Efficacy and safety of segmental pulmonary vein isolation and circumferential pulmonary vein isolation in patients with atrial fibrillation: a comparative study / 南方医科大学学报

<p><b>OBJECTIVE</b>To compare the efficacy and safety of segmental pulmonary vein isolation (SPVI) and circumferential pulmonary vein isolation (CPVI) guided by EnSite NavX system in patients with atrial fibrillation (AF).</p><p><b>METHODS</b>Eighty-five patients with paroxysmal AF and persistent AF were enrolled in this study. Forty patients (30 with paroxysmal AF and 10 with persistent AF) underwent SPVI procedure, and 45 (31 with paroxysmal AF and 14 with persistent AF) underwent CPVA guided by EnSite NavX three-dimensional electrophysiological mapping system. All the patients were followed up for over six months.</p><p><b>RESULTS</b>The success rate was 65% in the SPVI group and 84.4% in the CPVI group (P=0.0332), with incidence of major complications of 17.5% and 6.7%, respectively (P=0.0845). In the SPVI group, 12.5% patients had pulmonary vein stenosis after the operation, which occurred in none of the patients in the CPVI group (P=0.0312). The total procedure time was 200.4+/-37.0 min in the SPVI group, significantly shorter than that in the CPVI group (226.5+/-26.1 min, P=0.002). The fluoroscopy time in the SPVI group was obviously longer than that in the CPVI group (54.7+/-9.7 vs 27.1+/-3.1 min, P<0.001).</p><p><b>CONCLUSIONS</b>CPVI guided by EnSite NavX system is more effective than SPVI for treatment of atrial fibrillation with significantly shortened fluoroscopy time but prolonged procedure time. The two procedures results in comparable incidences of major complications, but CPVI is associated with reduced rate of pulmonary vein stenosis in comparison with SPVI.</p>

Circumferential pulmonary vein ostial isolation for atrial fibrillation guided by EnSite NavX three-dimensional electrophysiological mapping / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the efficacy and safety of circumferential pulmonary vein ostial isolation guided by EnSite NavX three-dimensional electrophysiological mapping in patients with atrial fibrillation (AF).</p><p><b>METHODS</b>Thirty-eight patients with drug refractory paroxysmal or persistent AF underwent circumferential pulmonary vein ostial isolation and were followed up to investigate the efficacy and safety of the treatment.</p><p><b>RESULTS</b>All cases reached the endpoint of the ablation, and both sides of the pulmonary vein were completely isolated, with an average procedure time of 200.4-/+37.0 min, X-ray exposure time of 54.7-/+9.7 min, and three-dimensional left atrial geometry reconstruction time of 27.5-/+7.5 min. During the follow-up for 9-/+3 months, the success rate of initial ablation was 89.5%, and the incidence of procedure-related complications were 7.9%.</p><p><b>CONCLUSIONS</b>Circumferential pulmonary vein ostial isolation guided by EnSite NavX three-dimensional electrophysiological mapping can be effective and safe for AF treatment.</p>

Therapeutical efficacy of routine intra-aortic balloon pump support in patients with high-risk acute myocardial infarction undergoing percutaneous coronary intervention / 南方医科大学学报

<p><b>OBJECTIVE</b>To assess the value of routine intra-aortic balloon pump (IABP) support in patients with high-risk acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI).</p><p><b>METHODS</b>The clinical data of 41 patients with high-risk AMI undergoing emergency PCI with routine IABP support were retrospectively reviewed, and 38 patients paired with the former group receiving emergency PCI for high-risk AMI without IABP support at the same time were included as the control group. Thirty days after the operation, the two groups were compared for myocardial ischemic events, left ventricular function and major adverse cardiac events (MACE).</p><p><b>RESULTS</b>Patients receiving IABP support had a significantly lower incidence of myocardial ischemic events than those without IABP (4.9% vs 15.8%, P<0.05), and showed greater improvement in the left ventricular function. Significant differences were also observed in the mortality rate, incidence of reinfarction and revascularization rate between the two groups, but not in the rate of MACE.</p><p><b>CONCLUSION</b>Patients undergoing PCI for high-risk acute AMI can benefit from routine IABP support in terms of improvement of left ventricular function and reduce myocardial ischemic events and the rate of MACE. These results, however, still await further confirmation by large-scale clinical trials.</p>

Relation of plasma brain natriuretic peptide to serum creatine kinase MB level in patients with acute myocardial infarction following primary percutaneous coronary intervention / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the relation between plasma brain natriuretic peptide (BNP) and serum creatine kinase MB (CK-MB) level in patients with acute myocardial infarction (AMI) following primary percutaneous coronary intervention (PCI).</p><p><b>METHODS</b>Sixty-three consecutive patients with AMI were divided into two groups according to the timing of PCI, namely direct PCI and indirect PCI groups. Plasma BNP levels were measured in all patients on admission and at 4, 24 and 48 h after admission. The CK-MB level was measured every 3 h on the first day of hospitalization, every 6 h on the second day and every 12 h on the third day.</p><p><b>RESULTS</b>BNP level increased gradually following admission and began to decrease 48 h after admission in the two groups of patients. The peak BNP level occurred at 24 h after admission, and the BNP levels in patients of indirect PCI group were significantly higher than that of direct PCI group at 4, 24 and 48 h after admission. The peak CK-MB level of the direct PCI group occurred significantly earlier than that of the indirect group.</p><p><b>CONCLUSION</b>Plasma BNP level may serve as an important objective indicator for recanalization of the infarct-related arteries following PCI in the early stage of AMI, which can help in the decision on clinical treatment plans for AMI.</p>