JOURNAL OF PRACTICAL ELECTROCARDIOLOGY

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JOURNAL OF PRACTICAL ELECTROCARDIOLOGY

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JOURNAL OF PRACTICAL ELECTROCARDIOLOGY

	2013 Vol.22 Issue.2 Published 2013-04-20

Article

	540


		2013 Vol. 22 (2): 540-540 [Abstract] ( 1361 ) [HTML 1KB] [ PDF 12514KB] ( 1308 )

	541
		LU Xi-lie

		2013 Vol. 22 (2): 541-542 [Abstract] ( 1117 ) [HTML 1KB] [ PDF 1042KB] ( 1890 )

	543
		CHEN Qing-qi

		2013 Vol. 22 (2): 543-551 [Abstract] ( 1112 ) [HTML 1KB] [ PDF 7518KB] ( 1963 )

	552
		JIA Xing-qian

		2013 Vol. 22 (2): 552-557 [Abstract] ( 1270 ) [HTML 1KB] [ PDF 10504KB] ( 7770 )

	558
		LI Xing-jie, ZHANG Chen

		2013 Vol. 22 (2): 558-564 [Abstract] ( 1358 ) [HTML 1KB] [ PDF 10983KB] ( 1589 )

	565	Comparison of diagnostic value between remote ECG monitoring, 12 lead ECG and Holter in arrhythmia and myocardial ischemia
		GU Min，GU Xiang，HE Sheng-hu，SUN Lei，ZHANG Jing，SUN Jia-bin
		Objective To investigate the clinical value of remote monitoring system in diagnosing patients with arrhythmia and ST-T change.Methods A total of 78 patients with heart diseases or heart symptoms were undergone 12 lead electrocardiogram(ECG) and remote ECG monitoring examination; 42 out of 78 cases received Holter examination．The recall rate of remote ECG monitoring, 12 lead ECG and Holter in the diagnosis of arrhythmia and ischemic ST-T change was compared．Results There were significant differences in the detection of arrhythmia and ST-T changes between remote ECG monitoring and 12 lead ECG (79.5% vs 59.0%,P<0.05 for arrhythmia; 17.9% vs 7%, P<0.05 for ST-T change). There was no significant difference in the detection of arrhythmia and ST-T changes between remote ECG monitoring and 24-hour Holter （81.0% vs 71.4%,P>0.05 for arrhythmia; 23.8% vs 16.7%,P>0.05 for ST-T changes）. Among the 42 patients with Holter, 34 patients with arrhythmia were recorded by remote ECG monitoring while 30 patients with arrhythmia were recorded by Holter.No significant difference was found between these two methods(81.0％vs71.4%,P>0.05). 10 patients with ischemic ST-T change were recorded by remote ECG monitoring (23.8%), insignificantly different from that by ECG (7/42, 16.7%, P>0.05).Conclusion Compared with 12 lead ECG, remote ECG monitoring shows higher detection rate in diagnosing arrhythmia and ischemic ST-T changes. While compared with Holter, remote ECG monitoring failed to diagnose arrhythmia and ischemic ST-T changes.
		2013 Vol. 22 (2): 565-569 [Abstract] ( 1644 ) [HTML 1KB] [ PDF 2815KB] ( 2781 )

	570	Clinical analysis of changes of ECG, serum myocardial enzyme combined with EEG from 13 children with severe hand-foot-mouth disease
		ZHANG Hui-wen
		Objective To investigate the characteristics and clinical significance of the electrocardiogram, serum myocardial enzyme combined with electroencephalogram (EEG) from children with hand-foot-mouth disease(HFMD). Methods 13 children with severe HFMD were enrolled in the study. 12 lead ECG, serum myocardial enzymes, cardiac troponin and 16 lead EEG were performed within 2-12 h. Results Among all patients before treatment, 11 cases were with abnormal ECG, mostly sinus tachycardia, ST-T change，atrioventricular block, atrial premature contraction; 10 cases were with abnormal myocardial enzymes (aspartate aminotransferase, lactate dehydrogenase, creatine kinase and creatine kinase isoenzyme); all patients′ cardiac troponin values were higher than the normal upper limit values; 6 cases were with EEG boundaries and 7 cases were with abnormal EEG. After treatment, all patients had improvement in different degrees or were cured. Conclusion Children with severe HFMD mostly had myocardial damage and central nervous system involvement. ECG, myocardial enzymes and EEG detection should be done earlier in order to take active treatment promptly, which has important clinical application value for the observation of curative effect and prognosis evaluation.
		2013 Vol. 22 (2): 570-572 [Abstract] ( 1194 ) [HTML 1KB] [ PDF 927KB] ( 1841 )

