JOURNAL OF PRACTICAL ELECTROCARDIOLOGY

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JOURNAL OF PRACTICAL ELECTROCARDIOLOGY

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JOURNAL OF PRACTICAL ELECTROCARDIOLOGY

	2023 Vol.32 Issue.5 Published 2023-10-21

	303


		2023 Vol. 32 (5): 303-303 [Abstract] ( 15 ) [HTML 1KB] [ PDF 93119KB] ( 636 )

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		2023 Vol. 32 (5): 304-304 [Abstract] ( 14 ) [HTML 1KB] [ PDF 218KB] ( 587 )

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		2023 Vol. 32 (5): 305-305 [Abstract] ( 15 ) [HTML 1KB] [ PDF 329KB] ( 581 )

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		2023 Vol. 32 (5): 306-306 [Abstract] ( 17 ) [HTML 1KB] [ PDF 2337KB] ( 739 )

	307	Comparison among different correction methods of QT interval in patients with atrial fibrillation: Based on ECG-ViEW database

		Objective To explore the effect of different correction methods of QT interval in patients with atrial fibrillation (AF) separately at AF and sinus rhythms. Methods The ECGs of AF patients both with AF and sinus rhythms were selected from the public information platform ECG-ViEW database. The correction effect of Bazett, Fridericia, Framingham and Hodges formulas is compared and analyzed for the same patient separately at AF and sinus rhythms. The linear relationship between QTc corrected by different formulas and heart rate or the measured value of QT interval was analyzed. ResultsThere is a statistically significant difference in the QT interval among AF patients during AF and sinus rhythme[(374.57±67.73) ms vs. (396.71±55.68) ms, P<0.01]. The QTc corrected by Hodges formula does not vary significantly between the two rhythms. Its slope of the regression line to the heart rate is very small, and the QTc corrected by Hodges formula shows a good linear relationship with the measured value of QT interval. The QTc corrected by commonly used Bazett formula in clinical practice shows a positive linear relationship with the measured value of QT interval. Conclusion Commonly used Bazett, Fridericia and Framingham formulas lead to poor performances in correcting QT interval of ECGs during AF rhythm. The effect of Hodges formula on correcting QT interval is close separately at AF and sinus rhythms, which could greatly reduce the influence of heart rate on QT interval. Hodges formula is universal in the population, and makes a good clinical indicator for monitoring the prolongation of QT interval in AF patients.
		2023 Vol. 32 (5): 307-312 [Abstract] ( 43 ) [HTML 1KB] [ PDF 6505KB] ( 630 )

	313	Comparison of QT interval correction methods based on ECG-ViEW database
		LI Yuan, ZHANG Fengzhi, XU Zongzheng, WANG Yue, CHEN Shuning, LI Xiangdong, WANG Deguo
		Objective To investigate the correction effect of different QT interval correction formulas applied in various ranges of heart rate. Methods A total of 699 778 ECGs with heart rate ranged from 30 to 200 times/min were selected from the ECG-ViEW database (a public information platform of ECGs). These ECGs were divided into four groups including 30-60, 60-100, 100-150 and 150-200 times/min groups according to the heart rate. The QT interval was corrected by Bazett, Fridericia, Framingham and Hodges formulas respectively. The linear relationship between QTc and heart rate or measured QT interval value was analyzed within different ranges of heart rate and by using different formulas. Results The uncorrected QT interval is prolonged as the heart rate slows down. The Bazett formula shows a poor performance in correcting QT interval, especially in the population with too slow heart rate. The Hodges formula shows a better correction effect among the population with low heart rate but a poor correction effect in those with fast heart rate. The Fridericia and Framingham formulas have better correction effects in the population with normal and fast heart rate. Conclusion The Bazett formula commonly used in clinical practice has some defects in QT interval correction. The Hodges formula shows greater practical value for the patients with low heart rate. The Fridericia and Framingham formulas are more suitable for correcting the ECGs with normal or fast heart rate.
		2023 Vol. 32 (5): 313-318 [Abstract] ( 19 ) [HTML 1KB] [ PDF 3262KB] ( 551 )

