JOURNAL OF PRACTICAL ELECTROCARDIOLOGY

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JOURNAL OF PRACTICAL ELECTROCARDIOLOGY

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JOURNAL OF PRACTICAL ELECTROCARDIOLOGY

	2017 Vol.26 Issue.1 Published 2017-02-28

Article

	1	ECG changes related to “A PACE ON PVC” function of dualchamber pacemaker
		LIU Xia
		By the function of “PVC OPTIONS”, dualchamber pacemaker responds to premature ventricular contraction. This function is set in two response modes: “+PVARP ON PVC” and “A PACE ON PVC”. Generally, the default setting is opening both of the two functions simultaneously in a pacemaker with this special function. The function of “A PACE ON PVC” is characterized by prior atrial pacing, which may be misdiagnosed as pacing dysfunction. This paper focuses on the ECG changes related to this function.
		2017 Vol. 26 (1): 1-5 [Abstract] ( 1169 ) [HTML 1KB] [ PDF 31982KB] ( 1171 )

	6	Mechanical tension and arrhythmias
		GU Chun-Ying, LI Yi
		The disorder of cardiac electrical activity is the essencial cause of arrhythmia. Among all the influential factors resulting in abnormalities of cardiac electrical activity, mechanical tension is an important one. Mechanicaltensionrelated arrhythmia is closely associated with clinical practice, and arises more and more attention gradually. It is verified by research that abnormal mechano-electrical feedback is one of the important mechanisms of arrhythmia. This paper elaborates the cellular electrophysiological mechanism of mechanical arrhythmia and research progress.
		2017 Vol. 26 (1): 6-9 [Abstract] ( 812 ) [HTML 1KB] [ PDF 3966KB] ( 1661 )

	10	Clinical application of E-U08 Snap ECG recorder in remote monitoring of arrhythmia and myocardial ischemia
		FAN Ping, CHEN Chen, PENG Yi, HU Jia-Lu, HOU Yue-Mei
		Objective To investigate the clinical application value of EU08 Snap ECG recorder in remote realtime monitoring of arrhythmia and myocardial ischemia. Methods Fifty outpatients were enrolled in our study who had consulted from cardiovascular department of comprehensive grade 3A hospitals in Urumqi and Nanjing from June to September in 2015. All the research objects underwent routine 12 lead ECG monitoring and remote ECG monitoring by E-U08 Snap ECG recorder. If signs of cardiac irritations occurred, patients would collect ECG with Snap ECG recorder by themselves and transmit the recordings to hospitals for further analysis and diagnosis. The differences of detection rates of arrhythmia and myocardial ischemia in the two methods were separately compared. Results In the process of remote ECG monitoring, the detection rate of abnormal ECG by E-U08 Snap ECG recorder was 76% while the rate was only 20% by routine 12 lead ECG machine, and the difference was statistically significant(P＜0.001). Among ECG abnormalities, the detection rates of arrhythmia and myocardial ischemia monitored by ECG recorder were significantly higher than those by routine 12 lead ECG machine(48% vs12%, P＜0.001; 28% vs. 8%, P＜0.05). Conclusion E-U08 Snap ECG recorder helps in improving detection rates of arrhythmia and myocardial ischemia for patients outside the hospital and thus has some clinical application value.
		2017 Vol. 26 (1): 10-15 [Abstract] ( 1261 ) [HTML 1KB] [ PDF 14716KB] ( 1576 )

