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JOURNAL OF PRACTICAL ELECTROCARDIOLOGY
 
2022 Vol.31 Issue.6
Published 2022-12-28
378
2022 Vol. 31 (6): 378-378 [Abstract] ( 16 ) [HTML 1KB] [ PDF 62185KB] ( 610 )
379
2022 Vol. 31 (6): 379-379 [Abstract] ( 15 ) [HTML 1KB] [ PDF 10448KB] ( 458 )
380
2022 Vol. 31 (6): 380-380 [Abstract] ( 14 ) [HTML 1KB] [ PDF 329KB] ( 472 )
381 Research progress of artificial intelligence-enabled ECG in diagnosing coronary artery diseases
WEI Ziyu, LIU Xingpeng
Electrocardiogram (ECG) plays an important role in the diagnosis of cardiovascular diseases, but accurate ECG interpretation requires solid foundation of professional knowledge and rich clinical experience of physicians. Artificial intelligence (AI) has been one of hot research topics at present. Loads of research is devoted to developing AI models based on ECG, trying to elevate the reliability of ECG in diagnosing coronary artery diseases. This review introduces the important advances of AIenabled ECG in the detection of coronary artery lesions, and  discusses its clinical significance, development prospects and limitations.
2022 Vol. 31 (6): 381-385 [Abstract] ( 37 ) [HTML 1KB] [ PDF 994KB] ( 974 )
386 Application of artificial intelligence in diagnosis and treatment of hypertension
WANG Lina, LEI Jingshu, TAN Chen
The application of artificial intelligence (AI) and machine learning develops new pathways and new modalities for the diagnosis and treatment of hypertension. This paper reviews the progress of AI applied in aspects of hypertension prediction, assessment, and assistance for treatment decisionmaking. In terms of hypertension prediction, AI could build hypertension risk prediction models based on traditional hypertension risk factors combined with imaging, genomics and other factors, which improves the early diagnosis rate of hypertension. The AI expert system identifies complex etiology of hypertension, which makes up for the limitations of clinicians in diagnosis. In terms of hypertension assessment, the prediction model of hypertension complication constructed by AI could predict  complications in the heart and the brain blood vessel, and screen out highrisk population for early intervention. In terms of hypertension treatment, the application of clinical decisionmaking model, drug factor analysis model, monitoring and early warning system, humancomputer interaction, etc. could improve the accuracy, timeliness and patient compliance of hypertension treatment, and assist clinicians in making optimal treatment decisions. The exploration of AI in the field of hypertension diagnosis and treatment has established a new model for the chronic disease management of hypertension.
2022 Vol. 31 (6): 386-391 [Abstract] ( 35 ) [HTML 1KB] [ PDF 907KB] ( 783 )
392 Progress of ECGbased machine learning applied in predicting cardiovascular diseases
WANG Lei, DANG Shipeng, WANG Ruxing
Electrocardiogram (ECG) is an electrical signal of the heart recorded from the body surface by ECG recorder, which is an important tool for diagnosing cardiovascular diseases. As an important branch of artificial intelligence, machine learning can obtain information features from large ECG data sets to make accurate classification, diagnosis and interpretation of ECG,  and its diagnostic efficacy even reaches the level of medical experts.  Machine learning has been widely used in clinical practice. In recent years, it has been found that machine learning  also can effectively extract features in ECGs  that cannot be recognized by human eyes  to predict unidentified cardiovascular diseases such as left ventricular systolic dysfunction, asymptomatic atrial fibrillation and paroxysmal supraventricular tachycardia. As an important algorithm of machine learning, deep learning represented by convolutional neural network  also can make disease prediction more accurate. This review mainly summarizes the progress of ECGbased machine learning applied  in predicting cardiovascular diseases.
