Cardiology Research and Practice最新文献_第3页

Guidewire Ablation within the Coronary Venous System for Epicardial or Intramural Ventricular Arrhythmia: A Preclinical Study of Biophysical Characterization 在冠状静脉系统内进行导丝消融治疗心外膜或室内室性心律失常：生物物理特征的临床前研究

IF 2.1 4区医学 Q2 Medicine

Cardiology Research and Practice

Pub Date : 2024-01-04 DOI: 10.1155/2024/4412758

Fengqi Xuan, Zhongyin Zuo, Jie Zhang, Shibei Zhang, Zichen Liu, Yunfan Meng, Kuo Sun, Yaling Han, Ming Liang, Zulu Wang

Background. Catheter ablation failure poses a clinical challenge for epicardial or intramural ventricular arrhythmia (VA); however, guidewire ablation within the coronary venous system (CVS) may be effective and safe for targeting VAs. Methods. The ex vivo phase included four steps. In step 1, the steam pop incidence rates during guidewire ablation at power settings of 5, 10, 15, 20, and 25 W were analyzed using 10 mm- and 20 mm-tip guidewires. In step 2, guidewire ablation was performed for application durations of 10, 20, 30, 40, 50, 60, and 90 s, and the lesion size was measured. In step 3, the effects of saline infusion (0, 1, 2, 3, and 4 mL/min) on lesion dimensions and steam pop formation were examined. In step 4, an orthogonal array was constructed to obtain the optimal guidewire ablation parameters. In the in vivo phase, guidewire ablation within the CVS was performed in three dogs, and the lesion features in 10 days after ablation were observed. Results. In step 1, the steam pop incidence rates at 5, 10, 15, 20, and 25 W were 0%, 0%, 12.5%, 62.5%, and 100% using the 10 mm-tip guidewires and 0%, 0%, 0%, 25%, and 75% using the 20 mm-tip guidewires, respectively. In step 2, we found that the lesion areas increased with an increase in the ablation duration (the maximum lesion diameters at 30, 60, and 90 s were 4.9 ± 0.4, 7.0 ± 0.8, and 9.2 ± 0.7 mm in the 10 mm group and 3.2 ± 0.5, 4.5 ± 0.4, and 5.3 ± 0.7 mm in the 20 mm-tip group, respectively). In step 3, we observed that saline infusion was negatively correlated with ablation lesions but had a lower risk of steam pop. The optimal parameters for the 20 mm-tip guidewire ablation were 15 W, 50 s, and 2 mL/min or 20 W, 70 s, and 2 mL/min. In the in vivo phase, effective ablation lesions with maximum and minimum diameters of 3.2 ± 0.3 and 2.8 ± 0.5 mm, respectively, were created by the guidewires during the 10-day observation period after ablation. Conclusion. This novel radiofrequency guidewire ablation technique can feasibly create effective lesions within the CVS, which may improve the efficacy of catheter ablation for challenging epicardial or intramural VA.

背景。导管消融失败给心外膜或心内膜室性心律失常（VA）的临床治疗带来了挑战；然而，冠状静脉系统（CVS）内的导丝消融可能对靶向 VA 有效且安全。方法。体外阶段包括四个步骤。第一步，使用 10 毫米和 20 毫米尖端的导丝，在 5、10、15、20 和 25 瓦的功率设置下分析导丝消融过程中的蒸汽爆裂发生率。第二步，在 10、20、30、40、50、60 和 90 秒的应用时间内进行导丝消融，并测量病灶大小。第 3 步，研究生理盐水输注（0、1、2、3 和 4 mL/min）对病灶尺寸和蒸汽爆裂形成的影响。第四步，构建正交阵列以获得最佳导丝消融参数。在体内阶段，对三只狗进行了 CVS 内的导丝消融，并观察了消融后 10 天的病变特征。结果显示在步骤 1 中，使用 10 mm 尖端导丝，5、10、15、20 和 25 W 的蒸汽爆裂发生率分别为 0%、0%、12.5%、62.5% 和 100%；使用 20 mm 尖端导丝，蒸汽爆裂发生率分别为 0%、0%、0%、25% 和 75%。在步骤 2 中，我们发现病灶面积随着消融时间的延长而增加（30、60 和 90 秒时的最大病灶直径分别为：10 mm 组 4.9 ± 0.4、7.0 ± 0.8 和 9.2 ± 0.7 mm，20 mm 尖端组 3.2 ± 0.5、4.5 ± 0.4 和 5.3 ± 0.7 mm）。在步骤 3 中，我们观察到生理盐水输注与消融病灶呈负相关，但蒸汽爆裂的风险较低。20 毫米尖端导丝消融的最佳参数为 15 瓦、50 秒、2 毫升/分钟或 20 瓦、70 秒、2 毫升/分钟。在体内阶段，消融后 10 天的观察期内，导丝形成的有效消融病灶的最大和最小直径分别为 3.2 ± 0.3 毫米和 2.8 ± 0.5 毫米。结论这种新颖的射频导丝消融技术可以在 CVS 内创建有效的病灶，从而提高导管消融治疗具有挑战性的心外膜或心内膜 VA 的疗效。

