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JOURNAL OF PRACTICAL ELECTROCARDIOLOGY
 
2020 Vol.29 Issue.6
Published 2020-12-28
1
2020 Vol. 29 (6): 1-1 [Abstract] ( 26 ) [HTML 1KB] [ PDF 151271KB] ( 467 )
379
2020 Vol. 29 (6): 379-379 [Abstract] ( 25 ) [HTML 1KB] [ PDF 7387KB] ( 549 )
380
2020 Vol. 29 (6): 380-380 [Abstract] ( 47 ) [HTML 1KB] [ PDF 347KB] ( 585 )
381 Roles of ECG in acute coronary syndrome among patients presenting without persistent  ST-segment elevation: based on the 2020 ESC Guidelines for the management of these patients
Qin Hai-ou, Lu Xi-lie, Zhu Jin-xiu
Acute coronary syndrome(ACS) is a clinically common acute and critical disease, especially non-persistent ST-segment elevation ACS(NSTE-ACS). NSTE-ACS accounts for  25%-30% of the unscreened emergency patients with acute chest pain. ESC updated  the 2015 ESC Guidelines for the management of ACSs in patients presenting without persistent ST-segment elevation  in 2020 and proposed new clinical recommendations. This article interprets the main points of the new edition  Guidelines, makes a comparison between the two editions, and focuses on illustrating the important role of ECG in  making diagnosis, risk evaluation and coronary artery revascularization decision on NSTE-ACS.
2020 Vol. 29 (6): 381-385 [Abstract] ( 70 ) [HTML 1KB] [ PDF 938KB] ( 840 )
386 Application of regional ECG remote consultation center in hospital intranet
Zhang Shu-gui, Zhou Tong-xia, Wu Ye-xin, Liu Zhi-ying
Objective  To explore the application effect of regional ECG remote consultation center in hospital internal clinical departments. Methods  Retrospective analysis was performed on the ECG data collected by hospital internal clinical departments after the establishment of the regional ECG remote consultation center. Within a statistical period of 2013-2019, the statistics of ECG workload, detection rate of abnormal ECG and different types of commonlyseen abnormal ECG were obtained; the number of the patients with ECG critical values in hospital intranet was counted. The accuracy rate of ECG diagnosis report was made a comparison before and after the establishment of the ECG remote consultation center. Results  From 2013 to 2019, the detection rate of abnormal ECGs in hospital intranet is 59.08%, among which there is 38.67% of ST and T-wave changes, 7.73% of complete right bundle branch block, 4.28% of atrial premature beats, and 3.99% of atrial fibrillation. During the period of 2013-2019, the accumulative total patients with ECG critical values in hospital intranet reach 643 cases. After the establishment of the ECG consultation center, the accuracy rates of ECG diagnosis reports from 2013 to 2019 are all significantly higher than that in 2012(P<0.01), and the accuracy rate of ECG diagnosis report shows a progressively upward trend(P<0.01).Conclusion  Regional ECG remote consultation center can provide rapid ECG diagnosis for each clinical department by network,  identify the patients with ECG critical values in an early phase, and offer diagnosis and treatment in time. Additionally, the center helps to enhance the professional proficiency of ECG clinicians and improve the accuracy rate of ECG diagnosis report.
