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JOURNAL OF PRACTICAL ELECTROCARDIOLOGY
 
2022 Vol.31 Issue.1
Published 2022-02-28
1
2022 Vol. 31 (1): 1- [Abstract] ( 38 ) [HTML 1KB] [ PDF 100448KB] ( 754 )
1 Key issues in optimal treatment of acute myocardial infarction
TIAN Cuihong, CHEN Yequn, ZHU Jinxiu
Acute myocardial infarction (AMI) is one of the major critical diseases of the cardiovascular system with sudden onset and high mortality. Although the inhospital mortality rate of AMI patients has been  reduced due to the continuously improved and optimized therapeutic regimen, the incidence of major adverse cardiovascular events  is still significantly high.  Therefore, further optimizing the therapeutic regimen and treatment strategy for AMI  is still urgently needed by clinicians. This paper reviews from the following aspects including the balance between the bleeding risk and ischemic risk in the use of antiplatelet aggregation drugs after AMI, the residual microcirculation disorder in the opening of infarct related arteries, the timing of handling noninfarct related blood vessels, disease evaluation before other secondary preventive treatment, and the long-term benefits from mechanicallyassisted treatment.

Guide: 
2022 Vol. 31 (1): 1-6 [Abstract] ( 54 ) [HTML 1KB] [ PDF 1038KB] ( 726 )
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2022 Vol. 31 (1): 2- [Abstract] ( 49 ) [HTML 1KB] [ PDF 74KB] ( 459 )
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2022 Vol. 31 (1): 3- [Abstract] ( 46 ) [HTML 1KB] [ PDF 315KB] ( 544 )
7 Post-myocardial infarction major adverse cardiovascular and cerebrovascular events:current perspectives, and preventive and therapeutic approach
HUANG Zhaotao, CHEN Yequn
Post-myocardial infarction major adverse cardiovascular and cerebrovascular events (post-MI MACCE) are the most serious complications and remain the leading causes of death among MI patients. Despite advances in pharmaceutical therapy and the widespread use of percutaneous coronary intervention, the prognosis of MI patients complicated by MACCE is still far from satisfactory. This article briefly reviews the definition, incidence, risk factors, intervention measures and outcome of post-MI MACCE including all cause mortality, heart failure, reinfarction, cerebrovascular accidents and repeated revascularization.
2022 Vol. 31 (1): 7-12 [Abstract] ( 59 ) [HTML 1KB] [ PDF 940KB] ( 1039 )
13 Regulatory roles and significance of key inflammatory factors in post-acute myocardial infarction
CHEN Haixuan, CHEN Yequn, ZHU Jinxiu
Acute myocardial infarction (AMI) induced cardiomyocyte death causes a series of pathophysiological responses of the heart. The process involves proinflammatory reaction and extracellular matrix degradation, and antiinflammatory reaction and new scars formation. However, the redundancy of inflammatory reaction caused by tissue injury would lead to excessive cardiac fibrosis and antagonistic cardiac remodeling, eventually developing into adverse cardiovascular events such as heart failure. It is helpful to prevent and treat the adverse prognosis after AMI as far as understanding the inflammatory regulation mechanism. This review introduces the key inflammatory factors involved in cardiac repair after AMI, especially interleukin, matrix metalloproteinase and reactive oxygen species, influence the infarct area and left ventricular function after AMI through pro and antiinflammatory effects of themselves. These factors regulate cardiac repair after AMI, and provide references and strategies for clinically improving the prognosis of patients with AMI.
2022 Vol. 31 (1): 13-17 [Abstract] ( 78 ) [HTML 1KB] [ PDF 907KB] ( 1013 )
18 Progress in blood biomarkers to predict adverse cardiovascular events after myocardial infarction
YAN Jingyi, CHEN Yequn
Major adverse cardiovascular events(MACEs) after myocardial infarction(MI) decrease patients’ life quality and increase the risk of death. Timely detection of blood biomarkers can predict MACEs after MI which is beneficial for targeted prevention and treatment. This paper briefly  reviews the progress in blood biomarkers to predict MACEs after MI. These blood biomarkers cover classic peripheral blood biomarkers including cardiac troponin, natriuretic peptide, Ddimer,high sensitivity C-reactive protein and copeptin, and the newly discovered protein and non-coding RNA over the past 20 years.
