The therapeutic principle of clearing away the heart-heat to induce tranquilization was adopted in 107 middle-aged and senile patients with ventricular premature beat of coronary heart disease on the basis of pathogen...The therapeutic principle of clearing away the heart-heat to induce tranquilization was adopted in 107 middle-aged and senile patients with ventricular premature beat of coronary heart disease on the basis of pathogenic features of phlegm, heat, blood stasis and deficiency in this condition. Qing Xin An Shen Fang ([symbol: see text] a formula for clearing away the heart-heat to induce tranquilization) was used in the treatment group and compared with mexiletine and Fu Fang Dan Shen Tablets ([symbol: see text] Compound Salvia Tablets) used in the control group. The results turned to be that the markedly effective rate was 85.1% and the total effective rate 96.3% in the treated group, better than that in the control group, with the former having a good antihypertensive and antihyperlipemic effect and an effect of improving microcirculation and clinical symptoms.展开更多
Objective:To explore the clinical efficacy of Ningxin Tongluo Decoction(宁心通络汤)combined with Dapagliflozin in the treatment of type 2 diabetes mellitus complicated with ventricular premature beats.Methods:Ninety-t...Objective:To explore the clinical efficacy of Ningxin Tongluo Decoction(宁心通络汤)combined with Dapagliflozin in the treatment of type 2 diabetes mellitus complicated with ventricular premature beats.Methods:Ninety-two patients with type 2 diabetes mellitus complicated with ventricular premature beats in our hospital were randomly divided into control group(n=46)and observation group(n=46).The control group was treated with routine Western medicine,and the observation group was treated with Ningxin Tongluo Decoction on the basis of the control group.The clinical efficacy of the two groups before and after treatment,TCM syndrome score,blood glucose levels[fasting blood glucose(GLU),glycosylated hemoglobin(Hb A1c)],glucose metabolism levels[fasting insulin(FINS),insulin resistance index(HOMA-IR)],the number of ventricular premature beats detected by 24-hour ambulatory electrocardiogram,heart rate turbulence(HRT)[initial oscillation(TO),oscillation slope(TS)],and heart rate variability(HRV)standard deviation of two normal R-R intervals(SDNN),standard deviation of average normal R-R intervals every 5 minutes(SDANN)and root mean square of adjacent normal R-R intervals(RMSSD)were observed.Results:After treatment,the total effective rate of the observation group was 89.13%,significantly higher than that of the control group(73.91%),and the difference was statistically significant(P<0.05).Both groups could reduce TCM syndrome score,blood glucose level,glucose metabolism level,reduce the number of ventricular premature beats,improve HRT and HRV levels,and the observation group was superior to the control group,and the difference was statistically significant(P<0.05).Conclusion:Ningxin Tongluo Decoction combined with Dapagliflozin is effective in treating type 2 diabetes mellitus patients with ventricular premature beats.It can reduce blood glucose level,improve HRV and HRT,improve autonomic nerve function and exert antiarrhythmic effect.展开更多
A series of related electrophysiology phenomena can be caused by the occurrence of interpolated ventricular premature contraction.In our recent three-dimensional Lorenz R-R scatter plot research,we found that atrioven...A series of related electrophysiology phenomena can be caused by the occurrence of interpolated ventricular premature contraction.In our recent three-dimensional Lorenz R-R scatter plot research,we found that atrioventricular node double path caused by interpolated ventricular premature contraction imprints a specifi c pattern on three-dimensional Lorenz plots generated from 24-hour Holter recordings.We found two independent subclusters separated from the interpolated premature beat precluster,the interpolated premature beat cluster,and the interpolated premature beat postcluster,respectively.Combined with use of the trajectory tracking function and the leap phenomenon,our results reveal the presence of the atrioventricular node double conduction path.展开更多
Ventricular premature beat,a kind of arrhythmia,is one of common diseases which not only decreases the quality of life but also has the danger of death.The pathogenesis in Traditional Chinese Medicine is that the inju...Ventricular premature beat,a kind of arrhythmia,is one of common diseases which not only decreases the quality of life but also has the danger of death.The pathogenesis in Traditional Chinese Medicine is that the injury of heart and kidney is the essence and the block of solid evil such as phlegm and blood stasis is the manifestation.The teacher,Li Yuan,has worked in clinic for decades and considered that the important pathogenesis of the VP beat is“heat transformed from Yang”,which cannot be ignored as it is on the influence of diverse factors and can be observed in different symptoms and different treatment states of the disease.展开更多
From August 1989 to May 1994, 84 cases of ventricular premature beat (VPB) with deficiency syndrome were treated with our empirical prescription called Qi Lu Tang Decoction for Improving Abnormal Heart Beat). The tota...From August 1989 to May 1994, 84 cases of ventricular premature beat (VPB) with deficiency syndrome were treated with our empirical prescription called Qi Lu Tang Decoction for Improving Abnormal Heart Beat). The total effective rate was 88.10%, being significantly different from that of the control group treated with the Western drug propafenone (P展开更多
Recent studies have shown that premature ventricular contractions (PVCs) could enlarge the heart, but its risk factors are incompletely understood as a single 24-hour recording cannot reflect the true PVC burden due...Recent studies have shown that premature ventricular contractions (PVCs) could enlarge the heart, but its risk factors are incompletely understood as a single 24-hour recording cannot reflect the true PVC burden due to day-to-day variability. Our purpose was to investigate the effect of burden and origin sites on left ventricular (LV) function in patients with PVCs by 7-day Holter electrocardiography (ECG). From May 2012 to August 2013, 112 consecutive patients with PVCs were recruited from the authors' affiliated hospital. All patients received 2-dimensional transthoracic echocardiography, 12-lead routing ECG and 7-days Holter ECG. Serum N-terminal pro- brain natriuretic peptide (NT-proBNP) levels were measured. A total of 102 participants with PVCs were included in the final analysis. Origin of PVCs from the tricuspid annulus had the highest burden and NT-proBNP level. LV papillary muscle had a higher LV ejection fraction (EF) level and a lower LV end-systolic dimension (ESD) than other PVC foci (P〈0.05). The high burden group had a higher LV end-diastolic dimension (EDD) and LVESD but lower LVEF than the other two groups (P〈0.05). Female, older age, physical work, and history of PVCs had a significantly positive correlation with symptoms. Male, older age, physical work, and high burden were positive predictors of enlarged LVEDD, LVESD and higher serum NT-proBNP level, but lower LVEF. Seven-day dynamic ECG Holter monitor showed the true PVC burden on patients with PVCs. PVCs with a lower burden or origin from the LV papillary muscle and the fascicle were relatively benign, while PVCs with a higher burden or origin from the tricuspid annulus may lead to cardiac dysfunction.展开更多
