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JOURNAL OF PRACTICAL ELECTROCARDIOLOGY
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JOURNAL OF PRACTICAL ELECTROCARDIOLOGY
 
2021 Vol.30 Issue.5
Published 2021-10-28
1
2021 Vol. 30 (5): 1-82 [Abstract] ( 25 ) [HTML 1KB] [ PDF 56744KB] ( 598 )
303
2021 Vol. 30 (5): 303-303 [Abstract] ( 33 ) [HTML 1KB] [ PDF 3707KB] ( 525 )
304
2021 Vol. 30 (5): 304-304 [Abstract] ( 25 ) [HTML 1KB] [ PDF 343KB] ( 523 )
305 Application of 12-lead real-time wearable ECG device for remote early event detection among patients at home and in primary hospitals
WANG Jinli, CHEN Yundai, GAO Ling, WEN Dongling, GUO Yatao, SHI Yajun
Objective  To analyze the value of 12-lead real-time wearable ECG device for remote early event detection among patients at home and in primary hospitals. Methods  ECGs of 20 271 subjects were collected by using 12-lead real-time wearable ECG devices at home and in primary hospitals, and transferred to the consultation center of our hospital. All of the ECG data were classified according to the degree of severity—critical, urgent and ordinary; the ECG grading results were timely notified patients themselves and their family members or primary hospitals. Critical ECG cases were followed up within 1 to 12 days. Results  A total of 21 253 ECGs are enrolled into analysis. Among them, male’s ECGs account for 56.50% (12 007/21 253), slightly higher than female’s; 55.03% (11 695/21 253) of ECGs are collected from primary hospitals,slightly higher than those collected from families; 40.55% (8 619/21 253) of ECGs come from subjects with symptoms of discomfort, mainly chest tightness, chest pain and palpitation. Abnormalities are found in 66.63% (14 160/21 253) of the ECGs  including 39.45%  (8 385/21 253) of myocardial ischemia ECGs and 24.64%  (5 237/21 253) of arrhythmia ECGs with premature ventricular contraction ECGs accounting for the highest detection rate of 5.52%. Critical ECG reports account for 0.61%(130/21 253), and serious clinical events occur in 20.21%(19 cases) of the involved 94 subjects. Conclusion  The 12-lead real-time wearable ECG device can make remote early detection for arrhythmia and myocardial ischemia among patients at home and in primary hospitals, and divide remote ECGs into critical, urgent, and ordinary grades for further diagnosis. It can improve patients prognosis, and ultimately benefit patients and primary medical institutions.
2021 Vol. 30 (5): 305-309 [Abstract] ( 82 ) [HTML 1KB] [ PDF 990KB] ( 808 )
310 Application and development of mobile health technology in arrhythmia management in China
JIN Mengdi1， HONG Jiang2
Mobile Health（mHealth）refers to the technology that provides medical information and services for doctors, patients and healthy people through mobile communication (such as personal digital assistant, mobile phone, satellite communication, etc.). In recent years, with the development of cloud technology and 5G communication, and the updating of wearable devices, mHealth has gradually become a hotspot in the field of diagnosis and treatment of diseases. Especially in the management of arrhythmias, mHealth has established absolute predominance with its monitoring instantaneity and sustainability. This paper introduces the current status and prospect of mHealth applied in arrhythmia management in China, and discusses the development direction of this technology.
2021 Vol. 30 (5): 310-313 [Abstract] ( 106 ) [HTML 1KB] [ PDF 890KB] ( 1165 )
314 Management strategies on medical behaviors of regional remote ECG consultation
WANG Rui, SHEN Jingbo, ZHANG Shiyu
At the beginning of regional remote ECG consultation,  ECG diagnostic management center is established to take fulltime responsibility for managing medical behaviors and defining management strategies suitable for this area. These management strategies include formulating specifications for behaviors of remote consultation, strengthening  interunit communication, organizing targeted professional learning, making continuous improvement based on feedback, forming healthy competition environment by introducing excellence assessment system, which ensures the rapid, efficient and healthy operation of the online consultation platform. The implementation of the above measures can not only effectively solve difficult problems encountered in the remote ECG consultation, but also further improve the overall level of regional ECG diagnosis.
