JOURNAL OF PRACTICAL ELECTROCARDIOLOGY

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JOURNAL OF PRACTICAL ELECTROCARDIOLOGY

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JOURNAL OF PRACTICAL ELECTROCARDIOLOGY

	2023 Vol.32 Issue.6 Published 2023-12-14

	378


		2023 Vol. 32 (6): 378-378 [Abstract] ( 11 ) [HTML 1KB] [ PDF 58443KB] ( 580 )

	379


		2023 Vol. 32 (6): 379-379 [Abstract] ( 7 ) [HTML 1KB] [ PDF 10437KB] ( 380 )

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		2023 Vol. 32 (6): 380-380 [Abstract] ( 9 ) [HTML 1KB] [ PDF 343KB] ( 338 )

	381	Related mechanisms of cardiovascular events and sudden death due to QT interval prolongation
		ZHANG Zhaoguo, ZHAO Lanting, KONG Lingyun, ZHANG Ping
		This paper reviews the definition and measurement methods of QT interval prolongation, lists some clinical research evidences that QT interval prolongation leads to malignant ventricular arrhythmia and sudden cardiac death. It concludes that the mechanism of cardiovascular events and sudden death due to QT interval prolongation may be closely related to the interaction of multiple factors such as increased QT interval dispersion, uncoordinated coupling of myocardial electrical excitation and mechanical contraction, and imbalance in cardiac autonomic function regulation. It is suggested that clinicians should be highly alerted to the risk of acquired QTc prolongation caused by certain drugs in order to avoid adverse outcomes.
		2023 Vol. 32 (6): 381-388 [Abstract] ( 13 ) [HTML 1KB] [ PDF 11295KB] ( 462 )

	386	Effect of ivabradine on QT interval and heart rate in patients with chronic heart failure
		DI Chengye,WANG Qun, WU Yanxi, LI Longyu, ZHANG Yan, LIN Wenhua
		Objective To explore the effect of ivabradine on QT interval and sinus rhythm in patients with chronic heart failure ( HF). Methods A total of 179 patients with chronic HF were selected as the research subjects. They underwent 12-lead synchronous ambulatory electrocardiography ( AECG) examination, and re-examination of AECG 30-45 days after oral administration of ivabradine. The changes of QT interval and heart rate before and after medication were compared. Results A total of 143 patients complete clinical follow-up and are enrolled in this study. After oral administration of ivabradine, the maximum QT interval [(467. 9 ± 62. 6)ms vs. (473. 6±63. 4) ms], the maximum QTc [(489. 3±56. 0) ms vs. (496. 6±55. 4) ms], the average QT interval [(390. 5±41. 1) ms vs. (398. 6±43. 7) ms], the average QTc [(417. 2±31. 4) ms vs. (414. 4±36. 9) ms], and the minimum QTc [(377. 5± 36. 0) ms vs. (361. 3±37. 0) ms] of all the 143 patients are significantly different from those before medication (P<0. 01). The minimum QT interval [(348. 3 ± 42. 8) ms vs. (349. 6±38. 9) ms] does not vary significantly before and after medication ( P > 0. 05). The differences of the minimum heart rate [(50. 3±8. 6) times per minute vs. (47. 7±7. 8) times per minute], the average heart rate [(69. 9±11. 7) times per minute vs. (64. 9±10. 6) times per minute], and the maximum heart rate [(116. 6±23. 1) times per minute vs. (109. 0±20. 1) times per minute] are all statistically significant before and after medication (P<0. 01). During the follow-up period, there is no incidence of ventricular arrhythmia or sudden death. Conclusion Ivabradine could significantly shorten the maximum QT interval / QTc and the average QT interval, and slow down heart rate. Its clinical application is safe and effective.
		2023 Vol. 32 (6): 386-394 [Abstract] ( 17 ) [HTML 1KB] [ PDF 7046KB] ( 418 )

