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JOURNAL OF PRACTICAL ELECTROCARDIOLOGY
 
2023 Vol.32 Issue.2
Published 2023-04-19
74
2023 Vol. 32 (2): 74-74 [Abstract] ( 23 ) [HTML 1KB] [ PDF 85289KB] ( 608 )
75
2023 Vol. 32 (2): 75-75 [Abstract] ( 23 ) [HTML 1KB] [ PDF 10416KB] ( 569 )
76
2023 Vol. 32 (2): 76-76 [Abstract] ( 22 ) [HTML 1KB] [ PDF 339KB] ( 556 )
77  Analysis of efficacy, safety and recurrence factors of cryoballoon ablation for atrial fibrillation
ZHAO Xiaoxi, LI Kulin, YOU Huayan, ZHENG Jie, DANG Shipeng, LIU Xiaoyu, WANG Ruxing
 Objective  To investigate the efficacy, safety and recurrence risk factors of cryoballoon ablation for atrial fibrillation(AF). Methods  One hundred and fourteen patients were divided into paroxysmal AF group (n=61) and persistent AF group (n=53). Circumferential pulmonary vein cryoablation (CPVC) was performed in all the patients, and  persistent AF patients underwent pulmonary vein antrum cryoablation in addition. The operation  time, X-ray exposure time, immediate and long-term success rate of CPVC, and procedurerelated complications were analyzed in the two groups. The recurrence rate and related recurrence factors of AF within one year after operation were compared between the two groups.Results  The immediate success rates of pulmonary vein isolation are both 100% in the two groups. There are significant differences of the operation time,  X-ray exposure time and intraoperative heparin dosage between the two groups (P<0.05). No serious complication is found in either of the two groups. After 12 months of follow-up, the success rates of AF ablation in the paroxysmal and persistent AF groups are 85.25% and 81.13%, respectively (P=0.62). AF duration and left atrial diameter (LAD) are associated with the recurrence of persistent AF. Conclusion  Cryoballoon ablation is both effective and safe for patients with paroxysmal and persistent AF. AF duration and LAD  before ablation are  independent risk factors for postoperative recurrence in  persistent AF patients.

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2023 Vol. 32 (2): 77-82 [Abstract] ( 44 ) [HTML 1KB] [ PDF 1186KB] ( 709 )
83  Analysis of pacemaker electrocardiogram with abnormal pacemaker channel markings
DAI Jing, LI Zelin, YANG Yali, WU Yan, BI Yanfang, LI Juan, LU Xi
 The ambulatory electrocardiography pacemaker channel marking brings much convenience to the analysis of pacemaker electrocardiograms. However, abnormal marking (missed or incorrect marking) may lead to misdiagnosis.  This article selects three cases with abnormal  pacemaker channel markings, and determines  basic functions of the pacemaker and  marking situation of the pacemaker channel by analyzing the time interval, timing method, AV interval changes and graphic features of the pacemaker. Based on the marking situation of the pacemaker channel, it is possible to quickly get familiar with the pacemaker functions and identify the pacemakers brand in order to  provide references for  postoperative management of clinical pacemaker implantation.