	319	Advances in research of QT interval prolongation and poor prognosis among patients with corona virus disease 2019
		WANG Yue, CHEN Shuning, WANG Deguo
		In recent years, with the worldwide pandemic of corona virus disease 2019 (COVID-19), the safety of anti-infection drugs arouses more and more attention. Hydroxychloroquine alone or combined with azithromycin could cause prolonged QT interval in the ECGs of patients with COVID-19, which may induce severe arrhythmia. According to the clinical evidences reported at home and abroad, the changes of QT interval in COVID-19 patients should be strictly monitored. This paper reviews on the drugs leading to prolonged QT interval, inflammation, age and other factors in COVID-19 patients, and their impact on the prognosis, in order to provide references for clinicians to optimize the treatment options of COVID-19 patients.
		2023 Vol. 32 (5): 319-343 [Abstract] ( 22 ) [HTML 1KB] [ PDF 882KB] ( 555 )

	324	Causes and mechanisms of inappropriate shocks in entirely subcutaneous implantable cardioverter defibrillators
		CHENG Yan, WANG Ruxing
		Various reasons may lead to inappropriate shocks of entirely subcutaneous implantable cardioverter defibrillator as the detected frequencies reach the shock zone. These reasons include the oversensing of intracardiac signals (such as T, P, F, f, or U waves), multiple counting of QRS complexes, rapid supraventricular tachycardia, myopotential interference, air entrapment, failure of electrode lead or pulse generator, cardiopulmonary resuscitation, in vitro electromagnetic interference, and SenseBnoise. It is recommended to readjust its parameters by programmable controlling, and actively treat primary diseases. It is required to adjust the electrode lead and pulse generator, or implant a transvenous implantable cardioverter defibrillator instead if necessary.
		2023 Vol. 32 (5): 324-328 [Abstract] ( 31 ) [HTML 1KB] [ PDF 952KB] ( 653 )

	329	Comparison and significance of atrial low voltage areas among patients with atrial fibrillation in different rhythms
		ZHANG Wenjing, WANG Hao, DING Aolin, YANG Jingwei, GU Yunfei
		Objective To investigate the characteristics and significance of atrial low voltage areas(LVAs) measured by electroanatomical mapping among patients with atrial fibrillation(AF) in different rhythms, and to analyze the effect of pure pulmonary vein isolation (PVI) on LVAs. Methods Eighty-four patients (49 with paroxysmal AF and 35 with persistent AF) who had undergone radial frequency ablation for the first time were consecutively enrolled and matched using propensity scoring. The areas of LVAs in each region after the atrial quintile were measured and analyzed at a threshold of 0.5 mV. Results Thirty-one groups of patients are matched by using propensity scoring according to age, sex and BMI. The mean number of mapping points before and after the ablation are separately 1 434.2±393.6 and 1 281.3±372.7 in patients with paroxysmal AF while the numbers are 1 652.6±728.2 and 1 314.6±690.8 respectively in patients with persistent AF. LVAs could be recorded in all research subjects. There is no significant difference in LVAs preoperatively and postoperatively in patients with paroxysmal AF; the area of LVAs is significantly decreased postoperatively in patients with persistent AF (P<0.05). Among all the 84 AF patients, the proportions of LVAs presented in the anterior wall, septem, inferior wall, lateral wall, and posterior wall are 69.0%, 95.2%, 82.1%, 60.7% and 52.4%, respectively. Conclusion At the same voltage threshold, the area of LVAs in patients with persistent AF is significantly larger in AF rhythm than that in sinus rhythm, and pure PVI has little effect on LVAs. LVAs are prevalent in the anterior wall, septem and inferior wall in AF patients.
		2023 Vol. 32 (5): 329-344 [Abstract] ( 31 ) [HTML 1KB] [ PDF 2122KB] ( 562 )

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		2023 Vol. 32 (5): 335-338 [Abstract] ( 24 ) [HTML 1KB] [ PDF 14392KB] ( 512 )