	573	Analysis of arrhythmia events and clinical characteristics in patients with Brugada syndrome
		CHEN Si-mei, WU Yue-ping
		Objective To explore the occurrence and clinical characteristics of arrhythmia events in patients with Brugada syndrome（Brs）by Holter, implantable cardioverter defibrillater(ICD) and combined with the clinical situation. Methods Clinical features of 12 inpatients with Brs,who had been diagnosed in recent 5 years,were observed by following up.All patients were undergone Holter examination to analyze the clinical characteristics of arrhythmia events .According to the follow-up data by ICD, the time characteristics of episodes of ventricular fibrillation were analyzed. Results Holter examination showed that the total number of premature ventricular contraction(PVC) in 8 patients was 0-80/day. The other 4 patients had frequent PVCs and nonsustained ventricular tachycardia, mainly occurring from night to early morning(among them, 1 patient with paroxysmal atrial fibrillation, and 1 patient with frequent atrial premature contraction and atrial tachycardia while in night with a junction escape rhythm ). During a followup period of 6-50 months in 9 patients with implantation of ICD，70 episodes of ventricular fibrillation (VF) were documented, among which 92.8% occurred from night to early morning(22:00-07:00). All the 12 patients had syncope episodes；9 patients suffered from ventricular tachycardia/VF during in hospital, 2 patients with family history of sudden death. Two patients suffered from sudden death during follow-up. Conclusion The episodes of ventricular tachycardia /VF were mainly occurred from nocturnal time to early morning in Brs patients. Brs patients combined with atrial arrhythmias and slow arrhythmia had higher incidence rate of ventricular tachycardia and VF. When confirmed Brs patients suffer from palpitation, we should fully study the episodes of arrhythmia and give appropriate treatment.
		2013 Vol. 22 (2): 573-575 [Abstract] ( 1197 ) [HTML 1KB] [ PDF 987KB] ( 1635 )

	576	Analysis of the relationship between blood pressure circadian rhythm abnormalities in preeclampsia pregnant women and perinatal infant outcomes
		HUANG Jun, JU Wen-dong, XIONG Xiao-ying, CHEN Ang, WU Li-feng
		Objective To discuss the effect of blood pressure circadian rhythm abnormalities in preeclampsia patients on perinatal infant outcomes. Methods A total of 217 preeclampsia patients in hospital were selected in the research,including 99 cases with mild preeclampsia and 118 cases with severe preeclampsia. Other 57 pregnant women of concurrent hospital delivery were selected as the control group. The ambulatory blood pressure of all patients during day and at night were monitored.All patients were classified by three groups, dipper type, non-dipper type and antidipper type, according to the circadian rhythm of blood pressure. Results The incidence of nondipper type and antidipper type in group of preeclampsia patients was significantly higher than that of the control group (P <0.001).The incidence of various adverse perinatal infant outcomes were higher in patients with anti-dippers type blood pressure. The incidence of adverse perinatal infant outcomes in patients with anti-dipper type were markedly higher compared with patients from dipper and non-dipper type(both P<0.05). Conclusion Circadian rhythm abnormalities adversely affected the outcome of perinatal infants. Therefore, more attention should be focused on anti-dipper type patients. It will be helpful for maternal and infants′ safety by strengthening efforts to reduce nocturnal blood pressure and grasping the timely opportunity to terminate the pregnancy.
		2013 Vol. 22 (2): 576-579 [Abstract] ( 1076 ) [HTML 1KB] [ PDF 939KB] ( 1803 )

