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Establishment of a predictive model for inpatient sudden cardiac death in a Chinese cardiac department population:a retrospective study

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Chinese Medical Journal 2019年第1期132卷 17-24页

作者： Lu-Xiang Shang Xian-Hui Zhou Jiang-Hua Zhang Wen-Hui Zhang ZuKe-La TuEr-Hong Yang Zhao Wen-Kui Lyu Yao-Dong Li Bao-Peng Tang Department of pacing and electrophysiology First Affiliated Hospital of Xinjiang Medical UniversityUrumqiXinjiang 830054China

Background:Little is known about the risk factors for sudden cardiac death (SCD) in the overall hospitalized cardiac department *** study was conducted to investigate the risk factors and develop a predictive model for SCD in a hospitalized cardiac department ***:We conducted a retrospective study of patients admitted to the cardiac department of the First Affiliated Hospital of Xinjiang Medical University from June 2015 to February *** collected the clinical data from medical *** stepwise logistic regression analysis was carried out to confirm the risk factors for SCD and develop a predictive risk *** risk score was assessed by the area under receiver operating characteristic (AUROC) curve and the Hosmer-Lemeshow goodness-of-fit ***:A total of 262 patients with SCD and 4485 controls were enrolled in our *** regression modeling identified eight significant risk factors for in-hospital SCD:age,main admitting diagnosis,diabetes,corrected QT interval,QRS duration,ventricular premature beat burden,left ventricular ejection fraction,and estimated glomerular filtration rate.A predictive risk score including these variables showed an AUROC curve of 0.774 (95% confidence interval:0.744–0.805).The Hosmer-Lemeshow goodness-of-fit test showed the chi-square value was 2.527 (P= 0.640).The incidence of in-hospital SCD was 1.3%,4.1%,and 18.6% for scores of 0 to 2,3 to 5 and ≥6,respectively (P<0.001).Conclusions:Age,main admitting diagnosis,diabetes,QTc interval,QRS duration,ventricular premature beat burden,left ventricular ejection fraction,and estimated glomerular filtration rate are factors related to in-hospital SCD in a hospitalized cardiac department *** developed a predictive risk score including these factors that could identify patients who are predisposed to in-hospital SCD.

关键词： Sudden cardiac death inpatient risk factors predictive risk score

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Ventricular tachycardia as the initial symptom of cardiac hydatidosis

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Chinese Medical Journal 2019年第22期132卷 2765-2766页

作者： Yan-Mei Lu Ling Zhang Qiang Xing Xian-Hui Zhou Yao-Dong Li Jiang-Hua Zhang Tuerhong Zukela Bao-Peng Tang Department of pacing electrophysiology The First Affiliated Hospital of Xinjiang Medical UniversityUrumqiXinjiang 830054China

To the Editor:A 44-year-old female presented at the local hospital for repeated episodes of having palp Nations,accompanied with cold sweats,amaurosis,vomiting,and limb weakness in the previous 2 *** electrocardiogram indicated "ventricular tachycardia" when she was not feeling *** symptoms alleviated significantly after injections of"amiodarone"(dose unknown),after which the patient was discharged.A local physician recommended ablation,so the patient was transferred to our *** patient was generally healthy and had lived in a region with *** to the patient5 self-report,she had been diagnosed as having liver hydatidosis 30 years ago,but had recovered after surgical treatment at the local ***,the patient claimed to have no other medical history.

关键词： tachycardia transferred claimed

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INTRA-HISIAN BLOCK ASSOCIATED WITH UNUSUAL ETIOLOGIES

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中华医学杂志(英文版) 1987年第3期100卷 167-172页

作者：孙瑞龙王方正胡绳俊田瑞国 Cardiac pacing and electrophysiology Laboratory Institute of Cardiovascular Diseases and Fuwai Hospital Chinese Academy of Medical Sciences Beijing

Four cases with documented intra-Hisian block associated with unusual etiologies are reported. They occurred in rheumatoid arthritis, cysticercosis cellulosae, Behcet’s disease and aorto-arteritis.