2021 Vol. 30 (5): 314-317 [Abstract] ( 76 ) [HTML 1KB] [ PDF 877KB] ( 767 )
318 Relationship between red blood cell distribution width and recurrent atrial fibrillation after radiofrequency ablation
GU Yunfei， ZHANG Xuan， DUAN Kadan， JIN Jun， PAN Guangjie， GUO Yubing， WU Pengyu， QI Yujie， CHEN Weigang， TIAN Tian
Objective  To investigate the relationship between red blood cell distribution width (RDW) and the recurrence of atrial fibrillation (AF) after radiofrequency ablation. Methods  We selected 150  patients diagnosed with paroxysmal AF who had undergone radiofrequency ablation. They  were divided into normal RDW group (96 cases) and elevated RDW group (54 cases) according to preoperative RDW level. The AF recurrence  was followed up for observation and compared between the two groups; regression analysis was performed to explore the predictive factors of AF recurrence after  ablation. Results  In the elevated RDW group, the level of high sensitive Creactive protein (hs-CRP) of patients is  higher than that in the normal RDW group (P<0.05) while the recurrence rate of AF after ablation is also higher than that in the normal RDW group  (24.1% vs. 11.5%, P＜0.05). Multivariate regression analysis shows that RDW, AF duration, left atrial diameter and hs-CRP level are independent predictors of AF recurrence after ablation. Conclusion  Among the AF patients with increased RDW, the recurrence rate of AF after  ablation significantly increases. Intervention measures should be strengthened for these patients.
2021 Vol. 30 (5): 318-321 [Abstract] ( 68 ) [HTML 1KB] [ PDF 993KB] ( 640 )
322 Progress in application of pulsed field ablation for atrial fibrillation
LU Qiao, ZHANG Xianlin, WANG Hongju
Pulsed field ablation (PFA) as a non-thermal ablation technology is a novel  method for ablating  atrial fibrillation. This form of energy employs a series of highamplitude electric pulses lasting for several microseconds; when a strong pulsed electric field increases the membrane  permeability, irreversible electroporation will occur, leading to the disruption of cellular homeostasis and even cell death. Since pulsed electric field has distinct non-thermal property and tissue specificity, PFA can be applied in a wider range with higher safety and shorter time to work compared with radiofrequency or cryoballoon ablation. This paper mainly introduces the principles and characteristics of PFA, and illustrates its tissue specificity and limitations in the treatment of atrial fibrillation.
2021 Vol. 30 (5): 322-327 [Abstract] ( 57 ) [HTML 1KB] [ PDF 1004KB] ( 1856 )
328
2021 Vol. 30 (5): 328-333 [Abstract] ( 66 ) [HTML 1KB] [ PDF 29163KB] ( 592 )
334
2021 Vol. 30 (5): 334-336 [Abstract] ( 57 ) [HTML 1KB] [ PDF 7053KB] ( 624 )
337 State and significance of autonomic nerve function reflected by heart rate variability in females menstrual cycle
LI Ting1, WU Xufang2, WU Jing3, LIU Xiaoxia4, CHEN Liaoyi5, CUI Xuefeng1, LI Fangjie3
Objective  To explore the relativity between autonomic nerve function state and human endocrine system function by observing the changes of heart rate variability (HRV) in different time periods of female's menstrual cycle. Methods  We selected 62 healthy female volunteers with normal menstrual cycle and 57 days of menstruation as research subjects. The 24-hour ambulatory electrocardiography (AECG) was recorded 35 days before menstruation (luteal phase) and on the third day during menstruation (follicular phase), respectively. The time- and frequency- domain HRV analysis was performed to observe the autonomic nerve function states at different phases of female's menstrual cycle. Results  Ninety-seven cases of valid AECG data are obtained among which are 43 cases at the luteal phase (luteal phase group), 54 cases at the follicular phase (follicular phase group), and 35 cases of data valid at both of the two phases. In the follicular phase group, the timedomain HRV indexes of SDNN, SDANN and rMSSD, and frequency-domain HRV indexes of TP, LF and HF are all higher than those in the luteal phase group, without statistically significant difference (P>0.05); self-comparison of 35 cases of AECG data between luteal phase and follicular phase comes to similar results. ConclusionIn   female's menstrual cycle, HRV indexes in follicular phase with low hormone secretion level may be higher than those in luteal phase with high hormone secretion level, indicating that autonomic nerve energy in follicular phase tends to increase.
