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JOURNAL OF PRACTICAL ELECTROCARDIOLOGY
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JOURNAL OF PRACTICAL ELECTROCARDIOLOGY
 
2020 Vol.29 Issue.3
Published 2020-06-28
1
2020 Vol. 29 (3): 1-1 [Abstract] ( 28 ) [HTML 1KB] [ PDF 158724KB] ( 526 )
151
2020 Vol. 29 (3): 151-151 [Abstract] ( 43 ) [HTML 1KB] [ PDF 196KB] ( 1005 )
152
2020 Vol. 29 (3): 152-152 [Abstract] ( 43 ) [HTML 1KB] [ PDF 316KB] ( 1042 )
153 Effectiveness of artificial intelligence-based ECG algorithm for detection of clinical arrhythmia
Objective To evaluate the effectiveness of artificial intelligence-based ECG algorithm for detection of clinical arrhythmia. MethodsA total of 13 949 clinical data of arrhythmia were collected from 13 145 patients who were treated with artificial intelligence ECG network in our hospital. The data was analyzed using Lepu medical artificial intelligence ECG network system. The diagnosis results of the doctor team were defined as the gold standard, the sensitivity, specificity, positive predictive rate, negative predictive rate and correct rate of the screening test were used to evaluate the effectiveness of the artificial intelligence-based ECG algorithm compared with the gold standard.  ResultsCompared with the gold standard, 17 types of arrhythmia were detected by the artificial intelligence-based ECG algorithm including sinus arrhythmia, atrial fibrillation, etc. The overall sensitivity, specificity and accuracy were 98.08%, 99.84% and 99.84%, respectively. The consistency Kappa coefficients of 6 types of arrhythmias(pairing of supraventricular contractions, atrial escape and ventricular escape, etc.) were greater than 0.4 but less than 0.75, which meet the consistency requirements but without strong consistency. Conclusion  The test results of artificial intelligencebased ECG algorithm for arrhythmia is highly consistent with the clinical ECG test results. The artificial intelligence-based ECG algorithm   has good clinical practice prospects.
2020 Vol. 29 (3): 153-156 [Abstract] ( 94 ) [HTML 1KB] [ PDF 907KB] ( 1732 )
157 Diagrammatic differentiation of common clinical atrial fibrillation with wide QRS
孙海燕，于小林，高兰，白雪，杜振兰
Two most common types of atrial fibrillation with occasional wide QRS  in clinic including ventricular premature contraction and  aberrant ventricular conduction. The differentiation between them is the key and difficult point in clinical practice. It is easy to study and understand that the distinguishing points of the two types are explained by diagram.
2020 Vol. 29 (3): 157-164 [Abstract] ( 71 ) [HTML 1KB] [ PDF 25303KB] ( 1111 )
165 Mechanism of ST-segment elevation in acute transmural myocardial infarction
ST-segment elevation is the typical ECG manifestation in acute transmural myocardial infarction. There are many theories about the mechanism of ST-segment elevation in acute transmural myocardial infarction. In this paper, we described three mainstream theories. The theory of “ion current” is based on sufficient experiments and theories. So the theory of “ion current” should be promoted as the general theory.
2020 Vol. 29 (3): 165-169 [Abstract] ( 95 ) [HTML 1KB] [ PDF 1085KB] ( 1513 )
170 Application of plane QRS-T angle in the diagnosis and treatment of acute anterior wall myocardial infarction
Objective  To investigate the clinical significance of plane QRS-T angle in acute anterior myocardial infarction. MethodsA total of 115 patients with acute anterior wall myocardial infarction (AMI) were enrolled in the study. All patients underwent routine 12 lead ECG examination, and the plane QRS-T angle was measured. According to the QRS-T angle, the patients were divided into group A(QRS-T angle＞90°) and group B (QRS-T angle≤90°) . The left ventricular ejection fraction(LVEF), serum cardiac troponin T(cTnT), NT-proBNP and the incidence of malignant arrhythmia were compared between the two groups. ResultsLVEF in group A was significantly lower than that in group B(P<0.05), cTnT and NT-proBNP in group A were significantly higher than that in group B(P<0.05). The frequency of ventricular fibrillation(VF), short runs of ventricular tachycardia and ventricular premature beat(VPB) in group A were significantly higher than that in group B(P<0.05). ConclusionThe plane QRS-T angle >90° indicates that the patients have large myocardial infarction area, poor cardiac function and high incidence of malignant arrhythmia. Therefore, we should open blood vessels in time and strengthen medical measures to prevent adverse events.
