthy physical examinees. They were divided into four groups: EH group (n=61), EH accompanied with stable angina pectoris (SAP) group (EH+SAP group, n=29), EH complicating acute coronary syndrome (ACS) group (EH+ACS group, n=32), and healthy physical examinees (control group, n=34). We detected blood lipids and Hcy levels of the enrolled subjects in each group, and evaluated the changes of ApoA1, ApoB and Hcy levels in patients with single, double and multivessel lesions. The Gensini scores of patients with hypertension complicating CHD were calculated according to coronary CT or CAG results. The correlation of serum ApoA1, ApoB and Hcy levels with hypertension complicating CHD was explored by Logistic regression analysis. ResultsThere were no statistically significant differences in age, sex, BMI, smoking history and drinking history among the four groups (all P>0.05). The levels of ApoB and Hcy in the EH+SAP group and the EH+ACS group were all higher than those in the EH group and the control group (P<0.05), while the level of ApoA1 was the opposite. Binary multivariate Logistic regression analysis showed that ApoA1, ApoB and Hcy were all risk factors for hypertension complicating CHD. The higher the Gensini score and the number of diseased vessels were, the lower the level of ApoA1 was, indicating a negative correlation between them; the higher the Gensini score and the number of diseased vessels were, the higher the levels of ApoB and Hcy were, indicating a positive correlation between them, and the differences were all statistically significant (all P<0.05). ConclusionApoA1, ApoB and Hcy could be used as risk factors for hypertension complicating CHD, and could predict the severity of coronary artery disease to a certain extent. They could provide references for the prevention and treatment of the disease together with low and highdensity lipoprotein, and other traditional indexes of blood lipids.

ObjectiveTo investigate the probability and influencing factors of gastrointestinal bleeding in acute myocardial infarction(AMI) patients with dual antiplatelet therapy with aspirin and ticagrelor after percutaneous coronary intervention (PCI). MethodsWe selected 1 200 patients who had undergone PCI due to AMI, and had received dual antiplatelet therapy with aspirin and ticagrelor after PCI. They were divided into bleeding group and nonbleeding group according to the presence or absence of gastrointestinal bleeding. The clinical data were compared between the two groups. The risk factors of gastrointestinal bleeding after PCI in AMI patients were analyzed by univariate and binary multivariate Logistic analysis. ResultsAmong the 1 200 AMI patients treated by PCI, gastrointestinal bleeding occurred in 38 cases with an incidence rate of 3.17%. Univariate analysis results showed that creatinine, age, and the proportion of patients with history of peptic ulcer and smoking history in the bleeding group were all significantly higher than those in the nonbleeding group, while hemoglobin and the proportion of patients taking proton pump inhibitors were significantly lower than those in the nonbleeding group (all P<0.05). Binary multivariate Logistic regression analysis showed that age, smoking history, use of proton pump inhibitors, and hemoglobin were all independent influencing factors for gastrointestinal bleeding after PCI in AMI patients with dual antiplatelet therapy with aspirin and ticagrelor (all P<0.01). ConclusionThere is a high probability of gastrointestinal bleeding in AMI patients with dual antiplatelet therapy with aspirin and ticagrelor after PCI. Gastrointestinal bleeding could be influenced by various factors among these patients, and corresponding countermeasures should be formulated clinically, in order to reduce the occurrence of gastrointestinal bleeding and improve the prognosis of AMI patients.

ObjectiveTo investigate the literature characteristics and development trends of domestic research on rural hypertension in the past 20 years. MethodsBy using bibliometric approaches, we systematically combed through the papers on rural hypertension from the core and CSSCI journals, based on the literature data collected from the CNKI database of China Knowledge Network (2001-2023). We also summarized the hotspots and trends of domestic research by applying CiteSpace and VOSviewer softwares, and in the methods such as coword analysis, cluster analysis and burst word analysis. ResultsThe study of hypertension in rural areas has been paid extensive attention, and a stable coreauthors group has been formed. The cooperation within the team is relatively close, while the cooperation between teams is relatively loose. At present, the research hotspots mainly focus on its epidemiological characteristics, intervention means, and other aspects. ConclusionThe investigation of epidemiological characteristics of rural hypertension is currently a focus of relevant research. In addition, attention should be paid to the treatment rate and control rate of hypertension in rural areas. In the aspects of the management and intervention of rural hypertension, more attention is required to be paid to problems including health education, elderly population, and treatment and control rates. To investigate how to ensure the continuity of health intervention services among rural patients with chronic diseases such as hypertension and diabetes from the level of social service is a topic worthy of researchers attention in the future.