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Real-time cardiovascular magnetic resonance-guided radiofrequency ablation:A comprehensive review

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世界心脏病学杂志:英文版(电子版) 2023年第9期15卷 415-426页

作者： Konstantinos Tampakis Sokratis Pastromas Alexandros Sykiotis Stamatina Kampanarou Georgios Kourgiannidis Chrysa Pyrpiri Maria Bousoula Dimitrios Rozakis George Andrikopoulos Department of pacing&electrophysiology Henry Dunant Hospital CenterAthens 11526Greece Department of Radiology Henry Dunant Hospital CenterAthens 11526Greece Department of Anesthesiology Henry Dunant Hospital CenterAthens 11526Greece

Cardiac magnetic resonance(CMR)imaging could enable major advantages when guiding in real-time cardiac electrophysiology procedures offering high-resolu-tion anatomy,arrhythmia substrate,and ablation lesion visualization in the absence of ionizing *** the last decade,technologies and platforms for performing electrophysiology procedures in a CMR environment have been ***,performing procedures outside the conventional fluoro-scopic laboratory posed technical,practical and safety *** development of magnetic resonance imaging compatible ablation systems,the recording of high-quality electrograms despite significant electromagnetic interference and reliable methods for catheter visualization and lesion assessment are the main limiting *** first human reports,in order to establish a procedural workflow,have rationally focused on the relatively simple typical atrial flutter ablation and have shown that CMR-guided cavotricuspid isthmus ablation represents a valid alternative to conventional *** expansion to other more complex arrhythmias,especially ventricular tachycardia and atrial fibrillation,would be of essential impact,taking into consideration the widespread use of substrate-based ***,all limitations need to be solved before application of CMR-guided ablation in a broad clinical setting.

关键词： Interventional cardiac magnetic resonance Image-guided ablation Substrate ablation Cavotricuspid isthmus Catheter ablation Tracking

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Improvement in MR and in the dyssynchrony between the mid segments predict super responders in patients undergoing CRT

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World Journal of Cardiovascular Diseases 2012年第4期2卷 295-301页

作者： Miry Blich Shemy Carasso Mahmoud Suleiman Ibrahim Marai Tawfig Zeidan Shwiri Lior Gepstein Monther Boulos Division of Echocardiography Department of Cardiology Rambam Health Care Campus and Rappaport Faculty of Medicine Division of pacing and electrophysiology Technion Haifa Israel

Background: Twenty to thirty percent of patients with left heart failure in randomized trials do not respond clinically to cardiac resynchronization therapy (CRT). The objectives of our work were to estimate the effec-tiveness of CRT in our routine practice, and to find predictors of favorable response to CRT. Methods: Retrospective analysis of consecutive patients who underwent CRT from 2003-2007. Results: Fifty six consecutive patients (73.2% men, age 66.3 ± 10.2 years) with left heart failure (LHF) (ischemic cardiomyopathy 60.7%) received CRT and were followed for a mean of 27 months. After the implantation: Mean NYHA improved by one class (p < 0.001), LHF admissions were reduced by 79% (p < 0.0001) and mean ejection fruction improved by 31% (19.5% vs 25.6%, p < 0.002). Significant improvement in severity of mitral regurgitation (MR) was an important predictor of high responsiveness (p = 0.004). Improvement of MR was associated with complete left bundle branch block (CLBBB) (p = 0.04) and lower total mortality (p = 0.005). Improvement in synchronization between the mid lateral and mid septal segments, as was calculated with longitudinal strain using echocardiography (105 ± 38 vs 20 ± 23 msec, p = 0.008) was predictor of super responsiveness and reduction in MR among patients with moderate to severe MR prior to implantation. Worsening the delay between the mid posterior and mid anterior septal segments (21 ± 27 vs 120 ± 0 msec, p = 0.006) was associated with absence of response and lack of improvement in MR. Conclusions: Patients who improve mid segments dyssynchrony in four chamber view, have more chance to improve MR and to become super responders.

关键词： Mitral Regurgitation Cardiac Resynchronization Therapy

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Leadless pacemakers： a contemporary review

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Journal of Geriatric Cardiology 2018年第4期15卷 249-253页

作者： Neal Bhatia Mikhael El-Chami Department of Medicine Division of Cardiology Section of Electrophysiology Emory University School of Medicine Atlanta USA

1 Introduction Over one million cardiac pacemakers are implanted every year worldwide,[11 of which approximately 200,000 are implanted in the United States alone.121 Combined with an aging population and increasing pacing indications, these numbers are expected to grow. Since the first pacemaker implantation in 1950s, cardiac pacemaker technology has rapidly advanced. Reduction in generator size, increased battery longevity, quality of pacemaker leads, algorithmic and rate responsive programming-all have revolutionized and transformed the implantation and management of transvenous cardiac pacemaker （TV-PPM）.