Background:A high ablation success rate for ventricular arrhythmia (VA) from outflow tract has been achieved,but some of them cannot be eliminated from endocardium.We investigated the association between adenosine ...Background:A high ablation success rate for ventricular arrhythmia (VA) from outflow tract has been achieved,but some of them cannot be eliminated from endocardium.We investigated the association between adenosine sensitivity and ablation success/recurrence rates with a nonirrigated or an irrigated catheter.Methods:According to adenosine test,all patients were divided into a sensitive group (S group) or an insensitive group (Ⅰ group).The patients of each group were randomized into a nonirrigated catheter (NA) subgroup or an irrigated catheter (IA) subgroup with a 2∶1 ratio.Results:In S group of 122 patients (84 in NA subgroup),the ablation success rate was similar between two subgroups (94.7% vs.90.5%,P 〉 0.05),but in Ⅰ group of 94 patients (60 in NA subgroup),it was higher in IA subgroup (94.1%) than that in NA subgroup (73.3%,P 〈 0.05).The success rate using nonirrigated catheter was significantly higher in S group (90.5%) than that in Ⅰ group (73.3%,P 〈 0.01),and the recurrence rate was lower in S group than that in Ⅰ group (1.3%,vs.13.6%,P 〈 0.05).On the contrary,the success rate and the recurrence rate using irrigated catheter were similar between S group and 1 group (94.7%,94.1%,P 〉 0.05,vs.2.8%,6.3%,P 〉 0.05).Conclusions:Adenosine insensitivity is associated with a lower success rate and a higher recurrence rate for VA patients undergoing nonirrigated catheter ablation.Thus,irrigated catheters should be the first choice for VA ablation in adenosine insensitive patients.展开更多
BACKGROUND False tendon is a common intraventricular anatomical variation. It refers to a fibroid or fibromuscular structure that exists in the ventricle besides the normal connection of papillary muscle and mitral or...BACKGROUND False tendon is a common intraventricular anatomical variation. It refers to a fibroid or fibromuscular structure that exists in the ventricle besides the normal connection of papillary muscle and mitral or tricuspid valve. A large number of clinical studies have suggested that there is a significant correlation between false tendons and premature ventricular complexes. However, few studies have verified this correlation during radiofrequency catheter ablation of premature ventricular complexes.CASE SUMMARY A 45-year-old male was admitted to receive radiofrequency ablation for symptomatic premature ventricular complexes. A three-dimensional model of the left ventricle was established by intracardiac echocardiography using the CartoSound^TM mapping system. In addition to the left anterior papillary muscle,the posterior papillary muscle was mapped. False tendons were found at the base of the interventricular septum, and the other end was connected to the left ventricular free wall near the apex. An irrigated touch force catheter was advanced into the left ventricle via the retrograde approach. The earliest activation site was marked at the interventricular septum attachment of the false tendons and was successfully ablated.CONCLUSION This case verified that false tendons can cause premature ventricular complexes and may be cured by radiofrequency ablation guided by intracardiac echocardiography with the Carto Sound TM system.展开更多
Background:Premature ventricular complexes(PVCs)from the proximal left bundle branch(LBB)can be ablated in the left ventricular outflow tract but can easily damage normal conduction bundles.Here,we report a case of suc...Background:Premature ventricular complexes(PVCs)from the proximal left bundle branch(LBB)can be ablated in the left ventricular outflow tract but can easily damage normal conduction bundles.Here,we report a case of successful ablation of PVCs from the proximal LBB within the right coronary cusp(RCC).Case presentation:Our patient was a 70-year-old woman with PVCs from the proximal LBB that were successfully ablated via the RCC through radiofrequency catheter ablation with a 3D mapping system;she had a complication of incomplete right bundle branch block(RBBB)and remained asymptomatic during follow-up.Conclusion:The RCC provides an alternative approach for ablating PVCs originating from the proximal LBB,ow-ing to the close relationship between the RCC and proximal LBB.展开更多
BACKGROUND Cardiac lipomas are rare benign tumors commonly found in the right atrium or left ventricle.Patients are usually asymptomatic,and clinical presentation depends on location and adjacent structures impairment...BACKGROUND Cardiac lipomas are rare benign tumors commonly found in the right atrium or left ventricle.Patients are usually asymptomatic,and clinical presentation depends on location and adjacent structures impairment.Right ventricle lipomas are scarce in the literature.Moreover,the previous published cases were reported in over 18-year-old patients.CASE SUMMARY We report a giant right ventricle lipoma discovered incidentally in a 17-year-old female while performing preoperative work-up.The diagnosis was confirmed by histopathological examination,and a conservative approach was performed.CONCLUSION Multimodal cardiac imaging and histopathological examination are required for a definitive diagnosis.The therapeutic approach depends on clinical presentation.展开更多
BACKGROUND The R-on-T phenomenon is a malignant arrhythmia associated with potentially catastrophic consequences.It may initiate ventricular tachycardia or ventricular fibrillation,which can result in syncope or sudde...BACKGROUND The R-on-T phenomenon is a malignant arrhythmia associated with potentially catastrophic consequences.It may initiate ventricular tachycardia or ventricular fibrillation,which can result in syncope or sudden cardiac death.This manifestation poses a great challenge for anesthesiologists.However,it is rarely encountered in the perioperative setting.CASE SUMMARY We herein present a case in which the R-on-T phenomenon was incidentally revealed by 24-h Holter monitoring in a patient diagnosed with sigmoid colon cancer.Careful evaluation and treatment with mexiletine were carried out preoperatively under consultation with a cardiovascular specialist,and surgery was uneventfully performed under general anesthesia after thorough preparation.CONCLUSION Physicians should be vigilant about this infrequent but potentially fatal arrhythmia.Our experience suggests that the anesthetic process can be greatly optimized with careful preparation.展开更多