2022 Vol. 31 (6): 392-398 [Abstract] ( 58 ) [HTML 1KB] [ PDF 929KB] ( 840 )
399 Study on an  algorithm for detecting QRS complex from ECG signals
FAN Minghui, WANG Min, CHEN Liangji, WANG Lianghong, HUANG Baozhen, WANG Xinkang
Electrocardiogram(ECG) monitoring is a routine monitoring method in clinical practice. By observing ECG activities and ECG waveform changes, myocardial damage, myocardial ischemia and electrolyte disorder could be detected.  It is clinically significant to detect QRS complex in ECG. This paper proposes an algorithm for QRS complex detection using an adaptive threshold method based on window maximum or minimum value method，which includes detection of R-wave morphology in ECG, and verification of R-wave location accuracy rate (97.63%) by MIT-BIH arrhythmia database. On the basis of R-wave detection, the maximum or minimum value method and slope limit method are used to search for Q- and S- wave. After QRS complex positioning is completed,  P- and T- wave are detected, and located according to their morphological characteristics.
2022 Vol. 31 (6): 399-404 [Abstract] ( 29 ) [HTML 1KB] [ PDF 4056KB] ( 630 )
405 Progress of catheter ablation in treating ventricular tachycardia caused by nonischemic cardiomyopathy
JIANG Wei, ZHENG Qiangsun
The treatment of ventricular tachycardia caused by nonischemic cardiomyopathy (NICM-VT) is challenging in clinical practice, however, the related clinical data of catheter ablation for NICM-VT are limited. This paper reviews the progress of catheter ablation for NICM-VT from three aspects: clinical efficacy, mapping strategy, and future prospect.
2022 Vol. 31 (6): 405-409 [Abstract] ( 26 ) [HTML 1KB] [ PDF 950KB] ( 528 )
410 Efficacy of renal  denervation  guided by threedimensional mapping system on resistant hypertension
JIN Xiaoqi, LIU Yanqi, FAN Tao, LU Min, ZHU Zongcheng, ZHENG Guanqun, CHEN Zhixian, SHENG Xiaodong
Objective  To investigate the clinical efficacy and safety of renal   denervation (RDN) on resistant hypertension by using pressure sensing cold salineirrigated catheter. Methods  We selected 46 RH patients. All of them underwent RDN using pressure sensing cold salineirrigated catheter guided by  three-dimensional mapping system CARTO. We observed the changes of blood pressure, X-ray exposure, the average  operation time,  the average discharge time,  serum creatinine, glomerular filtration rate (GFR), renin, angiotensin Ⅱ, aldosterone and the number of antihypertensive drugs taken by these patients before and after the operation. Sixmonth follow-up was performed. ResultsThere is no renal artery traumatic complication during the operation or 6 months after the operation, and 4 cases are found postoperative local femoral artery hematoma. Blood pressure 30 min before the operation, during the operation and the first day after the operation vary statistically significantly (P＜0.01). The 24hour mean systolic blood pressure [（138.42±7.62）mmHg vs.(182.46±11.25）mmHg, P＜0.01] and diastolic blood pressure [(79.23±5.66)  mmHg vs.(95.52±7.28) mmHg，P＜0.01] are significantly decreased 6 months after the operation. The levels of renin, angiotensin Ⅱ and aldosterone  6 months after the operation are significantly lower than before (P＜0.05), however, the serum creatinine level and the number of patients at the estimate GFR classification do not vary significantly  (P＞0.05). The number of orallytaken antihypertensive drugs significantly decrease 6 months after the operation [(3.08±0.79) vs. (4.42±1.16), P＜0.05] with an average reduction of 1.34. ConclusionGuided by CARTO system, RDN therapy using pressure sensing cold salineirrigated  catheter is effective and safe for RH patients.
