Background Major atrial coronary arteries, including the sinus node artery （SNA）, were commonly found in the areas involved in atrial fibrillation （AF） ablation and could cause difficulties in achieving linear blo...Background Major atrial coronary arteries, including the sinus node artery （SNA）, were commonly found in the areas involved in atrial fibrillation （AF） ablation and could cause difficulties in achieving linear block at the left atrial （LA） roof. The SNA is a major atrial coronary artery of the atrial coronary circulation. This study aimed to determine impact of the origin of SNA on recurrence of AF after pulmonary vein isolation （PVI） in patients with paroxysmal AF. Methods Seventy-eight patients underwent coronary angiography for suspected coronary heart disease, followed by catheter ablation for paroxysmal AF. According to the origin of SNA from angiographic findings, they were divided into right SNA group （SNA originating from the right coronary artery） and left SNA group （SNA originating from the left circumflex artery）. Guided by an electroanatomic mapping system, circumferential pulmonary vein ablation （CPVA） was performed in both groups and PVI was the procedural endpoint. All patients were followed up at 1, 3, 6, 9 and 12 months post-ablation. Recurrence was defined as any episode of atrial tachyarrhythmias （ATAs）, including AF, atrial flutter or atrial tachycardia, that lasted longer than 30 seconds after a blanking period of 3 months. Results The SNA originated from the right coronary artery in 34 patients （43.6%） and the left circumflex artery in 44 patients （56.4%）. Freedom from AF and antiarrhythmic drugs （AADs） at 1 year was 67.9 % （53/78） for all patients. After 1 year follow-up, 79.4% （27/34） in right SNA group and 59.1% （26/44） in left SNA group （P=0.042） were in sinus rhythm. On multivariate analysis, left atrium size （HR=1.451, 95%Cl： 1.240-1.697, P 〈0.001） and a left SNA （HR=6.22, 95%Cl： 2.01-19.25, P=0.002） were the independent predictors of AF recurrence. Conclusions The left SNA is more frequent in the patients with paroxysmal AF. After one year follow-up, the presence of a left SNA was identified as an independent predictor of AF recurrence after CPVA in paroxysmal AF.展开更多
BACKGROUND Cardiac arrhythmias,including bradyarrhythmias,have been described as manifestations of coronavirus disease 2019(COVID-19).Herein,we present a case of junctional bradycardia secondary to possible sinus node...BACKGROUND Cardiac arrhythmias,including bradyarrhythmias,have been described as manifestations of coronavirus disease 2019(COVID-19).Herein,we present a case of junctional bradycardia secondary to possible sinus node dysfunction in a patient with COVID-19.CASE SUMMARY The patient was a 32-year-old woman with no significant medical history.On the third day of hospitalization,she developed junctional bradycardia while being hemodynamically stable.The episodes of nodal dysrhythmia with a low heart rate persisted for the next few days and were associated with elevated levels of systemic inflammatory markers.The patient received antiviral and anti-inflammatory treatments for the viral infection but no antiarrhythmic medications.She had a normal sinus rhythm on day 12.CONCLUSION Cardiac rhythm monitoring,focusing on the association between cardiac arrhythmias and the systemic inflammatory response,is important in COVID-19 patients.展开更多
The effects of Saponins of Panax Quinquefolium Leaf and Stem(SPQLS)were evaluatedin the rabbit sinus node and in the guinea pig papillary muscles both showing slow responses in high[k+].and being exposed to 0.3 μmol/...The effects of Saponins of Panax Quinquefolium Leaf and Stem(SPQLS)were evaluatedin the rabbit sinus node and in the guinea pig papillary muscles both showing slow responses in high[k+].and being exposed to 0.3 μmol/L verapamil using conventional microelcctrode technique.Inthe sinus node, SPQLS 100 mg/L decreased the APA and Vmax.At the concentration of 200 mg/L,in addition to further depressing the upotroke,SPQIS decreased the SP4,shortened the APD and prolonged the SCL.In the guinea Pig papillary muscle,SPQLS shortened the APD and decreased theAPA as well as Vmax in high[k+3].When verapamil was exposed to the normal Tyrode's solution,SPQLS depressed the upstroke without-affecting the APD in the guinea pig papillary muscle.Thesefindings suggest that SPQLS exerted a blockade effect on the transmembrane Ca2+ influx and Na+ influx in myocardium.展开更多
基金This work was supported by grants from the Beijing Municipal Science ＆ Technology Commission （No. Dl111070030-0000）, the National Science Foundation of China （No. 30971239, No. 81070147）, the Beijing Natural Science Foundation （No. 7101004） and Beijing Postdoctoral Science Foundation （No. 2012zz-40）.
