ABSTRACT
Objective: To investigate the efficacy and safety of left bundle branch area pacing (LBBaP) with the new simplified approach (nine-partition method). Methods: A total of 118 patients with clinical indications and received pacemaker implantation from December 1, 2018 to December 31, 2019 in Beijing Anzhen Hospital were enrolled. LBBaP was performed with the nine-partition method (in the right anterior oblique 30° position, the ventriculogram was divided into nine partitions and the initial implant sites were located in the lower base 1/3 partitions). In X-ray image, the 3830 lead is located in the left bundle branch area, the unipolar pacing QRS wave is in the form of right bundle branch block, and the peak time from stimulation to left ventricular activation<90 ms is defined as successful operation. The clinical characters, such as the methods of venipuncture, electrode parameters, operation duration, fluoroscopy duration, the peak time from stimulation to left ventricular, pacemaker types, surgical success rate, complications, and immediate postoperative ECG parameters were collected. The patients were followed up after the operation, and the electrode parameters and postoperative complications were recorded. Results: This study is a retrospective study. There were 62 (52.5%) male patients in this cohort, the average age was (65.9±13.4) years old,and there were 49(41.5%) sick sinus syndrome, 6(5.1%) abnormal sinus node and atrioventricular node simultaneously, 63(53.4%) atrioventricular block, 26(22.0%) atrial fibrillation, 20(16.9%) cardiomyopathy; the baseline duration of QRS was (109.21±39.03) ms. Successful LBBaP was achieved in 109 patients with"nine-partition method"and the success rate was 92.4%; 104 patients (95.5%) were axillary vein puncture, 5 (4.6%) were subclavian vein puncture; the operation duration was (80.3±23.0) min, the fluoroscopy duration was (12.29±5.13) min; the QRS duration after LBBaP was (116.36±18.11) ms. The threshold of the left bundle branch (LBB) lead was (0.92±0.63) V, the R wave amplitude was (10.60±5.04) mV and the impedance was (798.71±194.90) Ω. In 1 V pacing, the peak time from stimulation to left ventricular activation was (67.91±12.15) ms, and in 5 V pacing was (67.52±12.45) ms; 1 case (0.9%) with a single-chamber pacemaker implanted, 106 cases (97.3%) with dual-chamber pacemaker and 2 cases (1.8%) with three-chamber pacemakers. There were no hematomas, pneumothorax, hemothorax, electrode dislocation, infection, and capsular hemorrhage and other serious surgery-related complications during the operation. A total of 97 patients (89.0%) were followed up for (6.21±2.90) months. The electrode parameters of all patients were stable and no complications observed. Conclusions: The LBBaP with nine-partition method is a simple, safe and effective physiological pacing approach. However, its long-term effect still needs to be further verified.
Subject(s)
Aged , Humans , Male , Middle Aged , Atrioventricular Block , Bundle-Branch Block/therapy , Cardiac Pacing, Artificial , Feasibility Studies , Retrospective StudiesABSTRACT
ABSTRACT The taboos of man-spirit (RenShen) and bottom-spirit (KaoShen) are two kinds of time-related contraindications that are more commonly seen in the literature of acupuncture and moxibustion. The meaning of man-spirit is often extended to qi-blood or mind, or else directly equals to heaven-spirit (TianShen). It is highly possible that the bottom-spirit is subordinate to man-spirit, and both Taoist philosophy and the SanCai theory declare the importance of bottom in human body. The violation of contraindications could lead to diseases in the neighborhood where man-spirit travels. However, the results are generally recorded as ulcer, lingering disease and death in most medical texts. From Ming dynasty, more and more doctors have expressed disapproval of man-spirit and bottom-spirit.
Subject(s)
Humans , Acupuncture Therapy , Psychology , Moxibustion , PsychologyABSTRACT
In this article, the Chinese Traditional Medicine and Materia Medica Subject Headings, Standards of the People's Republic of China - Classification and Codes of Diseases and Zheng of Traditional Chinese Medicine and the Chinese Terms in Traditional Chinese Medicine and Pharmacy were compared. Three standards were compared from the terminology quantity, content and classification. Each standard has its special feature. The compatibility and consistency are not strong in these standards. More authoritative traditional Chinese medicine terminology standards need to be established for the application in the clinical practice and scientific research.
ABSTRACT
The accurate acupoint and application of acupuncture for throat diseases described in Zheng Mei-jian's book Chonglou Yuyao (Jade key to the secluded chamber) is clarified through exploration on recordings of the relative acupuncture skills in medical literatures of the mid-Qing Dynasty. It is found that the so called open-the-wind-way-acupuncture includes at least two groups of acupoints on the hand and the head, they are applied respectively for light and severe cases of sore-throat. Together with the third group of points which is used for the extremely severe cases, the three groups of points are all classified into the concept of qi-acupuncture. Although the composition of acupoints and process of application are different in recordings of various medical literatures in same periods, the treating principles are all focused on "opening the passage for elimination of the wind so as to remove the pathogenic wind-heat and promote blood circulation".