	16	Application value of remote realtime ECG monitoring in community medical association
		HUANG Deng, GUO Jun, XIA Ji-Tian, ZHANG Ai-Dong
		Objective To discuss the application value of remote realtime ECG monitoring in community medical association.Methods A total of 2 858 patients undergoing remote realtime ECG monitoring were selected from the community medical association of First Affiliated Hospital of Jinan University from May 25, 2015 to June 22, 2016. We statistically counted the detection rate of various types of arrhythmias, early warning rate of malignant arrhythmia, incidence of adverse events, detection rate of patients in accordance with cardiac electrophysiologic surgical indications, and the age and time distribution of detected arrhythmias. Results Among the enrolled patients, we identified sinus bradycardia in 88 cases, atrial tachycardia in 1 050, atrial premature beats in 2 014, atrial flutter in 28, atrial fibrillation in 195, ventricular tachycardia in 131, premature ventricular contraction in 1 530, preexcitation syndrome in 7, left and right bundle branch block separately in 25 and 120 cases, borderline rhythm in 46, and sinus arrest in 7. As far as the early warning of malignant arrhythmia was concerned, ventricular tachycardia occurred in 1 980 cases(69.28%), long RR interval(RR interval>2 s) in 1 258(44.02%), RonT in 304(10.64%), STsegment elevation and depression separately in 1 133(39.64%) and 1 141 cases(39.92%), and suspected myocardial infarction in 32(1.12%). Among adverse events, artifacts appeared in 9 cases(0.31%) and lead fell in 43(1.50%). Among the patients in accordance with cardiac electrophysiologic surgical indications, 41(1.43%) were fit for radiofrequency ablation including 27 with frequent ventricular premature beats, 10 with atrial fibrillation and 4 with preexcitation syndrome while 16(0.56%) were in accordance with indications of cardiac pacemaker implantation. The incidences of arrhythmias such as ventricular tachycardia and sinus arrest, and suspected myocardial infarction significantly increased in patients over 60 years old. The quantity of patients in accordance with surgical indications of pacemaker implantation took on a trend of rectilinear rise with age, and its difference was statistically significant among patients at different ages(P=0.022). Conclusion The detection rate of arrhythmia is relatively high in remote realtime ECG monitoring which could be promoted in diagnosing and screening cardiovascular diseases in the community healthcare as an important method.
		2017 Vol. 26 (1): 16-19 [Abstract] ( 1037 ) [HTML 1KB] [ PDF 924KB] ( 1488 )

	19


		2017 Vol. 26 (1): 19-19 [Abstract] ( 497 ) [HTML 1KB] [ PDF 894KB] ( 1140 )

	20	Quality control management of remote ambulatory electrocardiography examination: the operation and writing standards of report
		LUO Zhao-Lin, WU Bao-Ming
		With the monitoring technology of remote ambulatory electrocardiography(AECG), ECG data are transmitted by mobile communication. Since the remote AECG monitoring system is easy to be operated, users in monitoring terminals would be familiar with its manipulation after simple training. Therefore, besides being applied in monitoring critical patients in hospital, more important is that the system can be popularized in primary medical institutions, nonmedical institutions(such as geracomiums) and the population who need longterm ECG monitoring. It has obvious advantages in monitoring irregular paroxysmal arrhythmia and myocardial ischemia, and also valuable in reducing the incidence of cardiovascular events and improving the life quality of patients. This paper summarizes the composition of remote AECG monitoring system, the operating process of AECG examination and writing standards of AECG report.
		2017 Vol. 26 (1): 20-29 [Abstract] ( 2132 ) [HTML 1KB] [ PDF 9404KB] ( 2329 )

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		2017 Vol. 26 (1): 30-31 [Abstract] ( 671 ) [HTML 1KB] [ PDF 886KB] ( 1108 )

	32	Risk evaluation of Tpeak-Tend interval changes for patients with coronary borderline lesion after exerciseinduced myocardial ischemia
		WANG Ye, FAN Shu-Liang, FENG Xing, ZHANG Shu-Long
		Objective To observe if there is significant change in the length of Tpeak-Tend interval(Tpe) in patients with coronary borderline lesion before and after exerciseinduced myocardial ischemia, and to evaluate its predictive value on major adverse cardiovascular events(MACE) among the population with coronary borderline lesion by follow-up. Methods (i) Fifty cases were randomly selected as observation group who were diagnosed with coronary borderline lesion by coronary angiography from January 2014 to January 2015 in our hospital and underwent treadmill exercise test(TET). Fifty healthy people were taken as control group. (ii) The maximal Tpe(Tpe-Max), the average Tpe(Tpe-ave) and Tpe of single lead were measured before and after TET respectively. (iii) Tpe-Max, Tpe-ave and Tpe of single lead before and after TET were compared. (iv) The relationship between the incidence of MACE(cardiac death, acute coronary syndrome or reascularization of target lesions by ischemia and other clinical events) and Tpe was analyzed during an average of one year. Results (i) Tpemax and Tpe-ave in the observation group significantly lengthened after TET(P<0.05). (ii) There was no significant difference in Tpe between the two groups at resting state(P>0.05). (iii) No significant difference of Tpe was found before and after TET in the control group(P>0.05). (iv) Among the 50 cases with coronary borderline lesion, 6 cases suffered acute coronary syndrome, 2 underwent target organ reascularization by ischemia and no cardiac death was reported during a one-year follow-up. The patients with significantly lengthened Tpe were prone to be attacked by MACE while the cases in the control group were not haunted by the above MACE. Conclusion Tpe of patients with coronary borderline lesion significantly lengthens after TET. For the ones with significantly lengthened Tpe, the incidence of MACE increases during one year. However, it still waits for verification that if Tpe can be regarded as an independent predictor for MACE.
		2017 Vol. 26 (1): 32-35 [Abstract] ( 1038 ) [HTML 1KB] [ PDF 947KB] ( 1451 )