文摘Background Major atrial coronary arteries, including the sinus node artery （SNA）, were commonly found in the areas involved in atrial fibrillation （AF） ablation and could cause difficulties in achieving linear block at the left atrial （LA） roof. The SNA is a major atrial coronary artery of the atrial coronary circulation. This study aimed to determine impact of the origin of SNA on recurrence of AF after pulmonary vein isolation （PVI） in patients with paroxysmal AF. Methods Seventy-eight patients underwent coronary angiography for suspected coronary heart disease, followed by catheter ablation for paroxysmal AF. According to the origin of SNA from angiographic findings, they were divided into right SNA group （SNA originating from the right coronary artery） and left SNA group （SNA originating from the left circumflex artery）. Guided by an electroanatomic mapping system, circumferential pulmonary vein ablation （CPVA） was performed in both groups and PVI was the procedural endpoint. All patients were followed up at 1, 3, 6, 9 and 12 months post-ablation. Recurrence was defined as any episode of atrial tachyarrhythmias （ATAs）, including AF, atrial flutter or atrial tachycardia, that lasted longer than 30 seconds after a blanking period of 3 months. Results The SNA originated from the right coronary artery in 34 patients （43.6%） and the left circumflex artery in 44 patients （56.4%）. Freedom from AF and antiarrhythmic drugs （AADs） at 1 year was 67.9 % （53/78） for all patients. After 1 year follow-up, 79.4% （27/34） in right SNA group and 59.1% （26/44） in left SNA group （P=0.042） were in sinus rhythm. On multivariate analysis, left atrium size （HR=1.451, 95%Cl： 1.240-1.697, P 〈0.001） and a left SNA （HR=6.22, 95%Cl： 2.01-19.25, P=0.002） were the independent predictors of AF recurrence. Conclusions The left SNA is more frequent in the patients with paroxysmal AF. After one year follow-up, the presence of a left SNA was identified as an independent predictor of AF recurrence after CPVA in paroxysmal AF.
文摘BACKGROUND Cardiac arrhythmias,including bradyarrhythmias,have been described as manifestations of coronavirus disease 2019(COVID-19).Herein,we present a case of junctional bradycardia secondary to possible sinus node dysfunction in a patient with COVID-19.CASE SUMMARY The patient was a 32-year-old woman with no significant medical history.On the third day of hospitalization,she developed junctional bradycardia while being hemodynamically stable.The episodes of nodal dysrhythmia with a low heart rate persisted for the next few days and were associated with elevated levels of systemic inflammatory markers.The patient received antiviral and anti-inflammatory treatments for the viral infection but no antiarrhythmic medications.She had a normal sinus rhythm on day 12.CONCLUSION Cardiac rhythm monitoring,focusing on the association between cardiac arrhythmias and the systemic inflammatory response,is important in COVID-19 patients.
文摘The effects of Saponins of Panax Quinquefolium Leaf and Stem(SPQLS)were evaluatedin the rabbit sinus node and in the guinea pig papillary muscles both showing slow responses in high[k+].and being exposed to 0.3 μmol/L verapamil using conventional microelcctrode technique.Inthe sinus node, SPQLS 100 mg/L decreased the APA and Vmax.At the concentration of 200 mg/L,in addition to further depressing the upotroke,SPQIS decreased the SP4,shortened the APD and prolonged the SCL.In the guinea Pig papillary muscle,SPQLS shortened the APD and decreased theAPA as well as Vmax in high[k+3].When verapamil was exposed to the normal Tyrode's solution,SPQLS depressed the upstroke without-affecting the APD in the guinea pig papillary muscle.Thesefindings suggest that SPQLS exerted a blockade effect on the transmembrane Ca2+ influx and Na+ influx in myocardium.
