Heart rate-adjusted PR as a prognostic marker of long-term ventricular arrhythmias and cardiac death in ICD/CRT-D recipients

Objective To evaluate the PR to RR interval ratio (PR/RR,heart rate-adjusted PR) as a prognostic marker for long-term ventricular arrhythmias and cardiac death in patients with implantable cardioverter defibrillator (ICDs) and cardiac resynchronization therapy with defibrillators (CRT-D).Methods We retrospectively analyzed data from 428 patients who had an ICD/CRT-D equipped with home monitoring.Baseline PR and RR interval data prior to ICD/CRT-D implantation were collected from standard 12-lead electrocardiograph,and the PR/RR was calculated.The primary endpoint was appropriate ICD/CRT-D treatment of ventricular arrhythmias (VAs),and the secondary endpoint was cardiac death.Results During a mean follow-up period of 38.8 ± 10.6 months,197 patients (46%) experienced VAs,and 47 patients (11%) experienced cardiac death.The overall PR interval was 160 ± 40 ms,and the RR interval was 866 ± 124 ms.Based on the receiver operating characteristic curve,a cut-off value of 18.5% for the PR/RR was identified to predict VAs.A PR/RR ≥ 18.5% was associated with an increased risk of VAs [hazard ratio (HR)= 2.243,95% confidence interval (CI)= 1.665–3.022,P < 0.001) and cardiac death (HR = 2.358,95%CI = 1.240–4.483,P = 0.009) in an unadjusted analysis.After adjustment in a multivariate Cox model,the relationship remained significant among PR/RR ≥ 18.5%,VAs (HR = 2.230,95%CI = 1.555–2.825,P < 0.001) and cardiac death (HR = 2.105,95%CI = 1.101–4.025,P = 0.024.Conclusions A PR/RR ≥ 18.5% at baseline can serve as a predictor of future VAs and cardiac death in ICD/CRT-D recipients.

Exploring the characteristics of acupoints in the treatment of stroke with complex network and point mutual information method

Objective:Explore the characteristics of acupoints in the treatment of stroke with complex network and point mutual information method.Methods:The complex network and point wise mutual information system-developed by Chinese academy of Chinese medical sciences wereused to analyze the specific acupoints,compatibility,frequency etc.Results:174 acumoxibustion prescriptions were collected,including 163 acupoints.among them eighteen acupoints were used more than 30 times such as Hegu(LI4),Zusanli(ST36),Quchi(LI11)and Fengshi(GB31).The combinations of 31 acupoints were used more than 15 times,such as the combination of Quchi(LI11)and Zusanli(ST36),the combination of acupoint Quchi(LI11)and Jianyu(LI15),Hegu and Quchi(LI11).The most commonly used treatment method for stroke treatment is to dredge the Yangming meridian and Shaoyang meridian through acupuncture the multiple acupoints located on these two meridians..The commonly used acupoints are mainly distributed in the limbs,head and face.The most commonly used specific acupoint is intersection acupoint.The usage frequency of specific acupoints are higher than that of non-specific acupoints.Conclusion:Dredging the collaterals,dispelling wind-evil and restoring consciousness are the main principle for the treatment of stroke.Specific acupoints in head,face and climbs maybe the main targeted acupoints.Combination of Yang meridians with other meridians is needed to improve the effects.The Yangming meridian and Shaoyang meridian are most used meridians and Hegu(LI4),Quchi(LI11)and Zusanli(ST36)are the most used acupionts.

Pharmaceutical Rules of Traditional Chinese Medicine For Stroke Based on Dictionary of Prescriptions and Complex Network Analysis

Objective:Taking the Dictionary of Prescriptions as a clue,we collected effective prescriptions for treating Stroke,and systematically summarized the medication and compatibility rules of the core Chinese medicines for treating Stroke.Methods:A database of prescriptions for stroke based on complex relationship analysis system of traditional Chinese medicine was established.From the point of view of complex network,the hierarchy of drug compatibility rules of compound prescriptions(such as courtiers and envoys)was analyzed,the statistical characteristics of complex networks were analyzed,and an attempt was made to explain the characteristics of complex networks of drugs for stroke.Results:A total of 974 prescriptions were collected,including 1040 Chinese herbs.The core Chinese herbal medicines with nodal degree(>500)for Stroke were divaricate saposhnikovia root,liquorice root,Chinese angelica,tall gastrodia tuber,incised notopterygium rhizome and root.The compatibility relationship of the core Chinese medicines in the treatment of stroke is divaricate saposhnikovia root-liquorice root,ephedra-divaricate saposhnikovia root,divaricate saposhnikovia root-sichuan lovage rhizome,divaricate saposhnikovia root-Chinese angelica in order of frequency.Conclusion:Through the analysis of the common network structure of effective prescriptions for Stroke,the core prescription compatibility structure reflecting the prescription thinking and clinical characteristics was found.