2020 Vol. 29 (6): 386-390 [Abstract] ( 44 ) [HTML 1KB] [ PDF 1081KB] ( 742 )
391 Clinical influencing factor analysis of ECG critical value by remote ECG monitoring
Dong Neng-bin, Jiang Bin, Hu Kai, Zhang Ling-na
Objective  To detect electrocardiograms(ECGs) with critical value by remote ECG monitoring and to analyze its association with a part of clinical factors. Methods  A total of 180 inpatients in our hospital were selected; they all wore heart realtime monitoring and warning machine for 24 hours on the second day after admission. The research subjects were divided into criticalvalue group (73 cases) and non-critical-value group (107 cases) according to the absence or presence of critical value warning. We analyzed whether each clinical factor would affect critical value warning. Results  Monofactor analysis significantly shows no correlation between age, atrial fibrillation, hypertension, cerebral apoplexy, dyslipidemia,  elevation of brain natriuretic peptide and the emergence of critical value (P>0.05). Multivariate analysis implies the incidence of critical value in males is 43.5%  (OR=0.435, 95%CI0.228-0.829, P=0.011) if females  is referred to as 100% (OR=1.000). It suggests female sex is closely associated with the presence of critical value. If the incidence of critical value in diabetics is referred to as 100% (OR=1.000), the incidence of non-diabetes cases is 36.9%  (OR=0.369, 95%CI0.163-0.803, P=0.012). It suggests suffering from diabetes is closely associated with the emergence of critical value. ConclusionFemale sex and complication by diabetes are independent influencing factors of the presence of critical value.
2020 Vol. 29 (6): 391-393 [Abstract] ( 53 ) [HTML 1KB] [ PDF 4228KB] ( 873 )
394
2020 Vol. 29 (6): 394-396 [Abstract] ( 51 ) [HTML 1KB] [ PDF 17644KB] ( 573 )
397 Fine analysis of threedimensional Lorenz scatter plot: blocked arrhythmia
Jing Yong-ming, Li Shi-feng, Zhang Fang-fang, Yang Wei
This paper carefully selects three classic cases of blocked arrhythmia, and explores the  regularity of their threedimensional Lorenz scatter plots step by step based on the detailed analysis of their twodimensional time scatter plot, Lorenz scatter plot and difference scatter plot. The threedimensional Lorenz scatter plot characteristics of second degree typed Ⅰ and Ⅱ atrioventricular block (AVB), and third degree AVB were analyzed and summarized. The intrinsic correlation of threedimensional Lorenz scatter plot with twodimensional Lorenz scatter plot and difference scatter plot was compared. The results show different features in the scatter plots of second degree typed Ⅰ and Ⅱ AVB, which serves for rapid identification. The Lorenz scatter plot of third degree AVB expresses electrophysiological characteristics of escaped rhythm—relative fixation of escape cycle and reorganization at any time. Its scatter plot is mainly featured by the fact that point set after premature beats or capture is overlapped in the dominant rhythm of constant velocity line, which is symmetrical distributed by premature beat point set and preprematurebeat point set.  Methods such as reverse technique and waterfall graphic analysis are usually utilized to judge atrioventricular relationship and identify properties of escaped rhythm. Twodimensional Lorenz scatter plot is equivalent to the xOy and yOz plane of  threedimensional Lorenz scatter plot; twodimensional difference scatter plot is equivalent to the xyz plane of threedimensional Lorenz scatter plot with comparatively compact graphs which facilitates its illustration and understanding. The zOx plane is still symmetrically distributed along the constant velocity line.
2020 Vol. 29 (6): 397-406 [Abstract] ( 57 ) [HTML 1KB] [ PDF 20175KB] ( 688 )
407
2020 Vol. 29 (6): 407-409 [Abstract] ( 65 ) [HTML 1KB] [ PDF 4238KB] ( 838 )
410
2020 Vol. 29 (6): 410-413 [Abstract] ( 58 ) [HTML 1KB] [ PDF 11148KB] ( 629 )
414 Diagnostic value of remote transmission electrocardiograph in patients with acute myocardial infarction
Peng Bo, Yi Xin, Nie Xu-ri
Objective  To investigate the role of remote transmission electrocardiograph in the pre-hospital diagnosis of acute myocardial infarction(AMI). Methods  A total of 40 patients with pre-hospital AMI were selected and examined by routine electrocardiograph and remote transmission function electrocardiograph respectively. The  detection rate of AMI and frequency response range were compared between the two examination methods, and so was the patients  degree of  satisfaction with them. Results  The  detection rate of AMI by remote transmission electrocardiograph is 95%(38/40), significantly higher than that by routine electrocardiograph(75%,P<0.05); the frequency response range of AMI patients recorded by routine electrocardiograph does not vary significantly from that recorded by remote transmission 12-lead electrocardiograp(P＞0.05), and the patients satisfaction with the latter is significantly higher than that with the former(P<0.05). Conclusion   Remote transmission electrocardiograph can accurately record AMI patients  ECG signals with high diagnostic accuracy. It helps to increase their degrees of satisfaction with pre-hospital rescue work.