	339	Influence of different exercise and rest habits on young patients with chest tightness by noninvasive hemodynamic monitoring
		XIN Weiran, GUAN Jingjing, PAN Mingkang
		Objective To investigate the influence of different exercise and rest habits on hemodynamics of young patients with chest tightness. Methods We selected 100 outpatients under 40 years old with chief complaints of chest tightness and other discomforts. They all denied basic medical history, and were generally normal in preliminary screening of ECG, chest X-ray, ultrasound cardiogram and myocardial enzymes indexes. According to exercise and rest habits, they were divided into regular exercise and rest group (18 cases), less exercise or stay up late group (35 cases), and less exercise plus stay up late group (47 cases). The changes of hemodynamic monitoring indexes of each group were analyzed. According to clinic blood pressure, the enrolled patients were divided into normal blood pressure group (57 cases) and elevated blood pressure group (43 cases). The changes of body mass index (BMI) and hemodynamic monitoring indexes were comparatively analyzed between the two groups. Results Among these groups with different exercise and rest habits, BMI, cardiac index(CI), systemic vascular resistance index (SVRi), and early diastolic filling ratio (EDFR) show statistical differences of medium equivalence between the groups. There are statistical differences of high equivalence in BMI and left cardiac work index (LCWi) between the normal blood pressure group and the elevated blood pressure group while SVRi is statistically different between groups with medium equivalence. Compared with the normal blood pressure group, increased BMI and hemodynamic abnormalities are more common in the elevated blood pressure group (P<0.01); the hemodynamic abnormalities are more prone to present as high LCWi (P<0.01), high SVRi(P=0.01), and possibly high CI (P<0.05) and high EDFR (P<0.05). Conclusion Among the population with unhealthy exercise and rest habits, the incidence of obesity and hemodynamic abnormalities are higher than those with exercise habits and regular schedule. The hemodynamic abnormalities are mainly manifested by the blood flow circulation state with relatively low discharge and high resistance, which indicates increased preload. Unrecognized hypertension or hypertension without intervention are found in nearly half of the young patients with chief complaints of chest tightness. The hemodynamic abnormalities are mainly manifested by the blood flow circulation state with relatively high left ventricular stroke work, and normal or high systemic vascular resistance. In clinical practice, it should be paid more attention and given early intervention.
		2023 Vol. 32 (5): 339-343 [Abstract] ( 30 ) [HTML 1KB] [ PDF 947KB] ( 633 )

	344	Predictive value of P wave dispersion in early and late recurrences of paroxysmal atrial fibrillation after radiofrequency ablation
		CHEN Lina, LI Meijuan
		Objective To study the relationship between P wave dispersion (Pd) and early or late recurrence of paroxysmal atrial fibrillation (AF) after radiofrequency ablation, and to explore its predictive value on the recurrence. Methods We selected 181 patients with paroxysmal AF who had received radiofrequency ablation of AF. All the postoperative patients were followed up for an average of (93±29) months, and the recurrence time was recorded. Twelve lead electrocardiogram examination was performed at sinus rhythm separately before operation, and 1 month, 3 months and 6 months after operation. P wave duration was measured and Pd was calculated. The relativity between Pd and early or late recurrence of AF after radiofrequency ablation was analyzed. Results Early recurrence is defined as the onset of AF or atrial flutter≤3 months after radiofrequency ablation; late recurrence is defined as the onset of AF or atrial flutter more than 3 months after ablation. The early recurrence rate of paroxysmal AF after ablation is 11.6% (21/181) while the late recurrence rate is 17.7% (32/181). The difference of Pd is statistically significant between the early recurrence group and the nonearlyrecurrence group separately before ablation and one month after operation (P<0.05). There is a significant difference in Pd between the late recurrence group and the nonlaterecurrence group 6 months after operation (P<0.05). Multivariate Logistic regression results show that Pd before ablation and 1 month after ablation is an independent risk factor for early recurrence after ablation of AF while Pd 6 months after ablation is an independent risk factor for late recurrence after AF ablation. Conclusion Pd could provide references for predicting the early and late recurrences of AF.
		2023 Vol. 32 (5): 344-348 [Abstract] ( 29 ) [HTML 1KB] [ PDF 2327KB] ( 557 )