关键词： Leadless pacemakers Micra Nanostim Perforation

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Patients taking angiotensin-converting enzyme inhibitors/angiotensin II type I receptor blockers:higher risks of severe acute respiratory syndrome coronavirus 2 infection but milder clinical manifestations?

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Chinese Medical Journal 2020年第22期133卷 2650-2652页

作者： Jie-Lin Deng Yun-Qiu Jiang Yan-Kai Guo Hong-Liang Li Department of Cardiology Renmin Hospital of Wuhan UniversityCardiovascular Research InstituteWuhan UniversityHubei Key Laboratory of CardiologyWuhanHubei 430060China Department of Medicine University of Oklahoma Health Sciences CenterOklahoma CityOK 73117USA Cardiac pacing and electrophysiology Department The First Affiliated Hospital of Xinjiang Medical UniversityUrumqiXinjiang 830000China

Recently,there has been an unprecedented interest in the topic of angiotensin converting enzyme 2(ACE2)-associated drugs administration,such as angiotensin-converting enzyme inhibitors(ACEIs)/angiotensin II type I receptor blockers(ARBs),in COVID-19 patients.A recent article put forward the concern that patients taking ACEIs/ARBs were under higher risk of COVID-19 infection.[1]They revealed that expression of ACE2,the receptor for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)to enter host cells,is up-regulated,thus facilitating the initial viral attachment step of SARS-CoV-2 in these patients.[2]

关键词： ACE2 respiratory acute

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A MEDIAN FOLLOW-UP OF TWENTY-TWO MONTHS FOR CARDIOVERTER DEFIBRILLATOR IMPLANTATION IN SYMPTOMATIC OR ASYMPTOMATIC PATIENTS WITH BRUGADA SYNDROME

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Medical Bulletin of Shanghai Jiaotong University 2010年第1期22卷 47-53页

作者：蔡煦苏静英黄剑锋沈卫峰 Stéphane Garrigue Pierre Bordachar Jacques Cl menty Department of Cardiology Ruijin HospitalSchool of MedicineShanghai Jiaotong University Department of Cardiac pacing and Clinical electrophysiology Hpital Cardiologique du Haut-LévêqueUniversity Bordeaux Ⅱ19 Avenue de Magellan

Objective To explore the outcome of patients with Brugada syndrome by remedial or prophylactic implantable cardioverter defibrillator （ ICD ） for ventricular tachyarrhythmia. Methods Sixteen single chamber ICDs and 5 double chamber ICDs in 21 consecutive patients [ 17 males, 4 females; mean age, （ 36 ± 11） years ] with Brugada syndrome were involved. Fifteen patients with spontaneous or induced ventricular tachycardia/ventricular fibrillation （VT/VF） received the remedial and prophylactic ICD implantation. Six patients only with positive family history or syncope accepted the ICD implantation for prophylaxis. Results After a median follow-up of （22.3 ± 13. 4） months, all patients were alive. One patient was suspected with febrile syndrome due to endocarditis on the auricular face of the lead of defibrillator 18 months after 1CD implantation and disappearance of vegetation was found after receiving one-month antibiotic treatment. Nine appropriate ICD interventions took place in 3 individuals with documented spontaneous ventricular arrhythmias. Multivariable analysis suggested that occurrence of appropriate interventions was related to the spontaneous ventricular arrhythmias （ P 〈 0. 0001 ）. Eleven inappropriate ICD interventions occurred in 3 patients for atrial fibrillation or atrial flutter with rapid ventricular rate. Multivariable analysis suggested that occurrence of inappropriate interventions was related to documented spontaneous supraventricular arrhythmias （P 〈 O. 0062 ）. All appropriate interventions and inappropriate interventions occurred within six months after ICD implantation. Conclusion Appropriate interventions may associate to spontaneous ventricular arrhythmias before 1CD implantation in patients with Brugada syndrome. Patients may suffer from inappropriate ICD intervention for supraventricular arrhythmias with rapid ventricular rate when they had a history of supraventricular arrhythmias.