ObjectiveTo investigate the diagnostic efficiency of routine electrocardiogram (ECG) and ambulatory electrocardiography (AECG) for coronary heart disease (CHD), and to analyze the characteristics of fragmented QRS complex (fQRS) in ECG, providing references for making early clinical diagnosis and intervention program. MethodsWe selected 80 patients with suspected CHD as research objects. ECG and AECG examinations were both performed on them after admission. With the results of coronary angiography as “gold standard”, statistics were performed on the diagnostic results and efficiency of ECG and AECG for CHD, and the detection rates of different types of arrhythmias in CHD patients were compared between the two examination methods. The characteristics of fQRS in ECG were analyzed among CHD patients. ResultsThe results of ECG examination showed that in the 80 examinees, there were 45 arrhythmia positive cases and 35 negative cases, while AECG examination detected 55 positive cases and 25 negative cases. Compared with ECG, the sensitivity and accuracy rate of AECG for the diagnosis of CHD were significantly higher (74.14% vs. 93.10%, 78.75% vs. 93.75%), while the rate of missed diagnosis was significantly lower (25.76% vs. 6.90%, all P＜0.05). The detection rates of atrioventricular block, atrial premature beats, premature ventricular contraction, paired atrial premature beats, paired premature ventricular contraction, short paroxysmal supraventricular tachycardia and paroxysmal atrial fibrillation by AECG examination in CHD patients were significantly higher than those by ECG (all P＜0.05). The incidence of ECG fQRS in CHD patients was significantly higher than that in cases without CHD (P＜0.05), and most of fQRS occurred in the inferior wall lead. ConclusionThe accuracy rate of AECG in the diagnosis of CHD is significantly higher than that of ECG, which provides a basis for clinical early screening and diagnosis. AECG could be used to evaluate arrhythmias clinically and formulate intervention programs correspondingly.

This paper reviews the importance and challenges of ECG teaching in the cardiovascular standardized training of traditional Chinese medicine, and explores effective teaching methods and strategies. By summarizing the application of various innovative teaching methods in clinical teaching at present, this paper investigates the important value of diversified teaching model in the aspects including improving students understandings and application abilities of ECG, stimulating their subjective initiative of learning, enhancing the interaction in and out of class, and improving their independent learning abilities and the efficiency of ECG learning. Diversified teaching of ECG aims at cultivating comprehensive clinical thinking of students participated in the standardized training, which provides assurance for the cultivation of highquality professional talents in the cardiovascular field of traditional Chinese medicine.

Objective To investigate the efficacy of Qili Qiangxin Capsules combined with western medicine in the treatment of chronic heart failure (CHF), and to observe its impact on cardiac function, inflammatory factors and fibrosis index levels. Methods Ninety CHF patients were selected; by using the random number table method, they were divided into control group and observation group, with 45 cases in each group. The control group conventionally adopted western medicine therapy, while the observation group was additionally administered Qili Qiangxin Capsules. The efficacy was compared after 8 weeks of treatment between the two groups. ResultsAfter 8 weeks of treatment, the symptom scores of patients in the two groups all significantly decreased, while the scores for asthma, limb edema and chills with cold extremities in the observation group were all significantly lower than those in the control group (all P<0.05). The cardiac function of both groups significantly improved after 8 weeks of treatment as compared to before (P<0.05); LVEF and stroke volume (SV) in the observation group were significantly higher than those in the control group, while left ventricular enddiastolic diameter (LVEDD) and left ventricular endsystolic diameter (LVESD) were significantly lower than those in the control group (both P<0.01). After treatment, the levels of serum tumor necrosis factorα (TNF-α), NT-proBNP and hypersensitive Creactive protein (hs-CRP) in the observation group were significantly lower than those in the control group (all P<0.01); the levels of serum transforming growth factorβ1 (TGF-β1), fibroblasts growth factor23 (FGF-23) and tissue inhibitor of matrix metallo protease1 (TIMP1) in the observation group were significantly reduced compared with those in the control group (all P<0.05). The total effective rate in the observation group after treatment was significantly higher than that in the control group (93.33% vs. 68.89%), and the difference was statistically significant (P<0.05). ConclusionCompared with conventional western medicine therapy, the clinical application of Qili Qiangxin Capsules combined with western medicine in the treatment of CHF could further reduce inflammatory damage and improve cardiac function, which effectively relieves CHF.