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2023 Vol. 32 (2): 83-87 [Abstract] ( 52 ) [HTML 1KB] [ PDF 13136KB] ( 627 )
88
2023 Vol. 32 (2): 88-90 [Abstract] ( 40 ) [HTML 1KB] [ PDF 5032KB] ( 612 )
91 Accuracy evaluation of exercise stress test and related parameters in diagnosing coronary heart disease 
Accuracy evaluation of exercise stress test and related parameters in diagnosing coronary heart disease [J]. JOURNAL OF PRACTICAL ELECTROCARDIOLOGY, 2023,32(2): 91-95>')" href="#"> ZHAO Rui，WU Lei，LI Guangping，CHEN Yuanlu
 Objective  To analyze the value of exercise stress test (EST) and related parameters on diagnosing coronary heart disease (CHD), and to explore the influence of individual factors [such as age, sex and body mass index(BMI)] on its diagnostic accuracy. Methods  We selected 439 patients who had performed treadmill or bicycle exercise test and coronary angiography (CAG). There were 318 CAG positive patients and 121 negative cases among those patients. The sensitivity and specificity of their EST results were observed. All the enrolled patients were grouped according to age, sex, BMI, the number of lesioned vessels, the lesioned vessels whether including the left main artery (LM) and(or) the proximal branch of the left anterior descending artery (LAD1), and the presence or absence of ventricular arrhythmias. The reference value of EST parameters on the definite diagnosis of CHD was analyzed in each group.Results  The sensitivity and specificity of EST in diagnosing CHD is separately 81.22% and 34.71%. The true positive rate of the multibranch coronary artery lesion group is significantly higher than that of the singlebranch vascular lesion group (88.12% vs. 73.96%, P=0.011), however its false negative rate is lower than that of the singlebranch vascular lesion group (11.88% vs. 26.04%, P=0.011). The true positive rate of the LM and(or) LAD1 lesion group does not vary significantly from that of the nonLM and(or) LAD1 lesion group (76.92% vs. 8602%, P=0.103). In the EST true positive group, the peak heart rate (HR) during exercise, attainment rate of target HR, and 1 and 2 min HR during the recovery period are all lower than those in the false positive group (P＜0.05). Among the true positive cases, the peak HR during exercise, attainment rate of target HR, and 1 and 2 min HR during the recovery period of the singlebranch vascular lesion group are all higher than those of the multibranch coronary artery lesion group (P＜0.05). The incidence of ventricular arrhythmias of the true positive group is significantly higher than that of the false positive group (63.06% vs. 18.02%, P=0.048) and the false negative group (63.06% vs. 7.21%, P=0.046). Conclusion  EST has some diagnostic value for CHD. For the elderly overweight males with abnormal peak HR during exercise, attainment rate of target HR, and 1 and 2 min HR during the recovery period, and with ventricular arrhythmias, positive EST results suggest further CAG examination. For the patients with high suspicion of CHD and negative EST results, the related individual factors should be comprehensive analyzed.

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2023 Vol. 32 (2): 91-95 [Abstract] ( 42 ) [HTML 1KB] [ PDF 916KB] ( 658 )
96 Changes  and their significance  of serum levels of Wnt-1, DKK-1 and red cell distribution width in patients with coronary heart disease
LIU Tongtong, LIN Quanqiang, DONG Shasha, XU Xiuxiu, ZHANG Chen, ZHAO Jian
Objective  To explore the correlation between Wnt-1, Dickkopfassociated protein 1 (DKK-1), red cell distribution width (RDW) and coronary heart disease (CHD). To analyze the inherent relationship among Wnt-1, DKK-1 and RDW, and their joint diagnostic value on CHD. Methods  We selected 188 inpatients who had undergone coronary angiography (CAG). They were divided into  CHD group (n=128) and non-CHD group(n=60) according to CAG results. The clinical data were collected, and the levels of Wnt-1, DKK-1 and RDW were compared between the two groups. Results  In the CHD group, the serum level of Wnt-1 decreases while the levels of DKK-1 and RDW increase. There are statistically significant differences of the above indexes between the two groups (P＜0.05). The levels of Wnt-1, DKK-1 and RDW do not vary significantly among the three subgroups of the CHD group, that is, acute myocardial infarction group (30 cases), unstable angina pectoris group (54 cases) and stable angina pectoris group (44 cases) (P＞0.05). Logistic regression analysis reveals that OR values of Wnt-1, DKK-1 and RDW are separately 0.947, 1.023 and 64.995. In the joint diagnosis of CHD, the area under the receiver operating characteristic curve of the three indexes is 0977 (95%CI 0958-0997), with a sensitivity of 92.2% and a specificity of 96.7%. Conclusion  DKK-1 and RDW may be independent risk factors for CHD; Wnt-1 is probably its independent protective factor. The joint diagnostic value of Wnt-1, DKK-1 and RDW for CHD is higher than that of any of the above indexes alone.
2023 Vol. 32 (2): 96-101 [Abstract] ( 45 ) [HTML 1KB] [ PDF 2117KB] ( 677 )
102
Diagnostic value of high right precordial lead for Brugada syndrome
Diagnostic value of high right precordial lead for Brugada syndrome[J]. JOURNAL OF PRACTICAL ELECTROCARDIOLOGY, 2023,32(2): 102-106>')" href="#"> SHEN Xiulin, LIU Ming, LV Hang, ZHU Liu
 Objective  To explore the diagnostic value of detecting type Ⅰ Brugada wave from high right precordial lead in the diagnosis of Brugada syndrome (BrS). Methods  Retrospective analysis was performed on 28 patients with Brugada wave or suspected Brugada wave in  routine ECG examination. High right precordial lead was additionally applied in 10 of them   (experimental group) while the remained 18 cases only performed routine ECG examination (control group). The incidence of type Ⅰ Brugada wave was compared between the two groups. Results  Type Ⅰ Brugada wave is detected in 6 patients of the experimental group, with a detection rate of 60.0% while Brugada wave is found in 4 cases of the contol group, with a detection rate of 22.2%. Conclusion  The detection rate of type Ⅰ Brugada wave is higher with  high right precordial lead, which provides a necessary condition for BrS diagnosis.

