JOURNAL OF PRACTICAL ELECTROCARDIOLOGY

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JOURNAL OF PRACTICAL ELECTROCARDIOLOGY

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JOURNAL OF PRACTICAL ELECTROCARDIOLOGY

	2017 Vol.26 Issue.2 Published 2017-04-28

Article

	77	Influence of rabbit vagus nerves cutting on heart rate variability and blood pressure instant variability under respiratory rate regulation
		SHEN Zhong-Yuan, ZHU Ying-Qi, YAN Shi-Biao, Shin Lin
		Objective To observe the relationship between blood pressure instant variability(BPIV), heart rate variability(HRV) and respiration in rabbits separately before and after hibateral vagus nerves cutting and respiratory arrest under respiratory rate regulation. Methods Ten standard experiment rabbits were selected and rabbit model of mechanical ventilation was established. The rabbits were conducted with mechanical ventilation under anesthesia by ventilator, with a constant tide volume of 10 mL/kg and respiratory rate of 70 times/min. Continuous recording of ECG, respiration and blood pressure was performed separately before and after hibateral vagus nerves cutting and respiratory arrest. The relationship between changes of HRV, BPIV and respiratory rate was analyzed. Results Before cutting hibateral vagus nerves, R-R interval and BP-BP were synchronized with the respiratory phase, with the same trend. The central frequencies of HRV and BPIV were both consistent with the central frequency of respiratory power spectral density. After cutting hibateral vagus nerves, the synchronous periodic change and trend consistency of R-R interval, BP-BP and respiration was destroyed; the central frequency of HRV and BPIV almost disappeared and was inconsistent with the central frequency of respiratory power spectral density; HRV and BPIV disappeared after respiratory arrest. Conclusion The changes of HRV and BPIV under respiratory rate regulation accord with the physiological mechanism of respiratory sinus arrhythmia. It is the secondary effect of R-R interval change which reflects the result of balance adjustment of autonomic nerve. It also coincides with the mechanism of HeringBreuer reflex induced by excitation of the tow receptor in the lung.
		2017 Vol. 26 (2): 77-83 [Abstract] ( 1034 ) [HTML 1KB] [ PDF 3301KB] ( 2059 )

	84	Factors influencing the use of heart rate variability for evaluating autonomic nervous function in mind body -research
		Shin Lin, Zhong-Yuan Shen, Timothy Ross
		Heart rate variability (HRV) analysis is a common method to noninvasively evaluate autonomic nervous function. In many studies, low frequency variability (LF, <0.15 Hz as shown in the power spectrum produced by Fast Fourier Transformation) is taken as an indicator of sympathetic function and high frequency variability (HF, ≥0.15 Hz) as an indicator of parasympathetic function. Based on studies on over 20 control subjects and 15 mind/body practitioners, we found that the following are important factors that influence HRV. First, the frequency of the breathing cycle is reflected in the frequency of a peak in the power spectrum produced by respiratory sinus arrhythmia (RSA). In some cases involving younger subjects, multiple peaks can be seen in the power spectrum even though they were strictly controlling their breathing at a single rate. Second, the size of the HRV peak produced by RSA is dependent on the tidal volume of each breath and the posture of the subject. Third, under the same conditions, younger subjects (aging 20s-25s) generally show a larger RSA peak compared to older subjects (aging 50s-70s). This effect often overshadows differences based on other considerations, such as years of experience in mindbody practice. In conclusion, this study shows that HRV analysis can be a useful tool for assessing autonomic nervous function in mindbody research, but great care must be taken to control for all of the factors indicated above.
		2017 Vol. 26 (2): 84-93 [Abstract] ( 852 ) [HTML 1KB] [ PDF 2514KB] ( 1225 )