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 ...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.展开更多
Background:Premature ventricular contractions (PVCs) are common in the general population,and frequent PVCs may result in the poor quality of life or even the damage of cardiac function.We examined the efficacy and...Background:Premature ventricular contractions (PVCs) are common in the general population,and frequent PVCs may result in the poor quality of life or even the damage of cardiac function.We examined the efficacy and safety of a traditional Chinese medicine Wenxin Keli for the treatment of frequent PVCs among a relatively large Chinese cohort.Methods:We performed a randomized,double-blind,placebo-controlled,parallel-group,multicenter trial.A total of 1200 eligible participants were randomly assigned in a ratio of 1:1 to receive Wenxin Keli or the placebo for 4 weeks.The primary and secondary endpoint was the change of PVC numbers and PVC-related symptoms after a 4-week treatment compared with baseline,respectively.In addition,vital signs,laboratory values,and electrocardiographic parameters were assessed in a safety analysis.Results:At the initial evaluation,no significant differences in the baseline characteristics were observed between the Wenxin Keli group and the placebo group.A smaller number of PVCs was observed after the 4-week treatment than at baseline,in both the Wenxin Keli group (5686 ± 5940 vs.15,138 ± 7597 beats/d,P < 0.001) and the placebo group (10,592 ± 8009 vs.14,529 ± 5929 beats/d,P < 0.001);moreover,the Wenxin Keli group demonstrated a significantly greater reduction in the frequency of PVCs than the placebo group (P < 0.001).In a full analysis set,patients in the Wenxin Keli group exhibited significantly higher total effective responses in the reduction of PVCs compared to those in the placebo group (83.8% vs.43.5%,P < 0.001).The per-protocol analysis yielded similar results (83.0% vs.39.3%,P < 0.001).Treatment with Wenxin Keli also demonstrated superior performance compared to the placebo with respect to PVC-related symptoms.No severe adverse effects attributable to Wenxin Keli were reported.Conclusions:Wenxin Keli treatment effectively reduced the overall number of PVCs and alleviated PVC-related symptoms in patients without structural heart diseases and had no severe side effects.展开更多
Background Premature ventricular contraction (PVC) is one of the most common kinds of arrhythmias for which the treatment falls into dilemma. Previous clinical application showed that the traditional Chinese Medicin...Background Premature ventricular contraction (PVC) is one of the most common kinds of arrhythmias for which the treatment falls into dilemma. Previous clinical application showed that the traditional Chinese Medicine Shensongyangxin (SSYX) capsule is efficacious for the treatment of PVCs. This randomized clinical trial aimed to further evaluate the efficacy and safety of SSYX capsule on treating PVC. Methods The subjects who had frequent PVCs with or without organic heart disease and normal cardiac function were enrolled in the study. The primary endpoint was the change of PVC numbers after eight-week medication with SSYX capsule. The secondary endpoints included change of clinical symptoms related to PVCs and the safety evaluation of SSYX capsule. Totally 188 PVC patients were randomly enrolled in the non-organic heart disease PVCs trial and orally took either $SYX capsules or analogues (three times per day, 4 capsules one time). A total of 671 PVCs patients were randomly enrolled in the organic heart disease PVCs trial, and orally took either SSYX capsules (three times per day, 4 capsules one time) or mexiletine tablet (three times per day, 150 mg one time). The PVCs were monitored and calculated with 24-hour Holter electrocardiogram. Routine blood, liver and kidney function were tested before and after medication with SSYX capsule. Results SSYX capsules significantly decreased the PVCs numbers and alleviated the related symptoms in patients with or without organic heart disease. In non-organic heart disease group, SSYX capsules and the placebos decreased the PVCs from 12561.34±9777.93 to 4806.87±6507.17, and 12 605.69±8736.34 to 10364.94±9903.41, respectively. The total effective rate was 74.2% and 28.9% in SSYX and placebo groups (P〈0.001). In organic heart disease group, SSYX capsule and mexiletine decreased the PVCs from 8641.01±8923.57 to 3853.68±7096.42, 8621.61±8367.74 to 5648.29±8667.38, respectively, The total effective rate was 65.8% and 50.7% in SSYX and mexiletine groups (P〈0.001). In addition, SSYX capsule significantly alleviated PVCs-related symptoms such as palpitations, chest tightness, insomnia fatigue, and night sweats. No adverse cardiac events were observed except some slight gastrointestinal side effects during the study. Conclusions Compared with placebo or mexiletine, SSYX capsules have significant therapeutic efficacy in reducing PVCs numbers and alleviate PVCs-related symptoms.展开更多
Background Frequent premature ventricular complexes from the right ventricular outflow tract (RVOT-PVCs) are associated with left ventricular dysfunction.This study adopted two-dimensional speckle tracking imaging t...Background Frequent premature ventricular complexes from the right ventricular outflow tract (RVOT-PVCs) are associated with left ventricular dysfunction.This study adopted two-dimensional speckle tracking imaging to evaluate global and regional left ventricular myocardial function in patients with frequent RVOT-PVCs.Methods This study included 30 patients with frequent RVOT-PVCs and 30 healthy subjects.Aortic systolic velocity-time integral (AoVTI) and myocardium strain in circumferential (CS),radial (RS) and longitudinal (LS) directions were evaluated by conventional echocardiography and speckle tracking imaging.All values of patients with RVOT-PVCs were recorded during sinus (PVC-S) and PVC beats (PVC-V).Results Significant differences were demonstrated in global CS,RS and LS between the control subjects and the PVC-V (CS:(17.46±2.48)% vs.(11.52±3.28)%,RS:(48.26±10.20)% vs.(20.92±9.78)%,LS:(19.89±2.62)% vs.(11.79±3.66)%,P 〈0.01),and in segmental RS and LS of nearly all the left ventricular segments.Statistical differences in segmental CS between the PVC-V and the control subjects were only observed in anterior,anteroseptal and septal segments (only seen in anteroseptal and septal segments at apex).Furthermore,V/S AoVTI (AoVTI during the PVC beat divided by AoVTI during the sinus beat,then multiplied by 100%) correlated with coupling interval (r=0.67,P 〈0.001) and global strain (CS:r=0.48,P=0.007; RS:r=0.65,P 〈0.001; LS:r=0.65,P 〈0.001).Conclusions Frequent RVOT-PVCs can induce global and regional left ventricular systolic dysfunction.The reduction of hemodynamic parameters relates to the coupling interval and the global systolic function.展开更多
