JOURNAL OF PRACTICAL ELECTROCARDIOLOGY

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JOURNAL OF PRACTICAL ELECTROCARDIOLOGY

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JOURNAL OF PRACTICAL ELECTROCARDIOLOGY

	2020 Vol.29 Issue.1 Published 2020-02-29

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		2020 Vol. 29 (1): 0-0 [Abstract] ( 17 ) [HTML 1KB] [ PDF 123444KB] ( 505 )

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		2020 Vol. 29 (1): 1-1 [Abstract] ( 49 ) [HTML 1KB] [ PDF 288KB] ( 647 )

	1	Establishment and development prospect of the firstclass ECG big data platform
		Lu Xilie
		ECG big data is an important part of medical big data. The construction of a firstclass ECG big data platform is conducive to the integrated analysis and dynamic monitoring of all kinds of ECG data and the realization of remote sharing of ECG resources, which is of great value to clinical medicine, medical research and teaching. The basic concept of ECG big data was introduced first, then the important value and clinical significance of the construction of ECG big data platform was described. After that, ECG big data was emphasized to be closely combined with clinical medical information to achieve rapid and accurate diagnosis of patients. At the same time, it was proposed to improve the level of ECG artificial intelligence diagnosis, the difficulties and solutions of constructing ECG big data platform in China were proposed on the basis of summarizing the current situation of the construction of ECG big data platform at home and abroad. Finally, the development direction of ECG big data was prospected.
		2020 Vol. 29 (1): 1-4 [Abstract] ( 88 ) [HTML 1KB] [ PDF 392KB] ( 764 )

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		2020 Vol. 29 (1): 2-2 [Abstract] ( 42 ) [HTML 1KB] [ PDF 392KB] ( 698 )

	5	Changes and clinical significance of QT dispersion in patients with acute pulmonary embolism before and after thrombolysis therapy
		Xu Zhiyong,Xu Yide,Lin Shanying
		ObjectiveTo investigate the changes and clinical significance of QT dispersion(QTd) in patients with middle and high risk of acute pulmonary embolism before and after thrombolysis. MethodsA total of 44 cases of patients with middle and high risk of acute pulmonary embolism treated with thrombolysis were observed,36 cases of healthy persons with the same age and sex were selected as normal control group.Synchronous 12lead electrocardiogram（ECG) was recorded within 24 hours after admission and 1 week after thrombolysis in patients with acute pulmonary embolism. QT interval was calculated manually. QTd and heart ratecorrected QT dispersion (QTcd) were also calculated. PaO2, blood pressure, heart rate,respiratory rate and respiratory frequency were examined before and after thrombolysis. ResultsQTd and QTcd at admission \[(60.82±6.71) ms, (77.97±6.39) ms\] were significantly higher than those in normal control group \[(31.67±7.98) ms,(34.11±2.48) ms\](P<0.05). QTd and QTcd \[(52.71±6.68) ms,(59.98±11.19) ms\] after thrombolysis therapy were significantly lower than those at admission, but still higher than that of the healthy control group(P<0.05). In addition, after thrombolysis therapy, the clinical symptoms were significantly improved. ConclusionQTd and QTcd in patients with acute pulmonary embolism are increased significantly. QTd is significantly decreased and the clinical symptoms are improved after thrombolysis therapy.
		2020 Vol. 29 (1): 5-7 [Abstract] ( 88 ) [HTML 1KB] [ PDF 610KB] ( 637 )

	8	Clinical significance of microvolt T-wave alternans during different reperfusion periods in acute myocardial infarction
		Xiong Wangqiong, Wang Zilong
		Objective To investigate the dynamic change of microvolt T-wave electrical alternation(MTWA) in acute myocardial infarction(AMI) during different reperfusion periods and its correlation with ventricular arrhythmia after reperfusion. MethodsOne hundred and two AMI patients were divided into ventricular tachycardia(VT) group and nonVT group after percutaneous coronary intervention(PCI), and the clinical data and ECG parameters of the two groups were compared and analyzed. ResultsFortyseven among the 102 patients had VT and 55 had no VT. The average ventricular rate, hypersensitive troponin, MTWA and turbulence onset(TO) in VT group were significantly higher than those in the non-VT group, while turbulence slope(TS) and EF were significantly lower than those in the nonVT group（P＜0.05）. The results showed that there is no significant difference in SDNN between the two groups. MTWA had the highest sensitivity, specificity, positive predictive value and negative predictive value in predicting VT. The MTWA value of (82.9±10.2)μV appeared at 15 minutes before the appearing of the longest string of VT, which was significantly higher than that of 30 minutes and 60 minutes（P＜0.05）. Most of the time nodes of VT occurred in 1-3 hours after the blood flow recanalization. ConclusionsMTWA can predict the occurrence of reperfusion malignant VT in AMI patients after PCI, and the incidence of VT is the highest in 1-3 hours after blood flow recanalization. For MTWA positive patients during this period and before PCI, antiarrhythmic drugs such as amiodarone should be applied to prevent the occurrence of malignant VT, increase the postoperative survival rate of patients, and prevent sudden death.
		2020 Vol. 29 (1): 8-12 [Abstract] ( 85 ) [HTML 1KB] [ PDF 551KB] ( 689 )