	94	Influence of respiratory regulation on the changes of heart rate and blood pressure in rats with myocardial ischemia
		ZHU Ying-Qi, SHEN Zhong-Yuan, Shin Lin, XIA Chun-Mei, ZHU Da-Nian, CAO Yin-Xiang
		Objective To explore the role of respiratory rate change in regulating the balance of cardiovascular autonomic nerve and its influence on arrhythmia after myocardial ischemia. Methods Seventeen standard laboratory rats including 9 in normal group and 8 in myocardial ischemia model group were conducted with mechanical ventilation by ventilator to change respiratory rates. The fundamental tidal volume was constantly set at 10 mL/kg while respiratory rate changed(increasing by 10% and 20%, and decreasing by 10% and 20% of fundamental respiratory rate). Blood pressure and heart rate were recorded continuously; the influence of respiration rate regulation on heart rate variability(HRV) and blood pressure instant variability(BPIV) was analyzed; the synchronism of respiration rate with changes of heart rate and blood pressure was observed; the effect of reduced respiration rate on HRV in the two groups was evaluated. Results The cyclical changes of RR interval and blood pressure coincided with respiratory rate. The central frequencies of HRV and BPIV were both consistent with that of respiratory power spectral density. The variation trend of respiratory rate was essentially in agreement with that of heart rate and blood pressure, and especially, the variation trend of heart rate and blood pressure was completely identical. Conclusion HRV and BPIV under respiratory regulation correspond with physiological mechanism of respiratory sinus irregularity. It is the secondary effect of RR interval changes and reflects the results of autonomic nervous balance. The frequency of heart beat contributes to the synchronous changes of heart rate and blood pressure. It may reduce the incidence of myocardialischemiainduced arrhythmia to slow respiratory rate.
		2017 Vol. 26 (2): 94-98 [Abstract] ( 820 ) [HTML 1KB] [ PDF 2480KB] ( 1028 )

	99	The new technology of remote patchtype electrocardiography and its application
		GU Ju-Kang, CAI Zhen
		Remote patchtype electrocardiography is a newly developed lead wireless remote ECG technology in the world in recent years. Once the 5[CD*2]15g weight mini ECG device is pasted on the skin of chest or other parts of human body, it is capable of recording ECG information for a long time period—several days, months or even a year, and transmitting the collected and stored data to specified analysis center via remote information technology at any time. The technology of remote patchtype electrocardiography greatly challenges longterm ambulatory electrocardiography and implantable ECG. It is convenient in application and covers a huge amount of ECG information, and is especially fit for the aged population and primary medical institutions.
		2017 Vol. 26 (2): 99-106 [Abstract] ( 1542 ) [HTML 1KB] [ PDF 4426KB] ( 3223 )

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		2017 Vol. 26 (2): 107-110 [Abstract] ( 647 ) [HTML 1KB] [ PDF 921KB] ( 1865 )

	111	Analysis on influencing factors for positive result of head-up tilt test and vasovagal syncope patients’ clinical features〖
		GUO Bing-Li, ZHANG Shu-Long, HONG Li
		Objective To summarize the risk factors of headup tilt test(HUTT) in patients with vasovagal syncope(VSS), and to study their 24hour heart rate variability(HRV) during asymptomatic period. Methods A total of 173 patients suspected with VVS received HUTT, including basic HUTT(BHUTT) and sublingual nitroglycerin test(SNHUTT). They were divided into HUTT positive group(82 cases) and HUTT negative group(91 cases) according to test results. The clinical characterizations and HRV of the two groups were analyzed, and multivariate Logistic regression analysis was made. Results (ⅰ) HUTT hemodynamic types: in HUTT positive group, 8 patients were positive in BHUTT(6 cases with vasodepressor syncope and 2 with mixed response) while 74 were positive in SNHUTT(55 cases with vasodepressor syncope， 3 with cardioinhibitory syncope and 16 with mixed response). (ⅱ) Clinical manifestations: at the attack of syncope in HUTT positive group, the common accompanying symptoms were orderly chest tightness or pains(51.22%), dizziness or headache(50.00%), palpitation(47.56%), sweating(39.02%) and fatigue(37.80%). (ⅲ) Single factor analysis demonstrated that female（χ²=4.242，P=0.039）,≥60 years old（χ²=5.449，P=0.020）, clinical manifestations of sicchasia or emesia(χ²=4.759, P=0.029) and symptoms of abdominal pain(χ²=5.410, P=0.020) were risk factors for positive HUTT. (ⅳ) Logistic regression analysis indicated that ≥60 years old(OR=0.520, P=0.041) was an independent risk factor for positive HUTT. (ⅴ) Comparison of 24hour HRV: the timedomain index of rMSSD in HUTT positive group was statistically significantly higher than that in HUTT negative group[(37.41±24.19) ms vs. (30.76 13.16) ms, P=0.024]. Conclusion Sex, age, clinical features of sicchasia or emesia and abdominal pain are related factors for positive HUTT. The autonomic verve function in VVS patients during asymptomatic period is abnormal.
		2017 Vol. 26 (2): 111-115 [Abstract] ( 1609 ) [HTML 1KB] [ PDF 990KB] ( 1924 )