Background Anxiety appears to be more common in patients with coronary artery disease (CHD) than in the general population, and anxiety symptoms may precede onset of CHD and play an important role in development of ...Background Anxiety appears to be more common in patients with coronary artery disease (CHD) than in the general population, and anxiety symptoms may precede onset of CHD and play an important role in development of CHD. Little is known about the prevalence of anxiety symptoms in Chinese patients with premature ventricular contractions (PVCs). Our objective was to study anxiety symptoms and potential risk factors in a Chinese population with PVCs but without structural heart disease. Methods The Zung self-rating anxiety scale (ZSAS) was used to assess anxiety symptoms. Correlation between anxiety symptoms and socio-demographics and medical factors were analyzed by Logistic regression. Results Of 1144 patients with PVCs (487 males and 657 females), age (53+23) years old, disease duration 1 month to 24 years, a total of 381 (33.3%) patients were categorized as having anxiety symptoms. Anxiety symptoms increased with age, low income, low education level, nationality, PVC count/24 hours, bad social support, village settlement type (P 〈0.05). Multivariate Logistic regression indicated that six variablesmeducation level, ethnic minorities, dwelling place, age, PVC count/24 hours, and social support--significantly and independently related with anxiety symptoms (P 〈0.05). Conclusions In the Chinese population, anxiety symptoms in subjects with PVCs were frequent. Education level, ethnic minorities, dwelling place, age, PVC count/24 hours, and social support were independent risk factors for anxiety symptoms. Further research on the relationship between PVCs and anxiety symptoms in China is necessary.展开更多
Premature ventricular contractions(PVCs) are abnormal heart beats that indicate potential heart diseases. Diagnosis of PVCs is made by physicians examining long recordings of electrocardiogram(ECG), which is onerous a...Premature ventricular contractions(PVCs) are abnormal heart beats that indicate potential heart diseases. Diagnosis of PVCs is made by physicians examining long recordings of electrocardiogram(ECG), which is onerous and time-consuming. In this study, deep learning was applied to develop models that can detect PVCs in children automatically. This computer-aided diagnosis model achieved high accuracy while sustained stable performance. It could save time and repeated efforts for physicians, enabling them to focus on more complicated tasks.This study is a first step toward children's PVC auto-detection in clinics. Further study will improve the model's performance with optimized structure and more data in different sources, while facing the challenges of the variety and uncertainty of children's ECG with heart diseases.展开更多
Background Premature ventricular contractions(PVCs) are associated with an increased risk of morbidity and mortality. Therefore, this study was aimed to assess the prevalence and risk factors of frequent PVCs in Gua...Background Premature ventricular contractions(PVCs) are associated with an increased risk of morbidity and mortality. Therefore, this study was aimed to assess the prevalence and risk factors of frequent PVCs in Guangzhou communities. Methods Our population-based study included 12013 adults from the permanent residents aged 35 years old and above in 20 communities of Yuexiu District and Panyu District in Guangzhou. Standard 12-lead ECG was performed in 11,634 residents. PVC count was determined by 24-hour Holter ECG in8172 residents. We performed multivariable regression analysis using stepwise backward selection to identify factors independently associated with frequent PVCs(≥ 1% of the total beats). Results Among those who received12-lead ECG, 4,095 were men, accounting for 35.2% of 11634 participants. 1.6% the residents had PVCs and median age was 59 years. 2852(34.9%) were male in 8172 subjects who received 24-hour Holter ECG and 1239 of the 8172 subjects(15.2%) were diagnosed with PVCs by single-lead dynamic electrocardiogram. 2.9% subjects were accounted PVCs exceeded 1% of the total heartbeats, 0.2% subjects were accounted PVC exceeded 10% of the total heartbeats. The multivariable analysis showed that four factors related with frequent premature ventricular contractions included aging(odds ratio(OR) 1.027; 95% CI 1.015 to 1.039), male gender(1.533; 95% CI1.162 to 2.023), high diastolic pressure(1.027; 95% CI 1.015 to 1.039) and long QTc interval(1.016; 95% CI1.005 to 1.027). Besides, frequent vegetable intake(0.225; 95% CI 0.064 to 0.795), high LDL(0.787; 95% CI0.684 to 0.906) and high TG(0.873; 95% CI 0.771 to 0.989) were the protective factors of frequent PVCs. Conclusion PVCs is prevalent in Guangzhou communities. The factors such as age, gender, blood pressure, QTc,vegetable intake, LDL and TG care associated with PVCs.展开更多
BACKGROUND Coronary calcium poses a challenge for the interventional cardiologist often leading to stent under-expansion and subsequent ischemic events.Aggressive balloon post-dilatation though helpful is usually inad...BACKGROUND Coronary calcium poses a challenge for the interventional cardiologist often leading to stent under-expansion and subsequent ischemic events.Aggressive balloon post-dilatation though helpful is usually inadequate.Multiple plaque ablation techniques are in vogue,but they are technically demanding and are not without complications.Shockwave intravascular lithotripsy(S-IVL)has emerged as a user-friendly and effective mechanism for calcium management with a high safety margin.A series of trials(DISRUPT CAD I-IV)have demonstrated both short-term and long-term safety and efficacy of the technique.As experience with the technique grows more and more,therapy areas like stent restenosis are being covered by the S-IVL.CASE SUMMARY We report a series of 2 cases successfully managed with S-IVL therapy at our center.The first case is of a 57-year-old smoker who presented with acute coronary syndrome.His left anterior descending coronary artery revealed calcified 90%stenosis on angiogram and a combination of superficial-deep calcium on intracoronary imaging.The calcium was treated with 20 pulses of S-IVL to create discontinuity and a sirolimus eluting drug-eluting stent was successfully implanted.The second case is that of an elderly lady who presented with stable angina and demonstrated diffuse calcified lesions in the left anterior descending artery on angiogram.She also demonstrated a mixture of superficial and deep seated calcium zones on imaging.S-IVL therapy was applied to generate fractures in calcium,and two overlapping drug-eluting stents were implanted successfully without any complications.CONCLUSION S-IVL is an emerging,efficient,user-friendly and safe therapy for managing intracoronary calcium in routine interventional practice.展开更多