2021 Vol. 30 (5): 337-341 [Abstract] ( 65 ) [HTML 1KB] [ PDF 978KB] ( 889 )
342 Anti-ventricular arrhythmia effect of sacubitril/valsartan on patients with chronic heart failure
PEI Qiang, WANG Qiang, YANG Zhenyu, CHEN Maohua, WANG Ruxing
Objective  To explore the antiventricular arrhythmia effect of sacubitril/valsartan (LCZ696) on patients with chronic heart failure. Methods  We selected 116  heart failure patients with reduced  ejection fraction (HFrEF) as the research subjects. Electrocardiogram (ECG) and ambulatory electrocardiography(AECG) results were made comparative analysis before taking LCZ696 and 6 months after treatment. ResultsThe utilization rate of drugs including betablockers, spironolactone, digoxin and amiodarone does not vary significantly before taking LCZ696 and 6 months after treatment (P>0.05).  Compared with those before treatment,  QRS duration [(124.8±35.2) ms vs. (120.7±32.7) ms] and SV1+RV5[(20.9±11.3) mm vs. (17.1±9.3) mm]  after treatment both significantly decrease (P<0.05); corrected QT interval (QTc) [(461.6±40.2) ms vs. (448.5±39.5) ms] and QT dispersion (QTd)[(78.2±10.6) ms vs. (51.2±8.6) ms] after treatment  both significantly decrease (P<0.01). The number of patients attacked by sustained ventricular tachycardia  after treatment decreases from 8 to 3 (P<0.05); the total number of SVT attacks  decreases from 19 to 5 (P<0.01). The number of cases attacked by non-sustained ventricular tachycardia (NSVT) decreases from 61 to 49 (P<0.01); the number of attacks of NSVT per person decreases from (7.2±9.8) to (3.5±4.9) (P<0.01); the number of attacks of premature ventricular contraction  per hour  is reduced from (35.0±6.2) times  to (9.0±3.5) times (P<0.01). Conclusion  LCZ696 therapy is associated with decreased risk of ventricular arrhythmia, and significantly reduced QRS duration, QTc and QTd among patients with heart failure.
2021 Vol. 30 (5): 342-345 [Abstract] ( 69 ) [HTML 1KB] [ PDF 890KB] ( 878 )
346 Relationship between  occurrence of idiopathic premature ventricular contraction and autonomic nervous tension
WANG Xiaofei, ZOU Cao, DU Xiaojiao, HU Mingsheng, LIN Jia, SUN Shikun, XUE Feng, CHEN Tan, LI Xun
Objective  To investigate the relationship between the occurrence of idiopathic premature ventricular contraction (IPVC) and the mechanism of autonomic nerve. Methods  In a singlecenter retrospective study approach, we selected 156 patients with IPVC \[PVC group,with ≥10 000 times of PVCs per day recorded by 24hour ambulatory electrocardiography (AECG) or PVC burden≥10%\], and 84 physical examination subjects during the same period (control group) as research subjects. According to the 24-hour AECG examination results, the following heart rate variability  indexes were calculated, including rMSSD, pNN50, HF, HFnorm and LF/HF. We compared the autonomic nervous tension between the two groups, and analyzed the relationship between PVC burden and changes of autonomic nervous tension. Results  The indexes of rMSSD, pNN50, HF and HFnorm in the PVC group are all significantly higher than those in the control group (P<0.01) while LF/HF is significantly lower (P<0.01). In the PVC group, the 24-hour PVC burden is positively correlated with rMSSD, pNN50 and HF (correlation coefficient r=0.492, 0.425 and 0.372, respectively; P<0.01) while it is negatively correlated with LF/HF (r=－0.206, P<0.05). Hourly PVC burden is positively correlated with hourly HFnorm in 28.8% (45/156) of the enrolled IPVC patients, and it is positively correlated with hourly LF/HF in 16.0%(25/156) of IPVC patients. Among 53.8% (84/156) of IPVC patients, hourly PVC burden is correlated with neither hourly HFnorm nor hourly LF/HF. ConclusionIn   parts of patients, the occurrence of IPVC is associated with the changes of  sympathetic and (or) parasympathetic nervous tension.
2021 Vol. 30 (5): 346-350 [Abstract] ( 50 ) [HTML 1KB] [ PDF 910KB] ( 789 )
351 Two-dimensional speckle tracking imaging in evaluating left atrial function and predicting prognosis of diabetics complicating acute coronary syndrome
ZHOU Cuicui1, ZUO Tieniu2, WANG Zhongqun1, FAN Tingpan1, XU Liangjie1
Objective  To investigate the value of left atrial function related indexes in predicting the prognosis of diabetics with acute coronary syndrome (ACS) and their improvements of left ventricular function. Methods  We selected 142 diabetics complicating ACS (ACS group) and 67 diabetics without ACS (control group). Each echocardiographic parameter was collected by using GE Vivid E9 echocardiography and twodimensional speckle tracking imaging (2D-STI) technology. The mortality, incidence of major adverse cardiovascular events (MACEs), and echocardiographic parameters were followed up  one day, and 3, 6, 9, 12 and 18 months after operation. According to the level of left ventricular ejection fraction (LVEF) 18 months after operation compared with LVEF one day after operation, the ACS group were divided into good recovery group (n=77) and poor recovery group (n=65). The echocardiographic parameters were compared among the three groups. The receiver operating characteristic (ROC) curves were applied to analyze the predictive value of left atrial function for MACEs. ResultsAccording to the order of small to large, the left atrial strain and strain rate in systolic and early diastolic phase of left ventricle are sequenced as poor recovery group, good recovery group and control group, with statistically significant differences (P<0.05); in the ACS group, the left atrial strain and strain rate in late diastolic phase are significantly higher than those in the control group (P<0.05), but there is no significant difference between the good recovery group and poor recovery group (P>0.05). ROC curve analysis indicates that the area under curve of left atrial systolic strain (LAs-s) in predicting LVEF recovery is the largest. According to the cut-off value of LAs-s (20.15%), the enrolled patients are divided into low LAs-s group and high LAs-s group, and the survival curve is drawn. The incidence of endpoint events is lower in high LAs-s group than that in the low LAs-s group. Conclusion  Left atrial strain and strain rate can be employed in predicting the prognosis of diabetes complicated by ACS.