	116	The ambulatory electrocardiographic characteristics and mechanism of atrial fibrillation with slow ventricular rate
		WANG Dong, YANG Xin, JIA Xing-Qian
		Objective To analyze the ambulatory electrocardiographic characteristics of atrial fibrillation(AF) with slow ventricular rate and to explore its mechanism. Methods Slow ventricular rate referred to the average ventricular rate＜60 times/min and the fastest ventricular rate＜90 times/min. Combining with clinical data, retrospective analysis was performed on ambulatory electrocardiography(AECG) of 27 AF patients with slow ventricular rate. The frequency and distribution state of long RR interval(＞2.0 s) was studied. Results The total ventricular rate was 61,877-80,520 times during 24 hours. The 24hour average ventricular rate of 51-59 times was found in 19 cases and 43-49 times was found in 8 cases. Long RR interval(＞2.0 s) occurred for 6,808 times[1,994 times(29.28%) in the daytime and 4,814 times(70.72%) at night]. There were 11 cases(44%) with long RR interval occurring in the daytime while 14 cases(56%) with long RR interval occurring at night. Conclusion Besides basic pathological changes, degenerative change of conduction system is also an important factor of AF with slow ventricular rate. Analysis on long RR interval and the time point of its occurrence also provides evidences of degradation and functional incapacitation of atrioventricular conduction function during AF, which should be clinically attached great attention to.
		2017 Vol. 26 (2): 116-118 [Abstract] ( 1031 ) [HTML 1KB] [ PDF 924KB] ( 1514 )

	119	Application value of electrocardiogram in diagnosing anomalous origin of left coronary artery from pulmonary artery
		吕Hang , LIU Ming, KU Lei-Zhi, LI Wei
		Objective To evaluate the application value of electrocardiogram(ECG) in diagnosing anomalous origin of left coronary artery from pulmonary artery(ALCAPA). Methods Sixteen ALCAPA patients were enrolled in our study who had admitted in Wuhan Asia Heart Hospital from December 2004 to September 2016. They were diagnosed with ALCAPA by dual source computed tomography and confirmed by surgery. Theses patients were classified into group A(<12 months, 4 cases) and group B(>12 months, 12 cases), and their clinical manifestations and ECG features were analyzed. Results Crying and hard sucking were mainly observed among infants in group A while chest pain and backache were primary symptoms of group B. Patients in both of the two groups could be heard cardiac souffle in the apex of heart and between the fourth rib of the edge of left sternum. The incidences of abnormal Q wave and ST-T change in lead Ⅰ and aVL were both high in the two groups, with no statistically significant differences(P>0.05). However, the incidence of T wave inversion in lead V5and V6 in group A was significantly higher than that in group B, with statistically significant difference(P<0.05). Conclusion ECG of ALCAPA is characterized by abnormal Q wave complicating ST-T changes in lead Ⅰ and aVL. T wave inversion in lead V5 and V6 indicates serious myocardial ischemia among infants under 12 months. A combination of characteristic changes of ECG and physical examination is helpful for the diagnosis of ALCAPA.
		2017 Vol. 26 (2): 119-123 [Abstract] ( 834 ) [HTML 1KB] [ PDF 2159KB] ( 1455 )

