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.

Epicardial adipose tissue (EAT) as an active endocrine tissue located on the surface of the heart, not only provides energy for the heart, but also participates in inflammatory responses and metabolic regulation. Increased amount of epicardial adipose is significantly associated with the increased incidence of atrial fibrillation (AF), potentially promoting the occurrence and persistence of AF through mechanisms such as enhancing local cardiac inflammation, increasing oxidative stress, or directly affecting the electrophysiological properties of cardiomyocytes. This paper reviews the current research status on the relationship between EAT and AF, explores their association mechanism, and proposes future research directions regarding the role of EAT in AF pathogenesis.

Objective  To explore the characteristics of abnormal ECGs in elderly population aged 90 and above as well as their clinical significance. Methods  A retrospective analysis was conducted on the clinical data of 204 hospitalized patients aged 90 and above. These patients were divided into two groups based on sex (114 males and 90 females). Baseline clinical data, fasting blood glucose, blood lipids, liver and kidney function, brain natriuretic peptide(BNP), ECG, and echocardiography examination results were compared and analyzed between the two groups. Results  Systolic blood pressure and triglyceride levels at admission were significantly higher in the female group compared to the male group (P<0.05), while creatinine and blood urea nitrogen levels were significantly higher in the male group (P<0.05). Sinus rhythm was observed in 765% of the patients. According to the detection rate from high to low, the most common ECG abnormalities were ST-T changes (46.1%), atrial premature beats (22.1%), firstdegree atrioventricular block (22.1%), right bundle branch block (19.6%), and atrial fibrillation (13.7%) in order. The detection rates of atrial flutter, atrial premature beats, premature ventricular contraction, right bundle branch block, firstdegree atrioventricular block, and left anterior fascicular block were all higher in the male group than those in the female group. Conclusion  ECG abnormalities are common in hospitalized patients aged 90 and above, primarily manifesting as ST-T changes, atrial premature beats, firstdegree atrioventricular block, right bundle branch block, and atrial fibrillation. The distribution of these ECG abnormalities differs between different sexes.

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.

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.

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.

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.

The vector translation method is an analysis method of combining Lorenz scatter plot and difference scatter plot, which is derived from fully understanding their mapping principles and inherent relationship between the two kinds of plots. It embodies the complementary relationship between Lorenz scatter plot and difference scatter plot.The vector translation method is not only suitable for the comprehensive analysis of twodimensional Lorenz scatter plot and twodimensional difference scatter plot, but also for the comprehensive analysis of threedimensional Lorenz scatter plot and threedimensional difference scatter plot. The directed critically connected graph is a closed vector ring, which indicates that difference scatter plot satisfies the law of conservation of vectors. Correctly labeling the directed critically connected graph is a prerequisite for vector translation. The scatter plots of intractable case have complex typing and hidden regularity. The vector translation method by using a combination of two kinds of plots could fully reveal the inherent law of ECG big data, especially the characteristic point sets of difference scatter plot do not overlap with each other, which facilitates analysis operations such as editing and graph selection, and makes it possible to analyze difficult and complex ambulatory electrocardiography quickly and accurately.

Objective To investigate the predictive value of ECG Pwave parameters on the prognosis of atrial fibrillation (AF) after radiofrequency catheter ablation (RFCA). Methods A total of 70 AF patients who had undergone RFCA were selected. The Pwave dispersion (Pd) and the maximum Pwave duration (Pmax) of their ECGs before operation were recorded. According to the postoperative prognosis (the presence or absence of AF recurrence), they were divided into good prognosis group and poor prognosis group. Logistic regression analysis was used to explore the correlation between Pwave parameters of ECG and prognosis of AF patients after RFCA. ROC curve analysis was utilized to evaluate the predictive value of Pwave parameters on the prognosis of AF patients after RFCA. ResultsAmong the 70 AF patients, 30 cases had poor prognosis while 40 cases had good prognosis after RFCA. Pd and Pmax in the poor prognosis group were both higher than those in the good prognosis group (both P<0.05). There were no statistically significant differences in other parameters between the two groups (all P＞0.05). The results of Logistic regression analysis revealed that Pd and Pmax were risk factors influencing the prognosis of AF patients after RFCA (OR＞1, P＜0.05). The ROC curve analysis showed that the AUC values of Pd, Pmax and the combined indicators in assessing the risk factors of poor prognosis among AF patients after RFCA were 0.751, 0.760 and 0.900, respectively. ConclusionThe Pwave parameters of ECG are related to the prognosis of AF patients after RFCA; the combined detection of Pd and Pmax could improve the prognostic prediction efficiency.