	349	Electrophysiological mechanisms revealed by proximal caliper shaped patterns in Lorenz-RR scatter plot of ventricular pacing
		DAI Jing1, LI Zelin2, LONG Youling1,BI Yanfang1, WANG Ya1, SUN Qinxue3
		The different manifestations of pacing Lorenz-RR scatter plot in ambulatory electrocardiography(AECG) help to judge the property of the pacing electrocardiogram (ECG). The calipershaped pattern proximal to the 45° line of the Lorenz-RR scatter plot of ventricular pacing reveals the electrophysiological mechanisms behind the scatter plot characteristics. The Wenckebach phenomenon caused by the behavior of the pacemaker’s upper limit tracking frequency, that is, the upper limit tracking frequency set by pacemaker and (or) upper limit tracking frequency, indicates that the implanted pacemaker has been working in a tracking mode. This paper selects two cases with calipershaped patterns proximal to the 45° line of the Lorenz-RR scatter plot of ventricular pacing, analyzes different manifestations of AECG by reverse analysis technique, and identifies the modern functional operation related to pacemakers, so as to clarify its brand and judge its functions.
		2023 Vol. 32 (5): 349-354 [Abstract] ( 21 ) [HTML 1KB] [ PDF 24519KB] ( 670 )

	355	History and research progress of heart rate variability
		HU Zhicheng, YAO Yan
		Heart rate variability (HRV) is a non-invasive index for assessing the autonomic nervous system’s regulation of cardiac rhythm. This index reflects the automaticity of the heart and information related to physiological states. HRV has been used to evaluate the cardiac health, predict the risk of cardiovascular events, and monitor the efficacy of diseases. In recent years, related studies have found that HRV also has important values in evaluating non-cardiovascular system diseases, as well as mental stress and stress responses. This article reviews the history, recent advances in research and application of HRV, aiming to provide more information for clinical physicians.
		2023 Vol. 32 (5): 355-359 [Abstract] ( 36 ) [HTML 1KB] [ PDF 907KB] ( 739 )

	360	New understandings about electrocardiographic mechanism of Brugada wave
		LI Han, ZHONG Guoqiang
		Brugada wave is a special ECG pattern that presents as a “triad” of right bundle branch block, STsegment elevation in the right chest lead, and T wave inversion. It could lead to arrhythmia and sudden cardiac death. It has been previously considered that Brugada wave is associated with genetics, electrophysiological mechanism, nerve crest hypothesis and so on. The latest studies have found that mutations in mitochondrial DNA and tRNA, inflammation, and myocardial stroma abnormalities may also be involved in the occurrence and development of Brugada wave. This paper mainly reviews the latest research progress of the electrocardiographic mechanism of Brugada wave.
		2023 Vol. 32 (5): 360-364 [Abstract] ( 22 ) [HTML 1KB] [ PDF 874KB] ( 592 )

	365	Research advances of heart rate variability in cardiovascular diseases
		ZHANG Xiling, WANG Xinkang
		Heart rate variability (HRV) is a noninvasive index for evaluating cardiac autonomic function, which is closely related to many diseases. It could be used for disease screening, risk stratification, diagnosis and treatment, efficacy evaluation and so on. With the development of technology and optimization of algorithms, the application of HRV in pacemakers and wearable devices has developed further. This paper mainly illustrates the research background, progress in clinical application and research trends of HRV, and looks forward to the research directions in the future.
		2023 Vol. 32 (5): 365-369 [Abstract] ( 26 ) [HTML 1KB] [ PDF 898KB] ( 549 )

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		2023 Vol. 32 (5): 370-376 [Abstract] ( 25 ) [HTML 1KB] [ PDF 29820KB] ( 666 )

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		2023 Vol. 32 (5): 372-372 [Abstract] ( 17 ) [HTML 1KB] [ PDF 965KB] ( 548 )

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		2023 Vol. 32 (5): 377-380 [Abstract] ( 25 ) [HTML 1KB] [ PDF 13136KB] ( 631 )

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