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		2017 Vol. 26 (2): 123-124 [Abstract] ( 429 ) [HTML 1KB] [ PDF 1254KB] ( 1234 )

	125	The efficacy and safety of anticoagulant therapy on atrial fibrillation patients after PCI
		WANG Jin-Hua, LI Ling
		Objective To retrospectively observe the efficacy and safety of anticoagulation therapy on patients with atrial fibrillation(AF) undergoing percutaneous coronary intervention(PCI). Methods A total of 401 patients who had undergone PCI in the Ninth People’s Hospital of Zhengzhou from January 2008 to April 2015 were enrolled in our study. There were 64 cases complicating AF among them, with 39 males and 25 females at an average age of (66.2±11.0) years old. There were divided into three groups by medication treatment: Group 1(aspirin plus clopidogrel) with 16 cases, Group 2(aspirin plus warfarin) with 27 cases and Group 3(aspirin plus clopidogrel plus warfarin) with 21 cases. The mean followup duration was (8.4±2.6) months. The safety of anticoagulation therapy was observed according to the definition of hemorrhoea by ISTH standard, and TIMI and GUSTO grading criteria for bleeding. And the efficacy of the treatment was evaluated on the basis of major adverse cardiovascular events(MACEs). Results In Group 1, 0% of subjects reached a major safety endpoint for clinically significant bleeding while the proportion was 0% and 52.4% separately in Group 2 and 3. In Group 1, 0% of subjects had clinically relevant nonsignificant bleeding while the proportion was 29.6% and 4.8% separately in Group 2 and 3. There were all statistically significant differences among the three groups(P<0.001). Two cases of cardiac death were observed during treatment, accounting for 3.1% of the total observed population while 8 patients with acute myocardial infarction and 19 patients with stroke and(or) angina were readmitted to hospital. MACEs occurred in 43.75% of patients in Group 1, 44.4% in Group 2 and 47.6% in Group 3, with no statistically significant differences among the three groups(P=0.843). Conclusion Compared with dual antiplatelet therapy and aspirin plus warfarin treatment, traditional tripledose anticoagulation therapy has a high risk of clinically significant bleeding for AF patients implanted with PCI stent, and the incidences of MACEs are similar. For AF patients implanted with PCI stent, the incidence of clinical bleeding could be expected to fall with a strategy of anticoagulant therapy based on risk assessment.
		2017 Vol. 26 (2): 125-128 [Abstract] ( 949 ) [HTML 1KB] [ PDF 942KB] ( 1399 )

	129	Application value of lead S₅ in diagnosing arrhythmia
		CHEN Xiu-Ling, LIU Ming, XIANG Li-Ming
		Objective To explore the clinical application value of lead S₅ in diagnosing arrhythmia. Methods Retrospective analysis was performed on 22 outpatients suspected with atrial fibrillation and with unclear P and F waves in routine electrocardiogram(ECG). They underwent the examination of leadS₅ ECG as a complement. The detection rate of atrial wave in the two methods was compared. Results By leadS₅ ECG, it clearly showed P wave in 8 cases, P′ wave in 4, F wave in 2 and retrograde P wave in 2; no atrial wave was identified in one case of suspected F wave, P wave in one case was verified to be false, and there was no change at all in 4 cases of atrial wave. Conclusion The detection rate of P wave by leadS₅ ECG examination is higher than that by routine ECG examination, which is clinically valuable in diagnosing arrhythmia.
		2017 Vol. 26 (2): 129-131 [Abstract] ( 830 ) [HTML 1KB] [ PDF 2014KB] ( 1542 )