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引用次数: 0

Safety and Feasibility Using a Fluid-Filled Wire to Avoid Hydrostatic Errors in Physiological Intracoronary Measurements 使用充液导线避免冠状动脉内生理测量中的静水误差的安全性和可行性

IF 2.1 4区医学 Q2 Medicine

Cardiology Research and Practice

Pub Date : 2024-01-02 DOI: 10.1155/2024/6664482

Truls Råmunddal, Christian Dworeck, Petronella Torild, Sofie Andréen, Li-Ming Gan, Geir Hirlekar, Dan Ioanes, Anna Myredal, Jacob Odenstedt, Petur Petursson, Tetiana Pylova, Fanny Töpel, Sebastian Völz, Mats Hilmersson, Björn Redfors, Oskar Angerås

Background. Using a fluid-filled wire with a pressure sensor outside the patient compared to a conventional pressure wire may avoid the systematic error introduced by the hydrostatic pressure within the coronary circulation. Aims. To assess the safety and effectiveness of the novel fluid-filled wire, Wirecath (Cavis Technologies, Uppsala, Sweden), as well as its ability to avoid the hydrostatic pressure error. Methods and Results. The Wirecath pressure wire was used in 45 eligible patients who underwent invasive coronary angiography and had a clinical indication for invasive coronary pressure measurement at Sahlgrenska University Hospital, Gothenburg, Sweden. In 29 patients, a simultaneous measurement was performed with a conventional coronary pressure wire (PressureWire X, Abbott Medical, Plymouth, MN, USA), and in 19 patients, the vertical height difference between the tip of the guide catheter and the wire measure point was measured in a 90-degree lateral angiographic projection. No adverse events caused by the pressure wires were reported. The mean Pd/Pa and mean FFR using the fluid-filled wire and the sensor-tipped wire differed significantly; however, after correcting for the hydrostatic effect, the sensor-tipped wire pressure correlated well with the fluid-filled wire pressure (R = 0.74 vs. R = 0.89 at rest and R = 0.89 vs. R = 0.98 at hyperemia). Conclusion. Hydrostatic errors in physiologic measurements can be avoided by using the fluid-filled Wirecath wire, which was safe to use in the present study. This trial is registered with NCT04776577 and NCT04802681.

背景。与传统的压力导线相比，在患者体外使用带有压力传感器的充液导线可以避免冠状动脉循环内静水压带来的系统误差。目的评估新型充液导线 Wirecath（Cavis Technologies，瑞典乌普萨拉）的安全性和有效性，以及其避免静水压力误差的能力。方法和结果。瑞典哥德堡 Sahlgrenska 大学医院对 45 名符合条件的患者使用了 Wirecath 压力导线，这些患者均接受了有创冠状动脉造影术，并具有有创冠状动脉压力测量的临床指征。在 29 名患者中，使用传统冠状动脉压力线（PressureWire X，Abbott Medical，Plymouth，MN，USA）同时进行了测量；在 19 名患者中，在 90 度侧向血管造影投影中测量了导引导管尖端与压力线测量点之间的垂直高度差。没有关于压力导线导致不良事件的报告。使用充液导丝和传感器尖端导丝的平均 Pd/Pa 值和平均 FFR 值差异显著；但在校正静水效应后，传感器尖端导丝压力与充液导丝压力的相关性很好（静息时 R = 0.74 vs. R = 0.89，充血时 R = 0.89 vs. R = 0.98）。结论。使用充液 Wirecath 导丝可避免生理测量中的静水压误差，在本研究中使用该导丝是安全的。本试验已在 NCT04776577 和 NCT04802681 上注册。

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引用次数: 0

Enhanced External Counterpulsation for Management of Postacute Sequelae of SARS-CoV-2 Associated Microvascular Angina and Fatigue: An Interventional Pilot Study 加强体外反搏治疗 SARS-CoV-2 并发微血管性心绞痛和疲劳的急性后遗症：介入性试点研究

IF 2.1 4区医学 Q2 Medicine

Cardiology Research and Practice

Pub Date : 2023-12-27 DOI: 10.1155/2023/6687803

Eline Wu, Ali Mahdi, Jannike Nickander, Judith Bruchfeld, Linda Mellbin, Kristina Haugaa, Marcus Ståhlberg, Liyew Desta

Background. Postacute sequelae of SARS-CoV-2 infection (PASC) are a novel clinical syndrome characterized in part by endothelial dysfunction. Enhanced external counterpulsation (EECP) produces pulsatile shear stress, which has been associated with improvements in systemic endothelial function. Objective. To explore the effects of EECP on symptom burden, physical capacity, mental health, and health-related quality of life (HRQoL) in patients with PASC-associated angina and microvascular dysfunction (MVD). Methods. An interventional pilot study was performed, including 10 patients (male = 5, mean age 50.3 years) recruited from a tertiary specialized PASC clinic. Patients with angina and MVD, defined as index of microcirculatory resistance (IMR) ≥25 and/or diagnosed through stress perfusion cardiac magnetic resonance imaging, were included. Patients underwent one modified EECP course (15 one-hour sessions over five weeks). Symptom burden, six-minute walk test, and validated generic self-reported instruments for measuring psychological distress and HRQoL were assessed before and one month after treatment. Results. At baseline, most commonly reported PASC symptoms were angina (100%), fatigue (80%), and dyspnea (80%). Other symptoms included palpitations (50%), concentration impairment (50%), muscle pain (30%), and brain fog (30%). Mean IMR was 63.6. After EECP, 6MWD increased (mean 29.5 m, median 21 m) and angina and fatigue improved. Mean depression scores showed reduced symptoms (−0.8). Mean HRQoL scores improved in seven out of eight subscales (+0.2 to 10.5). Conclusions. Patients with PASC-associated angina and evidence of MVD experienced subjective and objective benefits from EECP. The treatment was well-tolerated. These findings warrant controlled studies in a larger cohort.