	395	Predictive value of Tp-Te interval on ventricular arrhythmias in patients with breast cancer treated by anthracycline-based chemotherapy
		CHEN Xinyue, WANG Lujie, ZHAO Xili, DU Hairong, Abulimiti Zaimila,WANG Rui
		Objective To explore the correlation between Tp-Te interval, Tp-Te / QT ratio and other ECG indexes, and the occurrence of ventricular arrhythmias in patients with breast cancer first treated by anthracycline based chemotherapy, and to investigate the predictive value of these ECG indexes. Methods A total of 150 females diagnosed with breast cancer were enrolled. All patients were treated by anthracycline chemotherapy. According to the occurrence of ventricular arrhythmias after treatment, these patients were divided into three groups: non-ventricular arrhythmia group ( n = 90 ), ventricular tachycardia group (n = 26) and premature ventricular contraction (PVC) group (n = 34). The general clinical data (including age, smoking history, diabetes history, hypertension history, Hb, TC, TG, HDL-C, LDL-C, K+, Na+and Ca2+), and ECG related indexes( including QT interval, Tp-Tec and Tp-Te / QT ) before and after treatment were compared among groups.Correlation analysis and receiver operating characteristic curve (ROC curve) were used to analyze the predictive value of ECG related indexes on the occurrence of ventricular tachycardia and PVC in patients with breast cancer after treatment. Results After treatment, the values of QTc, Tp-Tec and Tp-Te / QT in patients of the ventricular tachycardia group and the PVC group are all significantly increased (P<0. 05); these values are all higher than those in the normal controls(P<0. 05). Patients in the ventricular tachycardia group have the most obvious increase of ECG related indexes (P<0. 05). Spearman correlation analysis shows that QT interval, Tp-Tec and Tp-Te / QT are all significantly positively correlated with the occurrences of ventricular tachycardia and PVC in patients with breast cancer after treatment. ROC curve analysis indicates that the predictive value of Tp-Tec on the occurrences of ventricular tachycardia and PVC in patients with breast cancer is significantly higher than that of QTc and Tp-Te / QT; the best cut-off values are 93. 54 and 83. 07 ms, respectively. Conclusion QT interval, Tp-Te interval and Tp-Te / QT ratio have certain predictive value on the occurrence of ventricular arrhythmias in patients with breast cancer first treated by anthracycline-based chemotherapy, and the predictive value of Tp-Te interval is the highest. In the future, it may be used as an important ECG index to make early prediction and evaluation of the risk of ventricular arrhythmias in breast cancer patients undergoing chemotherapy, and provide theoretical basis for its early prevention and treatment.
		2023 Vol. 32 (6): 395-399 [Abstract] ( 16 ) [HTML 1KB] [ PDF 1569KB] ( 426 )

	400	Safety evaluation of radiofrequency catheter ablation for atrial fibrillation in tumor survivors
		ZHANG Wei, YUAN Wei, DONG Yan, CAO Kejiang, YANG Bing, LI Xiaorong
		Objective To explore the safety of radiofrequency catheter ablation in patients with atrial fibrillation (AF) and a history of tumor. Methods We collected the clinical data of 269 AF patients who had undergone radiofrequency ablation. Among the enrolled patients, those non-valvular AF patients with a history of tumor were labeled as the tumor group (16 cases) while those without a history of tumor were divided into the non-tumor group (253 cases). The clinical characteristics and incidences of peripheral complications were compared between the two groups. Results The top three previous tumors are separately gastrointestinal tract tumor (37.50%), gynecology tumor (25.00%), and lung tumor (18.75%). There is no significant difference in the incidence of peripheral complications between the two groups. During 12-month follow-up, the recurrence rate of AF between the two groups also does not vary significantly. Conclusion In AF patients with a history of tumor, the incidence of complications during perioperative period of catheter ablation is similar to that of AF patients without tumor history, so is the postoperative recurrence rate of AF. Radiofrequency ablation could be used as one of the treatment options for such patients.
		2023 Vol. 32 (6): 400-404 [Abstract] ( 15 ) [HTML 1KB] [ PDF 905KB] ( 479 )

	405	Risk factors and prognosis analysis of patients with hypertrophic cardiomyopathy complicating atrial fibrillation
		CAO Danning, ZHOU Birong
		Objective To investigate the clinical characteristics, risk factors and prognosis of patients with hypertrophic cardiomyopathy(HCM) accompanied with atrial fibrillation (AF). Methods Outpatients or inpatients with HCM were selected, and divided into AF group and nonAF group based on the presence or absence of AF. The clinical features and prognosis of the two groups were observed. Multiple Logistic regression analysis was applied in exploring the risk factors of HCM patients complicating AF. ResultsA total of 144 HCM patients are enrolled in our study, with 32 patients (22.2%) in the AF group and 112 patients (77.8%) in the non-AF group. Multiple Logistic regression analysis reveals that enlarged left atrial diameter (LAD, OR=2.013, P=0.004) and reduced left ventricular ejection fraction (LVEF, OR=0.920, P<0.01) are independent risk factors for HCM patients with AF. During an average follow-up period of two years and three months, the readmission rate of patients in the AF group is significantly higher than that in the non-AF group (P＜0.05); there is no significant difference in the primary endpoints (death) or other secondary endpoints (heart failure and thrombembolia) between the two groups (P＞0.05). Conclusion The readmission rate of HCM patients complicated by AF is significantly increased. The enlarged LAD and reduced LVEF are independent risk factors for complicated AF among HCM patients.
		2023 Vol. 32 (6): 405-410 [Abstract] ( 19 ) [HTML 1KB] [ PDF 966KB] ( 365 )