2020 Vol. 29 (6): 414-416 [Abstract] ( 73 ) [HTML 1KB] [ PDF 887KB] ( 693 )
417 Clinical study on the treatment of heart rate-related premature ventricular contraction with Shensong Yang-xin capsule combined with metoprolol
Ye Min-xia, Zhou Xiao-jun, Zhang Ling-juan,Su Hong
Objective  To investigate the clinical efficacy of Shensong Yangxin (SSYX) capsule combined with metoprolol on heart rate-related premature ventricular complex(PVC). Methods  Three hundred PVC patients with symptoms were selected, and randomized into combined medication group and control group—in the former group a combined metoprolol and SSYX capsules were simultaneously prescribed while in the latter group metoprolol was took alone. The Holter monitoring indexes and symptom alleviation rate were analyzed before and after the treatment. The efficacy of the combined medication was compared among fast heart rate-dependent PVC (F-HR-PVC), heart rate-independent PVC (I-HR-PVC) and slow heart ratedependent PVC (S-HR-PVC). ResultsCompared with the control group, the frequency of PVCs during 24 hours in the combined medication group is significantly declined\[(5 536.22±3 826.35) times vs (4 348.59±3 267.48) times, P=0.037], and so is the PVC load[(5.82±4.29)% vs (3.77±3.37)%, P=0.018］. Subgroup analysis shows that the clinical symptom relief rate and the number of patients with a reduced PVC frequency by 50% both significantly increase among patients with I and S-HR-PVC from the combined medication group, if compared with the control group (P＜0.05); the effectiveness rate on patients with F-HR-PVC does not vary significantly between the two groups. ConclusionCompared with metoprolol used alone, the effectiveness rate of SSYX capsule combined with metoprolol proves to be significantly higher, especially on those with I and S-HR-PVC.
2020 Vol. 29 (6): 417-421 [Abstract] ( 56 ) [HTML 1KB] [ PDF 1088KB] ( 829 )
422 Predictive value of  Tp-Te interval changes on arrhythmia in  paraquatpoisoned patients
Li Pei-pei
Objective  To investigate the variation of Tpeak-Tend (Tp-Te) interval in patients with arrhythmia caused by paraquat poisoning. Methods  Ninety paraquatpoisoned patients treated in our hospital were selected. They were divided into two groups—control group (n=50) and observation group (n=40) according to the absence or presence of arrhythmia in the first EEG results. Tp-Te intervals of three cardiac cycles (at acute and recovery phase) were measured by ECG monitoring, and the mean values were obtained and denoted as Tp-Te. Tp-Te and heart rate corrected Tp-Te interval (Tp-Tec) values were compared between the two groups at acute and recovery phase; their association with arrhythmia was analyzed.  Results  In the observation group, Tp-Te and Tp-Tec values at acute phase are both higher than those in the control group [(136.58±4.95) ms vs (124.93±4.91) ms, (127.59±4.92) ms vs (110.87±4.96)ms], with statistically significant differences (P<0.05); Tp-Te and Tp-Tec values at recovery phase are both higher than those in the control group (11484±593)  ms vs (102.93±5.98)ms, (111.63±5.76)ms vs (101.85±5.74)ms], with statistically significant differences (P<0.05) Tp-Te and Tp-Tec are significantly  positively correlated with the occurrence of arrhythmia (r=0.669, 0.714, P<0.05).  Conclusion  Tp-Te and Tp-Tec significantly increase in the acute and recoveryphase ECGs of patients with arrhythmia caused by paraquat poisoning,which has important predictive value on the occurrence and development of arrhythmia. 