Premature ventricular contraction(PVC) is the most frequent arrhythmia encountered in clinical practice. PVC may occur in health subjects, which is not imminently life-threatening but may require therapies to prevent ...Premature ventricular contraction(PVC) is the most frequent arrhythmia encountered in clinical practice. PVC may occur in health subjects, which is not imminently life-threatening but may require therapies to prevent further problems. So,the timely PVC recognition becomes very important for the analysis of electrocardiogram(ECG), especially for the remote ECG monitoring using mobile phones. In this paper,a construction method of personalized ECG template and a PVC recognition method based on template matching were studied. Firstly, we selected 43 ECG recordings from the MIT-BIH arrhythmia database. All recordings were divided into two datasets(DS1for training and DS2 for testing) and each dataset approximately contained the same proportion of PVC beats. Subsequently, for each recording(30 min) in DS1, the first5 min recordings were used to construct the personalized ECG template and the last25 min recordings were used for the R-wave peaks detection and PVC recognition,where the template matching method were used. The validity of the proposed methods was tested using DS2. The results showed that: 1) high beat detection accuracy was achieved for both PVC beats and non-PVC beats; 2) the sensitivity and specificity of PVC recognition were 99.11% and 99.96% for the first 5 min recordings respectively,99.17% and 99.43% for the last 25 min recordings respectively. All the proposed methods can be real-time performed, which show a promising prospect for the application of ECG mobile phones.展开更多
文摘The therapeutic principle of clearing away the heart-heat to induce tranquilization was adopted in 107 middle-aged and senile patients with ventricular premature beat of coronary heart disease on the basis of pathogenic features of phlegm, heat, blood stasis and deficiency in this condition. Qing Xin An Shen Fang ([symbol: see text] a formula for clearing away the heart-heat to induce tranquilization) was used in the treatment group and compared with mexiletine and Fu Fang Dan Shen Tablets ([symbol: see text] Compound Salvia Tablets) used in the control group. The results turned to be that the markedly effective rate was 85.1% and the total effective rate 96.3% in the treated group, better than that in the control group, with the former having a good antihypertensive and antihyperlipemic effect and an effect of improving microcirculation and clinical symptoms.
文摘Objective:To explore the clinical efficacy of Ningxin Tongluo Decoction(宁心通络汤)combined with Dapagliflozin in the treatment of type 2 diabetes mellitus complicated with ventricular premature beats.Methods:Ninety-two patients with type 2 diabetes mellitus complicated with ventricular premature beats in our hospital were randomly divided into control group(n=46)and observation group(n=46).The control group was treated with routine Western medicine,and the observation group was treated with Ningxin Tongluo Decoction on the basis of the control group.The clinical efficacy of the two groups before and after treatment,TCM syndrome score,blood glucose levels[fasting blood glucose(GLU),glycosylated hemoglobin(Hb A1c)],glucose metabolism levels[fasting insulin(FINS),insulin resistance index(HOMA-IR)],the number of ventricular premature beats detected by 24-hour ambulatory electrocardiogram,heart rate turbulence(HRT)[initial oscillation(TO),oscillation slope(TS)],and heart rate variability(HRV)standard deviation of two normal R-R intervals(SDNN),standard deviation of average normal R-R intervals every 5 minutes(SDANN)and root mean square of adjacent normal R-R intervals(RMSSD)were observed.Results:After treatment,the total effective rate of the observation group was 89.13%,significantly higher than that of the control group(73.91%),and the difference was statistically significant(P<0.05).Both groups could reduce TCM syndrome score,blood glucose level,glucose metabolism level,reduce the number of ventricular premature beats,improve HRT and HRV levels,and the observation group was superior to the control group,and the difference was statistically significant(P<0.05).Conclusion:Ningxin Tongluo Decoction combined with Dapagliflozin is effective in treating type 2 diabetes mellitus patients with ventricular premature beats.It can reduce blood glucose level,improve HRV and HRT,improve autonomic nerve function and exert antiarrhythmic effect.
文摘A series of related electrophysiology phenomena can be caused by the occurrence of interpolated ventricular premature contraction.In our recent three-dimensional Lorenz R-R scatter plot research,we found that atrioventricular node double path caused by interpolated ventricular premature contraction imprints a specifi c pattern on three-dimensional Lorenz plots generated from 24-hour Holter recordings.We found two independent subclusters separated from the interpolated premature beat precluster,the interpolated premature beat cluster,and the interpolated premature beat postcluster,respectively.Combined with use of the trajectory tracking function and the leap phenomenon,our results reveal the presence of the atrioventricular node double conduction path.
文摘Ventricular premature beat,a kind of arrhythmia,is one of common diseases which not only decreases the quality of life but also has the danger of death.The pathogenesis in Traditional Chinese Medicine is that the injury of heart and kidney is the essence and the block of solid evil such as phlegm and blood stasis is the manifestation.The teacher,Li Yuan,has worked in clinic for decades and considered that the important pathogenesis of the VP beat is“heat transformed from Yang”,which cannot be ignored as it is on the influence of diverse factors and can be observed in different symptoms and different treatment states of the disease.
