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JOURNAL OF PRACTICAL ELECTROCARDIOLOGY
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JOURNAL OF PRACTICAL ELECTROCARDIOLOGY
 
2022 Vol.31 Issue.5
Published 2022-10-28
302
2022 Vol. 31 (5): 302-302 [Abstract] ( 22 ) [HTML 1KB] [ PDF 106535KB] ( 1287 )
303
2022 Vol. 31 (5): 303-303 [Abstract] ( 20 ) [HTML 1KB] [ PDF 499KB] ( 376 )
304
2022 Vol. 31 (5): 304-304 [Abstract] ( 24 ) [HTML 1KB] [ PDF 337KB] ( 474 )
305 Research advances in atrial fibrillation during pregnancy
ZHANG Jian, LI Dianfu
Atrial fibrillation (AF) during pregnancy is rare, but if it is complicated by structural heart disease, its prevalence may be increased, leading to hemodynamic disturbances that threaten maternal and fetal safety in severe cases. There are limited research data on AF in pregnancy, and this article reviews the current status and progress of research from the four aspects of electrophysiological substrates, epidemiology, assessment and management.
2022 Vol. 31 (5): 305-309 [Abstract] ( 30 ) [HTML 1KB] [ PDF 990KB] ( 490 )
310 Progress of artificial intelligence applied in managing atrial fibrillation
LI Xiaorong, YANG Bing
As one of the most common arrhythmias in clinical practice, atrial fibrillation is characterized by being occult, paroxysmal, complex, and high mortality and disability. It is considered as a “silent killer”. This paper summarizes the progress of artificial intelligence applied in the diagnosis and prediction of atrial fibrillation, assistance for decisionmaking in ablation,  plasma drug concentration monitoring, prognosis prediction, etc. from clinical perspectives.
2022 Vol. 31 (5): 310-314 [Abstract] ( 53 ) [HTML 1KB] [ PDF 1907KB] ( 607 )
315 Prevalence and current status of anticoagulation therapy of atrial fibrillation in patients60 years old: A cross-sectional community-based survey in Shanghai
SUN Huan, ZHANG Wenyu, WANG Wenjiao, LI Xiaorong
Objective  To estimate the prevalence and current status of anticoagulation therapy of atrial fibrillation (AF) among the population aged ≥60 years old in a community of Pudong New Area, Shanghai, and to provide evidences for community management and intervention of AF. Methods  In a cluster sampling method, the prevalence of AF among the population aged 60 and above in the community were surveyed; AF was screened and diagnosed by electrocardiogram. The general information, past medical history, laboratory indicators and medication of patients with AF were collected. Results  A total of 8 739 residents aged 60 and above are included in the final analysis; 178 patients with AF are detected with a morbidity rate of 2.04%, among whom are 168 cases (94.38%) with non-valvular AF. Patients with AF are at an average age of (74.1±7.8) years old of whom 102 cases (57.30%) are males. The top three comorbidities are separately hypertension (84.3%), diabetes (39.3%), and coronary heart disease (25.8%). Among the 178 patients with AF, the anticoagulation rate is 39.33% while  21.91% receive antiplatelet therapy, and 38.76% fail to receive antithrombotic therapy. The average HAS-BLED  bleedingrisk prediction score is (2.73±0.91); the score of males is lower than that of females[(2.60±0.81) vs. (2.91±1.01), P<0.05]. The CHA2DS2-VASc score of patients with non-valvular AF is (3.92±1.68); the score of males is also lower than that of females [(3.33±1.50) vs. (4.74±1.57), P<0.01]. Conclusion  The morbidity rate of AF in the participants aged ≥60 years old in the community is relatively high with old average age, and the overall risk of stroke is high, however, the anticoagulation rate of AF is low. It is urgent to strengthen community management, and propaganda and education of AF.
2022 Vol. 31 (5): 315-318 [Abstract] ( 46 ) [HTML 1KB] [ PDF 1416KB] ( 467 )
319 Application of scatter point drifting method in rapid identification of second degree atrioventricular block complicating frequent premature beats
ZHAO Rui, JING Yongming, ZHANG Fangfang, GENG Yiming
We selected patients with second degree atrioventricular block (AVB) complicating frequent premature ventricular beats and junctional premature beats. Their characteristics of ECG scatter plot were analyzed, and analysis skills were summarized. There is an  analogy  between  the characteristic point set related to second degree AVBinduced long period and the homonymous one without long period. The former is equivalent to a drift from the latter. The drifting law of Lorenz scatter plot is as follows: the front period is extended and moves to the right, the back period is extended and moves up, and both of the front and back period extend to the upper right. The drifting law of  difference scatter plot is as follows: the front period is extended and moves to the left, the back period is  extended and moves up, and the middle period is extended and moves to the bottom right. The appearance of AVBinduced long period complicates the original scatter plot of arrhythmia. The scatter point drifting method serves as a “secret weapon” to identify these cases.