	580	Clinical value and identification of ST segment elevation in ambulatory electrocardiogram
		XU Jin-lan，GUO Mei-qin，WANG Xiao-hua，CHU Cheng-hua
		Objective To explore the clinical value of ST segment elevation in 24hour ambulatory electrocardiogram（AECG）. Methods A total of 111 cases with ST segment elevation were divided into four groups，that is, angina group，Brugada wave group，pericarditis group and early repolarization variability group. The dynamic electrocardiogram were compared between four groups.Results In angina group,ST segment elevation was associated with patients onset of symptoms and attack time;In pericarditis group,all leads were continuously elevated. Althoughthe ST segment elevation in remaining two groups had dynamic changes and was not synchronous with the onset of symptoms，it was associated with the dynamic and static state of patients per se.Conclusion Combined with the clinical symptoms and patients dynamic and static state， ST segment elevation and form，distribution lead is the key factor of identifying the nature of ST segment elevation in AECG.
		2013 Vol. 22 (2): 580-583 [Abstract] ( 1460 ) [HTML 1KB] [ PDF 3011KB] ( 2619 )

	584	Diagnostic value and clinical significance of telemetry Holter electrocardiogram monitoring system in patients with acute coronary syndrome
		GUO Ying-jie
		Objective To discuss the diagnostic value and clinical significance of wireless and intermittent Holter monitoring system for acute coronary syndrome（ACS）. Methods A total of 246 patients were investigated by using a telemetric Holter system, intermittent transmission of ECG data.The clinical characteristics of the patients, who were diagnosed ACS by digital Holter recording were analyzed, and compared with conventional Holter examination. Results There were 66 out of 246 patients(66/246,26.8%)diagnosed ACS by digital Holter recordings. Among 66 cases with ACS,there were 39 cases with acute myocardial infarction(39/66,59.1%),27 angina pectoris(27/66,40.9%). Compared with the detection rate of ACS in hospital(14/53,26.4%),the primary medical organizations had higher detection rates (142/193,21.8%). In the 66 patients with ACS, Holter monitoring time was 52 minutes -22 hours 46 minutes, all in the default monitoring time. Conclusion Patients with ACS could be confirmed by wireless intermittent Holter transmission, which remedies conventional Holter′s defects that it could only make retrospective analysis. Meanwhile, it had very important clinical application value in giving prompt treatment, reducing complications and improving the quality of treatment and prognosis.
		2013 Vol. 22 (2): 584-586,590 [Abstract] ( 1329 ) [HTML 1KB] [ PDF 1293KB] ( 1845 )

	587	Analysis of myocardial damage after acute carbon monoxide poisoning in 108 cases
		KOU Feng-jun，WANG Yue-wen
		Objective To study the clinical significance of change of electrocardiogram(ECG), myocardial enzymes and troponin (cTNT) for myocardial damage after acute carbon monoxide poisoning(ACOP). Methods Quantitative clinical observation and retrospective analysis about ECG，myocardial enzymes and cTNT of 108 patients who were diagnosed with ACOP between November 2008 and December 2012 in our hospital were carried out. Results Different degrees of disturbance of consciousness were found among 108 patients. In the observed group, coma was found in 82 cases(75.9%); electrocardiographic abnormality was found in 80 cases (74.1%), including STT change in 69 cases(63.9%). Among 108 ACOP patients, the increase of myocardial enzymes activity was found in 69 cases (63.9%); the increase of cTNT activity in 25 cases (27.8%). The change of ECG, activity increases of myocardial enzymes and cTNT are proportional to the age while has positive relationship with the degree of CO poisoning. There lies significant difference among 3 levels of ACOP. Compared with mild poisoning patients, severe and moderate ones have statistical significant, and so do severe poisoning patients comparing with moderate ones（P<0.01）. After treatment, 101 cases got fully recovered. However, 5 cases died of multiple organs failure and long poisoning time while 2 cases died of delayed encephalopathy after ACOP. Conclusion ACOP can cause myocardial damage in different degrees, which requires appropriate treatment.
		2013 Vol. 22 (2): 587-590 [Abstract] ( 1008 ) [HTML 1KB] [ PDF 943KB] ( 1841 )