文摘From August 1989 to May 1994, 84 cases of ventricular premature beat (VPB) with deficiency syndrome were treated with our empirical prescription called Qi Lu Tang Decoction for Improving Abnormal Heart Beat). The total effective rate was 88.10%, being significantly different from that of the control group treated with the Western drug propafenone (P
基金supported by the innovation project in Jiangsu province,Chinathe Program for Development of Innovative Research Team in the First Affiliated Hospital of NJMU(IRT-004)
文摘Recent studies have shown that premature ventricular contractions (PVCs) could enlarge the heart, but its risk factors are incompletely understood as a single 24-hour recording cannot reflect the true PVC burden due to day-to-day variability. Our purpose was to investigate the effect of burden and origin sites on left ventricular (LV) function in patients with PVCs by 7-day Holter electrocardiography (ECG). From May 2012 to August 2013, 112 consecutive patients with PVCs were recruited from the authors' affiliated hospital. All patients received 2-dimensional transthoracic echocardiography, 12-lead routing ECG and 7-days Holter ECG. Serum N-terminal pro- brain natriuretic peptide (NT-proBNP) levels were measured. A total of 102 participants with PVCs were included in the final analysis. Origin of PVCs from the tricuspid annulus had the highest burden and NT-proBNP level. LV papillary muscle had a higher LV ejection fraction (EF) level and a lower LV end-systolic dimension (ESD) than other PVC foci (P〈0.05). The high burden group had a higher LV end-diastolic dimension (EDD) and LVESD but lower LVEF than the other two groups (P〈0.05). Female, older age, physical work, and history of PVCs had a significantly positive correlation with symptoms. Male, older age, physical work, and high burden were positive predictors of enlarged LVEDD, LVESD and higher serum NT-proBNP level, but lower LVEF. Seven-day dynamic ECG Holter monitor showed the true PVC burden on patients with PVCs. PVCs with a lower burden or origin from the LV papillary muscle and the fascicle were relatively benign, while PVCs with a higher burden or origin from the tricuspid annulus may lead to cardiac dysfunction.
文摘Background:A high ablation success rate for ventricular arrhythmia (VA) from outflow tract has been achieved,but some of them cannot be eliminated from endocardium.We investigated the association between adenosine sensitivity and ablation success/recurrence rates with a nonirrigated or an irrigated catheter.Methods:According to adenosine test,all patients were divided into a sensitive group (S group) or an insensitive group (Ⅰ group).The patients of each group were randomized into a nonirrigated catheter (NA) subgroup or an irrigated catheter (IA) subgroup with a 2∶1 ratio.Results:In S group of 122 patients (84 in NA subgroup),the ablation success rate was similar between two subgroups (94.7% vs.90.5%,P 〉 0.05),but in Ⅰ group of 94 patients (60 in NA subgroup),it was higher in IA subgroup (94.1%) than that in NA subgroup (73.3%,P 〈 0.05).The success rate using nonirrigated catheter was significantly higher in S group (90.5%) than that in Ⅰ group (73.3%,P 〈 0.01),and the recurrence rate was lower in S group than that in Ⅰ group (1.3%,vs.13.6%,P 〈 0.05).On the contrary,the success rate and the recurrence rate using irrigated catheter were similar between S group and 1 group (94.7%,94.1%,P 〉 0.05,vs.2.8%,6.3%,P 〉 0.05).Conclusions:Adenosine insensitivity is associated with a lower success rate and a higher recurrence rate for VA patients undergoing nonirrigated catheter ablation.Thus,irrigated catheters should be the first choice for VA ablation in adenosine insensitive patients.
文摘BACKGROUND False tendon is a common intraventricular anatomical variation. It refers to a fibroid or fibromuscular structure that exists in the ventricle besides the normal connection of papillary muscle and mitral or tricuspid valve. A large number of clinical studies have suggested that there is a significant correlation between false tendons and premature ventricular complexes. However, few studies have verified this correlation during radiofrequency catheter ablation of premature ventricular complexes.CASE SUMMARY A 45-year-old male was admitted to receive radiofrequency ablation for symptomatic premature ventricular complexes. A three-dimensional model of the left ventricle was established by intracardiac echocardiography using the CartoSound^TM mapping system. In addition to the left anterior papillary muscle,the posterior papillary muscle was mapped. False tendons were found at the base of the interventricular septum, and the other end was connected to the left ventricular free wall near the apex. An irrigated touch force catheter was advanced into the left ventricle via the retrograde approach. The earliest activation site was marked at the interventricular septum attachment of the false tendons and was successfully ablated.CONCLUSION This case verified that false tendons can cause premature ventricular complexes and may be cured by radiofrequency ablation guided by intracardiac echocardiography with the Carto Sound TM system.
文摘Background:Premature ventricular complexes(PVCs)from the proximal left bundle branch(LBB)can be ablated in the left ventricular outflow tract but can easily damage normal conduction bundles.Here,we report a case of successful ablation of PVCs from the proximal LBB within the right coronary cusp(RCC).Case presentation:Our patient was a 70-year-old woman with PVCs from the proximal LBB that were successfully ablated via the RCC through radiofrequency catheter ablation with a 3D mapping system;she had a complication of incomplete right bundle branch block(RBBB)and remained asymptomatic during follow-up.Conclusion:The RCC provides an alternative approach for ablating PVCs originating from the proximal LBB,ow-ing to the close relationship between the RCC and proximal LBB.
文摘BACKGROUND Cardiac lipomas are rare benign tumors commonly found in the right atrium or left ventricle.Patients are usually asymptomatic,and clinical presentation depends on location and adjacent structures impairment.Right ventricle lipomas are scarce in the literature.Moreover,the previous published cases were reported in over 18-year-old patients.CASE SUMMARY We report a giant right ventricle lipoma discovered incidentally in a 17-year-old female while performing preoperative work-up.The diagnosis was confirmed by histopathological examination,and a conservative approach was performed.CONCLUSION Multimodal cardiac imaging and histopathological examination are required for a definitive diagnosis.The therapeutic approach depends on clinical presentation.
文摘BACKGROUND The R-on-T phenomenon is a malignant arrhythmia associated with potentially catastrophic consequences.It may initiate ventricular tachycardia or ventricular fibrillation,which can result in syncope or sudden cardiac death.This manifestation poses a great challenge for anesthesiologists.However,it is rarely encountered in the perioperative setting.CASE SUMMARY We herein present a case in which the R-on-T phenomenon was incidentally revealed by 24-h Holter monitoring in a patient diagnosed with sigmoid colon cancer.Careful evaluation and treatment with mexiletine were carried out preoperatively under consultation with a cardiovascular specialist,and surgery was uneventfully performed under general anesthesia after thorough preparation.CONCLUSION Physicians should be vigilant about this infrequent but potentially fatal arrhythmia.Our experience suggests that the anesthetic process can be greatly optimized with careful preparation.
文摘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.
