真心痛的综合治疗研究

主要阐述真心痛,即现代医学所述冠状动脉硬化性心脏病的中药、针灸、气功综合治疗研究情况。指出综合治疗真心痛,可使脉舌征及临床自觉症状好转或消失,且心电图改变,血压趋向正常而稳定,治愈率在84％以上。综合治疗,不仅见效快,且能长期巩固疗效,并可稳定情绪,健康形体。与单一中药、针灸、气功治疗,具明显优势。

Reversible cardiogenic shock caused by atrioventricular junctional rhythm after percutaneous coronary intervention

An 82-year-old female patient undergoing cardiogenic shock caused by atrioventficular junctional rhythm immediately after percutaneous coronary intervention （PCI） is described. Pharmacotherapy was invalid, and subsequent application of atrial pacing reversed the cardiogenic shock. PCI-related injury of sinuatrial nodal artery leading to acute atrial contractility loss, accompanied by atrioventricular junctional arrhythmia, was diagnosed. We recommend that preoperative risk evaluation be required for multi-risk patients. Likewise, emergent measures should to be established in advance. This case reminds us that atrial pacing can be an optimal management technique once cardiogenic shock has occurred.

TCM Treatment of Extrasystole with Huanglian Shengmai Yin—A Report of 357 Cases

The previous experimental studies have demonstrated that addition of Huang Qi ([symbol: see text] Radix Astragali) to the formulated recipe Sheng Mai Yin ([symbol: see text] Decoction for Pulse-activation) exerts the effects of strengthening the myodynamia, increasing the coronary flow, improving myocardial metabolism, and resisting the arrhythmia. The active component of Huang Lian ([symbol: see text] Rhizoma Coptidis) can prolong the myocardial action potential and antagonize the chloroform-, aconitine-, barium chloride-, epinephrine- or coronary ligation-induced arrhythmia by blocking the calcium channel. Ku Shen ([symbol: see text] Radix Sophorae Flavescentis) contains matrine and flavones, which act as quinidine to decrease the excitability of the myocardium, prolong the refractory period, and inhibit the ectopic cardiac rhythm. And Dan Shen ([symbol: see text] Radix Salviae Miltiorrhizae) has the action of improving the ischemic state of the myocardium by dilating the coronary vessels. In conclusion, the definite therapeutic effects of Huang Lian Sheng Mai Yin in treating ventricular, atrial and nodal arrhythmia suggests that the prescription is rational and accords with the therapeutic principle of TCM. Except discomfort in the gastric cavity and poor appetite experienced by some patients, there is no toxic or adverse reaction.

Cardiac arrhythmia and heart failure： From bench to bedside

Cardiac arrhythmia is an abnormal rate and/or rhythm of a heart due to its abnormal electrical impulse origination and/or propagation. Various etiologies can cause arrhythmias. Heart failure （HF） is a clinical syndrome due to an impaired heart that can not pump sufficient blood to meet the systemic metabolic needs.

Minimally invasive surgical techniques in the era of hybrid coronary revascularization： additional benefits for the elderly patients？

Geriatric patients affected by stable multi-vessel coronary artery disease （CAD） are at the crossroad： they can live with the risks of acute coronary syndrome, malignant arrhythmias or heart failure, or they can undergo a rapid evaluation for myocardial revascularization.

Effects of Dingjifumai Decoction on Electrocardiogram and sodium potassium pump of rats with ventricular arrhythmia

