ABSTRACT
Objective To investigate the quality of life and its influence factors in patients with atrial fibrillation 3 months after catheter ablation. Methods From April 2014 to February 2016,AF patients who underwent single catheter ablation in our hospital were included. The quality of life was assessed by MOS 36 item short form health survey (SF-36), and the effect of related factors on QOL scores were further analyzed. Results There were no significant changes in quality of life at baseline and 3 months after catheter ablation including physical component summary (PCS) [(70.6±17.1) vs.(72.9±10.7),P =0.078]score, mental component summary (MCS) [(70.9±12.3) vs.(71.8±12.5), P =0.44] score and SF-36 score [(70.8±13.0) vs. (72.3±10.3), P=0.138]. Multivariate analysis indicated that there was negative correlation between patients who relapsed after ablation and better quality of life(PCS, β=―3.162, P=0.036;MCS, β=―5.675, P =0.001; total SF-36 score, β=―4.385, P =0.003), MCS score and warfarin use (MCS,β=―4.020,P =0.014). There was negative correlation between PCS score and smoking(PCS, β=―3.129,P =0.037).Conclusion All patients had stable quality of life in 3 months after catheter ablation. Ablation outcome was probably the main influencing factors. The use of dabigatran and smoking might also have effects on their quality of life.
ABSTRACT
Objective To evaluate the application of real-time three-dimensional transesophogeal echocardiography(RT-3D TEE)in percutaneous left atrial appendage closure and its follow-up in patients with non-valvular atrial fibrillation.Methods Fifteen patients including 6 males and 9 females were refractory to percutaneous closure of left atrial appendage.The morphology of the left atrial appendage (LAA)in those patients was evaluated by RT-3D TEE.Combined with two-dimensional transesophogeal echocardiography(2D-TEE),RT-3D TEE was performed during the procedure of LAA occlusion,including the measurement of left atrial appendage,the selection of occluder,the puncture of atrial septal,the delivery and release of occlusive device.Finally,it was also used immediately to evaluate the effect of blocking and complications after the operation.The closure effect and related complication were also evaluated by RT-3D TEE at 3 months and 1 2 months followed up,respectively.Results Fifteen patients were successfully undergone the LAA closure procedures with LAmbre TM device.The dimension of LAA landing zone was (21.60±4.08)mm,the measurement of cardiac angiography(CAG)during the procedure was(20.91 ± 3.93)mm and finally the fixed plate size of LAmbreTMdevice was(26.13±4.69)mm.Correlation between the measurements by RT-3D TEE and selective angiography was significant(r =0.84,P =0.0001). Bland-Altman plot showed that 86.67% of plots were among limits of agreement.The width of the flow jet was <3 mm near the LAA closure device in 2 patients immediately after the procedure.At the 3 months and 1 2 months follow-up,the LAA closures had good morphology,fixed position,and no thrombus formation on the surface.There was still slight flow j et near the closure device in 2 patients at that time. Conclusions RT-3D TEE plays an important role in the procedure of left atrial appendage closure and its follow-up.There is better correlation and consistency between the measurements by RT-3D TEE and CAG.
ABSTRACT
The rapid atrial pacing model is one of the most popular atrial fibrillation animal models. In this paper, a novel implementation of wireless implantable stimulating and ECG monitoring system is described based on the requirements of rapid atrial pacing model. Hardware circuits and software structure of the system are introduced. And test outcomes through in-vitro simulation and in-vivo animal models are presented. After verified by animal tests, the system can be used to initiate and monitor chronic atrial fibriation in real time.
