ABSTRACT
Objective@#To explore the electrocardiographic characteristics of patients with idiopathic ventricular arrhythmias (VAs) originating from different portions of distal great cardiac veins (DGCV).@*Methods@#The study included 49 patients underwent successful RFCA of premature ventricular complex(PVCs)/ventricular tachycardia(VT) from different portions of the DGCV in our department from July 2009 to March 2016. The surface 12-lead electrocardiogram (ECG) and intraventricular ablation mapping features were analyzed. Patients were divided into four groups according to the mapping and ablation results: DGCV1(10 patients), DGCV2 (13 patients), proximalanterior interventricular vein (PAIV, 17 patients)and extend distal great cardiac vein (EDGCV, 9 patients). We analyzed the similarities and differences between surface 12-lead ECG of patients with PVCs/VT from different portions of DGCV, and compared with random chosen 290 patients with PVCs/VT from ventricular outflow tract and adjacent structure.@*Results@#A positive R wave in inferior leads, a negative QS morphology in lead aVL and aVR were found among all groups. The different characteristics of surface 12-lead ECG of VAs originating from DGCV were as follows: (1)EDGCV patients demonstrated a positive R or r wave on lead Ⅰ(6/9) while a negative rS or qr wave was evidenced in other three groups (39/40). (2)A positive R pattern on lead V1, V5-V6 (11/13) was presented in patients of DGCV2 group; R (without S or s) wave on V1 (9/10), RS or Rs wave on V5-V6 were found in DGCV1 group; RS or rS wave was seen on lead V1, R(without S)wave in lead V5-V6 (25/26) were found in EDGCV and PAIV group and the amplification of R wave in EDGCV was higher than V1 of PAIV group.(3)Precordial lead transition zone was in front of V1 for DGCV1 and DGCV2 groups (23/23), within V1-V3 for EDGCV group, but on V2 or within V2-V3 for PAIV group.(4)Patients of DGCV1 and DGCV2 demonstrated a longer Pseudo delta wave time(PdW), intrinsicoid deflection time (IDT), significantly larger maximum deflection index (MDI) than those in PAIV and EDGCV groups (P<0.001). (5)The different characteristics of surface 12-lead ECG between VAs originating from DGCV and those from ventricular outflow tract and adjacent structure were as follows: ① The ECG features were similar between PVIA and LCC group, both demonstrated a rs wave on the lead Ⅰ, rS wave on V1-V2 and R wave on V5-V6; ②The ECG features were similar betweenEDGCV and RCC group, both presented with R or r wave on the lead Ⅰ, the QRS wave of precordial leads was similar as PAIV and LCC groups; ③A R wave on the lead V1, V5-V6 was found in group DGCV2, and ILCC; ④Similar to the group Endo-MAA, patients in DGCV1 group also demonstrated a R wave on the lead V1 and a Rs wave on V5-V6.@*Conclusion@#A positive R wave in inferior leads, a negative QS morphology in lead aVL and aVR are seen in all patients, but different electrocardiographic characteristics of PVC/VT originating from the different portions of the DGCV are presented on lead Ⅰ and V1-V6.
ABSTRACT
Objective To explore the nursing effects of self-care body posture in patients after modified radical mastectomy. Methods The clinical data of 102 patients with modified radical mastectomy were randomly divided into the study group and the control group, all patients met the following standard:clear consciousness, effective communication, no paralysis of limbs, no fracture. In the study group, according to Orem"self-care theory" concept, patients carried out self-care body posture with mainly focus on self-emancipated and the body center of gravity position, in the control group patients were given traditional posture care with mainly emancipated assistance. The first time getting out-of-bed, the occurrence of various complications, the comfort level of emancipation and posture, as well as nursing satisfaction on the first day after surgery were observed and compared between the two groups. Results The two groups showed significant difference in the first time out-of-bed, anxiety, the comfort level of emancipation and posture, as well as nursing satisfaction. There was no significant difference between the two groups in dizziness, limb swelling, flap effusion, flap necrosis. No pressure ulcer occurred. Conclusions Making use of self-care body posture in patients after modified radical mastectomy can improve the satisfaction and comfort of the patients, and improve the patients' recovery, without increasing the complication, which is worth promoting.
ABSTRACT
Objective To evaluate the safety and clinical effects of radiofrequency single catheter ablation (RESCA)for right ventrieular arrhythmia(RVA).Method A total of 111 patients data in the Second Affiliated Hospital of Wenzhou Medical College from May 2003 to May 2008,were retrospectively analyzed aged(45.2±16.7)years old including 41 men and 70 women,consisted of 13 patients of ventricular tachycardia(VT)and 98 patients of premature ventricular contractions(PVC).There were 104 casess from right ventricular outflow tract arrhythmia(RVOTA)and 7 cases from right ventricular inflow tract arrhythmia(RVITA).According to use single catheter approach or common technique,electrophysiolo-gical study,pacing and/or activation mapping and Catheter ablation were performed,were separated into two groups.①Single catheter group:27 men and 49 women,ages(44.5±16.9)years old;consisted of 62 patients of RVOT-PVC,9 patients of RVOT-VT and 5 patients of RVIT-PVC.②Control group:14 men and 21 women,ages(46.7±16.5)years old;consisted of 29 patients of RVOR-PVC,4 patients of RVOT-VT and 2 patients of RVIT-PVC.Results Operations in two groups came off smoothly and no ablation related complications in two groups.Procedure time and fluoroscopy time[(55.23±26.24)min and(9.93±5.32)min]in single catheter group were significantly shorter than those in control group [(68.37±21.83)min and(12.96±4.54)min,t=2.76 and 3.09,all P<0.01].Cost in the fromer (12440.32±761.24)RMB were significantly less than those in the latter[(22119.51±1071.07)RMB,t=46.09,P<0.01].Ablated successful rate in the near future,at a specified future date and other parameter were similar in two groups.Conclusions Right ventricular arrhythmia can be ablated with single catheter approach in safety,efficacious,easy to operate and lower cost.