背景。SARS-CoV-2 感染急性后遗症（PASC）是一种新型临床综合征，其部分特征是内皮功能障碍。增强体外反搏（EECP）可产生搏动性剪切应力，这与全身内皮功能的改善有关。研究目的探讨 EECP 对 PASC 相关心绞痛和微血管功能障碍（MVD）患者的症状负担、体能、心理健康和健康相关生活质量（HRQoL）的影响。研究方法从一家 PASC 三级专科诊所招募了 10 名患者（男性 5 名，平均年龄 50.3 岁），进行了一项干预性试点研究。研究对象包括心绞痛患者和 MVD（定义为微循环阻力指数（IMR）≥25 和/或通过应激灌注心脏磁共振成像确诊）患者。患者接受了一个改良EECP疗程（15次，每次一小时，共5周）。在治疗前和治疗后一个月，对患者的症状负担、六分钟步行测试以及用于测量心理困扰和 HRQoL 的有效通用自我报告工具进行了评估。结果显示基线时，最常报告的 PASC 症状是心绞痛（100%）、疲劳（80%）和呼吸困难（80%）。其他症状包括心悸（50%）、注意力不集中（50%）、肌肉疼痛（30%）和脑雾（30%）。平均 IMR 为 63.6。EECP 后，6MWD 增加（平均 29.5 米，中位数 21 米），心绞痛和疲劳有所改善。平均抑郁评分显示症状减轻（-0.8）。在八个分量表中，有七个分量表的平均 HRQoL 分数有所改善（+0.2 至 10.5）。结论有 MVD 证据的 PASC 相关心绞痛患者从 EECP 中获得了主观和客观的益处。治疗的耐受性良好。这些研究结果值得在更大的群体中进行对照研究。

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引用次数: 0

Relationship between Coronary Artery Calcium Score and Coronary Stenosis 冠状动脉钙化评分与冠状动脉狭窄之间的关系

IF 2.1 4区医学 Q2 Medicine

Cardiology Research and Practice

Pub Date : 2023-12-15 DOI: 10.1155/2023/5538111

Xinyan Chen, Jianbin Zhao, Qingqing Cai, Rong Chen, Wenhao Wu, Peng Wang, Gaoxing Zhang, Jinhuan Zhen

Background. The coronary artery calcium score (CACS) is commonly employed to quantify the degree of calcification in coronary atherosclerosis. Indeed, increased coronary stenosis severity is associated with a progressive increase in CACS. Objectives. This study sought to explore the association between CACS and coronary stenosis of ≥50% and ≥70%. Methods. We conducted a retrospective analysis of patient data collected between July 1, 2017, and March 3, 2022, at Jiangmen Central Hospital. A total of 208 patients, presenting with both symptomatic and asymptomatic manifestations and suspected coronary artery disease (CAD), were included. Statistical analyses included ROC curve assessments, subgroup analyses based on age, and comparisons of CACS values against the presence of coronary stenosis ≥50% and ≥70%. Results. Ultimately, 208 patients were included, with a median age of 65.0 years and a median CACS of 115.7 (interquartile range: 13.7–369.4). A CACS threshold of ≥1300 demonstrated a specificity of 100% for coronary stenosis of ≥50%. Notably, the percentage of patients with obstructive CAD showing CACS = 0 was significantly higher in those under 65 years (15.1%) compared to patients over 65 years (3.8%) (). The inflection point, at which the risk probability for coronary stenosis of ≥50% shifted from being a protective factor to a risk factor, was observed when CACS fell within the range of 63.3 to 66.0. Conclusion. CACS demonstrates good performance for the detection of coronary artery stenosis.

背景。冠状动脉钙化评分（CACS）通常用于量化冠状动脉粥样硬化的钙化程度。事实上，冠状动脉狭窄严重程度的增加与 CACS 的逐渐增加有关。研究目的本研究旨在探讨 CACS 与冠状动脉狭窄≥50% 和≥70% 之间的关系。方法。我们对江门市中心医院2017年7月1日至2022年3月3日期间收集的患者数据进行了回顾性分析。共纳入了208名有症状和无症状表现的疑似冠状动脉疾病（CAD）患者。统计分析包括ROC曲线评估、基于年龄的亚组分析以及CACS值与冠状动脉狭窄≥50%和≥70%的比较。结果。最终共纳入 208 名患者，中位年龄为 65.0 岁，中位 CACS 为 115.7（四分位间范围：13.7-369.4）。CACS阈值≥1300表明冠状动脉狭窄≥50%的特异性为100%。值得注意的是，与 65 岁以上的患者（3.8%）相比，65 岁以下患者（15.1%）中显示 CACS = 0 的阻塞性 CAD 患者比例明显更高（）。当 CACS 在 63.3 到 66.0 的范围内时，冠状动脉狭窄≥50% 的风险概率从保护因素转变为风险因素的拐点就出现了。结论CACS 在检测冠状动脉狭窄方面表现良好。

