BACKGROUND A modified Valsalva maneuver(VM)has been suggested to be superior to the standard VM for conversion of paroxysmal supraventricular tachycardia(PSVT).AIM To evaluate the efficacy and economic benefits of a m...BACKGROUND A modified Valsalva maneuver(VM)has been suggested to be superior to the standard VM for conversion of paroxysmal supraventricular tachycardia(PSVT).AIM To evaluate the efficacy and economic benefits of a modified VM in Chinese patients.METHODS Patients with PSVT admitted to our center between October 2017 and September 2019 were randomly assigned to the modified and standard VM groups.Conversion via VM was performed up to three times.The primary outcome of the study was the success rate of PSVT conversion to sinus rhythm.The secondary outcomes included the incidence of adverse events,economic cost during the visit,and the degree of patient acceptance of the treatment.RESULTS Overall,361 patients were enrolled,with 180 allocated to the modified VM group and 181 to the standard VM group.Baseline characteristics were well matched in the groups.Overall,the modified VM group had higher success rates of PSVT conversion after single(47.78%vs 15.38%,P<0.001)and multiple(62.22%vs 19.78%,P<0.001)VM sessions.No significant differences in the incidences of adverse events and rates of patient acceptance were detected between the two groups(both P>0.05).Moreover,the economic cost of the clinic visit was significantly lower for the modified VM group than for the standard VM group(P<0.05).CONCLUSION The modified VM may confer both therapeutic and economic benefits as compared with the standard VM for conversion of PSVT.展开更多
Radioimmunoassays were used to measure the concentration changes of plasma endothelin(ET) and atrial natriuretic peptide(ANP) during the onset and after termination of paroxysmal supraventricular tachycardia(SVT). 30 ...Radioimmunoassays were used to measure the concentration changes of plasma endothelin(ET) and atrial natriuretic peptide(ANP) during the onset and after termination of paroxysmal supraventricular tachycardia(SVT). 30 cases were reviewed and compansons with 42 normal subjects were made. There are very significant differences(P<0.0001) in the concentration changes of both plasma ET and ANP during the onset and 30 minutes after the termination of SVT. During the onset period of SVT. the plasma ET and ANP were markedly elevated and 30 minutes after its termination they were lowered significantly, but their concentrations were still 2-fold higher than ihose of the control group. As the biological effects of ANP and ET are antagonistic to each other. their parallel elevation and lowering of plasma concentrations during and.after the termination of SVT reveal that these 2 hormones parucipate in the pathophysiological process of SVT. This phenomenon is possibly one of the homeostatic regulatory functions in the organism.展开更多
Pregnant women show characteristic hemodynamics, and their heart rates ordinarily increase with uterine contractions during labor. Conversely, uterine contraction-associated decelerations of maternal heart rate (MHR) ...Pregnant women show characteristic hemodynamics, and their heart rates ordinarily increase with uterine contractions during labor. Conversely, uterine contraction-associated decelerations of maternal heart rate (MHR) are rare. We present a pregnant woman with paroxysmal supraventricular tachycardia (PSVT) who exhibited intrapartum MHR deceleration pattern. We performed simultaneous fetal heart rate monitoring with an external ultrasound transducer and MHR monitoring with a tocogram during her parturition. She developed a PSVT exacerbation in the second stage of parturition. As revealed by cardiotocography, the MHR baseline abruptly declined at onset of uterine contractions during the active phase of labor. Recovery followed, and the contraction resolved. The tachycardia got prolonged as the labor advanced. Our patient exhibited the unusual, up-and-down changes of the MHR pattern associated with labor contractions. The etiology of the occurrence of uterine contraction-associated MHR decelerations was unclear in the present case. Continuous tracing to visually inspect MHR patterns during parturition is a simple method for examining real-time MHR status of patients treated within obstetric practice settings.展开更多