	591	Comparison of efficacy and adverse reactions between amiodarone and metoprolol in elderly patients with atrial fibrillation
		SONG Ke，CHEN Qiao-ling
		Objective To evaluate the clinical efficacy of metoprolol and amiodarone on elderly patients with atrial fibrillation in clinical practice and analyze its adverse reactions.Methods Fifty elderly patients with atrial fibrillation were enrolled and randomly divided into observation group and control group. The control group was given a simple combined medication metoprolol；observation group was treated with metoprolol+amiodarone medication. The clinical efficacy of the two groups were compared. Results After treatment, compared with control group, observation group had higher levels of total effective rate (P<0.05). There was significant difference in adverse reactions between two groups (P<0.05). Conclusion Treating elderly atrial fibrillation patients with metoprolol +amiodarone had a good therapeutic effect and safety.
		2013 Vol. 22 (2): 591-592,595 [Abstract] ( 1040 ) [HTML 1KB] [ PDF 974KB] ( 1610 )

	593	Analysis of deceleration capacity of rate in patients with traumatic fracture
		LIU Xia, LIU Dan
		Objective To explore the change of deceleration capacity of rate(DC) in patients with traumatic fracture and the correlation between DC and heart rate variability （HRV）.Methods 60 cases of patients with traumatic fracture were divided into two groups according to their ages: Group I(age 40-60) and Group Ⅱ(age 61-80). Both of groups were detected by dynamic electrocardiogram for 24 hours and calculated the DC and HRV indexes.Results DC of Group I was (6.08±1.74) ms；DC of Group Ⅱ was (5.13±0.82) ms；DC was positively correlated with HRV indexes such as SDNN, rMSSD, pNN50 and HF(P<0.01), and was negatively correlated with HR. Conclusion There was a good correlation between indexes of DC and HRV in patients with traumatic fracture. DC can independently be an index of the autonomic nerve function tests.
		2013 Vol. 22 (2): 593-595 [Abstract] ( 1241 ) [HTML 1KB] [ PDF 931KB] ( 1936 )

	596	Analysis of fragmented QRS complex in patients with acute myocardial infarction
		HUANG Zhi-biao, SONG Wei
		Objective To explore the clinical value of fragmented QRS complex in diagnosis of acute myocardial infarction (AMI). Methods One hundred and sixtytwo patients with AMI were enrolled in the study and were divided into two groups, fQRS and non-fQRS, according to the presence of fQRS. Incidence rates of reoccur angina, arrhythmia, leads of ST-segment elevation, hospital mortality were compared between two groups. Results The incidence rates of reoccur angina, arrhythmia, leads of ST-segment elevation, hospital mortality in fQRS group were significantly higher than those of non-fQRS group (P<0.05). Conclusion The presence of fragmented QRS complex may be involved in the prognosis of patients with myocardial infarction.
		2013 Vol. 22 (2): 596-597 [Abstract] ( 1261 ) [HTML 1KB] [ PDF 932KB] ( 1906 )