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引用次数: 0

Comparative Analysis of Hypertension Guidelines: Unveiling Consensus and Discrepancies in Lifestyle Modifications for Blood Pressure Control 高血压指南比较分析：揭示控制血压的生活方式调整方面的共识与分歧

IF 2.1 4区医学 Q2 Medicine

Cardiology Research and Practice

Pub Date : 2023-12-12 DOI: 10.1155/2023/5586403

Yi Wang, Yanxiang Liu, Lu Liu, Liqiong Hong, Huimin Chen

Background. Hypertension is a major global health concern, and lifestyle modifications have been recommended as first-line treatment for hypertension in many guidelines. However, different guidelines may recommend different types of lifestyle adjustment, and it is unclear which ones are most effective. In this review, we compared hypertension guidelines to identify any differences and/or consensus in content, efficacy, and timing of initiation of lifestyle modifications. Methods. We conducted a search of databases to identify hypertension guidelines available in English. We extracted and compared information about lifestyle modifications recommended by the guidelines. Results. Five hypertension guidelines from America, Europe, the UK, Canada, and the International Society of Hypertension are included. They all recommend diet adaptation, sodium reduction, alcohol restriction, physical exercise, and weight reduction. Other lifestyle interventions emphasized by some guidelines, such as potassium supplementation, smoking cessation, and stress management, are not recommended by all the five guidelines. Among lifestyle changes, the dietary approaches to stop hypertension (DASH) diet may be considered the most effective treatment for reducing blood pressure. These guidelines recommend that for patients with high-normal blood pressure or grade 1 hypertension without high risk factors, lifestyle medicine should be used first for 3–6 months, if blood pressure is still not controlled, then start medication. For those patients who need drug treatment, lifestyle changes can also enhance the effects of antihypertensive therapy. Conclusion. Lifestyle modifications are crucial in the treatment of hypertension and should be recommended to most hypertensive patients. Among these lifestyle interventions, diet adaptation containing low sodium and alcohol restriction may be the most effective in reducing blood pressure. Physical exercise and weight reduction are also recommended. In some cases, lifestyle modifications should be tried first. They may also enhance the effects of antihypertensive drugs in other patients.

背景。高血压是全球关注的主要健康问题，许多指南都建议将调整生活方式作为高血压的一线治疗方法。然而，不同的指南可能推荐不同类型的生活方式调整，目前尚不清楚哪种生活方式调整最有效。在本综述中，我们对高血压指南进行了比较，以确定在生活方式调整的内容、疗效和启动时机方面的差异和/或共识。方法。我们对数据库进行了检索，以确定现有的英文高血压指南。我们提取并比较了指南推荐的生活方式调整信息。结果。共收录了来自美国、欧洲、英国、加拿大和国际高血压学会的五份高血压指南。它们都建议调整饮食、减少钠盐摄入、限制饮酒、体育锻炼和减轻体重。一些指南强调的其他生活方式干预措施，如补充钾、戒烟和压力管理，并不是所有五份指南都推荐的。在改变生活方式的方法中，高血压饮食疗法（DASH）可能被认为是降低血压最有效的治疗方法。这些指南建议，对于血压正常或一级高血压且无高危因素的患者，应首先使用生活方式药物治疗 3-6 个月，如果血压仍未得到控制，再开始药物治疗。对于需要药物治疗的患者，改变生活方式也能增强降压治疗的效果。结论改变生活方式是治疗高血压的关键，应推荐给大多数高血压患者。在这些生活方式干预措施中，低钠饮食和限制饮酒可能对降低血压最有效。此外，还建议进行体育锻炼和减轻体重。在某些情况下，应首先尝试改变生活方式。对其他患者来说，这些措施也可能会增强降压药物的效果。

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引用次数: 0

Evaluation of Left Atrial Function in Patients with Paroxysmal Atrial Fibrillation Using Left Atrial Automatic Myocardial Functional Imaging Ultrasonography. 应用左心房自动心肌功能显像超声评价阵发性心房颤动患者的左心房功能。

IF 2.1 4区医学 Q2 Medicine

Cardiology Research and Practice

Pub Date : 2023-11-20 eCollection Date: 2023-01-01 DOI: 10.1155/2023/6924570

Hailan Liu, Lili Chen, Yan Song, Yingying Xu, Chunquan Zhang

Aim: To evaluate volume and strain of the left atrium (LA) in people suffering from paroxysmal atrial fibrillation which is not valvular (NVPAF) using the new technology of left atrial automatic myocardial function imaging (AFILA) and to analyze prognostic factors in patients with NVPAF by follow-up.

Methods: Between August 2019 and August 2022, a total of 80 NVPAF patients and 60 normal control patients who were hospitalized in the Department of Cardiology were included in the study. The LA volume and strain parameters of the two groups were analyzed. The differences in LA function (LAF) parameters were compared between the two groups to generate the receiver operating characteristic curve (ROC) and calculate the area under the curve (AUC), sensitivity, and specificity of each parameter. Follow-up was conducted on the 80 NVPAF patients included, their treatment methods after admission and their rehospitalization due to heart events were recorded, and independent risk factors influencing the prognosis of NVPAF were obtained.