	13	Clinical characteristics of ST segment elevation in elderly patients with acute myocarditis
		Wang Li，Xu Minzhi，Wu Yong
		Objective To explore the clinical characteristics of ST segment elevation in elderly patients with acute myocarditis and provide reference for clinical diagnosis and treatment. Methods A retrospective analysis was performed on 87 elderly patients with acute myocarditis treated in our hospital. Patients with ST segment elevation were included in group A, while patients with non-ST segment elevation were included in group B. The clinical characteristics of ST segment elevation, including treatment, outcome, laboratory and auxiliary examinations were analyzed. The incidence of cardiac events such as cardiogenic shock, ventricular fibrillation and death were counted. Results The rate of ventilator application in group A was significantly higher than that in group B(P<005). The incidence of temporary pacemaker, CRRT, IABP and ECMO treatment in group A were slightly higher than that in group B, and there was no statistical difference（all P＞0.05）. The levels of myocardial injury markers such as CK peak value, CKMB peak value, and Tn I peak value in group A were significantly higher than that in group B (all P<0.05). Cardiac adverse events in group A occurred. The rate was 20.8%, which was significantly higher than 2.5% in group B, and the difference was statistically significant (P<0.05). Conclusion ST-segment elevation in elderly patients with acute myocarditis is characterized by acute onset, severe illness, and rapid progress, and the risk of cardiac adverse events such as ventricular fibrillation is greater. Therefore, clinicians should attach great importance to STsegment elevation in elderly patients with acute myocarditis and provide timely targeted treatment.
		2020 Vol. 29 (1): 13-15 [Abstract] ( 73 ) [HTML 1KB] [ PDF 520KB] ( 707 )

	16	Correlation between heart rate variability and deceleration capacity of rate in children with viral myocarditis
		Chen Huihong,Liu Dongliang, Pan Yue
		Objective To investigate the changes and significance of heart rate variability(HRV) and deceleration capacity of rate(DC) in children with viral myocarditis. Methods Fifty children with viral myocarditis were selected as the experimental group, and 50 healthy children who had undergone health checkups in our hospital during the same period were selected as the control group. The 24 h ambulatory electrocardiogram test was performed in the two groups of children. The levels of DC and HRV indicators were recorded and the correlation between DC and HRV indicators was analyzed. Results DC, lowfrequency power, highfrequency power, standard deviation of RR interval mean(SDANN), overall standard deviation of RR interval(SDNN), and root mean square difference of adjacent RR intervals(RMSSD) of the test group are lower than that of the control group, and the difference is statistically significant(P<0.05). The bivariate Pearson correlation analysis test confirmed that DC was positively correlated with low frequency power, high frequency power, SDANN, SDNN, and RMSD(r values were 0.632, 0.703, 0.781, 0.608 and 0.772, P<0.05). Conclusions Children with viral myocarditis are often associated with impaired vagus nerve function, and HRV indicators are positively correlated with DC, suggesting that the use of DC for judging the severity of viral myocarditis in children and its treatment guidance have certain clinical significance.
		2020 Vol. 29 (1): 16-18 [Abstract] ( 94 ) [HTML 1KB] [ PDF 337KB] ( 712 )