	598	Analysis on premature ventricular beats over 10 000 times in 94 cases with 12 lead dynamic electrocardiograms
		LIU Yan, LIU Li
		Objective To analyze and discuss the characteristics and meaning of premature ventricular beats of more than 10 000 times with dynamic changes of 12 lead electrocardiograms.Methods Give a retrospective analysis of the general distribution of 94 cases of patients with premature ventricular beats of more than 10 000 times，who were Classify by different conditions. Results Among 94 cases of patients with premature ventricular beats of more than 10 000 times, ① classify by pathogeny：27 cases with coronary disease, 17 cases with arrhythmia cordis, 15 cases with dilated cardiomyopathy, 11 cases with hypertensive heart disease, 8 cases with pulmonary heart disease, 5 cases with diabetes, 3 cases with chest dejected and palpitate to be checked further, 2 cases with myocardial infarction, 2 cases with myocarditis, 2 cases with angina pectoris, one case with cerebral infarction and one case with cholelithiasis. ② Classify by Lown classification: 31 cases of level Ⅱ, 21 cases of level Ⅲ, 15 cases of level ⅣA, 26 cases of level ⅣB, and one case of levelⅤ. ③ Classify by time of the occurrence of premature ventricular beats: 32 cases mostly strike in the daytime; 34 cases mostly strike at night, and 28 cases strike by day and night. ④ Classify by the frequency of premature ventricular beats(times/day): 4 cases with 40 000-50 000 times /day，9 cases with 30 000-40 000 times/day，20 cases with 20 000-30 000 times/day，and 61 cases with 10 000-20 000 times/day. Conclusion To successfully detect premature ventricular beats over 10 000 times with 12 lead dynamic electrocardiograms, first we should dig out the cause of premature ventricular beats and then combine comprehensive clinical experience, so that we can make correct evaluation and prognostic evaluation of premature ventricular beats.
		2013 Vol. 22 (2): 598-599,608 [Abstract] ( 1106 ) [HTML 1KB] [ PDF 1566KB] ( 1641 )

	600
		CHENG Zhong-Wei

		2013 Vol. 22 (2): 600-603 [Abstract] ( 988 ) [HTML 1KB] [ PDF 2562KB] ( 1611 )

	604
		YU Xiao-Lin, GU Fang

		2013 Vol. 22 (2): 604-606 [Abstract] ( 1531 ) [HTML 1KB] [ PDF 5289KB] ( 2431 )

	607
		CHEN Yue-Ying, ZHAN Hong-Ji, LUO Ya-Xiong, XIANG Hong-Ju, WANG Fu-Jun

		2013 Vol. 22 (2): 607-608 [Abstract] ( 1071 ) [HTML 1KB] [ PDF 2467KB] ( 1568 )

	609
		ZHANG Guang-Hong, MENG Xiang-Bing, SHI Yi-Tao

		2013 Vol. 22 (2): 609-611 [Abstract] ( 1166 ) [HTML 1KB] [ PDF 1824KB] ( 1676 )

	610
		BAO Ying, DU Zhen-Lan

		2013 Vol. 22 (2): 610-611 [Abstract] ( 1079 ) [HTML 1KB] [ PDF 1439KB] ( 1799 )

	612	Ambulatory electrocardiogram in clinical application and current situation
		ZOU Qiao-ling, LIU Xiao-mei, SONG Hui
		The ambulatory electrocardiogram(AECG) was first invented in 1961 by an American Holter，which was introduced to China for clinical application in the late 1970s and greatly improved the level of clinical diagnosis of cardiovascular disease. The application of dynamic electrocardiogram plays an important role in current clinical diagnosis and monitoring, including evaluation of focal atrial fibrillation,detection of arrhythmia, monitoring of sleep apnea syndrome, as well as the monitoring of antiarrhythmic drugs . Therefore，it′s necessary to provide insight into the clinical applications and current situation of dynamic electrocardiogram.
		2013 Vol. 22 (2): 612-613 [Abstract] ( 1201 ) [HTML 1KB] [ PDF 930KB] ( 2162 )

	614	Advances in cerebral-cardiac syndrome
		CHEN Yu, CHU Wei
		Cerebral-cardiac syndrome refers to the secondary change of electrical activity in the heart caused by various reasons, such as acute cerebrovascular disease, acute craniocerebral injury, intracranial inflammation. Electrocardiogram(ECG) showed ST changes, various arrhythmia and J wave changes as the main features. Mechanism of ECG changes has relationship with neurohumoral regulation, electrolyte disturbances and etc. For prognosis of patients, there lies significant meaning of Glasgow coma score(GCS) and relative research about ECG abnormality. The disease is urgent, fast-developing and causes high death rate, therefore, we should clinically attach great importance to the occurrence and development of cerebral-cardiac syndrome, which has important value and serves as a guidance for practice.
		2013 Vol. 22 (2): 614-616 [Abstract] ( 1594 ) [HTML 1KB] [ PDF 930KB] ( 2254 )

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