JOURNAL OF PRACTICAL ELECTROCARDIOLOGY

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JOURNAL OF PRACTICAL ELECTROCARDIOLOGY

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JOURNAL OF PRACTICAL ELECTROCARDIOLOGY

	2012 Vol.21 Issue.2 Published 2012-07-01

Article

	79	Clinical research of circumferential pulmonary vein isolation guided by Ensite3000 3D mapping system in patients with atrial arrhythmia

		Objective To investigate the efficacy of circumferential pulmonary vein isolation guided by Ensite3000 3D mapping system in patients with atrial arrythmia. Methods Consecutive patients with atrial arrhythmia underwent circumferential pulmonary vein isolation guided by Ensite3000 3D mapping system. Disappearance of pulmonary vein potential was considered as the ablation endpoint.Success was defined as without atrial tachyarrhythmia after 3 months,as well as asymptomatic atrial tachyarrhythmia. Results Clinical success achieved 71.8% and the effective rate was 12.6% in 64 patients. Severe complications included 2 cases of pericardial tamponade and 2 cases of mild pericardial effusion,1 case of femoral embolism and 1 case of arteriovenous fistula. There was no death case. Conclusion Circumferential pulmonary vein isolation guided by Ensite3000 3D mapping system is an effective therapy and safe for patients with atrial arrhythmia.
		2012 Vol. 21 (2): 79- [Abstract] ( 2123 ) [HTML 1KB] [ PDF 923KB] ( 2099 )

	82	Application of ⁹⁹Tc^m-Syt I-C2A in apoptosis imaging of cardiocytes based on myocardial ischemia-reperfusion

		Objective To investigate application of mutation protein of C2A domain of synaptotagmin I（Syt I-C2A-G4C） labeled with technetium in myocardial apoptosis imaging. Methods （1） The C2A domain of Syt I was labeled with ⁹⁹Tc^m using reduction photoetry of Tin chloride. Radiochemical purity was determined with thin layer chromatography. The binding activity with phosphatidylserine of radiolabeled protein was assessed using cell binding experiment.（2） Myocardial ischemia-reperfusion models were produced in 5 pigs. SPECT images were acquired at 2h after post injection of ^99mTc-Cyt-C2A-G4C via the tail， and the ratio of target/background was also cal- culated using region of interest（ROI） method. Apoptosis in the ischemic myocardium was assessed using terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling assay. Results （1） The radiochemical purity of ⁹⁹Tc^m-Syt I-C2A-G4C was（96.42±0.76）%.（2） The radioactivity in the camptothecin-treated group was （5.23±0.38） folds higher than that of non-treated viable control group.（3）At 2 h post-injection of the radiotracer， the focal uptake of radioactivity was observed at the ischemic myocardium areas， and T/B ratio was 3.40± 0.43 . Myocardial apoptosis was confirmed by TUNEL assay in the ischemic myocardium with high radioactivity. Conclusion ⁹⁹Tc^m-Syt I-C2A-G4C should be a potential radiotracer for imaging of myocardial apoptosis.
		2012 Vol. 21 (2): 82- [Abstract] ( 1390 ) [HTML 1KB] [ PDF 1618KB] ( 1819 )

	85	Clinical research of heart rate turbulence on predictive value in patients with acute myocardial infarction

		Objective To explore the HRT and short term prognostic value of heart rate turbulence on acute myocardial infarction and the relationship of HRT and heart rate variability. Methods Chose 200 patients with sinus rhythm after AMI to monitor their 24 h dynamic electrocardiography，TO，TS， HRV time domain indexes and 24 h R-R interval standard difference during the follow-up survey period of 20.6 months. The end event is cardiac death. Results Compared with the survival group（164 patients），the TS of the death group after AMI（36 patients）weakened obviously（P <0.05）and the TO increased. There is a significant correlation between TS and SDNN（r =0.447，P =0.009）. Conclusions The values of TO and TS（factors of HRT）may be a new predictor to evaluate the autonomic nerve activity and predict the adverse cardiovascular events and sudden cardiac death of patients after AMI.
		2012 Vol. 21 (2): 85- [Abstract] ( 1363 ) [HTML 1KB] [ PDF 853KB] ( 1735 )