ObjectiveTo compare the efficacy of drugcoated balloon (DCB) and drugeluting stents (DES) for de novo diffuselong lesion in macrovascular coronary artery, so as to explore the chances of DCB as a routine therapy. MethodsWe enrolled 102 patients with uncomplex de novo diffuselong lesions in macrovascular coronary artery who had undergone coronary intervention therapy. They were divided into DCB group and DES group according to intervention strategies. Quantitative flow ratio (QFR) technology was used to analyze the characteristics of lesions before intervention, immediately after intervention and during oneyear followup after intervention. The curative effect was compared between DCB and DES. Results(ⅰ) There were no statistically significant differences in clinical data. (ⅱ) There were no statistically significant differences between the two groups in the site of intervention vessels, the proportion of singlevessel and bifurcated lesions, and the use of antiplatelet drugs. In terms of pretreatment, the proportion of nonslip element balloon used in the DCB group was significantly higher than that in the DES group (P<0.05). (ⅲ) The results of QFR analysis showed that there were no statistically significant differences in the reference vessel diameter, lesion length, and stenosis rate of lesion area before intervention between the two groups (P>0.05). Immediately after intervention, the minimum lumen diameter ［(2.57±0.27)mmvs. (2.95±0.46)mm, P<0.01］, and QFR gain ［0.22(0.17,0.53) vs. 0.27(0.20,0.63), P=0.001］ in the DCB group were both lower than those in the DES group, while the stenosis rate of residual area was significantly higher than that in the DES group ［(27.80±7.29)%vs. (13.08±6.93)%, P<0.01］. During followup, Although the stenosis rate of lesion area in the DCB group was higher than that in the DES group ［3876(3056,4816)%vs. 2714(2022,3475)%, P＜001］, the late lumen loss was smaller than that in the DES group ［0.19(0.05,0.30)mmvs. 0.25(0.15,0.39)mm, P=0.030］. The minimum lumen diameter did not vary significantly between groups (P>0.05). (ⅳ) There was no statistically significant difference in the incidence of major adverse cardiovascular events (MACE) between the two groups during followup (all P>0.05). ConclusionThe efficacy and the incidence of MACE of DCB guided by QFR are similar to that of DES for uncomplex de novo diffuselong lesion in macrovascular coronary artery. However, in consideration of the small sample size of this study, more evidences are needed to support the clinical application of DCB for de novo diffuselong lesion in macrovascular coronary artery.

Objective To screen out sensitive heart rate variability (HRV) index reflecting left ventricular(LV) stiffness in patients with heart failure with preserved ejection fraction (HFpEF), and to assess its prognostic evaluation value for HFpEF patients. Methods We selected 150 patients with normal LVEF who had undergone 24hour ambulatory electrocardiography and routine echocardiography examinations. The enrolled patients were divided into normal control group (68 cases) and HFpEF group (82 cases). The receiver operating characteristic curve analysis was used to screen out the sensitive HRV index associated with LV stiffness in HFpEF patients. The primary endpoint events were followed up. Results Among HRV indexes, the area under curve (AUC) of SDANN was the largest in the prediction of HFpEF (AUC=0.68, P<0.01); the cutoff value was 90 ms. SDANN was negatively associated with LV diastolic wall strain. The higher the SDANN was, the higher the LV stiffness was. According to the cutoff value of SDANN, the patients with HFpEF were divided into highSDANN group (cutoff value≥90 ms, 44 cases) and lowSDANN group (cutoff value<90 ms, 38 cases). In the lowSDANN group, the LV stiffness was lower. The survival curve analysis revealed that in the highSDANN group the incidence of major adverse cardiac events and total mortality were significantly higher than those in the lowSDANN group (P<0.05). Conclusion SDANN could be served as a sensitive indicator for making clinical diagnosis and prognostic evaluation among patients with HFpEF.

