Early recurrence of atrial arrhythmias(ERAA) after ablation is common and strongly predicts late recurrences and ablation failure. However, since arrhythmia may eventually resolve in up to half of patients with ERAA, ...Early recurrence of atrial arrhythmias(ERAA) after ablation is common and strongly predicts late recurrences and ablation failure. However, since arrhythmia may eventually resolve in up to half of patients with ERAA, guidelines do not recommend immediate reintervention for ERAA episodes occurring during a 3-mo postablation blanking period. Certain clinical demographic, electrophysiologic, procedural, and ERAA-related characteristics may predict a higher likelihood of longterm ablation failure. In this review, we aim to discuss potential mechanisms of ERAA, and to summarize the clinical significance, prognostic implications, and treatment options for ERAA.展开更多
Backgound Red cell distribution width(RDW) and neutrophil-to-lymphocyte ratio(NLR) are simple hematologic indices that have been used to predict adverse outcomes in different clinical settings. The aim of our study is...Backgound Red cell distribution width(RDW) and neutrophil-to-lymphocyte ratio(NLR) are simple hematologic indices that have been used to predict adverse outcomes in different clinical settings. The aim of our study is to determine whether RDW and NLR can predict atrial fibrillation(AF) recurrence in patients undergoing AF ablation. Methods Consecutive patients, without known hematological disorders, who underwent AF catheter ablation between January 2014 and April 2017 were enrolled into this study. Blood samples were taken one day before and five hours after the ablation procedure. Results A total of 346 patients(224 males(65%), mean age: 59 ± 11 years old) were included. After a mean follow up of 26.2 ± 12.1 months, 80(23.1%) patients experienced late AF recurrence(defined as any recurrence after the blanking period of three months), while 97(28%) patients experienced early AF recurrence during the blanking period. Univariate analysis showed that early arrhythmia recurrence, type of AF and NLR after the procedure were significantly associated with late AF recurrence, while early arrhythmia recurrence and NLR remained significant in multivariate analysis. RDW was not associated with late AF recurrence. None of the parameters above predicted early arrhythmia recurrence. Conclusions Simple and inexpensive hematological indices such as NLR should be evaluated for their ability to predict AF recurrence in patients undergoing catheter ablation in larger prospective studies.展开更多
目的在27例儿茶酚胺介导的多形性室速患者及家庭成员中寻找CASQ2基因突变。方法应用直接DNA序列分析对临床诊断为家族性多形性室速27例患者及家庭成员进行进行基因突变分析。应用Taqman基因分型检测在以1400名正常人群中确定CASQ2变异...目的在27例儿茶酚胺介导的多形性室速患者及家庭成员中寻找CASQ2基因突变。方法应用直接DNA序列分析对临床诊断为家族性多形性室速27例患者及家庭成员进行进行基因突变分析。应用Taqman基因分型检测在以1400名正常人群中确定CASQ2变异的频率。结果在一个多形性室速家系中发现了1个新的杂合子改变F189L。通过与多种生物比对，证实该改变发生于在第2结构域一个高度保守的氨基酸上，位于第5外显子的F189L的改变，使编码蛋白的第189位氨基酸由苯丙氨酸改变为亮氨酸。应用Taqman SNP genotyping assay分析方法证实正常人群1400名中未发现同样改变。在CASQ2基因中未发现其他引起疾病的基因突变。结论发现了CASQ2基因的1个新F189L突变。展开更多
Background Clinical outcomes of cardiac resynchronization therapy （CRT） in patients over the age of 80 have not been well de-scribed.MethodsWe retrospectively identified 96 consecutive patients≥ 80 years old who un...Background Clinical outcomes of cardiac resynchronization therapy （CRT） in patients over the age of 80 have not been well de-scribed.MethodsWe retrospectively identified 96 consecutive patients≥ 80 years old who underwent an initial implant or an upgrade to CRT, with or without defibrillator （CRT-Dvs. CRT-P）, at our institution between January 2003 and July 2008. The control cohort consisted of 177 randomly selected patients 〈 80 years old undergoing CRT implant during the same time period. The primary efficacy endpoint was all-cause mortality at 36 months, assessed by Kaplan-Meier time to first event curves.Results In the octogenarian cohort, mean age at CRT implant was 83.1 ± 2.9 yearsvs. 60.1 ± 8.8 years among controls （P 〈 0.001）. Across both groups, 70% were male, mean left ventricular ejection fraction （LVEF） was 24.8% ± 14.1% and QRS duration was 154 ± 24.8 ms, without significant differences between groups. Octo-genarians were more likely to have ischemic cardiomyopathy （74%vs. 37%,P 〈 0.001） and more likely to undergo upgrade to CRT instead of an initial implant （42%vs. 19%,P 〈 0.001）. The rate of appropriate defibrillator shocks was lower among octogenarians （14%vs. 27%,P = 0.02） whereas the rate of inappropriate shocks was similar （3%vs. 6%,P = 0.55）. At 36 months, there was no significant difference in the rate of all-cause mortality between octogenarians （11%） and controls （8%,P = 0.381）.ConclusionAppropriately selected octogenarians who are candidates for CRT have similar intermediate-term mortality compared to younger patients receiving CRT.展开更多