2020 Vol. 29 (3): 170-172 [Abstract] ( 82 ) [HTML 1KB] [ PDF 833KB] ( 1190 )
173 Analysis of heart rate variability in diabetic patients with paroxysmal atrial fibrillation
Objective  To investigate the characteristics of heart rate variability in diabetic patients with paroxysmal atrial fibrillation. Methods  Twenty-six cases of type 2 diabetic patients with paroxysmal atrial fibrillation were selected as case group while fifty cases of type 2 diabetic patients without paroxysmal atrial fibrillation were selected as control group. Heart rate variability indexes including standard deviation of sinus R-R interval(SDNN), root mean square of the successive normal sinus R-R interval difference(rMSSD), standard deviation of the average normal 5minute R-R interval (SDANN), the percentage of differences between adjacent normal R-R intervals more than 50 ms(PNN50), low frequency(LF), high frequency(HF), and the ratio of low frequency to high frequency(LF/HF) were analyzed between the two groups. ResultsThe rMSSD, PNN50 and HF of case group were larger than the control group\(50.9±21.8) ms vs. (25.5±9.5)ms, (22.5±13.9)% vs. (5.9±6.9)% and (704.0±157.7) vs. (132.3±10.9)\]. The LF/HF of case group was smaller than that of the control group [(0.65±0.0) vs. (2.1±0.2),P<0.05\].The sensitivity and specificity of LF/HF<1 in the diagnosis of paroxysmal atrial fibrillation in diabetic patients were 84.6% and 80.0% respectively, and the area under the ROC curve was 0.823 (95%CI: 0.720-0.926, P=0.000).Conclusions LF/HF<1 in diabetic patients can predict the occurrence of paroxysmal atrial fibrillation to a certain extent. The assessment of heart rate variability is helpful for the prevention and detection of arrhythmia in diabetes.
2020 Vol. 29 (3): 173-176 [Abstract] ( 79 ) [HTML 1KB] [ PDF 855KB] ( 1284 )
177 Vectorcardiogram characteristics of left anterior branch block
Objective  The electrocardiogram and vectorcardiogram were synchronously collected by stereo electrocardiograph using Wilson and Frank dual-lead system to timely detect and diagnose left anterior branch block. MethodsThe case of left anterior branch block with clinical manifestations and welldefined by vectorcardiogram were selected. Results  Vectorcardiogram of 4 patients with left anterior branch block showed that the starting vector of frontal QRS ring was located at the lower right or left side, while the maximum vector shifted to the upper left. The main feature of the ring is that it ran counterclockwise and expanded to the upper left quadrant. Conclusion  Vectorcardiogram is superior to electrocardiogram in the diagnosis of left anterior branch block. In the practical work, we should adopt the principle of complementary advantages of ECG and vectorcardiogram to well serve the clinic. The combination of the two methods can improve the accuracy of diagnosis.
2020 Vol. 29 (3): 177-182 [Abstract] ( 82 ) [HTML 1KB] [ PDF 22728KB] ( 1077 )
183 Relationship between electrocardiographic abnormalities and Child-Pugh classification in patients with liver cirrhosis
Objective  To investigate the relationship between electrocardiographic(ECG) abnormalities and Child-Pugh classification in patients with liver cirrhosis. MethodsThirty patients with hepatitis and cirrhosis admitted to our hospital were enrolled as case group. Among them, 12 were Child-Pugh grade A, 11 were Child-Pugh grade B and 7 were Child-Pugh grade C. Meanwhile, 30 healthy subjects were enrolled as control group. ECG and the Child-Pugh grade were assessed in all participants.  ResultsECG abnormalities were closely related to Child-Pugh classification in patients with cirrhosis. The incidence of ECG abnormalities in the case group was significantly higher than that in the control group (P<0.05). ConclusionThere is a closely relationship between abnormal ECG and Child-Pugh classification in patients with liver cirrhosis. The measurement of ECG may be a useful marker to evaluate the ChildPugh grade of liver cirrhosis.
2020 Vol. 29 (3): 183-184 [Abstract] ( 80 ) [HTML 1KB] [ PDF 849KB] ( 2204 )
185 Establishment and application of visual database for cardiac auscultation
Cardiac examination is the focus of diagnostic teaching all the time, and cardiac auscultation is the key and difficult points, which is difficult for most students to understand and master. In order to improve the teaching quality of cardiac auscultation, teachers at home and abroad have tried so many teaching reforms. Yet, there is no effective method for it due to various conditions. Recently, it is possible to change the sound to visualization as the heart sound acquisition device developed. In the early stage, the project team has collected a variety of cardiac auscultation sound, and combining theoretical explanation, ultrasound guidance, set up the heart auscultation visual database. Meantime, we have applied it to the diagnostics probation teaching, the students can learn heart auscultation by the database quickly and effectively. Through it, we have achieved good teaching results. This is help  to explore a new method for cardiac auscultation teaching.