Results: A total of 140 patients participated in the study, including 80 in the NVPAF group and 60 in the normal control group. There was no statistically significant difference in age and sex between the two groups. Compared to the normal group, the LA minimum volume (LAVmin), LA maximum volume (LAVmax), and volume at onset of LA contraction (LAVpreA) in the NVPAF group were significantly increased. The LA emptying fraction (LAEF) was significantly decreased, and LA reservoir strain (S_R), LA conduit strain (S_CD), and LA contractile strain (S_CT) were significantly compromised (P < 0.05). There was no significant difference in LA evacuation volume (LAEV) reduction (P > 0.05). Logistic regression analysis of LAF parameters in NVPAF patients showed that LAEF and S_R were independently correlated with NVPAF (odds ratio values: 0.883 (0.827-0.943), P < 0.001; 0.916 (0.569-1.474), P = 0.047). The ROC curve results showed that LAEF had a high efficiency in the diagnosis of NVPAF, with P < 0.001, AUC of 0.843, sensitivity of 0.788, and specificity of 0.867. For the LA strain parameters, the S_R test efficiency was higher, with P < 0.001, AUC of 0.762, sensitivity of 0.713, and specificity of 0.783. There was a strong correlation between S_R and LAEF in patients with no end event and those with end event. The ROC curve revealed that the S_R was better than LAEF in predicting prognosis of patients with AF (AUC = 0.914, P < 0.0001 vs. AUC = 0.876, P < 0.0001). S_R of 10.5 and LAEF of 21 were the cut-off values for endpoint events in NVPAF patients, with sensitivity of 0.909 and 0.727 and specificity of 0.904 and 0.901, respectively.

Conclusions: AFILA ultrasound technology comprehensively evaluated the LA size and function in patients with NVPAF. The LAEF and S_R were independently correlate

目的:应用新型左心房自动心肌功能显像技术(AFILA)评价阵发性非瓣膜性心房颤动(NVPAF)患者左心房的容积和应变，并通过随访分析NVPAF患者的预后因素。方法:选取2019年8月至2022年8月期间在心内科住院的80例NVPAF患者和60例正常对照患者作为研究对象。分析两组的LA体积和应变参数。比较两组患者LA函数(LAF)参数的差异，生成受试者工作特征曲线(ROC)，并计算各参数的曲线下面积(AUC)、敏感性和特异性。对入选的80例NVPAF患者进行随访，记录其入院后的治疗方法及因心脏事件再次住院的情况，获得影响NVPAF预后的独立危险因素。结果:共140例患者参与研究，其中NVPAF组80例，正常对照组60例。两组患者年龄、性别差异无统计学意义。与正常组比较，NVPAF组左室最小容积(LAVmin)、左室最大容积(LAVmax)和左室收缩起始容积(LAVpreA)均显著升高。LA排空分数(LAEF)显著降低，LA水库应变(S_R)、LA导管应变(S_CD)和LA收缩应变(S_CT)显著降低(P P > 0.05)。对NVPAF患者LAF参数进行Logistic回归分析，LAEF和S_R与NVPAF独立相关(优势比值:0.883 (0.827-0.943)，P = 0.047)。ROC曲线结果显示LAEF对NVPAF的诊断效率较高，P P P P结论:AFILA超声技术综合评价了NVPAF患者LA的大小和功能。LAEF和S_R与NVPAF独立相关，可决定NVPAF患者的预后。

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引用次数: 0

Complications of Implantable Cardioverter Defibrillator and Their Potential Risk Factors in Patients with Hypertrophic Cardiomyopathy 肥厚性心肌病患者植入式心律转复除颤器的并发症及其潜在危险因素

4区医学 Q2 Medicine

Cardiology Research and Practice

Pub Date : 2023-11-13 DOI: 10.1155/2023/4552100

Mohammad Taghi Hedayati Goudarzi, Maryam Moradi, Saeed Abrotan, Mehrdad Saravi, Hoda Shirafkan, Rana Irilouzadian, Hossein Salehi Omran

Background. Hypertrophic cardiomyopathy (HCM) has different complications such as cardiac arrhythmia and sudden cardiac death (SCD). Insertion of an implantable cardioverter defibrillator (ICD) is recommended for HCM patients who are at high risk of SCD and malignant arrhythmias, despite having their own potential complications. Hypothesis. We aimed to investigate the prevalence of different complications of ICD insertion and the impact of the potential influential baseline characteristics in a one-year follow-up period. Methods. This was a retrospective study with a total of 71 HCM patients with ICD insertion. We evaluated the prevalence of different complications of ICD implantation and the impact of baseline characteristics on the occurrence of ICD complications using multivariate regression analysis in three 4-month periods. Results. In a one-year follow-up, 13 patients (18.3%) experienced at least one of the complications including pneumothorax, lead failure, ICD infection, inappropriate shocks, perforation, and upper limb deep vein thrombosis (DVT) with no mortality. Inappropriate shocks were reported as the most common (11.3%) complication during this period, with a gradual increase in the second (4.2%) and third (5.6%) follow-up sessions. Among all of the baseline characteristics that were investigated in this study, a positive history of hypertension was the only risk factor with significant impact on the occurrence of complications (

P

= 0.01). Conclusion. We demonstrated the occurrence of complications during a one-year follow-up as 18.3% in HCM patients with ICD insertion. A positive history of hypertension was the only baseline characteristic affecting the occurrence of complications, and inappropriate shocks were the most common complication.