2022 Vol. 31 (1): 18-23 [Abstract] ( 71 ) [HTML 1KB] [ PDF 938KB] ( 611 )
24 Practical demand and key issues of automatic analysis of ECG artificial intelligence
SHEN Zhongyuan
Electrocardiogram (ECG) analysis is one of the earliest and the most successful fields of automated analysis using artificial intelligence (AI). The establishment of authoritative and opensourced or transplantable ECG database, and the generation of excellent algorithms require for the cooperation and runningin of disciplines including computer technology and biomedical engineering, and medical professionals. It also needs medical institutions, medical academic disciplines and administrative departments, and science and technology companies to work together; it also needs supports from a set of improved policies, laws and regulations to make a better promotion and application. This paper analyzes the demand, status of database and algorithm, and the existing key issues  of ECG AI automatic analysis.
2022 Vol. 31 (1): 24-27 [Abstract] ( 67 ) [HTML 1KB] [ PDF 899KB] ( 810 )
28 Application of artificial intelligence-enabled ECG in diagnosis of inherited arrhythmia
SONG Wenhua, XIE Jiawei, LIU Tong
With the emerging and mutation of various pathogenic genes, the prevalence of corresponding genetic diseases also increases year by year. The penetrance of potentially pathogenic mutation is often atypical or the mutation manifests itself only in one’s later years, which tends to complicate and delay the diagnosis of genetic heart diseases. With the development and application of new technologies such as machine learning, artificial intelligence (AI) has become a powerful tool in many fields including personalized medicine, medical imaging, and disease diagnosis. By using AI, we can specifically analyze and summarize the characteristic manifestations of ECG in patients with genetic arrhythmias, contributing to the early diagnosis of related diseases. This paper reviews the latest research progress of AI enabled ECG utilized in the diagnosis of inherited arrhythmias, mainly including congenital long QT syndrome, Brugada syndrome, and catecholaminergic polymorphic ventricular tachycardia.
2022 Vol. 31 (1): 28-31 [Abstract] ( 86 ) [HTML 1KB] [ PDF 917KB] ( 599 )
32 Scatterpoint drifting method for ECG scatter plot analysis
JING Yongming, ZHANG Fangfang, LI Shifeng
The appearance of long period complicates the original scatter plot of arrhythmia, and the  scatter point drifting method serves as a “secret weapon” to solve these cases. The long period related characteristic point set is similar to the homonymous one without long period, and the former is equivalent to a drift from the latter. The drifting law of Lorenz scatter plot is as follows: the extended front period moves to the right, the extended back period moves up, and both of the front and back period extend to the upper right. The drifting law of the difference scatter plot is as follows: the extended front period moves to the left, the extended back period moves up, and the extended middle period moves to the bottom right. Taking  second degree atrioventricular block scatter plot as an example, this paper summarizes the positional relationship between long period related point set and basic point set, which is popularized to premature beat related characteristic point set. This paper  aims to lay a foundation for rapid analysis of ambulatory electrocardiography by exploring the analytical skills of long period related ECG scatter plot.
