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Objective@#To compare the value of two 3D imaging reconstruction methods for left atria and pulmonary vein on guiding the catheter ablation for atrial fibrillation (AF).@*Methods@#From January 2014 to January 2017, a total of 100 drug refractory paroxysmal AF patients were divided into left atria direct angiography group (n=50), and indirect angiography group (n=50). 3D CARTO system was applied for mapping and guiding the ablation procedure. Patients assigned to direct angiography group were treated as follows: intraoperative puncture of atrial septum, inject contrast agent directly into the left atrium, conduct left atrial and pulmonary venous rotation angiography, reconstruct three-dimensional image, integrate the image into real-time X-ray system to facilitate circumferential pulmonary vein isolation. Patients assigned into the indirect angiography group were treated as follows: inject contrast agent through the right ventricle, conduct delayed rotation angiography of the left atria and pulmonary vein to guide circumferential pulmonary vein fixation and ablation. The left atrial and pulmonary venous image acquisition, the operation and X-ray exposure time, the success rate and the incidence of complication of the two groups were compared. The patients were followed up for 3-6 months.@*Results@#General clinical characteristics of the two groups were similar(all P>0.05). Ablation was successful in all 100 patients. The operation time[(112.0±21.4)min vs. (134.0±24.3)min]and X-ray exposure time((10.7±4.7)min vs. (15.8±5.2)min)were significantly lower in direct angiography group than in indirect angiography group (both P<0.01). There was no significant difference between the two groups in the immediate (86%(43/50) vs. 82%(41/50), P=0.59) and short-term (76%(38/50) vs. 72%(36/50), P=0.65) success rate and complication rate (1 aneurysm in the direct angiography group, 1 pericardial tamponade in the indirect angiography group). In-hospital mortality was zero percent.@*Conclusion@#It is safe and effective method to guide the radiofrequency catheter ablation of paroxysmal atrial fibrillation by reconstruction 3D image of left atrium and pulmonary vein. Compared with indirect angiography group, direct angiography group can improve the imaging quality of left atrium and pulmonary vein, decrease the X-ray exposure time of the ablation procedure.
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Objective: To investigate the safety and efficacy of CARTO3 fast anatomical mapping during radiofrequency ablation in patients with paroxysmal atrial ifbrillation (PAF). Methods: A total of 120 PAF patients treated in our hospital from 2013-01 to 2015-07 were enrolled. All patients received CARTO3 system for mapping and they were randomly divided into 2 groups: Control group, the patients had selective pulmonary vein angiography, followed by conventional point by point method to reconstruct left atrial model for guiding the ablation of PFA and Treatment group, the patients had selective pulmonary vein angiography followed by fast anatomical mapping to build left atrial model for guiding the ablation of PFA; the rest operational steps such as trans-septal and circumferential pulmonary vein ablation were the same.n=60 in each group. The times of operation, X-ray exposure and the rates of success, complication occurrence were compared between 2 groups. Results: All patients were successfully completed radiofrequency ablation for PAF. Compared with Control group, Treatment group had increased modeling time (8.5 ± 3.6) min vs (5.2 ± 2.3) min, while decreased pulmonary vein ostium determing time (12.0 ± 5.6) min vs (25.0 ± 8.4) min, circumferential pulmonary vein ablation time (95.0 ± 22.0) min vs (115.0 ± 25.0) min and X-ray exposure time (15.0 ± 6.3) min vs (24.0 ±5.5) min, allP0.05. Conclusion: CARTO3 fast anatomical mapping is safe and effective for guiding radiofrequency ablation in PAF patients, it may decrease the X-ray exposure time and operation time which were important for treating the relevant patients.