背景。肥厚性心肌病(HCM)有不同的并发症，如心律失常和心脏性猝死(SCD)。对于SCD和恶性心律失常高风险的HCM患者，尽管存在潜在的并发症，但仍建议植入植入式心律转复除颤器(ICD)。假设。我们的目的是在一年的随访期间调查ICD插入的不同并发症的患病率以及潜在的影响基线特征的影响。方法。这是一项回顾性研究，共有71例植入ICD的HCM患者。我们通过3个4个月的多变量回归分析来评估ICD植入不同并发症的发生率以及基线特征对ICD并发症发生的影响。结果。在一年的随访中，13例患者(18.3%)出现了至少一种并发症，包括气胸、导联衰竭、ICD感染、不适当的电击、穿孔和上肢深静脉血栓形成(DVT)，无死亡。在此期间，不适当的电击是最常见的并发症(11.3%)，在第二次随访(4.2%)和第三次随访(5.6%)中逐渐增加。在本研究调查的所有基线特征中，高血压病史是唯一对并发症发生有显著影响的危险因素(P = 0.01)。结论。我们发现在一年的随访中，植入ICD的HCM患者的并发症发生率为18.3%。高血压病史是影响并发症发生的唯一基线特征，不适当的电击是最常见的并发症。

{"title":"Complications of Implantable Cardioverter Defibrillator and Their Potential Risk Factors in Patients with Hypertrophic Cardiomyopathy","authors":"Mohammad Taghi Hedayati Goudarzi, Maryam Moradi, Saeed Abrotan, Mehrdad Saravi, Hoda Shirafkan, Rana Irilouzadian, Hossein Salehi Omran","doi":"10.1155/2023/4552100","DOIUrl":"https://doi.org/10.1155/2023/4552100","url":null,"abstract":"Background. Hypertrophic cardiomyopathy (HCM) has different complications such as cardiac arrhythmia and sudden cardiac death (SCD). Insertion of an implantable cardioverter defibrillator (ICD) is recommended for HCM patients who are at high risk of SCD and malignant arrhythmias, despite having their own potential complications. Hypothesis. We aimed to investigate the prevalence of different complications of ICD insertion and the impact of the potential influential baseline characteristics in a one-year follow-up period. Methods. This was a retrospective study with a total of 71 HCM patients with ICD insertion. We evaluated the prevalence of different complications of ICD implantation and the impact of baseline characteristics on the occurrence of ICD complications using multivariate regression analysis in three 4-month periods. Results. In a one-year follow-up, 13 patients (18.3%) experienced at least one of the complications including pneumothorax, lead failure, ICD infection, inappropriate shocks, perforation, and upper limb deep vein thrombosis (DVT) with no mortality. Inappropriate shocks were reported as the most common (11.3%) complication during this period, with a gradual increase in the second (4.2%) and third (5.6%) follow-up sessions. Among all of the baseline characteristics that were investigated in this study, a positive history of hypertension was the only risk factor with significant impact on the occurrence of complications ( <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M1\"> <mi>P</mi> </math> = 0.01). Conclusion. We demonstrated the occurrence of complications during a one-year follow-up as 18.3% in HCM patients with ICD insertion. A positive history of hypertension was the only baseline characteristic affecting the occurrence of complications, and inappropriate shocks were the most common complication.","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136281842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prevalence and Risk Factors of Postprocedure Depression in Patients with Atrial Fibrillation after Radiofrequency Ablation 心房颤动射频消融患者术后抑郁的患病率及危险因素

4区医学 Q2 Medicine

Cardiology Research and Practice

Pub Date : 2023-11-07 DOI: 10.1155/2023/4635336

Mingli Du, Tieniu Cheng, Yutong Ye, Yong Wei

Background. Recent studies have shown a bidirectional relationship between atrial fibrillation (AF) and psychological depression. However, little is known about the prevalence of postprocedure depression (PPD) in patients with AF at the time of radiofrequency (RF) ablation. Objective. To describe the prevalence and identify risk factors for PPD. Methods. This was a prospective cohort study, including 428 AF patients who were willing to undergo the first catheter ablation in our hospital from 1st April to 30th December 2019. The primary outcome was PPD, which was determined by Hospital Anxiety and Depression Scale-Depression. Results. The prevalence of PPD was 16.8% (72/428) in our cohort, without difference between men (16.0%, 41/256) and women (18.0%, 31/172) (P = 0.586) but with a great difference among different age groups (P = 0.016). On the univariable binary logistic regression analysis, age, a history of coronary heart disease, Observer’s Assessment of Alertness/Sedation (OAA/S) score when ablating at the specific position, and OAA/S score when pulling out the catheter sheath were associated with PPD. Subsequent multivariable logistic regression analysis indicated only age (OR 0.96, 95% CI: 0.94–0.99,

P < 0.01

) and OAA/S score when ablating at the specific position (OR 0.58, 95% CI: 0.39–0.88, P = 0.01) were independently associated with PPD. Conclusion. PPD is common in patients with AF after RF ablation. Younger age and lower OAA/S score when ablating at the specific position are its most significant risk factors. Intensive management of sedation may be of great importance for reducing PPD. This trial is registered with the Chinese Clinical Trial Registry (ChiCTR2200057810).