It has been found that some patients with coronavirus disease 2019(COVID-19)have clinically relevant heart injuries,and the incidence of myocarditis among patients with COVID-19 was reported to be 12%in hospitals and ...It has been found that some patients with coronavirus disease 2019(COVID-19)have clinically relevant heart injuries,and the incidence of myocarditis among patients with COVID-19 was reported to be 12%in hospitals and 32%in intensive care units in Wuhan,China.[1]Acute myocardial injuries or myocarditis is a very important clinical issue due to the risk of rapid disease progression to severe arrhythmia,heart failure,cardiac shock,etc.[2,3]The bedside echocardiography examination is the first-line preferential imaging option for the evaluation of myocarditis and other complications,such as acute right heart failure specially due to pulmonary artery embolism,stress cardiomyopathy,acute myocardial infarction and coexisting fundamental chronic cardiovascular disease.展开更多
This paper reviews current recommendations on the appropriate evaluation and management of cardiac arrhythmias in the pregnant patient.Most arrhythmias during pregnancy are benign and require no intervention.When requ...This paper reviews current recommendations on the appropriate evaluation and management of cardiac arrhythmias in the pregnant patient.Most arrhythmias during pregnancy are benign and require no intervention.When required,the decision to treat should be based on symptom severity and the associated risk to mother and fetus posed by potentially recurring arrhythmia episodes throughout the pregnancy.Any treatment strategy in this patient population has inherent risk to both mother and unborn child.Before the initiation of any intervention,documentation of a clinical arrhythmia and correlation with clinical symptoms should be obtained.There is no role for empiric therapy.展开更多
In this issue of the Journal of Geriatric Cardiology, Gao et al.,1 in a report of increased ostial pulmonary vein diameter by multislice CT angiography reported a statistically significant enlargement of the pulmo... In this issue of the Journal of Geriatric Cardiology, Gao et al.,1 in a report of increased ostial pulmonary vein diameter by multislice CT angiography reported a statistically significant enlargement of the pulmonary veins in patients with congestive heart failure (CHF). This finding alone should not be of any surprise as anatomic remodeling and general dilation of the cardiac chambers are well described in patients with CHF.……展开更多
文摘Early recurrence of atrial arrhythmias(ERAA) after ablation is common and strongly predicts late recurrences and ablation failure. However, since arrhythmia may eventually resolve in up to half of patients with ERAA, guidelines do not recommend immediate reintervention for ERAA episodes occurring during a 3-mo postablation blanking period. Certain clinical demographic, electrophysiologic, procedural, and ERAA-related characteristics may predict a higher likelihood of longterm ablation failure. In this review, we aim to discuss potential mechanisms of ERAA, and to summarize the clinical significance, prognostic implications, and treatment options for ERAA.
文摘Backgound Red cell distribution width(RDW) and neutrophil-to-lymphocyte ratio(NLR) are simple hematologic indices that have been used to predict adverse outcomes in different clinical settings. The aim of our study is to determine whether RDW and NLR can predict atrial fibrillation(AF) recurrence in patients undergoing AF ablation. Methods Consecutive patients, without known hematological disorders, who underwent AF catheter ablation between January 2014 and April 2017 were enrolled into this study. Blood samples were taken one day before and five hours after the ablation procedure. Results A total of 346 patients(224 males(65%), mean age: 59 ± 11 years old) were included. After a mean follow up of 26.2 ± 12.1 months, 80(23.1%) patients experienced late AF recurrence(defined as any recurrence after the blanking period of three months), while 97(28%) patients experienced early AF recurrence during the blanking period. Univariate analysis showed that early arrhythmia recurrence, type of AF and NLR after the procedure were significantly associated with late AF recurrence, while early arrhythmia recurrence and NLR remained significant in multivariate analysis. RDW was not associated with late AF recurrence. None of the parameters above predicted early arrhythmia recurrence. Conclusions Simple and inexpensive hematological indices such as NLR should be evaluated for their ability to predict AF recurrence in patients undergoing catheter ablation in larger prospective studies.