2022 Vol. 31 (1): 32-36 [Abstract] ( 72 ) [HTML 1KB] [ PDF 9215KB] ( 871 )
37 Analysis on morphological characteristics of Lorenz-RR scatter plot in patients with rapid atrial arrhythmia
ZHENG Wenkai, KANG Hong, XU Zhiyong
Objective  To investigate the morphological characteristics of Lorenz-RR scatter plot in patients with rapid atrial arrhythmia and its formation mechanism. Methods  We selected 73 patients diagnosed with rapid atrial arrhythmia by ambulatory electrocardiography (AECG) examination, including 7 cases of atrial tachycardia, 32 cases of atrial flutter, 13 cases of impure atrial flutter and 21 cases of atrial flutteratrial fibrillation. By using 12lead AECG recorder and analysis software produced by DMS company, retrospective study was carried out on  Lorenz-RR scatter plots with all the heart beats. The characteristics of scatter plots in each group were summarized. We analyzed the ECG features, FF interval, atrial frequency, morphological types of F wave, the presence or absence of equivalent potential line, and their association with morphological characteristics of Lorenz-RR scatter plot. ResultsA  mong the 7 cases of atrial tachycardia, 2 are presented as individual ellipses, 3 are multi-distributional ellipses, and 2 look like grid-shaped block masses. Among the 32 cases of atrial flutter, 2 are presented as multi-distributional ellipses, 26 are clear grid-shaped block masses, and 4 are vague grid-shaped block masses. In the 13 cases of impure atrial flutter, 2 look like clear grid-shaped block masses, 10 are vague grid-shaped block masses, and one is fan-shaped with vague block masses. The scatter plot of atrial flutter-atrial fibrillation is fan-shaped with vague block masses or without block mass. Conclusion  The morphological characteristics of Lorenz-RR scatter plot in patients with rapid atrial arrhythmia are related to the frequency and regularity of atrial cycle, and are also associated with changes of   atrioventricular node refractory period. At a slow and regular atrial frequency, the scatter plot is presented as individual or multi-distributional elliptic block mass; at a quick and regular atrial frequency, it looks like clear grid-shaped block mass. With a loss of regularity in atrial frequency, the boundary of block mass gradually becomes blurred—developing from clear grid-shaped block mass to vague one and then  fan-shaped graphics with or without block mass. The number of block mass is related to the proportion of atrioventricular conduction; the enlargement or diffusion of individual block mass is influenced by the variability of atrial cycle and changes of  atrioventricular node refractory period.
2022 Vol. 31 (1): 37-42 [Abstract] ( 54 ) [HTML 1KB] [ PDF 11733KB] ( 713 )
43 Characteristics of ambulatory electrocardiography in  elderly patients with non-valvular atrial fibrillation complicating long RR interval and treatment efficacy of circumferential pulmonary vein isolation
XU Hongyuan, ZHONG Guoqiang, LI Lin, LI Jinyi
ObjectiveT  o analyze the characteristics and clinical significance of ambulatory electrocardiography (AECG) in the elderly patients with non-valvular atrial fibrillation (NVAF) complicating long RR interval, and to explore the treatment efficacy of radiofrequency ablation.  Methods  We selected 532 elderly patients with NVAF treated in our hospital and performed 24-hour AECG monitoring. According to the presence or absence of long RR interval, they were divided into long RR interval group (399 cases) and non-long RR interval group (133 cases). The ventricular rate, arrhythmia, left ventricular function, etc. were compared between the two groups, and so were  heart rate,  conversion of AF, etc. before and after circumferential pulmonary vein isolation (CPVI).  Results
  In the long RR interval group, the average, the slowest and the fastest ventricular rate  during sleep time are all higher than those during non-sleep time while the number of long RR intervals is significantly lower  (P<0.05). The level of C-reactive protein in the long RR interval group is lower than that in the non-long RR interval group, and the incidence of atrial premature beats and arrhythmia are higher than those in the nonlong RR interval group (P<0.05). In the patients with RR interval over 3.0 s, the incidence of seconddegree atrioventricular block, paroxysmal atrial tachycardia,  and complete or incomplete right bundle branch block are lower than those in the patients with RR interval of  2.0-3.0 s while the incidence of transient ventricular arrest is higher (P<0.05). The average and the fastest ventricular rate of the patients decrease after CPVI while the slowest ventricular rate increases, and the long RR interval disappears (P<0.05). Conclusion  Elderly patients complicated by NVAF and long RR interval are prone to arrhythmia, atrial premature beats, and  ventricular rate acceleration. AECG monitoring can provide  references for CPVI treatment on these patients.