2022 Vol. 31 (6): 410-415 [Abstract] ( 21 ) [HTML 1KB] [ PDF 2000KB] ( 566 )
416 Correlation between recurrence of atrial fibrillation after cryoballoon ablation, and perioperative atrial  tachyarrhythmia and cardiac troponin
CHU Ruirui, WANG Yuesong, DONG Xuebin, SHAO Xuwu, WANG Xuezhong
Objective  To investigate the correlation between the recurrence of atrial fibrillation (AF) after secondgeneration cryoballoon ablation (CBA), and perioperative atrial tachyarrhythmia (AT) and cardiac troponin I (cTnI). Methods  Forty-five AF patients undergoing CBA were enrolled, and divided into recurrence group and nonrecurrence group according to the presence or absence of AT after the ablation blanking period (3 months). Clinical data, laboratory examination results, surgical parameters, complications and follow-up data of the two groups were comparatively analyzed. Results  (ⅰ) At a mean follow-up period  of (14.3±3.7) months after ablation, sinus rhythm still maintains in 31 patients of the non-recurrence group while AF recurs in 14 patients of the recurrence group, with a success rate of 68.9%. Perioperative AT occurs in 5 cases (16.1%)  of the non-recurrence  group and 10 (71.4%) cases of the  recurrence group, respectively, with statistically significant difference(P<0.01). However, binary Logistic regression analysis shows no  significant correlation between perioperative AT and AF recurrence after ablation (OR=595, P>0.05). (ⅱ) The cTnI level 6 hours after operation in the recurrence group is lower than that in the non-recurrence group[(7.4±1.9) ng/mL vs. (11.8±3.1)ng/mL, P<0.01]. Regression analysis suggests a correlation between cTnI level 6 hours after ablation and postoperative  AF recurrence (OR=0.56, P=0.034).  (ⅲ) Subgroup analysis reveals that among 12 patients with persistent AF and 33 patients with paroxysmal AF, AF separately recurs in 5 (41.7%) and 9 (27.3%) cases after CBA, without statistically significant difference (P>0.05). Conclusion  CBA is safe and effective in treating both paroxysmal and persistent AF. Monitoring for postoperative cTnI level helps to rapidly predict the recurrence of AF after CBA, and provide clinical references for a secondary ablation.
2022 Vol. 31 (6): 416-421 [Abstract] ( 34 ) [HTML 1KB] [ PDF 896KB] ( 564 )
422 Hemodynamic characteristics of patients with neurogenic orthostatic hypotension in head-up tilt test
WANG Jiayu， WU Yueyang， ZHANG Jia， LIU Jiexin
Objective  To investigate the hemodynamic parameter characteristics of patients with neurogenic orthostatic hypotension (nOH) in the head-up tilt test (HUTT). Methods  Patients diagnosed with typical nOH in the syncope clinic of our hospital were selected. Hemodynamic parameters of these patients during HUTT including systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate, stroke volume, cardiac output and systemic vascular resistance in the supine and tilted upright positions were collected, and  retrospectively analyzed. The patients were divided into two groups according to age (age≥60 years group with 46 patients and age<60 years group with 36 patients ). The characteristics of the above hemodynamic parameters were compared between the two groups in the supine position, and at the 1st, 2nd, and 3rd minute in tilted upright position. Results  For all patients, systemic vascular resistance does not increase from the supine to the tilted upright position. The increase of heart rate,  the decrease of stroke volume and their degree of variability from the supine to the titled upright position are significantly lower in patients≥60 years  than those in patients <60 years.  Conclusion  In patients with typical nOH, the increase of systemic vascular resistance from the supine position to the tilted upright position is impaired. Among these  patients <60 years, heart rate increases and stroke volume decreases significantly in the tilted upright position.
2022 Vol. 31 (6): 422-428 [Abstract] ( 30 ) [HTML 1KB] [ PDF 986KB] ( 539 )
429 Correlation between ECG QRS amplitude parameters, and blood pressure and left ventricular hypertrophy in essential hypertensives with left ventricular hypertrophy
HUANG Mujian, LIN Yujuan, CHEN Dongming, LIANG Huajing, LIN Yufang, LIU Jing