背景。近年来的研究表明，心房颤动(AF)与心理抑郁之间存在双向关系。然而，射频消融时AF患者术后抑郁(PPD)的患病率知之甚少。目标。描述PPD的患病率并确定其危险因素。方法。这是一项前瞻性队列研究，包括428名房颤患者，他们愿意于2019年4月1日至12月30日在我院接受首次导管消融。主要终点是PPD，由医院焦虑抑郁量表-抑郁量表确定。结果。本组人群PPD患病率为16.8%(72/428)，男性(16.0%，41/256)与女性(18.0%，31/172)之间差异无统计学意义(P = 0.586)，但不同年龄组间差异较大(P = 0.016)。单变量logistic回归分析发现，年龄、冠心病史、特定部位消融时的观察者警觉/镇静评分(OAA/S)、拔出导管鞘时的OAA/S评分与PPD相关。随后的多变量logistic回归分析显示只有年龄(OR 0.96, 95% CI: 0.94-0.99, P <0.01)和特定部位消融时的OAA/S评分(OR 0.58, 95% CI: 0.39 ~ 0.88, P = 0.01)与PPD独立相关。结论。PPD常见于射频消融后的房颤患者。年龄较小、特定部位消融时OAA/S评分较低是其最显著的危险因素。加强镇静管理可能对减少PPD非常重要。本试验已在中国临床试验注册中心注册(ChiCTR2200057810)。

{"title":"Prevalence and Risk Factors of Postprocedure Depression in Patients with Atrial Fibrillation after Radiofrequency Ablation","authors":"Mingli Du, Tieniu Cheng, Yutong Ye, Yong Wei","doi":"10.1155/2023/4635336","DOIUrl":"https://doi.org/10.1155/2023/4635336","url":null,"abstract":"Background. Recent studies have shown a bidirectional relationship between atrial fibrillation (AF) and psychological depression. However, little is known about the prevalence of postprocedure depression (PPD) in patients with AF at the time of radiofrequency (RF) ablation. Objective. To describe the prevalence and identify risk factors for PPD. Methods. This was a prospective cohort study, including 428 AF patients who were willing to undergo the first catheter ablation in our hospital from 1st April to 30th December 2019. The primary outcome was PPD, which was determined by Hospital Anxiety and Depression Scale-Depression. Results. The prevalence of PPD was 16.8% (72/428) in our cohort, without difference between men (16.0%, 41/256) and women (18.0%, 31/172) (P = 0.586) but with a great difference among different age groups (P = 0.016). On the univariable binary logistic regression analysis, age, a history of coronary heart disease, Observer’s Assessment of Alertness/Sedation (OAA/S) score when ablating at the specific position, and OAA/S score when pulling out the catheter sheath were associated with PPD. Subsequent multivariable logistic regression analysis indicated only age (OR 0.96, 95% CI: 0.94–0.99, <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M1\"> <mi>P</mi> <mo><</mo> <mtext> </mtext> <mn>0.01</mn> </math> ) and OAA/S score when ablating at the specific position (OR 0.58, 95% CI: 0.39–0.88, P = 0.01) were independently associated with PPD. Conclusion. PPD is common in patients with AF after RF ablation. Younger age and lower OAA/S score when ablating at the specific position are its most significant risk factors. Intensive management of sedation may be of great importance for reducing PPD. This trial is registered with the Chinese Clinical Trial Registry (ChiCTR2200057810).","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135433077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bachmann's Bundle Modification in Addition to Circumferential Pulmonary Vein Isolation for Atrial Fibrillation: A Novel Ablation Strategy. Bachmann氏束改良加环肺静脉隔离治疗心房颤动：一种新的消融策略。

IF 2.1 4区医学 Q2 Medicine

Cardiology Research and Practice

Pub Date : 2023-10-27 eCollection Date: 2023-01-01 DOI: 10.1155/2023/2870188

Jiaqi Sun, Sanbao Chen, Ming Liang, Qi Zhang, Ping Zhang, Mingyu Sun, Jian Ding, Zhiqing Jin, Yaling Han, Zulu Wang

Background: Bachmann's bundle (BB) is the main pathway of interatrial connection that could be involved in the development of atrial fibrillation (AF). Based on this hypothesis, we raised a novel ablation strategy, BB modification in addition to circumferential pulmonary vein isolation (CPVI-BB) in patients with AF.

Methods: A retrospective cohort of patients with AF who underwent CPVI-BB or CPVI alone from March 2018 to July 2021 was enrolled in our study. Propensity score matching was performed in patients with paroxysmal AF and persistent AF, respectively, to reduce the risk of selection bias between the treatment strategies (CPVI-BB or CPVI alone). The primary endpoint was overall freedom from atrial arrhythmia recurrence through 12 months of follow-up.