关键词： Brugada syndorme implantable cardioverter defibrillator

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Effects of right atrial and ventricular DDD pacing on cardiac function and ventricular contraction synchrony

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Chinese Medical Journal 2004年第4期117卷 516-520页

作者：支力大华伟张澍史蓉芳王方正陈新 Division of Clinical electrophysiology Department of Nuclear Medicine

Background Right ventricular apical pacing has been reported to reduce cardiac performance. But there are few reports on the effects of dual chamber (DDD) pacing on cardiac function compared to sinus rhythm. In this study, we evaluated the effects of right atrial and ventricular DDD pacing on cardiac function and ventricular contraction synchrony using equilibrium radionuclide angiography. Methods Ten patients implanted with a right atrial and ventricular DDD pacemaker underwent equilibrium radionuclide angiography. The scintigraphic data were obtained during sinus rhythm and pacing rhythm. Cardiac function parameters were obtained semimanually. Phase analysis was used to study the ventricular activation sequence and ventricular synchrony. Results The left ventricular 1/3 ejection fraction decreased significantly during pacing compared with that during sinus rhythm[ (23.4 +/- 6.1)% vs (27.7 +/- 4.5) %, P = 0.01]. Regional ejection fraction also decreased during pacing, although the difference was not statistically significant. Phase analysis showed that the right ventricle was activated earlier than the left ventricle during pacing, and that the phase shift was significantly greater during pacing than that during sinus rhythm[ 64.13degrees +/- 16.80degrees vs 52.88degrees +/- 9.26degrees, P = 0. 007 ]. The activation of both ventricles occurred simultaneously during sinus rhythm, with the activation sequence from proximal septum or base of left ventricle to apex. The earliest activation during pacing occurred at the right ventricular apex, and subsequently spread to the base and left ventricle. Conclusion Right atrial and ventricular DDD pacing impairs left ventricular systolic function and ventricular synchrony.

关键词： equilibrium radionuclide angiography · phase analysis · cardiac pacing · cardiac function

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Leadless Cardiac Pacemaker: Does Anatomical Position at Implant Affect Long-Term Electrical Performance?

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Journal of Biomedical Science and Engineering 2017年第11期10卷 500-508页

作者： John Ip Abdul R. Safadi Randy Ip Matthew Gaskill Rajesh Banker Derek Exner Srinivas Dukkipati Mayer Rashtian Imran Niazi Cardiac electrophysiology Department Michigan State University Lansing USA Cardiac electrophysiology Department Premier Cardiology Inc Newport Beach USA Cardiac electrophysiology Department Foothills Medical Centre Calgary Canada Cardiac electrophysiology Department Mount Sinai Hospital New York USA Cardiac electrophysiology Department Huntington Memorial Hospital Pasadena USA Cardiac electrophysiology Department Aurora Medical Group Milwaukee USA

Background: The Nanostim {trade mark, serif} Leadless Cardiac Pacemaker (LCP) has been shown to be safe and effective in human clinical trials. Since there is little information on the effect of implant location on LCP performance, the aim of this study was to determine whether anatomic position affects the long-term pacing performance of the LCP. Methods: Patients who enrolled in the Leadless II IDE Clinical Trial and had finished 6 months follow up (n = 479) were selected for the study. The implanting investigators determined the LCP final position under fluoroscope, which was categorized into three groups: RV apex (RVA, n = 174), RV apical septum (RVAS, n = 101), and RV septum (RVS, n = 204) (Figure 1). Data on capture threshold (at a 0.4 ms pulse width), R-wave amplitude and impedance were analyzed at implant, hospital discharge and 2 weeks, 6 weeks, 3 months and 6 months post-implant. Results: At implant, the mean capture thresholds in the RVA, RVAS and RVS were 0.77 ± 0.45, 0.81 ± 0.61 and 0.78 ± 0.59 volts, respectively. R-wave amplitudes were 8.0 ± 3.0 mV, 7.7 ± 2.9 mV and 7.6 ± 2.9 mV, respectively. Impedance values were 727 ± 311, 765 ± 333, and 677 ± 227 respectively. There were no differences among the 3 implant locations in capture threshold or R-wave amplitudes at 6 months (P > 0.06);however, all 3 performance parameters significantly improved over time (P < 0.001). Conclusions: The LCP implant location does not affect capture thresholds or R-wave amplitudes at 6 months, and there is little effect on impedance. Although implant location does not appear to be a predictor of electrical performance, additional long-term data will help guide optimal implant location.

关键词： pacing Lead Location Leadless pacing Lead Impedance pacing Threshold R-Wave Amplitude

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