Radiofrequency catheter ablation(RFCA)were performed in 142 patients with paroxysmal supraventricular reentranltechycardia(PSVT),including 67 patients of left side accessory pathway,20 patients of right side accessory...Radiofrequency catheter ablation(RFCA)were performed in 142 patients with paroxysmal supraventricular reentranltechycardia(PSVT),including 67 patients of left side accessory pathway,20 patients of right side accessory pathway,48 patients with slow-fast type atrioventricular nodal reentrent tachyardia(AVNRT),and 7 patients with strialreetrant tachycardia(ART),The average of age was 40.9±13.8 years old(14-72ys).Transesophagus and intracardiacelectrophysiologic studies were carried out in all patients,and the Pv1-Pe,R-Pe were compared in these two methods.In order to assess the clinical significant of Pvl-Pe.R-Pe in diagnosis of various types of supratachycardia anddifferent accessory pathway.ResultsConclusionsThis article analysed the relations of the Pvl-Pe,R-Pe and the Δ A,V-A in all 142 patients with SVT.It is suggestthat AVRT with anterograde,Pvl-Pe was more than 25 ms,R-Pe more than 75ms,with the exception of RSAP Pvl-Pewas 0,R-Pe more than 75ms.In petients with ART,Pvl-Pe more than 25ms,R-Pe more than 150ms and R-Pe morethan Pe-R.AVNRT group Pvl-Pe less than 25ms,R-Pe less than 70ms.These are very sensitive and specific in makingthe diagnosis of SVT,It is also useful that conceled assessory pathway site can be decided,according to the trend ofchange of Pvl-Pe and R-Pe.We concluded that tranesophagus Pvl-Pe and R-Pe hold great value on diagnsis ofvarious types of supraventricular展开更多
The commonly proposed mechamism of syncope in patients(pts)withparoxymal supraventricular tachycardia(PSVT)is a more rapid tachycardiarate.Nevertheless,the probability of a coesxistent vasovagal syncope(VS)component h...The commonly proposed mechamism of syncope in patients(pts)withparoxymal supraventricular tachycardia(PSVT)is a more rapid tachycardiarate.Nevertheless,the probability of a coesxistent vasovagal syncope(VS)component has not bees adequatelly investigated in these patients.Westudied 3 groups:group 1(G1):20 syucopal patients(age:37±9 years,M/F:11/9)with supraventricular tachycardia,group 2(G2):40 Syncopalpatients(age:37±13 year,M/F:19/21)without supraventriculartachycardia,these syncopal patients with syncope of unknown etiology andgroup 3(G3):22 healthy controls(age:39±10 years,M/F:10/12).Thesame tilt table test(TTT)protocol was used(25min in 80 degreesUpright followed by two 10 min stages in the same postion undergraded isoproternol(iso)intravebiys infusion at 2ug/min and 5ug/min).The tilt table test was considered positive(pos)if induced syncope dueto hypocension with of without bradycardia.Results:A positive tilttable test result was observed in 13 patients of G1(65%)and 30 patientsof group 2(75%)(pNS).In contrast,only 5 of the healthy controls group(22.7%)developed syncope(p【0.05).We conclude that syncopalsupraventricular tachycardia patients commonly demonstrate a positivetilt table test.Tilt table test is a useful test for investigatingsyncope in patients with supraventricular tachycardia.Tilt table testis also a safe,simple and effective test for nonivasive identifyingvasovagal syncope.Tilt table test shoule be used widely.展开更多
The effect of selective radiofrequency ablation for treating paroxysmal supraventricular tachycardia （PSVT） and its associated paroxysmal atrial fibrillation （PAF） was assessed. Methods Data were collected retrosp...The effect of selective radiofrequency ablation for treating paroxysmal supraventricular tachycardia （PSVT） and its associated paroxysmal atrial fibrillation （PAF） was assessed. Methods Data were collected retrospectively from patients diagnosed of PSVT and subsequently treated with radiofrequency ablation. Regular monthly follow-up by dynamic electrocardiography （ECG） was performed. Incident rates of atrial fibrillation before and after ablation were compared. Results 382 PSVT patients with 58 having atrial fibrillation were en- rolled. The order of complicated PAF from high to low in these patients was displayed as： atrial tachycardia （AT）, atrioventricular reentrant tachycardia （AVRT） and atrioventricular nodal reentrant tachycardia （AVNRT）. Among AVRT patients, PAF was more frequent in patients having accessory pathways. AVNRT patients had significant- ly lower PAF rate comparing to other patients. PAF incident rate was significantly reduced by radiofrequency ablation therapy. Conclusion We advise regular dynamic ECG for PSVT patients, especially those with atrial flutter, AT or pre-excitation syndrome. Selective radiofrequency ablation is a feasible approach for treating AF complicated PSVT patients.展开更多
目的分析阵发性室上性心动过速(PSVT)患儿心率变异性(HRV),探讨自主神经系统活动在PSVT发生中的作用。方法选择25例PSVT患儿,其中16例为房室折返性心动过速(AVRT)患儿,30例健康儿童,分析及比较24 h HRV长程时域指标。结果与健康儿童相比...目的分析阵发性室上性心动过速(PSVT)患儿心率变异性(HRV),探讨自主神经系统活动在PSVT发生中的作用。方法选择25例PSVT患儿,其中16例为房室折返性心动过速(AVRT)患儿,30例健康儿童,分析及比较24 h HRV长程时域指标。结果与健康儿童相比,PSVT患儿RR间期总体标准差(SDNN)、相邻RR间期差值的均方根(RMSSD)降低,差异均有统计学意义(P均<0.05);而RR间期平均值的标准差(SDANN)、RR间期标准差的平均值(SDNNindex)差异均无统计学意义(P均>0.05)。16例AVRT患儿中,10例频繁发作患儿的SDNN、RMSSD、SDANN、SDNNindex均低于6例非频繁发作患儿,差异均有统计学意义(P均<0.05)。结论 PSVT患儿存在自主神经系统失衡,以迷走神经功能降低为主;频繁发作AVRT患儿心脏交感神经活动亦存在明显增强。展开更多
基金Supported by Key Research and Development Project of Shandong Province,No.2016GST201224and Jinan Clinical Medicine Science and Technology Innovation Plan,No.201907056.