ObjectiveTo explore the characteristics of atrial, ventricular and junctional escape rhythms in ECG waterfall diagram, and to lay a foundation for rapidly analyzing ambulatory electrocardiography of chronic arrhythmias such as sick sinus syndrome (SSS). MethodsA patient diagnosed with SSS complicated by the above three escape rhythms were selected. The characteristics of ECG waterfall diagram were further analyzed based on the routine view of the ECG scatter plots. Combined with the reversal technique of ECG waterfall diagram, we analyzed and summarized the characteristics of ECG waterfall diagrams of the three escape rhythms, and their correspondence with the corresponding ECGs. ResultsUnder the background of sinus block or sinus arrest, the frequencies of the three protective escape rhythms (atrial, ventricular and junctional escape rhythms) in the patient with SSS were close, competing with each other and alternating repeatedly. The characteristics revealed by the common analytical tools such as ECG scatter plot and RR interval histogram were not obvious, but the features of the ECG waterfall diagram of each rhythm were different which provided a shortcut to rapidly analyze this kind of cases. The R-peak band of normal sinus rhythm was horizontally centered and its width was 120 ms or less. The chromatogram represented the height of QRS complex. The P- and T-peak bands were in parallel, separately located at the upper and the bottom of R-peak band. The width and chromatography represented the duration and polarity of P- and T-waves, respectively. Rhythm transformation was indicated by the changes of the width or chromatography of the threepeakband ECG waterfall diagram of sinus rhythm. The ECG waterfall diagram characteristics of atrial escape rhythm were as follows: P-peak band was allochroic while R- and T-peak bands were normal. The ECG waterfall diagram characteristics of ventricular escape rhythm were as follows: P-peak band disappeared, R-peak band was widened and allochroic, and T-peak band changed its color. The ECG waterfall diagram characteristics of junctional escape rhythm were as follows: P-peak band disappeared while R- and T-peak bands were normal. ConclusionECG waterfall diagram could be used to quickly identify various kinds of escape rhythms in SSS patients, which makes up for the shortcomings of ECG scatter plot and RR interval histogram in ECG big data analysis.

Objective To explore the correlation between ST-segment depression, ST-T changes, and atrial premature beats (APB) or premature ventricular contraction (PVC). Methods  By univariate and multivariate Logistic regression analysis, retrospective analysis was conducted on clinical ECG data to determine the relationship between ST-segment depression, ST-T changes, and APB or PVC. Results  Analysis of the ECG data from 4 952 patients revealed a significant correlation of ST-segment depression and ST-T changes with APB and PVC. Among the patients with ST-segment depression, the incidences of APB and PVC separately increased to 9.00 and 13.65 times the incidences in the patients without ST-segment depression. Among the patients with ST-T changes, the incidences of APB and PVC separately increased to 27.60 and 22.00 times the incidences in the patients without ST-T changes. Multivariate Logistic regression analysis also found that ST-segment depression of up to 0.05 mV and ST-T changes were key factors influencing the occurrence of APB and PVC. Conclusion   ST-segment depression and ST-T changes may serve as risk factors for the occurrence of APB and PVC.

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 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 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.

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 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.

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.