ObjectiveTo explore the application effect of quantitative management nursing intervention in patients with acute heart failure. MethodsA total of 85 patients with acute heart failure were selected, and divided into two groups based on different nursing plans. The control group (n=42) all received routine nursing while the observation group (n=43) all received both routine nursing combined with quantitative management nursing intervention. The nursing quality, ICU stay time, hospitalization time, mechanical ventilation time, cardiac function, and incidence of adverse events were compared between the two groups, as well as left ventricular endsystolic diameter (LVESD), health promoting lifestyle profile (HPLP) score, LVEF, selfrating anxiety scale (SAS) score, and left ventricular enddiastolic diameter (LVEDD) before and after intervention. ResultsThe observation group scored higher in the nursing quality of basic nursing, patient management, risk assessment, emergency management, and daily life guidance compared to the control group (P<0.01). The mechanical ventilation time, ICU stay time, and hospitalization time of the observation group were shorter than those of the control group (P<0.01). After intervention, the LVEDD, LVESD, and SAS score of the observation group were lower than those of the control group while LVEF and HPLP score were higher than those of the control group (P<0.05); the incidence of adverse events in the observation group was 4.65% (2/43), which was lower than that in the control group ［21.43% (9/42), P<0.05］. ConclusionAmong patients with acute heart failure, quantitative management nursing intervention is helpful for improving nursing quality and reducing the incidence of adverse events, and additionally, improving patients psychological state, enhancing healthy behaviors and promoting cardiac function improvement.

ObjectiveTo investigate the clinical characteristics of patients with myocardial infarction with nonobstructive coronary arteries (MINOCA) in different ECG manifestations. MethodsWe selected 361 patients diagnosed with MINOCA from those with acute myocardial infarction undergoing coronary angiography. According to ECG manifestations of STsegment elevation myocardial infarction (STEMI) or non-ST-segment elevation myocardial infarction (NSTEMI), they were divided into STEMI group (n=84) and NSTEMI group (n=277). The general clinical data, laboratory examination results and coronary angiography results of the two groups were retrospectively analyzed. ResultsCompared with the STEMI group, the mean age of disease onset was greater in the NSTEMI group, while the proportion of females, and patients with hypertension and diabetes were all higher; the proportion of cases with smoking history was higher in the STEMI group, all with statistically significant differences (all P<0.05). The white blood cell count, neutrophil count, and platelet count in the STEMI group were all higher than those in the NSTEMI group, and the differences were statistically significant (P<0.05). Platelet distribution width and left ventricular ejection fraction were higher in the NSTEMI group with statistically significant differences (P<0.05). Plaque rupture, coronary spasm and thrombosis accounted for the majority of the disease causes in the STEMI group while the proportion of disease causes of oxygen supply imbalance and unknown etiology were higher in the NSTEMI group with statistically significant differences (P<0.05). ConclusionNSTEMI was the most common ECG change in MINOCA patients. Compared with MINOCA patients with ECG manifestations of STEMI, patients in the NSTEMI group had a greater age of disease onset, and more females are in the group, while these patients had a higher proportion of clinical risk factors, lower inflammatory and platelet indicators, and oxygen supply imbalance and unknown etiology account for higher proportion of disease causes.

患者男，59岁，因反复心悸3月余入院，心电图示窄QRS型室性早搏，在Carto系统指导下行激动标测，最早激动点位于左前分支近端附近，因靠近传导束，消融风险高，遂至右冠窦行滴定解剖消融成功，早搏消失，术后未再出现室性早搏。

患者男，72岁，因“胸闷、气促20余天”入院。心电图示窦性心动过缓，二度Ⅱ型房室阻滞，心率43次/min。心脏超声示三尖瓣下移畸形，房间隔缺损，右心房增大，右心室继发减小，右心室收缩功能降低。结合患者病情及家属意愿，拟植入Micra AV起搏器。经右股静脉途径，行右心室造影提示右心室较小，测量三尖瓣到心尖距离大约3.0 cm，有容纳Micra的空间；但操作空间小，手术难度大。经术中精确定位，跨三尖瓣后将Micra AV植入中低位间隔，测试各参数正常（阻抗770 Ω，阈值1.0 V/0.42 ms，感知6 mV），术中术后无特殊不适，手术顺利。

Arrhythmia is one of the most common heart diseases and is usually a direct cause of sudden cardiac death. The stability of myocardial electrical activity depends on the balance of autonomic nervous system tension. Autonomic nervous system plays an important role in the onset and persistence of arrhythmias. This article reviews from aspects including the role of autonomic nerves in arrhythmias, intervention measures of autonomic nerve regulation, and assessment methods of autonomic nervous function, in order to provide an emerging therapeutic strategy for the prevention and treatment of arrhythmias.