	411	Correlation between small and dense low-density lipoprotein and coronary stenosis in patients with coronary heart disease complicating type 2 diabetes
		JIANG Shan, LIU Tongtong, LUAN Chunyu, ZHANG Peng
		Objective To investigate the relationship between small and dense low-density lipoprotein (sd-LDL) and coronary stenosis in patients with coronary heart disease (CHD) complicating type 2 diabetes. Methods We collected the clinical data and testing results of 326 CHD patients with type 2 diabetes. Quantitative evaluation of coronary artery were performed according to coronary angiography results and by using Gensini Scoring. According to the average Gensini Score and the type of disease respectively, all the patients were grouped and made statistical analysis. Results There is no statistically significant difference in sex, history of hypertension or LDL between groups while the differences of age, glycosylated hemoglobin and sd-LDL are statistically significant (P＜0.05). The index of sd-LDL (OR=1.129，95%CI 1.075-1.221, P＜0.01) is correlated with the severity of coronary artery lesion. Its sensitivity and specificity are separately 57% and 88% in predicting the degree of coronary stenosis. Conclusion Among patients with CHD and type 2 diabetes, sd-LDL is an independent risk factor for the severity of coronary artery lesion.
		2023 Vol. 32 (6): 411-415 [Abstract] ( 13 ) [HTML 1KB] [ PDF 1241KB] ( 434 )

	416	Safety analysis of two different methods for producing canine atrial fibrillation models#br#
		MAIMAITIMIN Maimaitiabudula, YANG Xu, ZHANG Ling, MAIMAITIMIN Maimaitiaili, CAO Guiqiu, LI Yaodong, SUN Huaxin, MA Mei, TANG Baopeng
		Objective To compare the safety of the thoracotomy implantation of electrodes and the implantation of electrodes under X-ray fluoroscopy in creating a rapid atrial pacing model, and to provide a basis for producing an atrial fibrillation (AF) animal model. Methods Twelve experimental dogs were randomly divided into two groups according to different pathways of pacemaker electrode implantation. In the thoracotomy group (n=6), pacemaker electrodes were fixed in the left atrial appendage following thoracotomy while in the intervention group (n=6), pacemaker electrodes were implanted into the right atrial appendage or right atrium through the external jugular vein. Based on stable general situations, the pacemaker was opened and continuously paced for 6 weeks at 400 times per minute in each group. Changes of the cardiac structure was evaluated by performing cardiac B ultrasound examinations separately in the baseline state and after six weeks of continuous pacing. After the surgery, subcutaneous infection, pouch infection, bloody infection, infectious endocarditis, heart failure were assessed by observing the wound, monitoring body temperature, and detecting procalcitonin and NT-proBNP. Results Among the 12 dogs, one in the thoracotomy group died on the third day after the surgery while one in the intervention group suddenly died on the seventh day after the surgery; the remaining 10 dogs all completed the experiment. AF could be induced in both groups. Compared with the cardiac structure before the pacing, the cardiac structure of both groups change to a certain extent following six weeks of pacing; the left atrial diameter, the left ventricular end systolic diameter, the left ventricular end diastolic diameter, the right atrial diameter, and the right ventricular diameter of the two groups all increase after six weeks of pacing. However, there is no statistically significant difference of ejection fraction before and after pacing. The incidence of heart failure in the thoracotomy group is significantly higher than that in the intervention group (50.0% vs. 16.7%，P＜0.05) while the infection rate is also significantly different between the two groups (66.7% vs. 33.3%，P＜0.05). Conclusion In terms of reducing the infection rate and the incidence of heart failure, the method of implanting electrodes in an external jugular vein under X-ray fluoroscopy is superior to the thoracotomy implantation of electrodes to produce a canine rapid atrial pacing model.
		2023 Vol. 32 (6): 416-421 [Abstract] ( 11 ) [HTML 1KB] [ PDF 2896KB] ( 395 )