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2023 Vol. 32 (2): 102-106 [Abstract] ( 48 ) [HTML 1KB] [ PDF 5700KB] ( 585 )
107  Study on normal reference range of electrocardiogram in healthy neonates
LI Juan, LI Xiaomin, ZHANG Wei, HU Shuang, ZHANG Yanmin
 Objective  To establish the normal reference range of electrocardiogram (ECG) in healthy neonates with different sexes. Methods  We recorded and measured routine 12-lead synchronous ECGs of 906 healthy neonates (including 474 males and 432 females), and made statistical analysis of the collected data. We  obtained the normal  reference  ranges of the related ECG indexes  (including heart rate, mean QRS axis, P-wave duration, PR interval, P-wave amplitude, QRS duration, QRS amplitude, QTc, T-wave amplitude, etc.), and the morphologies of P-wave, QRS complex and T-wave in the neonates with different sexes. Results  There are significant differences of P-wave amplitude in leads Ⅰ,Ⅱ, aVL, aVR, V2 and  V4-V6, QRS duration in leads Ⅰ,Ⅱ,Ⅲ, aVR, aVL, aVF, V1 and V3-V6, QRS amplitude in leads Ⅲ, aVR, aVF and V1-V4, T-wave amplitude in leads aVR, aVL and V4-V6, QRS complex morphology in leads Ⅰ,Ⅱ, aVR, aVF, V1 and V3-V6, and T-wave morphology in leads Ⅰ, aVL and V6 between the male and female neonates (P<0.05). Conclusion  The normal  reference ranges of ECG indexes recorded by 12lead synchronous ECGs in healthy neonates are different between the sexes.

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2023 Vol. 32 (2): 107-114 [Abstract] ( 43 ) [HTML 1KB] [ PDF 875KB] ( 734 )
115 Relativity between glucose-regulated protein 94, transforming growth factor-β1 and prognosis of patients with atrial fibrillation
LU Qiao, ZHANG Xianlin, WANG Hongju, HUANG Yuli, SHI Xiaojun, LI Miaonan, ZHANG Heng
Objective  To explore the predictive value of glucose-regulated protein 94 (GRP94) and transforming growth factor-β1 (TGF-β1) levels for  long-term recurrence events in patients with atrial fibrillation (AF) after ablation. Methods  A total of 202 inpatients undergoing radiofrequency ablation for AF were selected and uniformly attributed to AF group. They were further divided into paroxysmal AF group (n=132) and persistent AF group (n=70) according to the occurrence time and duration of AF. Healthy subjects with sinus rhythm and  previously without AF rhythm were selected as control group (n=55). Serum GRP94 and TGF-β1 levels were measured by enzyme linked immunosorbent assay and the enrolled patients’ baseline data were collected. After discharge, patients with AF were followed up in the outpatient department or by telephone. Receiver operating characteristic curve and Kaplan-Meier survival analysis were used to evaluate the value of serum GRP94 and TGF-β1 levels in predicting long-term recurrence events in AF patients after ablation. Results  Serum GRP94 and TGF-β1 levels of the control group, paroxysmal AF group and persistent AF group increase in turn. Binary Logistic regression analysis suggests that serum TGF-β1, GRP94 and body mass index are independent risk factors for AF. Spearman correlation analysis shows a positive correlation between serum GRP94 and TGF-β1 levels in AF patients. The TGF-β1 level of the recurrence group is higher than that of the non-recurrence group while the GRP94 level of the recurrence group is lower than that of the non-recurrence group. Binary Logistic regression analysis shows that TGF-β1 is an independent risk factor for postoperative recurrence of AF while GRP94 is an independent protective factor. Analysis of KaplanMeier curve shows that AF patients with high GRP94 level and low TGF-β1 level have a lower risk of recurrence after ablation, and longer duration without recurrence. Conclusion  GRP94 and TGF-β1 levels are closely related to AF, which probably provides references for the early identification, diagnosis and   prevention of recurrent AF after operation.