2022 Vol. 31 (5): 319-324 [Abstract] ( 25 ) [HTML 1KB] [ PDF 10011KB] ( 459 )
325 Application of chromatogram of ambulatory electrocardiography in patients with variant angina pectoris
ZHANG Fujun, ZHAN Yasha, LI Jingxiu, PENG Ding
Objective  To explore the value of chromatogram of ambulatory electrocardiography(AECG)  in diagnosing variant angina pectoris (VAP). Methods  Four typical VAP patients were selected and analyzed; chromatogram was utilized to accurately and quickly capture the ECG changes at its onset.Results  Changes of chromatographic strips of R, ST and T waves are all found in the four patients at the onset of VAP; EGG changes and arrhythmia occur in different leads when the left or right coronary artery is involved. Conclusion  AECG is an important detection method for diagnosing VAP. Reasonable use of chromatogram  helps to  quickly and accurately identify the ECG changes at the onset of VAP.
2022 Vol. 31 (5): 325-329 [Abstract] ( 45 ) [HTML 1KB] [ PDF 15551KB] ( 463 )
330 Diagnostic value of transcranial Doppler combined with head-up tilt test in orthostatic cerebral hypoperfusion syndrome patients
WANG Jiayu, WU Yueyang, ZHANG Jia, LIU Jiexin
Objective  To investigate the diagnostic value of transcranial Doppler (TCD) combined with head-up tilt test (HUTT) in patients with orthostatic cerebral hypoperfusion syndrome (OCHOs). Methods  We selected the patients going to hospital due to syncope or suspected orthostatic intolerance, and their etiology was considered as OCHOs. Cerebral blood flow parameters   and hemodynamic parameters of patients  were collected separately by TCD and HUTT, and healthy control group was set up. TCD cerebral blood flow parameters and HUTT hemodynamic parameters were compared between the OCHOs patients and the control group. Results  A total of 56 OCHOs patients (case group) and 21 healthy adults in the control group are enrolled. In terms of TCD cerebral blood flow parameters, compared with the supine position, the absolute values of the decrease of systolic,  end-diastolic and mean cerebral blood flow velocity in the case group are significantly higher than those in the control group during the tilt upright position; the absolute values of the increase of pulse index and circulation resistance index are also significantly higher than those in the control group (P<0.01). There is no significant difference in HUTT hemodynamic parameters between the two groups (P>0.05). The receiver operator characteristic curve is drawn. Compared with the supine position,  systolic,  end-diastolic and mean cerebral blood flow velocity in the case group decrease by 14.5, 9.5 and 13.5 cm/s, respectively during the tilt upright position. Their sensitivity is separately 94.6%, 87.5% and 91.1% while the specificity is separately 95.2%, 85.7% and 95.2% in diagnosing OCHOs (P＜0.01). Conclusion  TCD combined with HUTT plays an important role in  diagnosing OCHOs.
2022 Vol. 31 (5): 330-335 [Abstract] ( 47 ) [HTML 1KB] [ PDF 916KB] ( 524 )
336 Differential diagnostic value of DETERMINE score for right ventricular outflow tract ventricular premature contraction and  arrhythmogenic right ventricular cardiomyopathy
WANG Jun, XU Zongzheng, LI Qingzhu, WANG Xianghai, WANG Deguo
Objective  To investigate the value of DETERMINE score in differentiating right ventricular outflow tract premature ventricular contraction (RVOT-PVC) and arrhythmogenic right ventricular cardiomyopathy (ARVC). Methods  Twenty-five patients with ARVC and 59 patients with RVOT-PVC  were retrospectively analyzed. Their ECG parameters and characteristics of sinus rhythm were  compared. DETERMINE score was calculated based on the number of leads with pathological Q waves, fragmented QRS complex, and T wave inversion. Results  ARVC group in sinus rhythm has higher incidences of epsilon waves  (12.00% vs. 0, P<0.01), T wave inversion in leads V1-V3 (68.00% vs. 37.29%, P=0.010) and ventricular tachycardia with left bundle branch block morphology  (52.00% vs. 16.95%, P=0.001). The single ECG characteristic above is poor in identifying ARVC (sensitivity<70.0%). The DETERMINE score in the ARVC group is significantly higher than that in the RVOTPVC  group ［(5.80±2.56) vs. (0.58±1.22), P<0.01］. The sensitivity and specificity of higher DETERMINE score(>3) are separately 92.0% and 91.5% while positive and negative predictive values are 82.8% and 98.2%, respectively. Conclusion  Simple DETERMINE score can be utilized to differentiate ARVC from RVOT-PVC. The score system has certain clinical application value.