2022 Vol. 31 (1): 43-48 [Abstract] ( 48 ) [HTML 1KB] [ PDF 933KB] ( 819 )
49 Influence of sleep disorders on ventricular repolarization and electrical excitation conduction
LI Qianqing, LIU Yuqiong, HUANG Haiming
Objective  To investigate whether the indexes of ventricular repolarization and electrical excitation conduction in sleepdisordered  patients   are different from those in normal people, and to provide cardiac rehabilitation basis for sleep disordered  patients with  heartrelated diseases. Methods  We randomly selected a routine physical examination population of 130 from our hospital, and carried out a questionnaire survey on all the subjects with the Pittsburgh sleep quality index(PSQI) scale. The subjects with a total PSQI score of 0.7 were set as normal sleep group (91 cases) while those with PSQI score no less than 8 were divided into sleepdisordered group (39 cases). Retrospective analysis was performed on the cardiac electrophysiological indicators of all the surveyed subjects including  QRS duration, heart rate, QT interval, QTc, QTd，QTcd，Tpeak-Tend interval (Tp-Te), Tp-Te/QT,  etc. The  changes of ST-T  in ECG were recorded. ResultsCompared with the normal sleep group, QTc, QTd, QTcd, TpTe, TpTe/QT and Tp-Te/QTc are  all significantly prolonged in the sleepdisordered group (P<0.05); the incidence of ST-T change is significantly increased (P<0.01). Logistic regression analysis shows that sex and sleep time are the most influential variables for ST-T change in ECG (sex:OR=7.521, 95%CI  2.534-22.325, P<0.05; sleep duration: OR=2.604, 95%CI 1.470-4.611, P<0.05). Conclusion  Sleep disorders may contribute to the inhomogeneity of ventricular repolarization, and possibly serve as one of the risk factors of cardiovascular disease. Female and shortened sleep time are proved to be the independent risk factors for ST-T changes.
2022 Vol. 31 (1): 49-54 [Abstract] ( 40 ) [HTML 1KB] [ PDF 940KB] ( 588 )
55 ECG manifestations of left bundle branch area pacing
PING Jialiu, YANG Yali, JI Yajun
Left bundle branch area pacing (LBBAP) is the current research hotspot because of its excellent electrical synchronization and  postoperative parameter stability. This paper introduces the ECG manifestations of four different types of LBBAP including selective left bundle branch pacing, nonselective left bundle branch pacing, left ventricular septal pacing and anode capture, so as to provide references for clinical work.
2022 Vol. 31 (1): 55-59 [Abstract] ( 81 ) [HTML 1KB] [ PDF 10545KB] ( 582 )
60 Prevention of sudden cardiac death after revascularization of coronary heart disease
SHAO Shuai, LI Guangping
Implantable cardioverter defibrillator (ICD) as the main therapy to prevent sudden cardiac death (SCD) after revascularization in patients with ischemic cardiomyopathy, has been widely used in clinic at present. However, the timing and indications of ICD  application are still unclear for clinicians. This article reviews the incidence of SCD after revascularization in patients with coronary heart disease, and the application of ICD, in order to emphasize the correct and rational application of ICD for saving more lives of patients.
2022 Vol. 31 (1): 60-64 [Abstract] ( 71 ) [HTML 1KB] [ PDF 943KB] ( 655 )
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2022 Vol. 31 (1): 65-67 [Abstract] ( 52 ) [HTML 1KB] [ PDF 12723KB] ( 689 )
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2022 Vol. 31 (1): 68-71 [Abstract] ( 58 ) [HTML 1KB] [ PDF 10943KB] ( 705 )
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2022 Vol. 31 (1): 72-74 [Abstract] ( 63 ) [HTML 1KB] [ PDF 10092KB] ( 669 )
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2022 Vol. 31 (1): 75-76 [Abstract] ( 53 ) [HTML 1KB] [ PDF 17912KB] ( 547 )
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2022 Vol. 31 (1): 77-77 [Abstract] ( 38 ) [HTML 1KB] [ PDF 519KB] ( 499 )
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2022 Vol. 31 (1): 78-78 [Abstract] ( 41 ) [HTML 1KB] [ PDF 865KB] ( 512 )
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2022 Vol. 31 (1): 79-79 [Abstract] ( 39 ) [HTML 1KB] [ PDF 526KB] ( 479 )
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2022 Vol. 31 (1): 80-80 [Abstract] ( 40 ) [HTML 1KB] [ PDF 840KB] ( 497 )
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