Subject(s)
Animals , Atrial Fibrillation , Diagnosis , Electrocardiography , Heart Atria , Models, Animal , Monitoring, Physiologic , Prostheses and Implants , SoftwareABSTRACT
<p><b>OBJECTIVE</b>To investigate the association between CHADS2 score and long-term ( ≥ 3 years) outcomes post catheter ablation in patients with atrial fibrillation (AF).</p><p><b>METHODS</b>AF patients who received single catheter ablation in our hospital from January 2004 to March 2009 in our department were included and patients received regular follow-up. AF recurrence was defined as the occurrence of atrial arrhythmias (AF, atrial flutter and atrial tachycardia) recorded by electrocardiogram monitor ( ≥ 30 seconds) after ablation during follow-up period (after 3 months blanking period). The relationship between baseline clinical and echocardiographic characteristics and the time to recurrence during follow-up was evaluated using Cox multivariate analysis.</p><p><b>RESULTS</b>A total of 280 patients who received single catheter ablation procedure were included in the study, 3 patients died and there were 50 patients lost to follow-up. A total of 227 patients with AF (163 paroxysmal and 64 non-paroxysmal ) were enrolled in the final analysis. During a median follow-up of 51 months (41-56 months), 109 patients experienced AF recurrences and the recurrence rate after catheter ablation ( ≥ 3 years) was 48.0% (109/227). Cox multivariate analysis showed that the high CHADS2 score (HR: 1.417, 95%CI 1.194-1.682, P < 0.001) and AF non-termination during ablation (HR: 2.077, 95%CI 1.380-3.126, P = 0.043) were risk factors of AF recurrence. AF recurrence rates in the termination and non-termination group were 41.0% (75/183) and 77.3% (34/44), respectively. In the AF termination group, the recurrence rates and the median recurrence free time in patients with CHADS2 score ≥ 3 were 80.0% (12/15) and 1 year, respectively. In the non-AF termination group, the recurrence rates in patients with CHADS2 score = 0, CHADS2 score = 1-2 and CHADS2 score ≥ 3 were 60.0% (6/10), 77.8% (21/27) and 100% (7/7), respectively; the median recurrence free time of patients with CHADS2 score = 0, CHADS2 score = 1-2 and CHADS2 score ≥ 3 were 30 months, 12 months and 6 months, respectively.</p><p><b>CONCLUSIONS</b>CHADS2 score is a predictor of AF recurrences after catheter ablation. Patients with high CHADS2 score is associated with higher risk of long-term ( ≥ 3 years) AF recurrences.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Atrial Fibrillation , General Surgery , Catheter Ablation , Methods , Follow-Up Studies , Recurrence , Risk Factors , Treatment OutcomeABSTRACT
Objective: To explore the regulative role of extracellular regulated protein kinase-5 (ERK5)/Bcl-2 interacting mediator of cell death (Bim) pathway in hypothermal stimulation induced neonatal rat’s cardiomyocytes (CMs) damage and apoptosis. Methods: CMs were cultured for hypothermal stimulation and the speciifc siRNA was used to down-regulate the ERK5 or Bim in CMs. The cell apoptosis was detected by lfow cytometry, protein expression was examined by Western blot analysis, the intracellular Ca2+, reactive oxygen species (ROS) and mitochondrial membrane potential (ΔΨm) were evaluated by lfuorescent labeling and lfow cytometry. Results: In hypothermal stimulated CMs, ERK5 siRNA could promote Bim protein expression, but Bim siRNA could not inlfuence ERK5, while attenuated p-ERK5 expression. ERK5 siRNA induced higher apoptosis rate, while Bim siRNA could decrease such effect. ERK5 siRNA increased the intracellular Ca2+overloading, ROS activation andΔΨm damage, while Bim siRNA played the role to against those effects in hypothermal stimulated CMs. Conclusion: Our study revealed that ERK5/Bim pathway played the important regulative roll in hypothermal stimulation induced neonatal rat’s CMs damage and apoptosis.
ABSTRACT
Objective To evaluate the influnce of atrial fibrillation(AF)/atrial flutter on the mortality and prognosis of patients with AMI. Methods A total of 297 consecutive patients were studied from Jan.2001 to Dec. 2005 and were categorized into 2 groups according to the presence or absence of AF/atrial flutter. The 30 d and 6 mo mortalities, Killip Grades, cardiogenic shock, arrhythmia and left ventricular ejectory functional (LVEF) 6 months after AMI with Doppler US between the 2 groups were compared. Results The incidence of AF/atrial fluttler was 12.5% with older age, higher Killip Gorade, higher CPK peak, higher rates of previous myocardial infarction and multivascular involvement than those without AF/atrial flutter. The short and medium-term mortalities in AF/atrial flutter group were both significantly higher than those of non-AF/atrial flutter group(P