2022 Vol. 31 (5): 336-340 [Abstract] ( 31 ) [HTML 1KB] [ PDF 5107KB] ( 514 )
341 Impact on heart rate variability of patients with aortic valve stenosis after transcatheter aortic valve replacement
CHEN Simei, GUO Jincun, LIN Zhenguo, ZHOU Faguang, YE Mingcai
Objective  To explore the relativity between heart rate variability (HRV), related indexes of Lorenz scatter plot, and cardiac function in patients with aortic valve stenosis after transcatheter aortic valve replacement(TAVR). Methods  Patients with aortic valve stenosis after TAVR were enrolled in our study. The time domain indexes of HRV (SDNN, SDANN, rMSSD, pNN50 and HRV triangular index), and frequency domain indexes of HRV (HF, LF and LF/HF) were compared before and 3 months after surgery. We compared the morphology of Lorenz scatter plot,and its projection length of L in the x-axis and dispersion of D in the y-axis before and after surgery. The indexes of cardiac function including LVEF, left ventricular end-diastolic diameter (LVEDD) and left ventricular endsystolic diameter (LVESD), and NT-proBNP level were compared before and after surgery. ResultsThe values of SDNN, SDANN, HRV triangular index and L -are higher after TAVR while  D value is lower after  surgery, with statistically significant differences (P＜0.01). LF and HF show a tendency to improve after  surgery, but there is no statistically significant difference as compared to those before  surgery. The time  domain indexes of HRV are significantly improved after TAVR; parts of HRV indexes are positively correlated with LVEF, and negatively correlated with NT-proBNP level, LVEDD and LVESD. Conclusion  The functional status of the autonomic nervous system is improved in patients with aortic valve stenosis  after TAVR. HRV changes are associated with cardiac function.
2022 Vol. 31 (5): 341-345 [Abstract] ( 22 ) [HTML 1KB] [ PDF 874KB] ( 485 )
346 Comparative analysis of heart rate variability in patients with discordant or concordant left bundle branch
LI Yu, LIN Suhua, YANG Lijuan
Objective  To analyze the changes of cardiac autonomic function in patients with discordant or concordant left bundle branch block (LBBB). Methods  A total of 112 patients manifested by LBBB in ECG were selected for ambulatory electrocardiography examination. There were 80 patients with discordant LBBB (discordant group) and 32 patients with concordant LBBB (concordant group). We analyzed heart rate variability (HRV) time domain indexes of SDNN, SDANN and ASDNN, and compared the incidence of HRV decrease between the two groups. Results  The SDNN, SDANN and ASDNN values of the discordant group are significantly lower than those of the concordant group (P＜0.05). In the concordant group, HRV indexes of 6 cases (18.75%) are reduced. In the discordant group, HRV indexes of 36 cases (45.00%) are reduced. The incidence of HRV decrease in the discordant group is significantly higher than that in the concordant group (P＜0.05). Conclusion  Compared with the concordant group, the patients in the discordant group are more prone to declined cardiac autonomic regulation function and instable electrical activities, which leads to a higher risk of cardiovascular events. Clinicians should pay more attention to making timely diagnosis,  treatment and follow-up for patients with discordant LBBB to reduce complications and mortality.