	36	Clinical significance of detection rate of abnormal ECG:analysis on ECGs of 871 neonates with pneumonia
		WANG Yun, HUANG Zhi-Biao
		Objective To explore the clinical significance of detection rate of abnormal electrocardiogram(ECG) of neonates with pneumonia. Methods A total of 871 cases with neonatal pneumonia were selected as research objects who had been admitted by our hospital from January 2014 to May 2015. They were divided into mild pneumonia group(785 cases) and severe pneumonia group(86 cases) according to its severity while another 100 healthy newborns in the same period were taken as healthy control group. ECGs were compared among the three groups. Results The incidence of abnormal ECG in severe pneumonia group and mild pneumonia group was significantly higher than that in health control group and the rate in severe pneumonia group was also significantly higher if compared with mild pneumonia group, both with statistically significant differences(P<0.05). In severe pneumonia group and mild pneumonia group, the incidences of complications of ECG abnormalities were significantly higher if compared with health control group and the incidences in severe pneumonia group were also significantly higher than those in mild pneumonia group, both with statistically significant differences(P<0.05). Conclusion Various types of ECG abnormalities can be found in neonates with pneumonia. Myocardial damage is associated with the presence of ECG abnormalities which are related to the degree of myocardial lesions. Therefore, routine ECG changes have important practical value in diagnosing, treating and making prognosis evaluation of diseases.
		2017 Vol. 26 (1): 36-38 [Abstract] ( 1047 ) [HTML 1KB] [ PDF 938KB] ( 1529 )

	39	The relativity between Lown’s classification of premature ventricular contraction and severity of myocardial fibrosis in hypertrophic cardiomyopathy patients
		GAO Hong-Ling, ZHANG Yi, XU Hua-Yan
		Objective To investigate the relativity between Lown’s classification of premature ventricular contraction(PVC) and the severity of myocardial fibrosis in hypertrophic cardiomyopathy(HCM) patients. Methods Fifty-nine HCM patients underwent cardiac magnetic resonance scanning and 24 h Holter examination, thereby we obtained late gadolinium enhancement(LGE, characterizing the severity of myocardial fibrosis) and the occurrence of PVC. The patients were grouped by Lown’s classification and myocardial LGE was compared. By Spearman correlation analysis, the relativity between LGE and the severity of PVC was analyzed. Results PVC occurred in 43 patients(72.88%). According to Lown's classification, there were 16 patients in grade 0, 6 in grade 1, 3 in grade 2, 18 in grade 3 and 16 in grade 4. The LGE rate, total LGE volume and total LGE mass of grade4 patients were (34.05±14.53)%, (66.33±29.96) mL and (66.81±30.35) g, respectively, all significantly higher than those of grade 0-3 patients(P＜0.05). The above values of grade3 patients were separately (26.86±12.91)%, (38.62±25.23) mL and (36.98±24.06) g, all significantly higher than those of grade0-2 patients but significantly lower than those of grade4 patients(P＜0.05). The above values of grade0 patients were separately (15.93±11.35)%, (18.62±16.19) mL and (17.64±15.40) g, all significantly lower than those of grade1-4 patients(P＜0.05). The LGE rate, total LGE volume and total LGE mass were all positively correlated with Lown’s classification(correlation coefficient r=0.639, 0.640 and 0.551, respectively; P＜0.000 1). Conclusion The severity of PVC in HCM patients were positively correlated with the degree of myocardial fibrosis. The higher the grade of Lown’s classification, the more severe the degree of myocardial fibrosis.
		2017 Vol. 26 (1): 39-42 [Abstract] ( 923 ) [HTML 1KB] [ PDF 1594KB] ( 1615 )