2023 Vol. 32 (2): 115-122 [Abstract] ( 35 ) [HTML 1KB] [ PDF 3808KB] ( 606 )
123 Analytical strategies for ECG scatter plot：Differential method  of constants and variables
JING Yongming, SHEN Jihong, GENG Yiming, NIE Liantao
Objective  To explore the effect of the constant and variable nature of RR interval on the position and trend of ECG scatter plot, and to summarize the application and analytic techniques of differential method of constants and variables in rapid analysis of ambulatory electrocardiography (AECG). Methods  Combined with the RR interval characteristics of classic cases such as premature ventricular contraction (PVC), consecutive PVC and  atrial premature beats, we analyzed the relationship between the position and trend of the characteristic  point set, and the constant and variable nature of RR interval. The analytical strategy of differential method of constants and variables were summarized. Results  In the time scatter plot, when RR interval is a constant, the trend is horizontal (such as NV, VV layer, etc.); when RR interval is a variable, the scatter plot is manifested by fluctuating up and down (such as NN, SN, VN layer, etc.). In the Lorenz scatter plot, when the abscissa is a constant, the characteristic point set is vertically distributed (such as NVN, VVN point set, etc.); when the ordinate is a constant, the characteristic  point set is horizontally distributed (such as NNV, VNV point set, etc.); when the abscissa and ordinate are both constants, the  distribution of the characteristic  point set is localized  (such as NVV, VVV point set, etc.). When the abscissa and ordinate are both variables, the characteristic  point set has a oblique distribution (such as VNN, NNN point set, etc.), and the slope of its principal axis depends on the ratio of the coefficients of the two variables according to the principal of the differential calculus. Conclusion  The constant and variable nature of RR interval determines the position and trend of ECG scatter plot. The constant and variable rapidly identified by scatter plot technique can reveal parts of the electrophysiological mechanism of arrhythmia, which is similar to a natural electrophysiological examination. Differential method of constants and variables is an effective method for analyzing ECG scatter plot, and it is also a basic skill to analyze AECG quickly.
2023 Vol. 32 (2): 123-129 [Abstract] ( 31 ) [HTML 1KB] [ PDF 15493KB] ( 537 )
130 Arrhythmia and ECG changes after transcatheter aortic valve replacement
LV Tonglian, QIU Jiuchun, LIU Tong
Transcatheter aortic valve replacement (TAVR) has become the firstline treatment in patients with mild or severe symptomatic aortic stenosis. Patients after TAVR are usually accompanied by various arrhythmias and ECG changes; arrhythmias such as atrioventricular block, bundle branch block and atrial fibrillation commonly occur in these cases, which mostly leads to poor prognosis. Understanding arrhythmias and ECG changes after TAVR is helpful for the clinical diagnosis, efficacy evaluation and prognosis judgment of patients. This paper reviews the arrhythmias and ECG changes after TAVR.
2023 Vol. 32 (2): 130-135 [Abstract] ( 39 ) [HTML 1KB] [ PDF 905KB] ( 735 )
136
2023 Vol. 32 (2): 136-138 [Abstract] ( 37 ) [HTML 1KB] [ PDF 17140KB] ( 592 )
139
2023 Vol. 32 (2): 139-141 [Abstract] ( 30 ) [HTML 1KB] [ PDF 6744KB] ( 662 )
142
2023 Vol. 32 (2): 142-146 [Abstract] ( 27 ) [HTML 1KB] [ PDF 9326KB] ( 565 )
147
2023 Vol. 32 (2): 147-148 [Abstract] ( 45 ) [HTML 1KB] [ PDF 5154KB] ( 564 )
149
2023 Vol. 32 (2): 149-152 [Abstract] ( 31 ) [HTML 1KB] [ PDF 8242KB] ( 604 )
152
2023 Vol. 32 (2): 152-152 [Abstract] ( 21 ) [HTML 1KB] [ PDF 584KB] ( 559 )
153
2023 Vol. 32 (2): 153-153 [Abstract] ( 23 ) [HTML 1KB] [ PDF 987KB] ( 551 )
154
2023 Vol. 32 (2): 154-154 [Abstract] ( 21 ) [HTML 1KB] [ PDF 825KB] ( 518 )
155
2023 Vol. 32 (2): 155-155 [Abstract] ( 21 ) [HTML 1KB] [ PDF 577KB] ( 580 )
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