	422	Diagnostic value of ECG changes in myocardial damage among children with mycoplasma pneumonia
		DU Zhaoli，ZHANG Yusong
		Objective To explore the diagnostic value of ECG changes in children with mycoplasma pneumonia complicated by myocardial damage. Methods A total of 296 children with mycoplasma pneumonia were selected. According to the absence or presence of ECG abnomalities, they were divided into normal ECG group (82 cases) and abnormal ECG group (214 cases). One hundred health children were selected as control group. Basic conditions and difference of myocardial damage were comparatively analyzed among the three groups. The correlation between ECG abnormalities and myocardial damage, and the proportion of each type of ECG abnormalities were also analyzed. Results There is no significant difference in age or sex ratio among groups (P>0.05). The myocardial enzyme indexes in the abnormal ECG group are significantly higher than those of the normal ECG group and the control group. Only each myocardial enzyme index of the control group is within the normal reference range. And the difference of each index is statistically significant among the three groups (P<0.01). Among the children with mycoplasma pneumonia, ECG abnormalities are significantly correlated with myocardial damage (χ²=8.248，P<0.05), that is, the probability of complicated myocardial damage significantly increases in child patients with ECG abnormalities. In the child patients with mycoplasma pneumonia, various types of ECG abnormalities are found, including arrhythmias and ST-T changes, among which sinus tachycardia, ST-T changes and sinus arrhythmia are more common, accounting for 44.86%, 34.11% and 12.15%, respectively. Conclusion ECG abnormalities have important diagnostic value in child patients with mycoplasma pneumonia complicated by myocardial damage, which help to make early diagnosis and treatment, and improve the prognosis.
		2023 Vol. 32 (6): 422-425 [Abstract] ( 11 ) [HTML 1KB] [ PDF 4091KB] ( 374 )

	426	Diagnostic efficacy of ambulatory electrocardiography on stable and variant angina pectoris
		YANG Jianfeng, YU Rongrong
		Objective To explore the sensitivity and specificity of ambulatory electrocardiography (AECG) in the auxiliary diagnosis of stable and variant angina pectoris. Methods Patients with suspected stable and variant angina pectoris were selected, each group with 50 cases. AECG examination was performed, and its diagnostic sensitivity and specificity was analyzed by using coronary angiography as the gold standard. The duration of QRS complex and ECG characteristics of the two groups were recorded. Results Coronary angiography results show that out of 50 patients suspected with stable angina pectoris, 45 cases are positive, and the positive coincidence rate of AECG examination is 97.78%. Among 50 cases suspected with variant angina pectoris, 43 cases are positive, and the positive coincidence rate of AECG examination is 95.35%. The sensitivity and specificity of AECG examination in diagnosing stable angina pectoris are 95.56% and 80.00%, respectively while its sensitivity and specificity for variant angina pectoris are 93.02% and 85.71%, respectively. In the stable angina pectoris group, the duration of QRS complex is significantly shorter than that in the variant angina pectoris group (P<0.05) while the detection rate of ST-T depression is significantly higher than that in the variant angina pectoris group. However, the proportion of T-wave inversion, and the detection rates of ST-T depression complicating T-wave inversion in the stable angina pectoris group are significantly lower than those in the variant angina pectoris group (P<0.05). Conclusion The sensitivity and specificity of AECG examination are high for diagnosing stable and variant angina pectoris with clear image features, which provides important references for differential diagnosis.
		2023 Vol. 32 (6): 426-429 [Abstract] ( 17 ) [HTML 1KB] [ PDF 890KB] ( 541 )

	430	Clinical application and evaluation of wearable ECG monitoring device
		LU Kun, ZHANG Songwen, CHU Jianjun, PENG Nan, CHENG Chuandong, ZHAO Qinghao, HONG Shenda
		Objective To assess the accuracy of wearable electrocardiogram ( ECG) monitoring device for detecting arrhythmias ( sinus rhythm, premature ventricular contraction premature atrial contraction, and atrial fibrillation), and heart rate in a clinical. Methods A total of 321 volunteers (875 ECG records) participated in this study, including 146 males ( 531 ECG records) and 175 females ( 344 ECG records). A wearable ECG monitoring device was employed to record ECGs for detecting arrhythmias and heart rate. The detection results were compared with physicians clinical diagnostic results based on 12-lead ECG machine (regraded as the gold standard for diagnosing arrhythmias and detecting heart rate). Accuracy and consistency evaluation of the two detection methods was conducted in all the subjects, including accuracy, sensitivity, specificity, F1 score, area under curve (AUC) of the receiver operating characteristic curve, Bland-Altman consistency analysis, mean absolute error, and correlogram. Results Regarding arrhythmia identification, wearable ECG monitoring device exhibits impressive performance metrics, with an AUC of 0. 98, accuracy of 0. 98, sensitivity of 0. 96, specificity of 0. 99, and an F1 score of 0. 96. In terms of heart rate monitoring, a robust correlation between the wearable ECG monitoring equipment and the ECG machine is evident, with a substantial total correlation coefficient of 0. 84 (P< 0. 01). Bland-Altman consistency analysis reveals that the two methods display a mean difference of - 0. 97 times per minute, a mean standard deviation of 8. 02 times per minute, and a 95% confidence interval ranging from -16. 69 to 14. 75 within an acceptable level. Conclusion Wearable ECG monitoring device can accurately detect arrhythmias and heart rate.
		2023 Vol. 32 (6): 430-434 [Abstract] ( 11 ) [HTML 1KB] [ PDF 2242KB] ( 439 )

