Reduction of atrial fibrillation in remotely monitored pacemaker patients: results from a Chinese multicentre registry / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Many recipients of implantable cardiac electronic devices have atrial fibrillation (AF) occurrences after device implantation, even if there is no previous history of AF, and some of the episodes are asymptomatic. The purpose of this study was to evaluate trends in AF burden following early AF detection in patients treated with pacemakers equipped with automatic, daily Home Monitoring function.</p><p><b>METHODS</b>Between February 2009 and December 2010, the registry recruited 701 pacemaker patients (628 dual-chamber, 73 biventricular devices) at 97 clinical centers in China. Daily Home Monitoring data transmissions were analyzed to screen for the AF burden. In-office follow-ups were scheduled for 3 and 6 months after implantation. Upon first AF (i.e., mode-switch) detection in a patient, screening of AF burden by Home Monitoring was extended for the next 180 days.</p><p><b>RESULTS</b>At least one episode of AF was observed in 22.9% of patients with dual-chamber pacemakers and in 28.8% of patients with biventricular pacemakers. The first AF detection in a patient occurred, on average, about 2 months before scheduled follow-up visits. In both pacemaker groups, mean AF burden decreased significantly (P < 0.05) over 180 days following first AF detection: from 12.0% to 2.5% in dual-chamber and from 12.2% to 0.5% in biventricular pacemaker recipients. The number of patients with an AF burden >10% per month was significantly reduced over 6 months of implantation in both dual chamber (38 patients in the first month vs. 21 patients in month 6, P < 0.05) and biventricular (7 patients in the first month vs. 0 patient in months 4-6, P < 0.05) pacemaker recipients.</p><p><b>CONCLUSIONS</b>Automatic, daily Home Monitoring of patients treated with cardiac pacemakers allows early detection of AF, and there is a gradual and significant decrease in AF burden.</p>

Multi-center clinical trial on efficacy of national-made radiofrequency ablation catheter for the treatment of atrioventricular nodal reentrant tachycardia and atrioventricular reentrant tachycardia / 中华心血管病杂志

<p><b>OBJECTIVE</b>The aim of this trial is to compare the efficacy and safety between national-made and imported ablation catheters for the treatment of atrioventricular nodal reentrant tachycardia (AVNRT) and atrioventricular reentrant tachycardia (AVRT).</p><p><b>METHOD</b>A total of 1342 patients with AVNRT or AVRT were randomly treated with national-made ablation catheter (Group 1, n = 672) or imported ablation catheter (Group 2, n = 670).</p><p><b>RESULTS</b>The immediate ablation success rate was similar in Group 1 and Group 2 (97.9% vs. 99.1%, P > 0.05). There were also no significant differences in the procedure time [(68 +/- 36) min vs. (67 +/- 34) min], the fluoroscopic time [(14 +/- 14) min vs. (10 +/- 11) min], the number of energy delivery [(4.5 +/- 4.5) beats vs. (4.6 +/- 3.9) beats], the ablation time [(260 +/- 218) s vs. (257 +/- 207) s] and the score of ablation catheter performance evaluation [(4.4 +/- 0.5) vs. (4.5 +/- 0.4) ] between the two groups (all P > 0.05). Three patients developed pericardial effusion (1 in Group 1 and 2 in Group 2, P > 0.05). Incidence of recurrence of tachycardia during the 3 months follow up was similar between the 2 groups (14 in Group1 vs. 16 in Group 2, P > 0.05).</p><p><b>CONCLUSION</b>National-made and imported radiofrequency ablation catheters have similar efficacy and safety for treatment of AVNRT and AVRT.</p>

Clinical profile and outcomes of atrial fibrillation in elderly patients with acute myocardial infarction / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Atrial fibrillation (AF) occurs commonly in patients with acute myocardial infarction (MI) and is associated with an increased long-term mortality. This study aimed to investigate the clinical characteristics and outcomes of AF in in-hospital elderly Chinese patients with acute MI.</p><p><b>METHODS</b>A total of 967 patients with acute MI, aged >/= 65 years, were categorized on the basis of the absence or presence of AF. Patients with documented AF were classified into two subgroups: the ongoing AF group and the new-onset AF group. We retrospectively evaluated the clinical profile, in-hospital outcomes, and effects of revascularization on the incidence of AF in elderly patients with acute MI.</p><p><b>RESULTS</b>AF was documented in 100 (11.53%) patients and the incidence of new-onset AF was 6.51% during hospitalization. History of old MI and cerebrovascular events were more common in patients with AF than in those without AF (P < 0.001, P < 0.01, respectively). The incidence of AF was higher in patients with non-ST elevated MI (P = 0.014), inferior wall MI (P = 0.004) and cardiac function of Killip class III or IV (P = 0.008). Patients with AF had more complication of pneumonia (P = 0.003) and longer hospital stay. Left circumflex coronary artery involvement was more common in patients with AF (compared with patients without AF, P < 0.001). Percutaneous coronary intervention or coronary artery bypass grafting significantly decreased the incidence of new-onset AF from 7.97% to 3.82% (P = 0.017). AF depended to heart failure, increased the in-hospital mortality.</p><p><b>CONCLUSIONS</b>AF is common in elderly patients with acute MI and is associated with poorer clinical outcomes. Revascularization reduces the incidence of AF and thus improves the clinical outcomes in these patients.</p>