电解质紊乱在临床常见，可通过影响心肌细胞的电活动而引起心电图的改变。本文报告1例低钙高钾血症引起心电图相关改变的病例，心电图表现为ST段延长伴T波高尖，QTc延长。心电图作为常用的无创检查，有助于早期发现电解质紊乱，为临床诊疗提供可靠依据。

Objective  To explore the principle of superposition diagram and its application in the analysis of ambulatory electrocardiography (AECG). Methods  We selected 4 typical AECG cases related to morphological information (sinus rhythm and ventricular rhythm, sinus rhythm and atrial rhythm, sinus rhythm and junctional rhythm, DDD pacing mode and VAT pacing mode of dualchamber pacemaker). The principle and advantages of superposition diagram were analyzed, and summarized in combination with Lorenz scattered plot, ECG waterfall diagram and reverse technique. Results  Ventricular rhythm showed a wide QRS complex pattern, while sinus rhythm was manifested by a narrow QRS complex pattern; the above two rhythms could be separated rapidly by superposition diagram. The sinus rhythm showed upright Pwave, while atrial rhythm showed inverted Pwave; the above two rhythms could be quickly separated by superposition diagram. The sinus rhythm showed upright Pwave, while the junctional rhythm showed no Pwave; the above two rhythms could be separated quickly by superposition diagram. In the DDD pacing mode of dualchamber pacemaker, the double pulses of AP and VP could be observed, while the single pulse of VP appeared in the VAT pacing mode; the two kinds of pacing modes could be quickly separated by superposition diagram. Conclusion  The superposition diagram has unique advantages in the analysis of AECGs with morphological information changes, and it is another efficient tool for rapid analysis of AECGs.

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.

Objective  To explore the effect of coenzyme Ⅰ combined with lovastatin on cardiac function and the levels of serum inflammatory factors in patients with coronary heart disease (CHD). Methods  Retrospective analysis was performed on the clinical data of 120 CHD patients. Among them, 60 cases had been treated with lovastatin as the lovastatin group (lovastatin group), while another 60 cases were given lovastatin + coenzyme Ⅰ for injection as the combined medication group. The clinical efficacy and adverse reaction incidences between the two groups were compared, as well as the cardiac function (wall motion score index and LVEF), and serum inflammatory factors (high-sensitivity C-reactive protein, nuclear factor Kappa B), tumor necrosis factor-α and interleukin-1) and blood lipid (LDL-C, triglyceride, HDL-C and total cholesterol) levels before and after treatment. Results  The total clinical effective rate of the combined medication group was statistically higher than that of the lovastatin group (90.00% vs. 75.00%; χ²＝4.675, P＜0.05). The improvement of cardiac function, and serum inflammatory factors and blood lipid levels in the combined medication group was also better than that in the lovastatin group (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (16.67% vs. 6.67%; χ²＝2.911, P>0.05). Conclusion  In the treatment of CHD, the combination of coenzyme Ⅰ for injection and lovastatin significantly improves cardiac function and the regulation of blood lipid level. Its efficacy is better than that of lovastatin alone with high safety.

Objective  To explore the application value of 24hour ambulatory electrocardiographic parameters in the clinical diagnosis of ventricular arrhythmia in patients with acute myocardial infarction (AMI). Methods  A total of 200 AMI patients were performed by ambulatory electrocardiography (AECG) examination, and related parameters were recorded. According to the presence or absence of ventricular arrhythmia, the enrolled patients were divided into ventricular arrhythmia group and nonventricular arrhythmia group. The 24-hour AECG parameters of rMSSD, SDNN, SDANN-index and QT interval variability (QTV) were compared between the two groups. Logistic regression analysis was used to explore the relationship between 24-hour AECG parameters and ventricular arrhythmia occurred in AMI patients; ROC curve analysis was utilized to investigate the efficiency of these parameters in the diagnosis of ventricular arrhythmia among AMI patients. ResultsAmong the 200 AMI patients, 76 cases developed ventricular arrhythmia, with an incidence rate of 38.0%. The indexes of rMSSD, SDNN, SDANNindex and QTV of the AMI patients in the ventricular arrhythmia group were all significantly lower than those in the nonventricular arrhythmia group (all P＜0.05). Logistic regression analysis results showed that rMSSD, SDNN, SDANN-index and QTV were all related to the occurrence of ventricular arrhythmia among AMI patients (all P＜0.05). ROC curve analysis revealed that the AUC values of rMSSD, SDNN, SDANN-index and QTV in the diagnosis of ventricular arrhythmia among AMI patients were 0.907, 0.761, 0.819 and 0.906, respectively, with a certain predictive value. Conclusion  The 24-hour AECG parameters of rMSSD, SDNN, SDANN-index and QTV have application values in the clinical diagnosis of ventricular arrhythmia among AMI patients.