2020 Vol. 29 (6): 422-424 [Abstract] ( 56 ) [HTML 1KB] [ PDF 866KB] ( 677 )
425 ECG characteristics of  ventricular arrhythmias originated from His bundle
Yu Ping
Premature ventricular contraction (PVC) and ventricular tachycardia originated from His bundle can be easily misdiagnosed since their QRS morphology is similar to that of  conducted sinus beats.  Combined with surface ECG and intracadiac electrogram, this paper analyzes the ECGs of PVC  and ventricular tachycardia originated from His bundle, and summarizes the ECG characteristics of  ventricular arrhythmias originated from His bundle.
2020 Vol. 29 (6): 425-433 [Abstract] ( 59 ) [HTML 1KB] [ PDF 43265KB] ( 667 )
434 Prevention and control of COVID-19 in treatment of esophagus atrial pacing
Li Yun-shan
During the operation of esophagus atrial pacing in patients with corona virus disease 2019(COVID-19), there is a high risk of aerosol exposure. Taking a COVID-19 patient as an example, this paper introduces medical staff’s experience of taking preventive measures to avoid novel coronavirus infection during the treatment of esophagus atrial pacing in the occurrence of persistent tachycardia which can not be terminated with drugs. It summarizes the procedures for disinfection and protection during epidemic paracmasis and outbreak period; proposes specific suggestions on normalized protection against COVID-19 for the current and the future.
2020 Vol. 29 (6): 434-437 [Abstract] ( 57 ) [HTML 1KB] [ PDF 1202KB] ( 630 )
438 Progress in preoperative ECG to predict the response to cardiac resynchronization therapy
Cheng Yan, Zhang Chang-ying,Wang Ru-xing
Non-response rate remains to be high when QRS duration combined with complete left bundle branch block is used as the patient selection criteria for cardiac resynchronization therapy （CRT）. QRS duration index, R-wave and T-wave heterogeneity, fragmented QRS complex, QRS area, sum absolute QRST integral and machine learning of ECG  are associated with cardiac asynchrony and degree of myocardial fibrosis, and could predict CRT response effectively. Combination of novel ECG indicators helps to predict CRT response more accurately. Machine learning has been providing a better solution for the selection of CRT candidates.
2020 Vol. 29 (6): 438-442 [Abstract] ( 56 ) [HTML 1KB] [ PDF 985KB] ( 703 )
443
2020 Vol. 29 (6): 443-447 [Abstract] ( 63 ) [HTML 1KB] [ PDF 19364KB] ( 600 )
448
2020 Vol. 29 (6): 448-451 [Abstract] ( 40 ) [HTML 1KB] [ PDF 20597KB] ( 619 )
452
2020 Vol. 29 (6): 452-453 [Abstract] ( 42 ) [HTML 1KB] [ PDF 10541KB] ( 612 )
454
2020 Vol. 29 (6): 454-456 [Abstract] ( 54 ) [HTML 1KB] [ PDF 5130KB] ( 747 )
455
2020 Vol. 29 (6): 455-455 [Abstract] ( 32 ) [HTML 1KB] [ PDF 269KB] ( 505 )
456
2020 Vol. 29 (6): 456-456 [Abstract] ( 26 ) [HTML 1KB] [ PDF 948KB] ( 613 )
457
2020 Vol. 29 (6): 457-457 [Abstract] ( 43 ) [HTML 1KB] [ PDF 821KB] ( 596 )
458
2020 Vol. 29 (6): 458-458 [Abstract] ( 32 ) [HTML 1KB] [ PDF 806KB] ( 601 )
459
2020 Vol. 29 (6): 459-459 [Abstract] ( 31 ) [HTML 1KB] [ PDF 1118KB] ( 666 )
460
2020 Vol. 29 (6): 460-460 [Abstract] ( 30 ) [HTML 1KB] [ PDF 763KB] ( 554 )
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