	19	Analysis of the heart rate variability and clinical characteristics in patients with resistant hypertension
		Zhang Shigeng, Guo Junfang, Ding Zhen, Zhang Guohui
		Objective To investigate heart rate variability and target organ damage in patients with resistant hypertension Methods Patients with resistant hypertension (n=30) and non-resistant hypertension(n=32) were prospectively collected when a control group composed of 36 healthy subjects were also usedThe heart rate variability index and target organ damages were compared among 3 groups by 24hour dynamic electrocardiogram (ECG) monitoring Results Compared with the control group, the indexes of heart rate variability in time domain and frequency domain of the resistant hypertension group and the nonresistant hypertension group were statistically significant (P<0.05), indicating that the heart rate variability was decreased Compared with the nonresistant hypertension group, rMSSD and pNN50 in the resistant hypertension group were significantly decreased (P<0.05), and other indexes of heart rate variability were also decreased, but the difference was not statistically significant (P>0.05)Compared with the nonresistant hypertension group, the estimated glomerular filtration rate of patients in the resistant hypertension group was decreased significantly, and the thickness of ventricular septum was increased significantly (P<0.05)；carotid plaque was also increased, but the difference was not statistically significant (P>0.05)Conclusion Heart rate variability is significantly decreased in patients with resistant hypertension, and the target organ damages is more serious
		2020 Vol. 29 (1): 19-22 [Abstract] ( 70 ) [HTML 1KB] [ PDF 346KB] ( 727 )

	23	Charactertics of rapid atrial arrhythmia in transeophageal electrophysiological examination
		Gao Lan,Du Zhenlan,Sun Haiyan,Jiang Fang,Li Li
		Objective To investigate the significance of transesophageal electrophysiological examination in the diagnosis and treatment of rapid atrial arrhythmia. Methods The course and mechanism of diagnosis and treatment of 5 patients with rapid atrial arrhythmia by transesophageal electrophysiological examination were analyzed retrospectively. Results Through the atrial mapping, the Pwave amplitude of transesophageal electrophysiological examination is increased It has obvious advantages in the diagnosis of rapid atrial arrhythmia compared with surface electrocardiogram, and it can also be used as a treatment to stop the attack of tachycardia. Conclusion As a noninvasive cardiac electrophysiological examination technology, transesophageal cardiac electrophysiological examination can diagnose, induce and terminate tachycardia and provide help for clinical diagnosis and treatment.
		2020 Vol. 29 (1): 23-28 [Abstract] ( 93 ) [HTML 1KB] [ PDF 34960KB] ( 739 )

	29	Correlation between C0 complexity of ECG chaotic signal characteristics and acute coronary syndrome
		Yi Li，Li Xiang，Li Wei，Wang Jie，Yang Shaowang
		Objective To explore the correlation between C0 complexity of ECG chaotic signal characteristics and acute coronary syndrome (ACS), and to find a better direction in auxiliary detection of ACS. Methods The electrocardiographic dynamics data were obtained by definite learning algorithm, and the chaotic characteristic index C0 complexity of electrocardiographic dynamics data was calculated based on chaos theory. The ECG with no significant change in ECG shape in 30 patients with ACS and 30 healthy subjects were randomly selected. The C0 complexity data of patients with ACS and healthy subjects were analyzed. Results The C0 complexity of ECG in patients with ACS was statistically significant compared with that of healthy individuals(P<0001). Conclusion The C0 complexity of electrocardiographic dynamics data between patients with ACS and healthy people is statistically different, which has potential clinical value for auxiliary detection in patients with ACS.
		2020 Vol. 29 (1): 29-32 [Abstract] ( 90 ) [HTML 1KB] [ PDF 775KB] ( 688 )

	33	Superiority of vectorcardiogram in identification and diagnosis of left deviation of electrocardiogram axis
		Pan Yue，Pan Deng，Pan Erming
		Objective Electrocardiogram(ECG) and vectorcardiogram(VCG) were collected by Wilson and Frank dual lead system. The diseases caused by left deviation of ECG axis were timely identified. Methods The symptomatic patients with left deviation of ECG were selected and their ECGs and VCGs were analyzed. Results Five cases were similar in ECG pattern, and all of them showed left axis deviation. But the performance and diagnosis of VCG were different. Conclusion VCG showed better performance in the diagnosis of diseases caused by left deviation of electrocardiogram axis compared to ECG. It should be careful when identify the diseases caused by left deviation of electrocardiogram axis without the help of VCG. We should combine the advantages of both ECG and VCG, to well serve the clinic application and improve the accuracy of diagnosis.
		2020 Vol. 29 (1): 33-38 [Abstract] ( 90 ) [HTML 1KB] [ PDF 60300KB] ( 682 )