2020 Vol. 29 (3): 185-187 [Abstract] ( 87 ) [HTML 1KB] [ PDF 1344KB] ( 1384 )
188 Investigation of current situation of ECG Network Alliance in Enshi
ObjectiveTo understand the present situation of the  ECG Network Alliance  in Enshi and provide the basis for strengthening the cooperation among the units. MethodsThe questionnaire star and the WeChat were used to investigate the status of the members of the ECG Network Alliance in Enshi.ResultsSixty-three allied units including 17(27.0%) county and city level Ⅱ hospitals and 46(73.0%) township and other hospitals. Among them, 59(93.7%) were willing to join the  ECG Network Alliance, while the other 4(6.3%) were not willing to join. Thirty-eight (60.3%) were connected to ECG network while the other 25(39.6%) were not connected. There were 23 hospitals (92%) were willing to join the ECG Network Alliance in the hospitals without ECG network. The accuracy of ECG interpretation in the hospitals covered by ECG network was 100% while this value was only 72% in the hospitals without ECG network. The difference was statistically significant(P<0.05). The satisfaction of the clinicians in the hospitals with ECG network coverage was 100%, while this value was 64% in the hospitals without ECG network. The difference was statistically significant (P<0.05). ConclusionThe ECG Network Alliance in Enshi were mainly composed of township and other primary hospitals, most of which were connected to ECG network. Hospitals connected to  ECG network can provide patients with accurate and timely diagnosis, monitoring and disease assessment, which make the hospital to have a good satisfaction. In the hospitals without ECG network, 92% of the hospitals were willing to accept the coverage of the ECG network. The data of ECG network are timely and objective, which could better serve the health of patients.
2020 Vol. 29 (3): 188-190 [Abstract] ( 81 ) [HTML 1KB] [ PDF 833KB] ( 1166 )
191 New progress in classification of antiarrhythmic drugs
Pharmacological intervention remains as cornerstone in the clinical management of cardiac arrhythmias. Traditional classification of antiarrhythmic drugs has been used widely, facilitating clinical practice and drug development. However, the limitations of previous classification has been gradually recognized because of recent progress in the development of cardiac electrophysiology. Therefore, a modernized comprehensive classification was proposed recently. In this review, we will summarize the major advance in the classification of antiarrhythmic drugs, potential mechanisms and clinical applications.
2020 Vol. 29 (3): 191-195 [Abstract] ( 77 ) [HTML 1KB] [ PDF 919KB] ( 1392 )
196 Application and development of remote monitoring of insertable cardiac monitor
The insertable cardiac monitor (ICM) is a subcutaneous implanted device that can perform continuous ambulatory ECG monitoring and is a good tool for clinicians to evaluate rare or potential asymptomatic arrhythmias. Although unexplained syncope is still the most common cause of ICM implantation, ICM is increasingly being used to monitor atrial fibrillation（AF）. Recent studies have shown that AF can be detected in a large number of patients with cryptogenic stroke only through longterm monitoring provided by ICM, which greatly increase the detection rate of asymptomatic atrial fibrillation. However, there is a lack of guidelines for the detection of subclinical atrial fibrillation in patients with cryptogenic stroke. More studies are needed to provide reliable evidence. In addition, in recent years, several studies have used ICM with automatic atrial fibrillation detection algorithm and continuous remote monitoring to guide anticoagulant therapy in patients with atrial fibrillation, which may potentially reduce the risk of bleeding.However,more studies are needed to confirm the effectiveness of ICM in guiding individualized anticoagulant therapy in patients with atrial fibrillation.
2020 Vol. 29 (3): 196-201 [Abstract] ( 77 ) [HTML 1KB] [ PDF 906KB] ( 1343 )
202 New progress in the study of T wave alternation
T wave alternation (TWA) refers to the alternation of T wave shape, polarity and amplitude on the surface electrocardiogram during the regular rhythm. Since the mechanism of its occurrence is still unclear,the diagnostic criteria of TWA is not uniform and the clinical tests are not easy to be found, which limit the application of TWA in the clinical practice. In this paper, referring to many literature, we make a comprehensive review on the development history, diagnostic criteria, mechanism and clinical application of TWA, providing a new direction for clinical research in future.
2020 Vol. 29 (3): 202-204 [Abstract] ( 75 ) [HTML 1KB] [ PDF 873KB] ( 1270 )
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2020 Vol. 29 (3): 205-207 [Abstract] ( 65 ) [HTML 1KB] [ PDF 13991KB] ( 1119 )
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2020 Vol. 29 (3): 208-210 [Abstract] ( 72 ) [HTML 1KB] [ PDF 15806KB] ( 934 )
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2020 Vol. 29 (3): 211-213 [Abstract] ( 68 ) [HTML 1KB] [ PDF 24478KB] ( 1024 )
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2020 Vol. 29 (3): 214-217 [Abstract] ( 77 ) [HTML 1KB] [ PDF 4435KB] ( 1164 )
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2020 Vol. 29 (3): 218-219 [Abstract] ( 79 ) [HTML 1KB] [ PDF 18233KB] ( 1070 )
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2020 Vol. 29 (3): 220-222 [Abstract] ( 61 ) [HTML 1KB] [ PDF 10089KB] ( 913 )
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2020 Vol. 29 (3): 223-225 [Abstract] ( 67 ) [HTML 1KB] [ PDF 6863KB] ( 901 )
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2020 Vol. 29 (3): 226-228 [Abstract] ( 53 ) [HTML 1KB] [ PDF 10133KB] ( 955 )
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