Results: Our propensity score-matched cohort included 82 patients with paroxysmal AF (CPVI group: n = 41; CPVI-BB group: n = 41) and 168 patients with persistent AF (CPVI group: n = 84; CPVI-BB group: n = 84). Among patients with persistent AF, one-year freedom from atrial arrhythmia recurrence rate was 83.3% in the CPVI-BB group and 70.2% in the CPVI group (log-rank P = 0.047). Among patients with paroxysmal AF, no significant difference was found in the primary endpoint between two groups (85.4% in the CPVI-BB group vs. 80.5% in the CPVI group; log-rank P = 0.581). In addition, procedure-related complications and recurrence of atrial tachycardia or atrial flutter were similar between the two treatment groups, regardless of the type of AF.

Conclusions: BB modification in addition to CPVI is an effective approach in increasing the maintenance of sinus rhythm in patients with persistent AF, while it does not improve the clinical outcomes of radiofrequency catheter ablation in patients with paroxysmal AF.

背景：巴赫曼束（BB）是心房颤动（AF）发生发展过程中心房连接的主要途径。基于这一假设，我们在房颤患者中提出了一种新的消融策略，即除环肺静脉隔离（CPVI-BB）外的BB改良。方法：我们的研究纳入了2018年3月至2021年7月单独接受CPVI-BC或CPVI的房颤患者的回顾性队列。分别对阵发性房颤和持续性房颤患者进行倾向性评分匹配，以降低治疗策略（CPVI-BB或单独CPVI）之间选择偏差的风险。主要终点是12个月内完全无房性心律失常复发结果：我们的倾向评分匹配队列包括82例阵发性房颤患者（CPVI组：n = 41；CPVI-BB组：n = 41）和168例持续性房颤患者（CPVI组：n = 84；CPVI-BB组：n = 84）。在持续性房颤患者中，CPVI-BB组一年无心律失常复发率为83.3%，CPVI组为70.2%（log秩P = 0.047）。在阵发性房颤患者中，两组之间的主要终点没有发现显著差异（CPVI-BB组为85.4%，CPVI组为80.5%；log秩P = 0.581）。此外，无论房颤类型如何，两个治疗组的手术相关并发症和房性心动过速或房扑复发情况相似。结论：在CPVI的基础上改良BB是增加持续性房颤患者窦性心律维持的有效方法，而它不能改善阵发性房颤患者的射频导管消融的临床结果。

{"title":"Bachmann's Bundle Modification in Addition to Circumferential Pulmonary Vein Isolation for Atrial Fibrillation: A Novel Ablation Strategy.","authors":"Jiaqi Sun, Sanbao Chen, Ming Liang, Qi Zhang, Ping Zhang, Mingyu Sun, Jian Ding, Zhiqing Jin, Yaling Han, Zulu Wang","doi":"10.1155/2023/2870188","DOIUrl":"https://doi.org/10.1155/2023/2870188","url":null,"abstract":"Background: Bachmann's bundle (BB) is the main pathway of interatrial connection that could be involved in the development of atrial fibrillation (AF). Based on this hypothesis, we raised a novel ablation strategy, BB modification in addition to circumferential pulmonary vein isolation (CPVI-BB) in patients with AF.Methods: A retrospective cohort of patients with AF who underwent CPVI-BB or CPVI alone from March 2018 to July 2021 was enrolled in our study. Propensity score matching was performed in patients with paroxysmal AF and persistent AF, respectively, to reduce the risk of selection bias between the treatment strategies (CPVI-BB or CPVI alone). The primary endpoint was overall freedom from atrial arrhythmia recurrence through 12 months of follow-up.Results: Our propensity score-matched cohort included 82 patients with paroxysmal AF (CPVI group: n = 41; CPVI-BB group: n = 41) and 168 patients with persistent AF (CPVI group: n = 84; CPVI-BB group: n = 84). Among patients with persistent AF, one-year freedom from atrial arrhythmia recurrence rate was 83.3% in the CPVI-BB group and 70.2% in the CPVI group (log-rank P = 0.047). Among patients with paroxysmal AF, no significant difference was found in the primary endpoint between two groups (85.4% in the CPVI-BB group vs. 80.5% in the CPVI group; log-rank P = 0.581). In addition, procedure-related complications and recurrence of atrial tachycardia or atrial flutter were similar between the two treatment groups, regardless of the type of AF.Conclusions: BB modification in addition to CPVI is an effective approach in increasing the maintenance of sinus rhythm in patients with persistent AF, while it does not improve the clinical outcomes of radiofrequency catheter ablation in patients with paroxysmal AF.","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10624549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71478362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Retracted: Development and Validation of a Risk Prediction Model for Ventricular Arrhythmia in Elderly Patients with Coronary Heart Disease. 收回：老年冠心病患者室性心律失常风险预测模型的开发和验证。

IF 2.1 4区医学 Q2 Medicine

Cardiology Research and Practice

Pub Date : 2023-10-11 eCollection Date: 2023-01-01 DOI: 10.1155/2023/9846248

Cardiology Research And Practice

[This retracts the article DOI: 10.1155/2021/2283018.].

[这收回了文章DOI:10.1155/2021/2283018.]。

引用次数: 0