	39	Characteristics of aging changes in 24-hour dynamic electrocardiogram of 98 elderly patients
		Deng Xianjin，Lao Chengqiang，Liu Yingzhi，Huang Xiufang
		Objective To explore the characteristics of aging changes in 24hour ambulatory electrocardiogram (AECG) of elderly patients. Methods The data of 12lead 24hour AECG from our hospital were retrospective analyzed, and the following conditions were required:① Local resident; ② The age of the patient is no less than 60 when taken first AECG; ③The same patient should take at least two AECG examinations, with an interval of at least 5 years between the first and the last examination; ④ No cardiac pacemaker implantation; ⑤ There is a complete life log, including work and rest time, daily activities, and when symptoms start and end, etc. A total of 98 patients were enrolled. The hospitalized medical records of the patients were reviewed, and the standard was developed. The 24hour mean heart rate, slowest heart rate, fastest heart rate, arrhythmia and ST segment ischemic attack detected by AECG were analyzed and compared between the two AECGs. Results With the increase of age, the 24hour mean heart rate, the slowest heart rate and the fastest heart rate of 98 elderly patients all showed a tendency of slowing down with statistical difference (P<0.001). All kinds of arrhythmias showed an increasing trend, among which the case of ventricular premature with Lown grade≥ Ⅲ increased from 0 to 10 cases, while the case of arrhythmias contained 3 or more types increased from 18 (18.37%) to 67(68.37%) (P<0.001). Twentyeight cases (125 times) of ST segment ischemic depression were detected in the first examination, including 82 times of silent myocardial ischemia (SMI), 43 times of symptomatic myocardial ischemia. Sixty cases (272 times) of ST segment ischemic depression were detected in the last examination, including 214 times of SMI and 58 times of symptomatic myocardial ischemia. The number of both SMI and symptomatic myocardial ischemic ST segment ischemic depression increased with age, and SMI increased significantly (P<0.001). All the patients showed a circadian rhythm of ST segment ischemic depression, but this circadian rhythm was weakened with the age growth, especially for SMI (P=0.535). Conclusions The elderly patients showed significant agerelated changes in 24hour AECG, and regular AECG examination is of great value.
		2020 Vol. 29 (1): 39-42 [Abstract] ( 76 ) [HTML 1KB] [ PDF 375KB] ( 733 )

	43	Value of electrocardiographic examination in the prediction of sudden cardiac death
		Yang Qing, Liang Yan
		Sudden cardiac death (SCD) is a public health incident that seriously threatens human health, which has a characteristic of sudden onset, rapid development and high mortality. How to predict the SCD population in the suspicious high risk state effectively and quickly is the core of providing timely preventive methods for clinicians. Electrocardiographic examination has been widely used in clinical practice. Because of its noninvasive, convenient and reproducible characteristics, it is used as an important method to detect, find and follow up suspicious SCD patients. By analyzing several different types of electrocardiographic techniques, this paper expounds the application value of electrocardiographic examination in the prediction of SCD, in order to assist clinicians to identify highrisk patients with SCD and reduce the incidence of SCD.
		2020 Vol. 29 (1): 43-48 [Abstract] ( 82 ) [HTML 1KB] [ PDF 7698KB] ( 771 )

	49	Application of ECG Information System in large public hospitals in Urban Medical Union
		Feng Yan, Cai Xiaoyu, Aminaihaiti, Yang Fen, Zhang Yan, Yin Wenyuan
		As a large public hospital, the People‘s Hospital of Xinjiang Uygur Autonomous Region (Thirdclass hospital) has taken the lead in setting up a medical union covering Xinjiang. In 2011, the hospital’s electrocardiogram department took the lead in establishing the first ECG(Electrocardiogram) network information diagnosis center in Xinjiang. In 2014, the coverage was extended from Urumqi to Xinjiang. The central radiation type and remote consultation type network information architecture were established to provide services on unified ECG analysis and diagnostic. In 2014, the business volume of ECG was higher compared with that before the establishment of the center: the detection rate of ECG critical value was increased by 5.0 times, the bedside and emergency ECG were increased by 7.1 times, the workload was increased by 9.2 times and the economic benefit was increased by 11.3 times. In 2018, the completed remote ECG consultation outside the hospital was as follows: the cases of conventional ECG, dynamic ECG, dynamic blood pressure and detected cardio emergency value of persontimes were 235 884, 9037, 787 and 4584 respectively. The establishment of the ECG information system in large public hospitals can integrate the medical unions, improving the overall level of ECG diagnosis, as a result, providing assistance for early screening, identification and timely treatment for acute patients.
		2020 Vol. 29 (1): 49-51 [Abstract] ( 75 ) [HTML 1KB] [ PDF 381KB] ( 1158 )