	88	Investigation of the therapeutic effect of percutaneous coronary intervention in 14 patients with coronary heart disease based on syncope symptom

		Objective To investigate the therapeutic effect of patients with coronary heart disease（CHD），which is characterized by syncope，accepting percutaneous coronary intervention（PCI）. Methods Enrolled patients with right conditions and treated by PCI and a follow-up observation was taken. Results Fourteen patients with coronary artery affection were found，follow-up observation was taken after stent implanting. The result indicated one case of sudden death，one case died of remyocardial infarction， one case accepted re-issue implantable cardioverter defibrillator（ICD）therapy，two cases of third degree atrioventricular block accepted of a permanent pacemaker implanting，and the remaining patients with satisfactory result. Conclusion The onset of sycope associated with risk factors of coronary heart disease，should be wary of coronary artery disease，early coronary angiography to find coronary artery disease，and operating the PCI，have important clinical significance for preventing sudden death of coronary heart disease.
		2012 Vol. 21 (2): 88- [Abstract] ( 1444 ) [HTML 1KB] [ PDF 845KB] ( 1867 )

	91	Performance and clinical importance of ECG of neonates with hyperpotassemia

		Objective To explore the performance and the importance of ECG of neonates with hyperpotassemia. Methods The ECG and density of element potassium in electrolyte of 64 neonates with hyperpotassemia were analyzed. Result The performance of neonates' ECG were abnormal P- wave，AVB，QRS widening，tall peaked T wave，Q-T shortening，VT，sinus-ventricular conduction and so on. The probability of getting arrhythmia is related with the increasing density of element potassium. Conclusion ECG is the easiest and the most effective method to find out neonates who have hyperotassemia. When find out an abnormal ECG of neonate，it is necessary to check the density of element potassium and try to cure hyperpotassemia，which is to prevent from a vital arrhythmia.
		2012 Vol. 21 (2): 91- [Abstract] ( 3281 ) [HTML 1KB] [ PDF 871KB] ( 2604 )

	93	Comparison analysis of dynamic ECG and coronary artery angiography based on chest tightness in patients with atrioventricular block

		Objective To investigate the diagnose value of dynamic electrocardiogram（ECG）on ischemic heart disease. Methods Thirty-two cases aged more than 40 years old with chest tightness were chosen，and atrioventricular block were found after dynamic ECG checking. Twenty-eight cases among them were examined by coronary artery angiography. Results Coronary artery angiography examination of 28 patients showed that 12 cases（42.8%）with right coronary artery posterior descending artery clogging by 70%， 8 cases with right coronary artery posterior descending artery clogging by 30% to 50%，3 cases with left circumflex coronary artery clogging by 50%，3 cases with negative coronary artery angiography. Conclusion Coronary artery clogging can be mostly found in the patients with atrioventricular block aged more than 40 years old who were suffered from chest tightness. A coronary artery angiography examination should be taken for diagnosing.
		2012 Vol. 21 (2): 93- [Abstract] ( 1126 ) [HTML 1KB] [ PDF 837KB] ( 1707 )

	95	Effect of amiodarone on treating ventricular arrhythmia based on dynamic ECG analyzing

		Objective To discuss the effect of amiodarone on treating ventricular arrhythmia by dynamic ECG. Methods A total of 150 cases of patients with ventricular arrhythmia were treated by oral administration of amiodarone. In the first three days，took amiodarone 200 mg orally every time，three times a day; in the second three days，took amiodarone 200 mg orally every time，twice a day; in the last three days，took amiodarone 200 mg orally every time，once a day. The dynamic ECG examination before and after the treatment were taken at the 3rd day， the 6 th day and the 9th day. The data of ventricular arrhythmia was analyzed before and after treatment. Results The dynamic ECG examination shows that taking amiodarone has a good effect on the ventricular arrhythmia，132 cases have a good effect among the 150 cases（the effective rate is 88%）. Conclusion Dynamic ECG is a necessary examination to check the effect of amiodarone on ventricular arrhythmia.
		2012 Vol. 21 (2): 95- [Abstract] ( 1264 ) [HTML 1KB] [ PDF 839KB] ( 1807 )

