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
Objective:To observe the HRV changes before and after the radiofrequency current catheter ablationventricular premature beats originated from different site of right ventricular outflow tract.Methods:A total of 102 pa...Objective:To observe the HRV changes before and after the radiofrequency current catheter ablationventricular premature beats originated from different site of right ventricular outflow tract.Methods:A total of 102 patients with frequent RVOT-VPC admitted to our hospital were accepted radiofrequency current catheter ablation (RF). According to the origin of RVOT-VPC, it was divided into 2 groups, one is from ventricular septum, and the other one is from free wall, and in each group, male and female are observed separately.Results:(1) HRV before RF ablation: 1) rMSSD in the female patients with RVOT-VPC from free wall was significantly lower than those from septum;2) frequency domain index (W, LF) were higher than normal range, and in male patients, LF/HF<1 were found, but in female patients, LF/HF>1. (2) HRV after RF ablation: 1) Significant changes were found in female patients with RVOT-VPC from septum, rMSSD, PNN50, HF and LF decreased;2) In female patients with RVOT-VPC from free wall, rMSSD decreased;3) In male patients, there were no significant HRV changes found before and after RF ablation. (3) Heart rate changes: 1) In female patients with RVOT-VPC from septum, heart rate decreased significantly ((76.47±9.47) bpm vs (69.29±14.59) bpm)2) No significant changes were found in male patients.Conclusion:In patients with RVOT-PVC sympathetic and vagus excitability increased, and after catheter ablation, in female patients with RVOT-PVC originated from septum, the HRV index relating to sympathetic and vagus excitability significantly decreased.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
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 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
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
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.
基金Natural Science Foundation Project of Beijing(7122173).
文摘Objective:To observe the HRV changes before and after the radiofrequency current catheter ablationventricular premature beats originated from different site of right ventricular outflow tract.Methods:A total of 102 patients with frequent RVOT-VPC admitted to our hospital were accepted radiofrequency current catheter ablation (RF). According to the origin of RVOT-VPC, it was divided into 2 groups, one is from ventricular septum, and the other one is from free wall, and in each group, male and female are observed separately.Results:(1) HRV before RF ablation: 1) rMSSD in the female patients with RVOT-VPC from free wall was significantly lower than those from septum;2) frequency domain index (W, LF) were higher than normal range, and in male patients, LF/HF<1 were found, but in female patients, LF/HF>1. (2) HRV after RF ablation: 1) Significant changes were found in female patients with RVOT-VPC from septum, rMSSD, PNN50, HF and LF decreased;2) In female patients with RVOT-VPC from free wall, rMSSD decreased;3) In male patients, there were no significant HRV changes found before and after RF ablation. (3) Heart rate changes: 1) In female patients with RVOT-VPC from septum, heart rate decreased significantly ((76.47±9.47) bpm vs (69.29±14.59) bpm)2) No significant changes were found in male patients.Conclusion:In patients with RVOT-PVC sympathetic and vagus excitability increased, and after catheter ablation, in female patients with RVOT-PVC originated from septum, the HRV index relating to sympathetic and vagus excitability significantly decreased.
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.
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.