Objective:To investigate the effect of Dingjifumai Decoction(DJFM)on Electrocardiogram(ECG)and sodium potassium pump in rats with ventricular arrhythmia.Methods:Forty healthy male SD rats(200±20g)were randomly divided into blank group,model group,Metoprolol group and DJFM group.Ten rats in each group were fed with normal diet and free drinking water.Each group was given gavage,and the amount of gavage in each group was calculated according to body weight.In the model group,0.001%Aconitine was injected into the tail vein at 30ug/kg.In the Metoprolol group,Metoprolol suspension was given according to the standard of 5.2mg/kg per day.In the DJFM group,DJFM was given at 17.6g/kg per day.After 2 weeks of administration,the biologic experiment system BL-420F was used to monitor the II lead ECG curve,and the ECG changes were observed and recorded.Then,the left ventricle of the rat was taken,and part of the heart tissue sodium potassium pump was detected.Results:(1)The effect of DJFM on ECG of rats with ventricular arrhythmia:After intravenous injection of aconitine,the incidence of Ventricular Premature beat(VP),Ventricular Tachycardia(VT),Ventricular Fibrillation(VF)in the model group was 100%,suggesting that the model building of rats with ventricular arrhythmia was successful.(2)VP,VT,and VF time:Compared with model group,DJFM group and Metoprolol group can significantly delay the VP,VT and VF,the difference was statistically significant(P<0.05).The effect of DJFM group and Metoprolol group on delaying the appearance of VP,VT and VF was the same,there was no significant difference(P>0.05).(3)The effect of DJFM on sodium potassium pump in rat ventricular arrhythmia heart tissues:Compared with the blank group,the sodium potassium pump value in the model group was significantly decreased,and the difference was statistically significant(P<0.05).Compared with the model group,the sodium potassium pump value of the tissues in the Metoprolol group and the DJFM group increased,and the difference was statistically significant(P<0.05).There was no significant difference in sodium potassium pump between the Metoprolol group and the DJFM group(P>0.05).Conclusion:1.The rat model of ventricular arrhythmia can be successfully prepared by intravenous injection of Aconitine.2.DJFM can prolong the occurrence time of cardiac arrhythmias caused by aconitine in rats,such as VP,VT,VF,et al.The mechanism may be related to fast Na^+channel,and it may prevent and control arrhythmias by inhibiting Na^+influx and reducing the fast response cellular self-discipline.3.DJFM can protect the myocardial tissue sodium potassium pump,which can protect the myocardial cells and improve the myocardial metabolism.

Shenxian Shengmai Oral Liquid for treatment of slow arrhythmia： a randomized controlled trial

Background： Slow arrhythmia, a common clinical condition, has a higher incidence in the elderly population. Shenxian Shengmai Oral Liquid has been shown to improve the symptoms of patients with slow arrhythmia in many clinical studies and systematic reviews. Sixty participants with slow arrhythmia will be randomized to treatment group （Shenxian Shengmai Oral Liquid） and control group （Shenxian Shengmai Oral Liquid Placebo） in a 2：1 ratio. This clinical trial is a pilot study to compare the effects of Shenxian Shengmai Oral Liquid and the control groups; to analyze the effect of Shenxian Shengmai Oral Liquid for slow arrhythmia.

Effects of Lüfukang Capsules (律复康胶囊) on Coronary Artery Ligation-Induced Arrhythmia in Dogs

Objective: To observe the effects of Lüfukang Capsules (律复康胶囊 LFKC) on arrhythmia induced by ligation of coronary artery in dogs. Methods: Thirty dogs were randomly divided into 5 groups, the model group administrated with equal volume of distilled water, the positive control group administrated with Wenxin Granules (稳心颗粒), and the small, medium and large dosage LFKC groups, 6 dogs in each group. Thirty minutes after medication, electrocardiogram was conducted and the time of arrhythmia occurrence, times of ventricular premature beat (VP), and incidence rates of ventricular tachycardia (VT) and ventricular fibrillation (VF) were recorded in the model dogs with arrhythmia induced by ligation of coronary artery. Results: Compared with the model group, the occurrence time of arrhythmia induced by the coronary artery ligation in the medium and large LFKC groups was significantly delayed (20.45±9.10 and 19.92±3.78, respectively, both P<0.05). The frequency of VP in the medium and large LFKC groups was also significantly decreased (8.17±6.62 and 3.83±2.79, respectively, both P<0.01). Conclusion: LFKC has anti-arrhythmic effects for the experimental arrhythmia induced by the ligation of coronary artery in dogs.

Implantation of dual chamber pacemaker defibrillator and placement of endocardial leads via the axillary vein

Objectives To assess the preliminary clinical results of implantation of dual chamber pacemaker defibrillator and to evaluate the safety and effectiveness of placement of endocardial leads in the axillary vein. Methods Seven patients with ventricular tachycardia and/or ventricular fibrillation (VT/VF), associated with bradyarrhythmia received implantation of a dual chamber pacemaker defibrillator, including 5 patients with coronary artery disease and 2 patients with dilated cardiomyopathy.The atrial and ventricular leads were introduced via the axillary vein under venographic guidance. Results Dual chamber pacemaker defibrillators were successfully implanted in the left chest subcutaneous pocket in 5 patients and the left pectoral muscular pocket in 2 patients. All the VT/VF occurring either inducibly during the procedure or spontanuously during follow-up were detected promptly and treated successfully. Both the pacing and sensing functions were satisfactory. The endocardial leads required were successfully introduced via the axillary vein without major complications.Conclusion Dual chamber pacemaker defibrillators can provide reliable therapy for VT/VF and the dual chamber pacing function. Placement of endocardial leads via the axillary vein under venographic guidance is safe and effective.