2022 Vol. 31 (5): 346-348 [Abstract] ( 31 ) [HTML 1KB] [ PDF 876KB] ( 562 )
349 Clinical significance of ST-segment  mirror-image change in patients with acute myocardial infarction complicating complete right bundle branch block
REN Xiujuan, HUANG Xinmiao, WANG Qian
Objective  To investigate the characteristics of ST-segment mirror-image change (MC) in electrocardiogram(ECG) among patients with acute myocardial infarction (AMI) complicated by complete right bundle branch block (CRBBB), and their correlation with culprit vessel location. Methods  We retrospectively collected 82 patients diagnosed with AMI complicating CRBBB by ECG. They were divided into MC group (55 cases) and non-MC group (27 cases) according to the presence or absence of ST-segment MC.The clinical data and coronary angiography results of the two groups were analyzed.  Fifty cases with coronary artery stenosis in the MC group were   further divided into two subgroups: the inferior wall AMI group (16 cases) and the anterior wall  AMI group (34 cases); the distribution of the infarctionrelated  vessels was analyzed. Results  The proportion of patients presenting as chest tightness and chest pain lasting no more than 6 hours in the MC group is significantly higher than that in the non-MC group (P<0.01). In the inferior wall AMI patients with ST-segment depression in lead Ⅰ, aVL and V1-V6, those with  right coronary lesions account for 90.9% while those with multivessel lesions account for 63.6%. All the anterior wall AMI patients with ST-segment elevation in inferior wall leads have anterior descending branch lesions, and 85.7% of them are multivessel involved. Conclusion  The earlier the ECG is recorded after AMI, the higher the incidence of MC. Based on MC, infarctionrelated  vessels can be predicted, whether the lesion involves a single vessel or multiple coronary arteries can be determined, and the myocardial infarct size can be assessed.
2022 Vol. 31 (5): 349-354 [Abstract] ( 21 ) [HTML 1KB] [ PDF 5066KB] ( 516 )
355 Comparison of diagnostic efficiency among different ECG voltage criteria for left ventricular hypertrophy
TANG Wei, OUYANG Weina, ZENG Chenhui, FAN Yongmei
Objective  To compare the clinical value of different voltage criteria of 12-lead routine ECG in diagnosing left ventricular hypertrophy (LVH) related to primary hypertension, and to explore a method for improving the diagnostic efficiency of ECG. Methods  A total of 161 patients with primary hypertension admitted to our hospital were selected. They all underwent examinations of echocardiography and 12-lead routine ECG, and these results were comparatively analyzed. According to the left ventricular mass index (LVMI), these patients were divided into LVH positive group (67 cases) and LVH negative group (94 cases). The sensitivity, specificity and Youden index of Sokolow, Cornell and Peguero-Lo Presti criteria, and the combined regimen were calculated based on ECG data, and compared between the genders. Results  The values of left ventricular mass and LVMI in the LVH positive group are significantly higher than those in the LVH negative group with statistically significant differences (P<0.01).  The sensitivity of Peguero-Lo Presti criterion is higher than that of the other two criteria, but the specificity is lower. Compared with single diagnostic criterion, the sensitivity of the combined regimen is the highest while its specificity is the lowest. Either in male or female patients, the Youden index of the combined regimen is the highest, followed by the index of Peguero-Lo Presti criterion,  and  the other two criteria. Conclusion  Peguero-Lo Presti criterion is more recommended in diagnosing LVH with single diagnostic criterion. The combined regimen of the three criteria helps to increase the detection rate of LVH by ECG, which provides certain clinical application value.
2022 Vol. 31 (5): 355-360 [Abstract] ( 21 ) [HTML 1KB] [ PDF 928KB] ( 496 )
361
2022 Vol. 31 (5): 361-364 [Abstract] ( 25 ) [HTML 1KB] [ PDF 11074KB] ( 485 )
365
2022 Vol. 31 (5): 365-367 [Abstract] ( 19 ) [HTML 1KB] [ PDF 20447KB] ( 565 )
368
2022 Vol. 31 (5): 368-370 [Abstract] ( 33 ) [HTML 1KB] [ PDF 12017KB] ( 553 )
371
2022 Vol. 31 (5): 371-374 [Abstract] ( 31 ) [HTML 1KB] [ PDF 14547KB] ( 514 )
374
2022 Vol. 31 (5): 374-374 [Abstract] ( 15 ) [HTML 1KB] [ PDF 597KB] ( 420 )
375
2022 Vol. 31 (5): 375-377 [Abstract] ( 29 ) [HTML 1KB] [ PDF 3263KB] ( 479 )
377
2022 Vol. 31 (5): 377-377 [Abstract] ( 20 ) [HTML 1KB] [ PDF 827KB] ( 539 )
378
2022 Vol. 31 (5): 378-380 [Abstract] ( 32 ) [HTML 1KB] [ PDF 3197KB] ( 529 )
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