文摘Background:Premature ventricular contractions (PVCs) are common in the general population,and frequent PVCs may result in the poor quality of life or even the damage of cardiac function.We examined the efficacy and safety of a traditional Chinese medicine Wenxin Keli for the treatment of frequent PVCs among a relatively large Chinese cohort.Methods:We performed a randomized,double-blind,placebo-controlled,parallel-group,multicenter trial.A total of 1200 eligible participants were randomly assigned in a ratio of 1:1 to receive Wenxin Keli or the placebo for 4 weeks.The primary and secondary endpoint was the change of PVC numbers and PVC-related symptoms after a 4-week treatment compared with baseline,respectively.In addition,vital signs,laboratory values,and electrocardiographic parameters were assessed in a safety analysis.Results:At the initial evaluation,no significant differences in the baseline characteristics were observed between the Wenxin Keli group and the placebo group.A smaller number of PVCs was observed after the 4-week treatment than at baseline,in both the Wenxin Keli group (5686 ± 5940 vs.15,138 ± 7597 beats/d,P < 0.001) and the placebo group (10,592 ± 8009 vs.14,529 ± 5929 beats/d,P < 0.001);moreover,the Wenxin Keli group demonstrated a significantly greater reduction in the frequency of PVCs than the placebo group (P < 0.001).In a full analysis set,patients in the Wenxin Keli group exhibited significantly higher total effective responses in the reduction of PVCs compared to those in the placebo group (83.8% vs.43.5%,P < 0.001).The per-protocol analysis yielded similar results (83.0% vs.39.3%,P < 0.001).Treatment with Wenxin Keli also demonstrated superior performance compared to the placebo with respect to PVC-related symptoms.No severe adverse effects attributable to Wenxin Keli were reported.Conclusions:Wenxin Keli treatment effectively reduced the overall number of PVCs and alleviated PVC-related symptoms in patients without structural heart diseases and had no severe side effects.
文摘Background Premature ventricular contraction (PVC) is one of the most common kinds of arrhythmias for which the treatment falls into dilemma. Previous clinical application showed that the traditional Chinese Medicine Shensongyangxin (SSYX) capsule is efficacious for the treatment of PVCs. This randomized clinical trial aimed to further evaluate the efficacy and safety of SSYX capsule on treating PVC. Methods The subjects who had frequent PVCs with or without organic heart disease and normal cardiac function were enrolled in the study. The primary endpoint was the change of PVC numbers after eight-week medication with SSYX capsule. The secondary endpoints included change of clinical symptoms related to PVCs and the safety evaluation of SSYX capsule. Totally 188 PVC patients were randomly enrolled in the non-organic heart disease PVCs trial and orally took either $SYX capsules or analogues (three times per day, 4 capsules one time). A total of 671 PVCs patients were randomly enrolled in the organic heart disease PVCs trial, and orally took either SSYX capsules (three times per day, 4 capsules one time) or mexiletine tablet (three times per day, 150 mg one time). The PVCs were monitored and calculated with 24-hour Holter electrocardiogram. Routine blood, liver and kidney function were tested before and after medication with SSYX capsule. Results SSYX capsules significantly decreased the PVCs numbers and alleviated the related symptoms in patients with or without organic heart disease. In non-organic heart disease group, SSYX capsules and the placebos decreased the PVCs from 12561.34±9777.93 to 4806.87±6507.17, and 12 605.69±8736.34 to 10364.94±9903.41, respectively. The total effective rate was 74.2% and 28.9% in SSYX and placebo groups (P〈0.001). In organic heart disease group, SSYX capsule and mexiletine decreased the PVCs from 8641.01±8923.57 to 3853.68±7096.42, 8621.61±8367.74 to 5648.29±8667.38, respectively, The total effective rate was 65.8% and 50.7% in SSYX and mexiletine groups (P〈0.001). In addition, SSYX capsule significantly alleviated PVCs-related symptoms such as palpitations, chest tightness, insomnia fatigue, and night sweats. No adverse cardiac events were observed except some slight gastrointestinal side effects during the study. Conclusions Compared with placebo or mexiletine, SSYX capsules have significant therapeutic efficacy in reducing PVCs numbers and alleviate PVCs-related symptoms.
文摘Background Frequent premature ventricular complexes from the right ventricular outflow tract (RVOT-PVCs) are associated with left ventricular dysfunction.This study adopted two-dimensional speckle tracking imaging to evaluate global and regional left ventricular myocardial function in patients with frequent RVOT-PVCs.Methods This study included 30 patients with frequent RVOT-PVCs and 30 healthy subjects.Aortic systolic velocity-time integral (AoVTI) and myocardium strain in circumferential (CS),radial (RS) and longitudinal (LS) directions were evaluated by conventional echocardiography and speckle tracking imaging.All values of patients with RVOT-PVCs were recorded during sinus (PVC-S) and PVC beats (PVC-V).Results Significant differences were demonstrated in global CS,RS and LS between the control subjects and the PVC-V (CS:(17.46±2.48)% vs.(11.52±3.28)%,RS:(48.26±10.20)% vs.(20.92±9.78)%,LS:(19.89±2.62)% vs.(11.79±3.66)%,P 〈0.01),and in segmental RS and LS of nearly all the left ventricular segments.Statistical differences in segmental CS between the PVC-V and the control subjects were only observed in anterior,anteroseptal and septal segments (only seen in anteroseptal and septal segments at apex).Furthermore,V/S AoVTI (AoVTI during the PVC beat divided by AoVTI during the sinus beat,then multiplied by 100%) correlated with coupling interval (r=0.67,P 〈0.001) and global strain (CS:r=0.48,P=0.007; RS:r=0.65,P 〈0.001; LS:r=0.65,P 〈0.001).Conclusions Frequent RVOT-PVCs can induce global and regional left ventricular systolic dysfunction.The reduction of hemodynamic parameters relates to the coupling interval and the global systolic function.
