ABSTRACT
Objective To evaluate the safety and clinical effect of radiofrequency catheter ablation below tricuspid valve using Carto3 system combined with SmartTouch contact force catheter in premature ventricular contraction (PVC) originating from tricuspid annulus. Methods The clinical data of 21 patients with PVC originating from tricuspid annulus from September 2016 to September 2018 were retrospectively analyzed. Radiofrequency catheter ablation below tricuspid valve was performed using Carto3 system combined with SmartTouch contact force catheter. Results The result of intraoperative mapping under Carto3 guidance showed that premature ventricular contraction in 12 cases originated from septal portion of the tricuspid annulus and in 9 cases originated from free wall of the tricuspid annulus. All patients′ ablation were successful, and no operative complications occurred. The patients were followed up for 1 to 23 months, and no recurrence occurred. However, there was 1 patient whose first radiofrequency ablation on the tricuspid valve was immediately successful, and PVC recurred 2 h after operation. Finally, radiofrequency ablation was performed successfully at 12 O′clock below the tricuspid valve 9 months later. Conclusions Radiofrequency catheter ablation below the tricuspid valve using carto3 guidance combined with SmartTouch contact force is safe in PVC originated from tricuspid annulus, and it can improve the success rate.
ABSTRACT
Diuretic treatment is the most common clinical treatment of heart failure, but it is easy to overlook another opposite treatment, rehydration treatment. Early treatment is required for patients with heart failure, whether it is high-capacity intensive diuretic therapy or low-volume fluid replacement therapy. Heart failure patients with low blood volume are not uncommon in clinical work, but it is easy to neglect. In order to prevent excessive urination, accurately determining whether there is a low blood volume in patients with heart failure, is particularly important.
ABSTRACT
Cardiac resynchronization therapy(CRT)is an important therapy for patients with heart failure with a reduced ejection fraction and interventricular conduction delay. Large trials have established the role of CRT in reducing heart failure hospitalizations and improving symptoms and left ventricular (LV) function. However, the problem is how to maximize the response in CRT patients. The choice of patients, individual left ventricular lead placing, research progress in the application of new problems such as CRT transmission technology are summarized.
ABSTRACT
Atrial fibrillation (AF) is one of the common arrhythmias. Catheter radiofrequency ablation is a only effective therapeutic method of AF currently. Contact force sensing catheter like SMART TOUCH can real time monitoring the pressure of catheter tip, which can help operators to understand the contact force between atrial and ablation points, and guide the atrial fibrillation ablation. It is significantly improved the effectiveness and safety of the atrial fibrillation. This article will focus on the current situation of radiofrequency ablation for AF by contact force catheter, in order to provide guidance for clinical work.
ABSTRACT
Objective The aim of this study was to investigate the application of low molecular weight heparin combined with alteplase for thrombolysis in patients with acute myocardial infarction(AMI),and to compare its thrombolysis effect with traditional anticoagulant-general heparin. Methods 35 AMI patients with alteplase intravenous thrombolytic therapy were divided into two groups,among which 15 cases in the study group were treated with 30 mg enoxaparin instant intravenous injection before thrombolysis,40 mg enoxaparin hypodermic injection 15 minutes after thrombolysis,40 mg enoxaparin hypodermic injection every 12 hours for 5 days. The other 20 cases were assigned to the control group and treated with 4 000 u(or 60 u/kg)general heparin instant intravenous injection,then pumped general heparin intravenously in the rate of 800-1 000 u/h. Meanwhile,detected coagulation convention every 3 hours and adjusted the dose of heparin according to the activated partial thromboplastin time(APTT)to keep APTT value within 1.5 to 2.0 times(50-70 s)the standard value. 48 hours later,patients in the control group was given hypodermic injection of 40 mg enoxaparin every 12 hours for 5 days. All cases were given regular treatment as guidelines recommended. Results The patency rate of infarct-related coronary artery assessed by unified clinical criteria was 86.66% and 65.00%,and the average recanalization time was(1.62±0.36)h and(1.81±0.33)h in the study and control groups,respectively. There were no significant differences on patency rate and recanalization time between the two groups(P > 0.05). One case of bleeding complication occurred in the study group(6.66%),while five cases occurred in the control group(25.00%). In the two groups,no cases appeared intracranial hemorrhage and other serious or fatal bleeding occurred. Conclusion The clinical efficacy of low molecular weight heparin was non-inferior to general heparin in AMI patients with alteplas thrombolysis. The application of low molecular weight heparin was simple and easy to operate. It can optimize the procedure of thrombolysis,reduce repetitive coagulation index monitoring and lessen clinical workload,which is worth being promoted to primary hospital and the emergency systems.
ABSTRACT
Acute ST-elevation myocardial infarction is a common clinical acute and severe disease, and it has a high fatality rate. At present, thrombolysis is still the most applicable and effective treatment method at the primary hospital. In the thrombolysis therapy, the best anticoagulation therapy can improve the patency of infarct-related coronary artery and lower the rate of reinfarction. For acute ST-elevation myocardial infarction, studies on thrombolysis anticoagulation mechanism, common anticoagulant, bleeding complications and prospect of research are necessary.