文摘BACKGROUND A modified Valsalva maneuver(VM)has been suggested to be superior to the standard VM for conversion of paroxysmal supraventricular tachycardia(PSVT).AIM To evaluate the efficacy and economic benefits of a modified VM in Chinese patients.METHODS Patients with PSVT admitted to our center between October 2017 and September 2019 were randomly assigned to the modified and standard VM groups.Conversion via VM was performed up to three times.The primary outcome of the study was the success rate of PSVT conversion to sinus rhythm.The secondary outcomes included the incidence of adverse events,economic cost during the visit,and the degree of patient acceptance of the treatment.RESULTS Overall,361 patients were enrolled,with 180 allocated to the modified VM group and 181 to the standard VM group.Baseline characteristics were well matched in the groups.Overall,the modified VM group had higher success rates of PSVT conversion after single(47.78%vs 15.38%,P<0.001)and multiple(62.22%vs 19.78%,P<0.001)VM sessions.No significant differences in the incidences of adverse events and rates of patient acceptance were detected between the two groups(both P>0.05).Moreover,the economic cost of the clinic visit was significantly lower for the modified VM group than for the standard VM group(P<0.05).CONCLUSION The modified VM may confer both therapeutic and economic benefits as compared with the standard VM for conversion of PSVT.
文摘Radioimmunoassays were used to measure the concentration changes of plasma endothelin(ET) and atrial natriuretic peptide(ANP) during the onset and after termination of paroxysmal supraventricular tachycardia(SVT). 30 cases were reviewed and compansons with 42 normal subjects were made. There are very significant differences(P<0.0001) in the concentration changes of both plasma ET and ANP during the onset and 30 minutes after the termination of SVT. During the onset period of SVT. the plasma ET and ANP were markedly elevated and 30 minutes after its termination they were lowered significantly, but their concentrations were still 2-fold higher than ihose of the control group. As the biological effects of ANP and ET are antagonistic to each other. their parallel elevation and lowering of plasma concentrations during and.after the termination of SVT reveal that these 2 hormones parucipate in the pathophysiological process of SVT. This phenomenon is possibly one of the homeostatic regulatory functions in the organism.
文摘Pregnant women show characteristic hemodynamics, and their heart rates ordinarily increase with uterine contractions during labor. Conversely, uterine contraction-associated decelerations of maternal heart rate (MHR) are rare. We present a pregnant woman with paroxysmal supraventricular tachycardia (PSVT) who exhibited intrapartum MHR deceleration pattern. We performed simultaneous fetal heart rate monitoring with an external ultrasound transducer and MHR monitoring with a tocogram during her parturition. She developed a PSVT exacerbation in the second stage of parturition. As revealed by cardiotocography, the MHR baseline abruptly declined at onset of uterine contractions during the active phase of labor. Recovery followed, and the contraction resolved. The tachycardia got prolonged as the labor advanced. Our patient exhibited the unusual, up-and-down changes of the MHR pattern associated with labor contractions. The etiology of the occurrence of uterine contraction-associated MHR decelerations was unclear in the present case. Continuous tracing to visually inspect MHR patterns during parturition is a simple method for examining real-time MHR status of patients treated within obstetric practice settings.