	435	The “third eye” of ECG physicians: Pacing channel
		TANG Chenshan, XIE Xueping，ZHENG Zhouling
		We selected 4 patients implanted with permanent cardiac pacemakers in different pacing methods. Their ECGs were recorded separately with traditional electrocardiograph and the new GE MAC5 electrocardiograph with an independent pacing channel. Comparative observation reveals that the pacing channel could be used for accurately identifying and labeling pacing signals, providing important references for analyzing pacing ECGs. ECG physicians should pay attention to and make good use of the pacing channel, which could greatly reduce the missed diagnosis and misdiagnosis of pacing ECGs. If the signals of the pacing channel could be successfully converted from the electrocardiograph to ECG network information system, the pacing channel technique would play a greater role in remote ECG diagnosis.
		2023 Vol. 32 (6): 435-438 [Abstract] ( 21 ) [HTML 1KB] [ PDF 5570KB] ( 501 )

	439	Research progress of leadless cardiac implantable devices
		GAO Yusi, ZHOU Jing
		Cardiac implantable devices are widely used in clinical practice. However, traditional transvenous pacemakers are associated with a series of complications such as infection due to the presence of leads and pockets. Leadless cardiac implantable devices, without leads or pockets, obtain unique advantages among the populations at high risk of infection. This article mainly provides an overview of the ventricular pacing function, atrioventricular synchronization function and defibrillation function of leadless pacemakers, and attempts at ventricular resynchronization therapy based on the existing clinical evidences and clinical applications at present. It also reviews the advantages and disadvantages of the devices, and current clinical recommendations.
		2023 Vol. 32 (6): 439-447 [Abstract] ( 22 ) [HTML 1KB] [ PDF 1061KB] ( 345 )

	448	ECG characteristics of dual chamber pacemaker in atrial and ventricular capture control operating mode
		LI Dan, LI Zelin, LAO Yi, LIU Tong
		Taking the ambulatory electrocardiography (AECG) fragment of Biotronik dualchamber pacemaker implanted in a patient as an example, this paper analyzes the design ideas and operation characteristics of its atrial and ventricular capture control. It is aimed at providing a reference for the vast number of ECG workers in analyzing and diagnosing pacemaker AECGs.
		2023 Vol. 32 (6): 448-452 [Abstract] ( 21 ) [HTML 1KB] [ PDF 13721KB] ( 392 )

	453	GE's phenotyping and heart failure with preserved ejection fraction
		KONG Lingqiu, GE Junbo
		Unlike other types of heart failure (HF), the efficacy of traditional medication and therapies are usually not reliable in patients with HF with preserved ejection fraction (HFpEF). It may be attributed to obviously heterogeneous etiologies and inconsistent pathophysiological pathways among such patients. GE's phenotyping is a novel etiology oriented classification method. It not only facilitates grouping HFpEF patients with similar pathophysiological mechanisms, but also contributes to making appropriate diagnosis and treatment plans, and taking prognosis assessment and management measures for different types of HF patients. In the future, GE's phenotyping is expected to be an important reference for clinical study design for these patients.
		2023 Vol. 32 (6): 453-456 [Abstract] ( 16 ) [HTML 1KB] [ PDF 938KB] ( 464 )

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		2023 Vol. 32 (6): 457-457 [Abstract] ( 9 ) [HTML 1KB] [ PDF 865KB] ( 373 )

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		2023 Vol. 32 (6): 458-458 [Abstract] ( 14 ) [HTML 1KB] [ PDF 866KB] ( 336 )

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		2023 Vol. 32 (6): 459-459 [Abstract] ( 13 ) [HTML 1KB] [ PDF 860KB] ( 313 )

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		2023 Vol. 32 (6): 460-460 [Abstract] ( 12 ) [HTML 1KB] [ PDF 758KB] ( 353 )

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		2023 Vol. 32 (6): 461-461 [Abstract] ( 14 ) [HTML 1KB] [ PDF 625KB] ( 437 )

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		2023 Vol. 32 (6): 462-462 [Abstract] ( 7 ) [HTML 1KB] [ PDF 273KB] ( 373 )

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