	43	Experience of ECG teaching in standardized training for general practitioners
		WANG De-Guo, DING Ding, WANG Yuan-Jing, WANG An-Cai
		It is a key point to establish and improve general practitioner system for China's medical and health system reform in the future. Electrocardiogram(ECG) is an inexpensive inspection method widely adopted by primary health institutions. It is one of necessary qualities for a qualified general practitioner to interprete ECG accurately. It is very important for general practitioners to quickly master necessary skills of ECG interpretation, especially the capability of quickly identifying ECG clues of some clinical critical diseases. This paper makes brief introduction to our teaching experience of ECG interpretation skill fostering for general practitioners.
		2017 Vol. 26 (1): 43-46 [Abstract] ( 917 ) [HTML 1KB] [ PDF 928KB] ( 1808 )

	47	Electrocardiographic indicators of ventricular repolarization stability and their evaluation
		WANG Jiao, ZHANG Shu-Long
		Myocardial action potential results from the regular opening and closing of ion channels on the cell membrane. Different from depolarization, the repolarization of ventricular muscle goes through a long period, influenced by many factors and thus performs poor stability. Ventricular repolarization is an important stage in electrical activities of the heart. Even micro interference in the process may trigger arrhythmia. Electrocardiogram is the most commonly used and convenient method of detecting the inconsistency of ventricular repolarization. Several electrocardiographic indicators such as corrected QT interval, QTd, QT/RR, Tp-Te, Tp-Te/QT, QRS-T angle and VG are frequently used to evaluate the stability of ventricular repolarization. These indicators are used extensively in the risk evaluation of various diseases clinically. This paper reviews on the research progress of the above indicators.
		2017 Vol. 26 (1): 47-51 [Abstract] ( 859 ) [HTML 1KB] [ PDF 947KB] ( 1797 )

	52	Evaluation of diagnostic value of cardiac implantable devices for atrial fibrillation
		SUN Liu, ZHANG Shu-Long
		Atrial fibrillation(AF) is a kind of clinically common arrhythmia, which can be divided into symptomatic and asymptomatic AF. Monitoring instruments for arrhythmia is various, which can be classified into external monitor and cardiac implantable devices. Despite being applied in diagnosing AF and its type, cardiac implantable devices can also be utilized in guiding the treatment of AF induced stroke and accurately evaluating the recurrence rate of AF after catheter ablation. This paper reviews on the above issues.
		2017 Vol. 26 (1): 52-56 [Abstract] ( 927 ) [HTML 1KB] [ PDF 929KB] ( 1480 )

	57	Research progress on locating the culprit vessel of acute inferior myocardial infarction by surface electrocardiogram
		CAO Zheng-Yu, XIA Si-Liang
		Acute inferior myocardial infarction could result from the occlusion of right coronary artery(RCA) and left circumflex artery(LCX). It may lead to ST segment elevation in all or parts of the inferiorwallinfarctrelated leads in surface electrocardiogram(ECG), accompanied with ST segment changes of adjacent leads, precordial leads, posterior wall leads, right ventricular leads or not. Clinically, it is highly sensitive and specific to locate the culprit vessel of acute inferior myocardial infarction through the changes of ST segment in the above leads, and its different combination and procedure. This paper reviews on the research advance of the culprit vessel location of acute inferior myocardial infarction via surface ECG.
		2017 Vol. 26 (1): 57-62 [Abstract] ( 854 ) [HTML 1KB] [ PDF 2075KB] ( 1409 )

	63
		TAN Jian-Cheng, ZHANG Tian-Kuang, CHA Qing, HU Wei

		2017 Vol. 26 (1): 63-65 [Abstract] ( 1019 ) [HTML 1KB] [ PDF 1254KB] ( 1756 )

	66
		QI Fei, HU Tao-Hong, JIA Shang-Hui

		2017 Vol. 26 (1): 66-67 [Abstract] ( 737 ) [HTML 1KB] [ PDF 2683KB] ( 1564 )

	68
		YU Xiu-Ming, 吕Hang , LIU Ming

		2017 Vol. 26 (1): 68-71 [Abstract] ( 729 ) [HTML 1KB] [ PDF 13869KB] ( 1098 )

	72
		吕Hui , JIANG Tao, WANG Hong-Yu, BIAN Yun-Fei, YANG Zhi-Ming

		2017 Vol. 26 (1): 72-74 [Abstract] ( 846 ) [HTML 1KB] [ PDF 5733KB] ( 1414 )

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		2017 Vol. 26 (1): 74-75 [Abstract] ( 518 ) [HTML 1KB] [ PDF 10026KB] ( 1293 )

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		2017 Vol. 26 (1): 76-76 [Abstract] ( 399 ) [HTML 1KB] [ PDF 10392KB] ( 1077 )

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