Objective  To explore the correlation between ECG QRS amplitude parameters, and blood pressure and left ventricular hypertrophy (LVH) in patients with essential hypertension with left ventricular hypertrophy (EH-LVH). Methods   A total of 126 patients with EH-LVH were enrolled as research objects. They were divided into mild group (n=51), moderate group (n=47) and severe group (n=28) according to the degree of  LVH. We compared the blood pressure, LVH indexes [left ventricular posterior wall thickness (LVPWT), interventricular septal thickness (IVST) and left ventricular mass index (LVMI)], and ECG QRS amplitude parameters [SVl+RV5  amplitude, the sum of QRS  amplitudes of all leads (12∑QRSWA), RⅠ+SⅢ amplitude\] among the three groups. The correlation between QRS amplitude parameters, and blood pressure and LVH indexes was analyzed while the relationship between QRS amplitude parameters and the degree of LVH was also analyzed. Results  Systolic blood pressure (SBP) and diastolic blood pressure (DBP) in the severe group are significantly higher than those in the mild and moderate groups while these parameters in the moderate group are also significantly higher than those in the mild group (P<0.05). The LVPWT, IVST and LVMI values of the severe group are significantly higher than those of the mild and moderate groups while the above indexes of the moderate group are also significantly higher than those of the mild group (P<0.05). The  RⅠ+SⅢ amplitude, 12∑QRSWA and SVl+RV5 amplitude in the severe group are all significantly lower than those in the mild and moderate groups while these amplitudes of the moderate group are also significantly lower than those in the mild group (P<0.05). Pearson correlation analysis shows that the  RⅠ+SⅢ amplitude, 12∑QRSWA and SVl+RV5 amplitude are  all negatively correlated with DBP, SBP, LVPWT,  IVST and LVMI (P<0.05). The  RⅠ+SⅢ amplitude, 12∑QRSWA and SVl+RV5 amplitude  are all correlated with the degree of LVH (P<0.05). Conclusion  The QRS complex in ECGs of EH-LVH patients are obviously abnormal, presenting as the decrease of the   RⅠ+SⅢ amplitude, 12∑QRSWA and SVl+RV5 amplitude, which are closely related to blood pressure and LVH indexes. The degree of LVH could be evaluated by measuring  QRS complex in the ECG of EH-LVH patients.
2022 Vol. 31 (6): 429-433 [Abstract] ( 25 ) [HTML 1KB] [ PDF 905KB] ( 459 )
434 Body surface ECG clues for inherited arrhythmia
SHI Bingshuo, LI Guangping
Inherited arrhythmia(IA) is a general term for a class of inherited diseases characterized by the onset of various arrhythmias, mainly including inherited ion channelopathy and inherited structural heart disease. Its risk of sudden death is high. At present, genetic testing for IA has relatively high false positive rate, or could only indicate “mutations with unclear significance”. Early identification and diagnosis of IA, and appropriate intervention are extremely important to improve prognosis. By  body surface ECG examinations, we can directly observe the changes of electrical activities in the heart of IA patients, and identify special ECG manifestation patterns, so as to provide clues for its early  diagnosis. Combined with  domestic and foreign literatures published in recent years, this paper systematically summarizes the body surface  ECG characteristics of inherited ion channelopathies such as Brugada syndrome, long QT syndrome and short QT syndrome, as well as the body surface ECG features of inherited structural heart diseases including arrhythmogenic right ventricular cardiomyopathy, hypertrophic cardiomyopathy, dilated cardiomyopathy and cardiac amyloidosis. It aims to provide references for early diagnosis of IA.
2022 Vol. 31 (6): 434-440 [Abstract] ( 17 ) [HTML 1KB] [ PDF 4997KB] ( 567 )
441
2022 Vol. 31 (6): 441-444 [Abstract] ( 27 ) [HTML 1KB] [ PDF 12601KB] ( 540 )
445
2022 Vol. 31 (6): 445-447 [Abstract] ( 26 ) [HTML 1KB] [ PDF 2910KB] ( 500 )
448
2022 Vol. 31 (6): 448-451 [Abstract] ( 29 ) [HTML 1KB] [ PDF 13214KB] ( 529 )
452
2022 Vol. 31 (6): 452-455 [Abstract] ( 33 ) [HTML 1KB] [ PDF 8615KB] ( 481 )
454
2022 Vol. 31 (6): 454-454 [Abstract] ( 16 ) [HTML 1KB] [ PDF 951KB] ( 429 )
455
2022 Vol. 31 (6): 455-455 [Abstract] ( 16 ) [HTML 1KB] [ PDF 582KB] ( 466 )
456
2022 Vol. 31 (6): 456-456 [Abstract] ( 23 ) [HTML 1KB] [ PDF 773KB] ( 438 )
457
2022 Vol. 31 (6): 457-457 [Abstract] ( 18 ) [HTML 1KB] [ PDF 773KB] ( 434 )
458
2022 Vol. 31 (6): 458-458 [Abstract] ( 20 ) [HTML 1KB] [ PDF 260KB] ( 436 )
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