	97	Clinical value of ECG localization diagnosis on acute myocardial infarction

		Objective To analyze the relativity between early localization diagnosis of ECG and coronary artery disease of vascular on acute myocardial infarction. Methods A total of 159 cases of ECG characteristics of acute myocardial infarction（the ST-segment and Q wave infarction）were compared with the results of coronary angiography analysis. Results Ninteen cases of ST-segment elevation of V₁～V₆leads on extensive anterior wall were found which companied with varying leads pathological Q waves appeared，while ST-segment depression of I， aVL，Ⅱ，Ⅲ，aVF leads also appeared，the main pathological change located in the former drop L-branch and branch. Twenty-four cases of ST-segment elevation of V₃～V₅leads were found on anterior wall with pathological Q waves appeared，the main pathological change located in the former depression artery. Fifteen cases of ST-segment elevation of V₄～V₆ leads were found on front wall while visible pathological Q wave appeared on V₄ and V₅ . The main pathological change located in left circumflex artery，followed by left descending artery.Eleven cases of ST- segment elevation of V₁～V₃leads were found on anteroseptal while pathologic Q waves appeared on V₂，V₃ leads with ST segment depression ofⅡ，Ⅲ，aVF appeared，the main pathological change located in the left circumflex artery，followed by the right coronary artery. Forty-three cases of ST-segment elevation ofⅡ，Ⅲ，aVF leads on inferior were found with pathological Q waves，the main pathological change located in the right coronary artery， followed by the left circumflex artery. Thirty-three cases of ST-segment elevation ofⅡ，Ⅲ，aVF lead were found on underside wall，while ST-segment depressing for I， aVL， V₁ ，V₆.While the main pathological change located in right coronary artery followed by circumflex artery. Six cases of ST-segment elevation ofⅡ，Ⅲ，aVF， V₁ ， V₂leads were found on under partitions，while ST-segment depression of V₃～V₆leads appeared. ST-segment elevation of I，aVL lead were found on high lateral wall associated with pathological Q waves appeared，while ST-segment depression ofⅡ，Ⅲ， aVF，V₅，V₆ were found，the main pathological changes located in left-anterior descending branch. ST- segment elevation of V₇，V₈were found on the posterior wall，while ST-segment depression of V₁，V₂，V_3R，V _4Rappeared，the main right coronary artery pathological changed，followed by L-branch. All 159 cases of acute myocardial infarction confirmed by coronary angiography were double-vessel or three-vessel disease. Conclusion Coronary anatomy and the characteristics of blood supply have important clinical significance on diagnosis of different ECG leads on acute myocardial infarction. With the development of clinical application of coronary heart disease，deep understanding will be paid for the relationship between correlation leads on infarct region and occlusion artery.
		2012 Vol. 21 (2): 97- [Abstract] ( 1804 ) [HTML 1KB] [ PDF 855KB] ( 3072 )

	100	Cardiac toxicity of adriamycin and related ECG analysis on 352 clinical cases

		Objective To explore the caidiac toxicity of adriamycin（ADM）. Method ECG of 1 088 cases treated by ADM were analyzed. Results After the ADM treatment，352 cases of abnormal ECG were found，which included sinus tachycardia，sinus bradycardia，atrial and ventricular contractions，ST- segment depression，T wave low and flat，T-wave inversion，limb lead QRS wave group of low voltage，atrial fibrillation. Conclusion ADM treatment is accompanied with strong cardiac toxicity，which may be evaluated by ECG .The ECG process is simple and economical，reproducible to provide information about the cardical toxicity of ADM.
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