ABSTRACT
Objective: To observe the application value of apical vertical angle and ejection velocity in diagnosis of apical hypertrophic cardiomyopathy (AHCM). Methods: A total of 51 patients with AHCM, including 30 typical AHCM (T-AHCM group) and 21 pre-AHCM (P-AHCM group) were enrolled. Forty matched healthy volunteers and 44 hypertensives were recruited as normal control (NC group) and hypertension group (HT group), respectively. Echocardiographic studies were performed in all subjects to acquire and analyze apical vertical angle (θap) and its systolic rate of change (△θap) in end diastolic and end systolic stage, peak ejection velocity (Vap) in systolic stage and its ratio to the velocity in left ventricular outflow tract (VLVOT). Results: Compared with NC and HT groups, θap decreased and △θap and Vap increased significantly in both P-AHCM and T-AHCM groups (all P<0.001). Conclusion: Decreased apical vertical angle and systolic rate of angle change and local ejection velocity are found in patients with AHCM even in early stage. Combination of these indicators with specific ECG changes are expected to improve the detection rate of AHCM with ultrasound.
ABSTRACT
Objective To explore the feasibility and safety of right ventricular septal pacing with active fixation electrodes.Methods This was a randomized and control clinical trial.Patients implanted with pacemaker were randomly divided into two groups.One group underwent the right ventrieular high septal pacing with the active fixation electrodes(RVS group),and the other group underwent the right ventricular apical pacing with the passive fixation electrodes(control group).The parameter was recorded in two groups in and after operation and compared accordingly.Results (1)There were no significant differences in the procedure time between two groups[averaged(59.6±3.2)and(60.2±3.7)minutes respectively].But the time of exposing X-ray was significant longer in RVS group.(2)There was no significant difference in acute implanting measurement,except perioperative and postoperative threshold 1 month in RVS group was higher than that in control group(P＜0.05 or＜0.01).After 3 months,there was no significant difference.(3)Impedance decreased significantly in 1 month and 3 months in RVS group[P＜0.01 or＜0.05).(4)There was no difference in R-wave sensing between two groups.(5)After 100%pacing,the mean QRS duration Was shorter in RVS group,but the difference was not significant.(6)Operations in two groups came off smoothly and there were no complications.Conclusion It is feasible and secure to pace from RVS with active fixation electrodes.