	52	A study on the effect of temporary cardiac pacemaker on acute cardiovascular disease
		Li Yanjie
		Objective To explore the effect of temporary cardiac pacemaker in the rescue of acute cardiovascular disease. Methods Eighty patients with acute cardiovascular disease in our hospital were divided into observation group (n=37) and control group (n=43), according to whether temporary cardiac pacemakers were performed or not during the rescue. The control group received traditional cardiopulmonary resuscitation and drug therapy, while the observation group received temporary pacemaker rescue. The success rate of rescue, quality of life score before and after rescue, APACHE Ⅱ score and complications were compared between the two groups. Results The success rate of rescue, quality of life score, APACHE Ⅱ score and complication rate of the observation group were all better than the control group, with statistically significant differences (P<0.05). Conclusion Temporary pacemaker rescue for patients with acute cardiovascular disease can improve the success rate of rescue, reduce complications and improve the life quality of patients.
		2020 Vol. 29 (1): 52-54 [Abstract] ( 68 ) [HTML 1KB] [ PDF 419KB] ( 696 )

	55	Diagnostic value of RR-Lorenz plot in frequent atrial premature beats and atrial parasystolic rhythm
		Ren Chunlin, Chen Zhiyong
		Objective To explore the value of RRLorenz plot in the diagnosis of frequent atrial premature beats(FAPB) and atrial parasystolic rhythm(APSR). Methods The dynamic electrocardiography(DCG) of 594 patients with FAPB were retrospectively analyzed by using traditional and RRLorenz plot analysis method respectively. Results Fiftythree patients and 78 patients were diagnosed as APSR and FAPB respectively by using traditional analysis, while 70 patients and 45 patients were diagnosed as APSR and FAPB by using RRLorenz plot analysis method. There was a significantly difference between the traditional method and RRLorenz plot method（χ2=4.629， P=0.032； χ2=4.939, P=0.026）.Compared to traditional analysis, the aggregate of premature beat and that of atrial premature beats failing to transfer examined by RRLorenz plot were increased significantly (t=9.263,t=5.28;P=0.018,P=0.022). A further analysis revealed that there was significant difference among the two analysis methods in intraventricular aberrant conduction, fusion wave and atrial premature failing beats to transfer(P<0.05).Conclusion RR-Lorenz plot is of great value to the diagnosis of atrial arrhythmia and could identify FAPB and APSR quickly.
		2020 Vol. 29 (1): 55-58 [Abstract] ( 88 ) [HTML 1KB] [ PDF 560KB] ( 800 )

	59	Research progress on the relationship between obstructive sleeping apnea hypopnea syndrome and cardiovascular diseases
		Mureti Abudixiaokuer，Feng Yan
		As an independent risk factor for a variety of cardiovascular diseases, obstructive sleep apnea hypopnea syndrome(OSAHS) can increase the prevalence and mortality of various cardiovascular diseases such as hypertension, coronary heart disease and arrhythmia. Intermittent hypoxia and hypercapnia, oxidative stress and chronic inflammatory response, sympathetic vagal imbalance, intrathoracic pressure changes, activation of neurohumoral factors, etc. are potential pathophysiological mechanisms of OSAHSinduced cardiovascular diseases. Early detection of OSAHS and its related cardiovascular diseases is helpful for early diagnosis and effective intervention. This article mainly describes the relationship among OSAHS and arrhythmia, hypertension, coronary heart disease and heart failure.
		2020 Vol. 29 (1): 59-65 [Abstract] ( 100 ) [HTML 1KB] [ PDF 0KB] ( 371 )

	66	Application status and prospect of subcutaneous implantable cardioverterdefibrillator
		Yang Yanqiu, Wang Xinkang
		Transvenous implantable cardioverterdefibrillator(TV-ICD) system is an effective method for the prevention of sudden cardiac death (SCD). However, the implanted electrodes of TV-ICD results in a high incidence of perioperative and longterm complications. Subcutaneous implantable cardioverterdefibrillator(S-ICD) avoids the complications associated with transvenous leads profit by its entirely extracardiac implantation. It provides a new treatment option for patients with highrisk of SCD. The purpose of this article is to introduce the working principle of SICD, and describe the clinical application status and prospect.
		2020 Vol. 29 (1): 66-69 [Abstract] ( 85 ) [HTML 1KB] [ PDF 721KB] ( 734 )

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		2020 Vol. 29 (1): 70-73 [Abstract] ( 74 ) [HTML 1KB] [ PDF 10041KB] ( 774 )

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		2020 Vol. 29 (1): 74-76 [Abstract] ( 83 ) [HTML 1KB] [ PDF 8081KB] ( 779 )

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		2020 Vol. 29 (1): 75-75 [Abstract] ( 50 ) [HTML 1KB] [ PDF 149KB] ( 640 )

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