2021 Vol. 30 (5): 351-356 [Abstract] ( 36 ) [HTML 1KB] [ PDF 1423KB] ( 736 )
357 Advances in gene therapy of  ventricular arrhythmias
LIU Junpeng, SHI Haifeng
In recent years, with the success of biological therapy represented by gene therapy  achieved in the field of singlegene diseases, gene therapy may become a promising option for treating refractory hereditary and acquired ventricular arrhythmias. This review covers the latest research progresses in this field.
2021 Vol. 30 (5): 357-359 [Abstract] ( 62 ) [HTML 1KB] [ PDF 894KB] ( 659 )
360 Research progress in atrial fibrillation after lung transplantation
ZHAO Xiaoxi1, CHEN Jingyu2, WANG Ruxing1
Lung transplantation has become a major treatment method for endstage lung diseases, however the incidence of atrial arrhythmias is relatively high after lung transplantation,among which atrial fibrillation (AF) is the most common. Understanding the inducing factors and pathogenesis of AF after lung transplantation helps to make early identification of highrisky patients and provide an appropriate scheme of treating postoperative AF, contributing to reducing mortality and improving prognosis. This paper mainly reviews on the incidence, risk factors, pathogenesis, therapy and influence on the prognosis of AF after lung transplantation.
2021 Vol. 30 (5): 360-363 [Abstract] ( 52 ) [HTML 1KB] [ PDF 887KB] ( 669 )
364 Primary cardiac ion channel diseases and sudden cardiac death
HUANG Yiping1, GUO Jihong2, WANG Xinkang1, GAO Jie1
In cardiac ion channel diseases, there are a part of primary electrical disorders which easily lead to sudden cardiac death (SCD) in the absence of structural heart diseases, accounting for approximately 30% of young SCD patients. These electrical disorders include congenital long QT syndrome, congenital short QT syndrome, Brugada syndrome and catecholaminergic polymorphic ventricular tachycardia. These diseases  usually have low penetrance and lack typical clinical manifestation, greatly challenging clinical diagnosis. However, SCD is probably the first symptom of primary cardiac ion channel diseases, and therefore it is especially important to make early diagnosis. This paper comprehensively introduces the clinical manifestations and diagnostic criteria, genetic background, pathophysiologic mechanism, and therapy of the above four kinds of primary cardiac ion channel diseases, in order to provide a clue for prevention and control of severe arrhythmias and even SCD.
2021 Vol. 30 (5): 364-370 [Abstract] ( 47 ) [HTML 1KB] [ PDF 955KB] ( 807 )
371
2021 Vol. 30 (5): 371-372 [Abstract] ( 62 ) [HTML 1KB] [ PDF 2834KB] ( 640 )
373
2021 Vol. 30 (5): 373-374 [Abstract] ( 35 ) [HTML 1KB] [ PDF 3337KB] ( 706 )
375
2021 Vol. 30 (5): 375-377 [Abstract] ( 45 ) [HTML 1KB] [ PDF 5385KB] ( 773 )
378
2021 Vol. 30 (5): 378-380 [Abstract] ( 46 ) [HTML 1KB] [ PDF 7445KB] ( 582 )
381
2021 Vol. 30 (5): 381-381 [Abstract] ( 35 ) [HTML 1KB] [ PDF 774KB] ( 536 )
382
2021 Vol. 30 (5): 382-382 [Abstract] ( 32 ) [HTML 1KB] [ PDF 926KB] ( 590 )
383
2021 Vol. 30 (5): 383-383 [Abstract] ( 35 ) [HTML 1KB] [ PDF 620KB] ( 1264 )
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