	132	Clinical value of continuing nursing care for elderly patients with H-type hypertension complicating cognitive dysfunction
		XIONG Xiao-Hua
		Objective To explore the clinical value of continuing nursing care for elderly patients with Htype hypertension complicating cognitive dysfunction. Methods A total of 86 elderly patients with Htype hypertension complicating cognitive dysfunction were selected and randomly divided into observation group and control group according to the time sequence of seeing doctor. Control group was given routine discharge guidance while continuing nursing care was adopted in observation group. The changes of blood pressure and homocysteine level, scores of life quality, and improvement of cognitive function were observed and compared between the two groups. Results For the patients in observation group, the systolic pressure, diastolic pressure and homocysteine level after continuing nursing care were all significantly lower than those in control group(P<0.05); the scores of somatic function, mental health, social function and material life and the total score were all higher compared with those in control group(P<0.05); the score of HDS cognitive function significantly increased if compared with that in control group(P<0.05). Conclusion Continuing nursing care of elderly patients with Htype hypertension complicating cognitive dysfunction is worthy of being promoted clinically for its effect on improving and maintaining blood pressure, and optimizing patients cognitive function and improving the prognosis.
		2017 Vol. 26 (2): 132-134 [Abstract] ( 703 ) [HTML 1KB] [ PDF 922KB] ( 1459 )

	135	Effect of different surgical methods of congenital heart disease on arrhythmia
		YANG Man, ZHENG Ming-Qi, LIU Gang
		Postoperative arrhythmia in patients with congenital heart disease(CHD) will significantly influence their prognosis and mortality. Its influencing factors include postoperative patch, and natural anatomical substrate, old age and cardiac extention of patients themselves, and so on. In order to improve the life quality and longterm prognosis of CHD patients, this paper introduces the occurrence of postoperative arrhythmia in different surgical methods.
		2017 Vol. 26 (2): 135-138 [Abstract] ( 938 ) [HTML 1KB] [ PDF 1242KB] ( 1616 )

	139	Research progress on fragmented QRS complexes related to coronary artery disease
		WANG Cheng-Chao, TAN Jian-Cheng-
		Fragmented QRS(fQRS) is a newly introduced important noninvasive electrocardiographic parameter. fQRS mostly occurres in the patients with coronary heart disease. Its emergence and changes are clinically valuable in diagnosing acute myocardial infarction, judging the severity of myocardial perfusion, predicting the degrees of coronary artery lesions, making risk evaluation and prognosis judgment of coronary artery disease, etc. And more and more research found out that when the degree of coronary artery lesion is relatively light, fQRS appears much earlier. It is very helpful for early diagnosis of coronary heart disease. This paper systematically reviews on the latest research progress on fQRS related to coronary artery disease.
		2017 Vol. 26 (2): 139-142 [Abstract] ( 1013 ) [HTML 1KB] [ PDF 1177KB] ( 1461 )

	143


		2017 Vol. 26 (2): 143-143 [Abstract] ( 416 ) [HTML 1KB] [ PDF 1119KB] ( 1033 )

	144
		ZHANG Wei-Qiang, LIU Shu-Jun, LUO Yu-Ping, LUO Su-Qun

		2017 Vol. 26 (2): 144-145 [Abstract] ( 630 ) [HTML 1KB] [ PDF 3677KB] ( 1332 )

	146
		ZHOU Fang, YIN Chun-E, WANG Fu-Jun

		2017 Vol. 26 (2): 146-147 [Abstract] ( 701 ) [HTML 1KB] [ PDF 1065KB] ( 1598 )

	148
		GENG Xue-Jun

		2017 Vol. 26 (2): 148-149 [Abstract] ( 731 ) [HTML 1KB] [ PDF 1725KB] ( 1431 )

	149


		2017 Vol. 26 (2): 149-149 [Abstract] ( 375 ) [HTML 1KB] [ PDF 910KB] ( 1002 )

	150
		YANG Gui-Ying, XIE Dong-Yang

		2017 Vol. 26 (2): 150-152 [Abstract] ( 1708 ) [HTML 1KB] [ PDF 0KB] ( 555 )

	153


		2017 Vol. 26 (2): 153-153 [Abstract] ( 418 ) [HTML 1KB] [ PDF 1122KB] ( 941 )

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