基金State Natural Science Foundation of China,the Eleventh Five-year Priority Projects of Hubei Science and Technology Department,Natural Science Foundation of Hubei,the National 211 Priority Projects of Wuhan University
文摘Background Anxiety appears to be more common in patients with coronary artery disease (CHD) than in the general population, and anxiety symptoms may precede onset of CHD and play an important role in development of CHD. Little is known about the prevalence of anxiety symptoms in Chinese patients with premature ventricular contractions (PVCs). Our objective was to study anxiety symptoms and potential risk factors in a Chinese population with PVCs but without structural heart disease. Methods The Zung self-rating anxiety scale (ZSAS) was used to assess anxiety symptoms. Correlation between anxiety symptoms and socio-demographics and medical factors were analyzed by Logistic regression. Results Of 1144 patients with PVCs (487 males and 657 females), age (53+23) years old, disease duration 1 month to 24 years, a total of 381 (33.3%) patients were categorized as having anxiety symptoms. Anxiety symptoms increased with age, low income, low education level, nationality, PVC count/24 hours, bad social support, village settlement type (P 〈0.05). Multivariate Logistic regression indicated that six variablesmeducation level, ethnic minorities, dwelling place, age, PVC count/24 hours, and social support--significantly and independently related with anxiety symptoms (P 〈0.05). Conclusions In the Chinese population, anxiety symptoms in subjects with PVCs were frequent. Education level, ethnic minorities, dwelling place, age, PVC count/24 hours, and social support were independent risk factors for anxiety symptoms. Further research on the relationship between PVCs and anxiety symptoms in China is necessary.
文摘Premature ventricular contractions(PVCs) are abnormal heart beats that indicate potential heart diseases. Diagnosis of PVCs is made by physicians examining long recordings of electrocardiogram(ECG), which is onerous and time-consuming. In this study, deep learning was applied to develop models that can detect PVCs in children automatically. This computer-aided diagnosis model achieved high accuracy while sustained stable performance. It could save time and repeated efforts for physicians, enabling them to focus on more complicated tasks.This study is a first step toward children's PVC auto-detection in clinics. Further study will improve the model's performance with optimized structure and more data in different sources, while facing the challenges of the variety and uncertainty of children's ECG with heart diseases.
文摘Background Premature ventricular contractions(PVCs) are associated with an increased risk of morbidity and mortality. Therefore, this study was aimed to assess the prevalence and risk factors of frequent PVCs in Guangzhou communities. Methods Our population-based study included 12013 adults from the permanent residents aged 35 years old and above in 20 communities of Yuexiu District and Panyu District in Guangzhou. Standard 12-lead ECG was performed in 11,634 residents. PVC count was determined by 24-hour Holter ECG in8172 residents. We performed multivariable regression analysis using stepwise backward selection to identify factors independently associated with frequent PVCs(≥ 1% of the total beats). Results Among those who received12-lead ECG, 4,095 were men, accounting for 35.2% of 11634 participants. 1.6% the residents had PVCs and median age was 59 years. 2852(34.9%) were male in 8172 subjects who received 24-hour Holter ECG and 1239 of the 8172 subjects(15.2%) were diagnosed with PVCs by single-lead dynamic electrocardiogram. 2.9% subjects were accounted PVCs exceeded 1% of the total heartbeats, 0.2% subjects were accounted PVC exceeded 10% of the total heartbeats. The multivariable analysis showed that four factors related with frequent premature ventricular contractions included aging(odds ratio(OR) 1.027; 95% CI 1.015 to 1.039), male gender(1.533; 95% CI1.162 to 2.023), high diastolic pressure(1.027; 95% CI 1.015 to 1.039) and long QTc interval(1.016; 95% CI1.005 to 1.027). Besides, frequent vegetable intake(0.225; 95% CI 0.064 to 0.795), high LDL(0.787; 95% CI0.684 to 0.906) and high TG(0.873; 95% CI 0.771 to 0.989) were the protective factors of frequent PVCs. Conclusion PVCs is prevalent in Guangzhou communities. The factors such as age, gender, blood pressure, QTc,vegetable intake, LDL and TG care associated with PVCs.
文摘BACKGROUND Coronary calcium poses a challenge for the interventional cardiologist often leading to stent under-expansion and subsequent ischemic events.Aggressive balloon post-dilatation though helpful is usually inadequate.Multiple plaque ablation techniques are in vogue,but they are technically demanding and are not without complications.Shockwave intravascular lithotripsy(S-IVL)has emerged as a user-friendly and effective mechanism for calcium management with a high safety margin.A series of trials(DISRUPT CAD I-IV)have demonstrated both short-term and long-term safety and efficacy of the technique.As experience with the technique grows more and more,therapy areas like stent restenosis are being covered by the S-IVL.CASE SUMMARY We report a series of 2 cases successfully managed with S-IVL therapy at our center.The first case is of a 57-year-old smoker who presented with acute coronary syndrome.His left anterior descending coronary artery revealed calcified 90%stenosis on angiogram and a combination of superficial-deep calcium on intracoronary imaging.The calcium was treated with 20 pulses of S-IVL to create discontinuity and a sirolimus eluting drug-eluting stent was successfully implanted.The second case is that of an elderly lady who presented with stable angina and demonstrated diffuse calcified lesions in the left anterior descending artery on angiogram.She also demonstrated a mixture of superficial and deep seated calcium zones on imaging.S-IVL therapy was applied to generate fractures in calcium,and two overlapping drug-eluting stents were implanted successfully without any complications.CONCLUSION S-IVL is an emerging,efficient,user-friendly and safe therapy for managing intracoronary calcium in routine interventional practice.
基金The China Postdoctoral Science Foundation Funded Projectgrant number:20110491593
文摘Premature ventricular contraction(PVC) is the most frequent arrhythmia encountered in clinical practice. PVC may occur in health subjects, which is not imminently life-threatening but may require therapies to prevent further problems. So,the timely PVC recognition becomes very important for the analysis of electrocardiogram(ECG), especially for the remote ECG monitoring using mobile phones. In this paper,a construction method of personalized ECG template and a PVC recognition method based on template matching were studied. Firstly, we selected 43 ECG recordings from the MIT-BIH arrhythmia database. All recordings were divided into two datasets(DS1for training and DS2 for testing) and each dataset approximately contained the same proportion of PVC beats. Subsequently, for each recording(30 min) in DS1, the first5 min recordings were used to construct the personalized ECG template and the last25 min recordings were used for the R-wave peaks detection and PVC recognition,where the template matching method were used. The validity of the proposed methods was tested using DS2. The results showed that: 1) high beat detection accuracy was achieved for both PVC beats and non-PVC beats; 2) the sensitivity and specificity of PVC recognition were 99.11% and 99.96% for the first 5 min recordings respectively,99.17% and 99.43% for the last 25 min recordings respectively. All the proposed methods can be real-time performed, which show a promising prospect for the application of ECG mobile phones.