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Objective To study and analyze the 24 h ambulatory blood pressure and ambulatory electrocardiography in pa-tients with primary hypertension and coronary heart disease,the characteristics of blood pressure level of patients with hypertension and coronary heart disease and its correlation with myocardial ischemic burden in these patients were explored.Methods Selected by coronary angiography examination,139 cases of patients with high blood pressure,according to the results of coronary artery ex-amination were divided into high blood pressure with coronary heart disease group(observation group)74 cases and simple hyper-tension group(control group)65 cases.Two groups all were used 24 hours ambulatory blood pressure monitoring and ambulatory ECG monitoring.The relevant data were analyzed.Results (1)Observation group nocturnal systolic blood pressure was higher than the average in control group,the time of diastolic pressure was lower than the control group,24 hours and the average artery pres-sure was lower than the control group,the difference was statistically significant(P <0.05).(2)Total ischemia burden(TIB)and the corresponding systolic pressure,diastolic pressure,pulse pressure levels existed significant correlation(respectively r =0.409, P =0.000;r=-0.306,P =0.008;r =0.61 5,P =0.000);there was a significant positive correlation between day TIB and corre-sponding systolic pressure,pulse pressure level(r=0.41 7,P =0.000;r=0.402,P =0.001);there was a significant positive correla-tion between TIB and the corresponding nighttime systolic blood pressure,pulse pressure level(r=0.5 1 1,P =0.000;r=0.596,P =0.000).Conclusion The levels of nocturnal systolic pressure,diastolic pressure and the time of 24 hours are higher,and the average artery pressure levels are relatively low.There is a significant correlation with the myocardial ischemic burden.
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Objective: To investigate the safety and effectiveness of three-dimensional (3-D) rotational angiography reconstruction of left atrial and pulmonary vein stereo image embedded with real-time X-ray fluoroscopy system for guiding radiofrequency catheter ablation (RFCA) in treating the patients with atrial ifbrillation (AF). Methods: A total of 60 consecutive AF patients who received RFCA in our hospital from 2011-04 to 2013-04 were studied. The patients were randomly divided into 2 groups and 3-D Carto3 mapping system was applied for guiding RFCA in both groups. n=30 in each group. Treatment group, the patients received Siemens ARTIS Zeego digital subtraction system for left atrial and pulmonary vein rotational angiography, then, stereo images were reconstructed and embedded with real-time X-ray lfuoroscopy for RFCA guidance. Control group, conventional left and right pulmonary venography was conducted for RFCA guidance. The procedural and X-ray exposure times, rates of success and complications were recorded and compared between 2 groups. Results: All 60 patients had successful RFCA, compared with Control group, the patients in Treatment group had obviously less procedural time and X-ray exposure time, while the success rate and complications were similar between 2 groups. Conclusion: 3-D rotational angiography reconstruction of left atrial and pulmonary vein stereo image embedded with real-time X-ray lfuoroscopy system is safe and effective for guiding RFCA in treating the AF patients, which may reduce the procedural and X-ray exposure times.
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A temporary demand pacemaker with electrocardiosignal display is introduced in this paper. Double way low-noise electrocardiosignal preamplifier, amplitude limiter, high and low pass filter, 50 Hz notch filter, TTL level generator and stimulating pulse formation circuit are components of the hardware electrocircuit. The demand pacing and the electrocardiosignal display are separately controlled by the software in which the double microcontrollers communications technique is used. In this study, liquid crystal display is firstly used in body surface electrocardiosignal display or intracardial electrophysiologic signal display when the temporary demand pacemaker is installed and put into use. The machine has proven clinically useful and can be of wide appliation.
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Humans , Electrocardiography , Pacemaker, ArtificialABSTRACT
Polygraph has become a necessary instrument in interventional cardiology and fundamental research of medicine up to the present. In this study, a LabView development system (DS) (developed by NI in U.S.) used as software platform, a DAQ data acquisition module and universal computer used as hardware platform, were creatively coupled with our self-made low noise multi-channels preamplifier to develop Multi-channels electrocardiograph. The device possessed the functions such as real time display of physiological process, digit highpass and lowpass, 50Hz filtered and gain adjustment, instant storing, random playback and printing, and process control stimulation. Besides, it was small-sized, economically practical and easy to operate. It could advance the spread of cardiac intervention treatment in hospitals.