文摘目的在27例儿茶酚胺介导的多形性室速患者及家庭成员中寻找CASQ2基因突变。方法应用直接DNA序列分析对临床诊断为家族性多形性室速27例患者及家庭成员进行进行基因突变分析。应用Taqman基因分型检测在以1400名正常人群中确定CASQ2变异的频率。结果在一个多形性室速家系中发现了1个新的杂合子改变F189L。通过与多种生物比对，证实该改变发生于在第2结构域一个高度保守的氨基酸上，位于第5外显子的F189L的改变，使编码蛋白的第189位氨基酸由苯丙氨酸改变为亮氨酸。应用Taqman SNP genotyping assay分析方法证实正常人群1400名中未发现同样改变。在CASQ2基因中未发现其他引起疾病的基因突变。结论发现了CASQ2基因的1个新F189L突变。
文摘Background Clinical outcomes of cardiac resynchronization therapy （CRT） in patients over the age of 80 have not been well de-scribed.MethodsWe retrospectively identified 96 consecutive patients≥ 80 years old who underwent an initial implant or an upgrade to CRT, with or without defibrillator （CRT-Dvs. CRT-P）, at our institution between January 2003 and July 2008. The control cohort consisted of 177 randomly selected patients 〈 80 years old undergoing CRT implant during the same time period. The primary efficacy endpoint was all-cause mortality at 36 months, assessed by Kaplan-Meier time to first event curves.Results In the octogenarian cohort, mean age at CRT implant was 83.1 ± 2.9 yearsvs. 60.1 ± 8.8 years among controls （P 〈 0.001）. Across both groups, 70% were male, mean left ventricular ejection fraction （LVEF） was 24.8% ± 14.1% and QRS duration was 154 ± 24.8 ms, without significant differences between groups. Octo-genarians were more likely to have ischemic cardiomyopathy （74%vs. 37%,P 〈 0.001） and more likely to undergo upgrade to CRT instead of an initial implant （42%vs. 19%,P 〈 0.001）. The rate of appropriate defibrillator shocks was lower among octogenarians （14%vs. 27%,P = 0.02） whereas the rate of inappropriate shocks was similar （3%vs. 6%,P = 0.55）. At 36 months, there was no significant difference in the rate of all-cause mortality between octogenarians （11%） and controls （8%,P = 0.381）.ConclusionAppropriately selected octogenarians who are candidates for CRT have similar intermediate-term mortality compared to younger patients receiving CRT.
文摘It has been found that some patients with coronavirus disease 2019(COVID-19)have clinically relevant heart injuries,and the incidence of myocarditis among patients with COVID-19 was reported to be 12%in hospitals and 32%in intensive care units in Wuhan,China.[1]Acute myocardial injuries or myocarditis is a very important clinical issue due to the risk of rapid disease progression to severe arrhythmia,heart failure,cardiac shock,etc.[2,3]The bedside echocardiography examination is the first-line preferential imaging option for the evaluation of myocarditis and other complications,such as acute right heart failure specially due to pulmonary artery embolism,stress cardiomyopathy,acute myocardial infarction and coexisting fundamental chronic cardiovascular disease.
文摘This paper reviews current recommendations on the appropriate evaluation and management of cardiac arrhythmias in the pregnant patient.Most arrhythmias during pregnancy are benign and require no intervention.When required,the decision to treat should be based on symptom severity and the associated risk to mother and fetus posed by potentially recurring arrhythmia episodes throughout the pregnancy.Any treatment strategy in this patient population has inherent risk to both mother and unborn child.Before the initiation of any intervention,documentation of a clinical arrhythmia and correlation with clinical symptoms should be obtained.There is no role for empiric therapy.
文摘 In this issue of the Journal of Geriatric Cardiology, Gao et al.,1 in a report of increased ostial pulmonary vein diameter by multislice CT angiography reported a statistically significant enlargement of the pulmonary veins in patients with congestive heart failure (CHF). This finding alone should not be of any surprise as anatomic remodeling and general dilation of the cardiac chambers are well described in patients with CHF.……