室性心律失常在临床上十分常见，既可发生在结构性心脏病与遗传性心律失常综合征患者，也可见于心脏结构正常的人群。不同类型的室性心律失常对患者的影响不同，有的预后良好，有的可致明显心悸与黑矇，甚至心脏性猝死。为了让基层医院的医生能更好地认识室性心律失常，提高诊断与治疗水平，降低室性心律失常死亡率，中华医学会心电生理和起搏分会与中国医师协会心律学专业委员会组织国内专家撰写了《室性心律失常中国专家共识基层版》。期望该“共识基层版”有助于促进我国基层医生规范化诊治室性心律失常。

Objective To investigate the relativity between anklebrachial index (ABI) and ventricular repolarization parameters among hospitalized patients with type 2 diabetes mellitus (T2DM). Methods Retrospective analysis was performed on the clinical data of inpatients with T2DM who had undergone ABI inspection. According to ABI values, they were divided into abnormal ABI (ABI≤0.9 or ≥1.3) group (82 cases) and normal ABI (0.9<1.3) group (88 cases). Clinical data, and echocardiographic and ventricular repolarization parameters were recorded and analyzed for the patients of both groups. ResultsPatients in the abnormal ABI group were older and had longer course of diabetes compared with the normal ABI group, and the differences were both statistically significant (both P<0.01). Additionally, the abnormal ABI group showed elevated values in TpeakTend (Tp-e) interval, corrected QT interval (QTc), Tp-e/QTc ratio, and frontal QRS-T (fQRS-T) angle compared with the normal ABI group, all with statistically significant differences (all P<0.05). According to Spearman correlation analysis, there were significant correlations between ABI and Tpe interval (r=-0.393, P<0.01), QTc (r=-0.198, P<0.01) or Tp-e/QTc ratio (r=-0.557, P<0.01). ConclusionABI bears a negative correlation separately with main ventricular repolarization parameters, namely Tpe interval, QTc, and Tp-e/QTc ratio. Therefore, for T2DM patients with abnormal ABI, more attention should be paid on the risk of malignant arrhythmias.

Objective To explore the influence of family member participatory nursing intervention mode on the disease control and selfmanagement ability of patients with chronic arrhythmia. Methods A total of 126 patients with chronic arrhythmia were included in the study, and were divided into control group and observation group in the random drawing method, with 63 cases in each group, both given intervention for 3 months. The control group implemented routine nursing intervention mode, while the observation group adopted family member participatory nursing intervention mode on this basis. The scores of Mishel uncertainty in illness scalefamily member form (MUIS-FM), selfmanagement ability scale (SMAS), selfrating anxiety scale (SAS) and selfrating depression scale (SDS), change of heart rate, treatment compliance, and complication rate were compared between the two groups before intervention, and 1 month and 3 months after intervention. ResultsAfter 1 month and 3 months of intervention, the scores of MUISFM, SAS and SDS in the observation group were all lower than those in the control group, while the score of SMAS was higher than that in the control group (all P<0.05). After 1 month of intervention, the minimum heart rate of the observation group was higher than that of the control group (P<0.05); after 3 months of intervention, the resting heart rate and the minimum heart rate of the observation group were both higher than those of the control group (all P<0.05). There was no statistically significant difference in the mean heart rate within 24 hours between the observation group and the control group after 1 month and 3 months of intervention (all P>0.05). The treatment compliance rate of the observation group was higher than that of the control group (96.83% vs. 85.71%, P<0.05). There was no statistically significant difference in complication rate between the observation group and the control group (1.59% vs. 9.52%, P>0.05). ConclusionFamily member participatory nursing intervention mode could improve patients emotional state, treatment compliance and selfmanagement ability, and alleviate family members uncertainty in illness, which helps patients with disease control.

ObjectiveTo explore the effect of regional collaborative emergency mode based on ECG remote network on the transport efficiency and recent prognosis in patients with acute ST-segment elevation myocardial infarction(STEMI). MethodsWe retrospectively analyzed clinical data of 43 patients with STEMI who had been admitted to our hospital in the regional collaborative emergency mode based on ECG remote network, and included them in the collaborative emergency group. We also reviewed clinical data of 43 patients with STEMI who had been admitted to our hospital during the same time period and implemented conventional emergency measures, and included them in the control group. The transport efficiency and recent prognosis were compared between the two groups. ResultsThe time from the first medical contact to entering the operating room, the time from entering the operating room to catheter patency, and the time from transporting to the ambulance to entering the operating room in the collaborative emergency group were all shorter than those in the control group (all P<0.05). The proportion of vascular recanalization in the collaborative emergency group was higher than that in the control group while the incidence of cardiovascular events was lower than that in the control group (all P<0.05). There was no statistically significant difference in the mortality between the two groups (P>0.05). ConclusionThe regional collaborative emergency mode based on ECG remote network could improve the transport efficiency and reduce the occurrence of cardiovascular events in STEMI patients.