文摘Radiofrequency catheter ablation(RFCA)were performed in 142 patients with paroxysmal supraventricular reentranltechycardia(PSVT),including 67 patients of left side accessory pathway,20 patients of right side accessory pathway,48 patients with slow-fast type atrioventricular nodal reentrent tachyardia(AVNRT),and 7 patients with strialreetrant tachycardia(ART),The average of age was 40.9±13.8 years old(14-72ys).Transesophagus and intracardiacelectrophysiologic studies were carried out in all patients,and the Pv1-Pe,R-Pe were compared in these two methods.In order to assess the clinical significant of Pvl-Pe.R-Pe in diagnosis of various types of supratachycardia anddifferent accessory pathway.ResultsConclusionsThis article analysed the relations of the Pvl-Pe,R-Pe and the Δ A,V-A in all 142 patients with SVT.It is suggestthat AVRT with anterograde,Pvl-Pe was more than 25 ms,R-Pe more than 75ms,with the exception of RSAP Pvl-Pewas 0,R-Pe more than 75ms.In petients with ART,Pvl-Pe more than 25ms,R-Pe more than 150ms and R-Pe morethan Pe-R.AVNRT group Pvl-Pe less than 25ms,R-Pe less than 70ms.These are very sensitive and specific in makingthe diagnosis of SVT,It is also useful that conceled assessory pathway site can be decided,according to the trend ofchange of Pvl-Pe and R-Pe.We concluded that tranesophagus Pvl-Pe and R-Pe hold great value on diagnsis ofvarious types of supraventricular
文摘The commonly proposed mechamism of syncope in patients(pts)withparoxymal supraventricular tachycardia(PSVT)is a more rapid tachycardiarate.Nevertheless,the probability of a coesxistent vasovagal syncope(VS)component has not bees adequatelly investigated in these patients.Westudied 3 groups:group 1(G1):20 syucopal patients(age:37±9 years,M/F:11/9)with supraventricular tachycardia,group 2(G2):40 Syncopalpatients(age:37±13 year,M/F:19/21)without supraventriculartachycardia,these syncopal patients with syncope of unknown etiology andgroup 3(G3):22 healthy controls(age:39±10 years,M/F:10/12).Thesame tilt table test(TTT)protocol was used(25min in 80 degreesUpright followed by two 10 min stages in the same postion undergraded isoproternol(iso)intravebiys infusion at 2ug/min and 5ug/min).The tilt table test was considered positive(pos)if induced syncope dueto hypocension with of without bradycardia.Results:A positive tilttable test result was observed in 13 patients of G1(65%)and 30 patientsof group 2(75%)(pNS).In contrast,only 5 of the healthy controls group(22.7%)developed syncope(p【0.05).We conclude that syncopalsupraventricular tachycardia patients commonly demonstrate a positivetilt table test.Tilt table test is a useful test for investigatingsyncope in patients with supraventricular tachycardia.Tilt table testis also a safe,simple and effective test for nonivasive identifyingvasovagal syncope.Tilt table test shoule be used widely.
文摘The effect of selective radiofrequency ablation for treating paroxysmal supraventricular tachycardia （PSVT） and its associated paroxysmal atrial fibrillation （PAF） was assessed. Methods Data were collected retrospectively from patients diagnosed of PSVT and subsequently treated with radiofrequency ablation. Regular monthly follow-up by dynamic electrocardiography （ECG） was performed. Incident rates of atrial fibrillation before and after ablation were compared. Results 382 PSVT patients with 58 having atrial fibrillation were en- rolled. The order of complicated PAF from high to low in these patients was displayed as： atrial tachycardia （AT）, atrioventricular reentrant tachycardia （AVRT） and atrioventricular nodal reentrant tachycardia （AVNRT）. Among AVRT patients, PAF was more frequent in patients having accessory pathways. AVNRT patients had significant- ly lower PAF rate comparing to other patients. PAF incident rate was significantly reduced by radiofrequency ablation therapy. Conclusion We advise regular dynamic ECG for PSVT patients, especially those with atrial flutter, AT or pre-excitation syndrome. Selective radiofrequency ablation is a feasible approach for treating AF complicated PSVT patients.
文摘目的分析阵发性室上性心动过速(PSVT)患儿心率变异性(HRV),探讨自主神经系统活动在PSVT发生中的作用。方法选择25例PSVT患儿,其中16例为房室折返性心动过速(AVRT)患儿,30例健康儿童,分析及比较24 h HRV长程时域指标。结果与健康儿童相比,PSVT患儿RR间期总体标准差(SDNN)、相邻RR间期差值的均方根(RMSSD)降低,差异均有统计学意义(P均<0.05);而RR间期平均值的标准差(SDANN)、RR间期标准差的平均值(SDNNindex)差异均无统计学意义(P均>0.05)。16例AVRT患儿中,10例频繁发作患儿的SDNN、RMSSD、SDANN、SDNNindex均低于6例非频繁发作患儿,差异均有统计学意义(P均<0.05)。结论 PSVT患儿存在自主神经系统失衡,以迷走神经功能降低为主;频繁发作AVRT患儿心脏交感神经活动亦存在明显增强。
