Arrhythmia-induced cardiomyopathy: a specific pediatric dilated cardiomyopathies / 中国小儿急救医学

Arrhythmia-induced cardiomyopathy(AIC) is an reversible dilated cardiomyopathy and appears to occur at any age.The morbidity of AIC is unclear and likely underestimated.The pathophysiology and mechanism of AIC is unknown.It is often difficult to determine whether arrhythmias are the cause or result of cardiac dysfunction.The diagnosis of AIC can be only confirmed after recovery or improvement of cardiac function after elimination of the tachyarrhythmia.Tachycardias, ventricular premature contraction, left bundle branch block and ventricular preexcitation are known to trigger AIC.Appropriate diagnosis and treatment of AIC can reverse cardiac function.However, arrhythmia recurrence can lead to rapid recurrence of AIC and symptoms of heart failure.

A new ECG sign for sudden death: Transient prolonged QT interval following premature contraction / 中南大学学报(医学版)

Early recognition and treatment for early warning electrocardiogram (ECG) of sudden death are very important to prevent and treat malignant arrhythmia and sudden death. Previous studies have found that R-on-T and T wave alternation, and QT interval prolongation are closely related to malignant arrhythmia or sudden death, which are included in the critical value of ECG.By analyzing the ECG characteristics of 4 patients with sudden death, we found that although the causes of the patients were different, there were transient prolongation of QT interval after premature contraction in 12 lead ECG, followed by malignant arrhythmia or sudden death. Thus, we thought that the transient prolongation of QT interval after premature contraction had a high value for warning malignant arrhythmia or sudden death. This phenomenon should be paid enough attention to reduce the risk of sudden death.

Diagnostic value of electrocardiogram scatter plot for arrhythmia / 中国基层医药

Objective@#To explore the diagnostic value of electrocardiogram (ECG) in common arrhythmias, and to provide an effective reference for clinical diagnosis of arrhythmias.@*Methods@#The clinical data of 100 arrhythmia patients in the Department of Cardiology of Rugao People's Hospital from July 2016 to June 2018 were analyzed.All the patients were examined by dynamic ECG.The t-RR scatter plot was used to diagnose arrhythmia, and the diagnosis results were compared between the dynamic ECG and ECG scatter plot.The efficacy of ECG scatter plot in the diagnosis of arrhythmia was analyzed.@*Results@#By ECG scatter plot, 22 cases of premature beat, 18 cases of ventricular premature beat, 14 cases of atrial fibrillation, 15 cases of atrial flutter, 8 cases of atrial fibrillation with ventricular early, 7 cases of atrial fibrillation with indoor differential transmission, 5 cases of atrial fibrillation combined with atrial flutter, 89 cases of correct diagnosis, and the total coincidence rate was 89.00%.The B line slope of the supraventricular premature beat point map was (0.45±0.13), which was the largest in each type of arrhythmia, and the minimum ventricular premature beat was (0.08±0.03). The difference in the slope of the supraventricular premature beat and the ventricular premature beat B line was statistically significant (F=5.031, P<0.05). The atrial fibrillation, atrial flutter, atrial fibrillation and ventricular early, atrial fibrillation accompanied with indoor had no statistically significant differences in the slope of B line (all P>0.05). The sensitivity, specificity and accuracy of ECG in the diagnosis of arrhythmia were 82.05%, 90.51%, 92.57%, respectively, and the area under the curve was 0.833 (95% CI: 0.271-0.942).@*Conclusion@#ECG scatter plot has a high application value in the diagnosis of arrhythmias, and can realize the accurate diagnosis of complex arrhythmias.

Diagnostic value of electrocardiogram scatter plot for arrhythmia / 中国基层医药

Objective To explore the diagnostic value of electrocardiogram (ECG) in common arrhythmias, and to provide an effective reference for clinical diagnosis of arrhythmias.Methods The clinical data of 100 arrhythmia patients in the Department of Cardiology of Rugao Peopleˊs Hospital from July 2016 to June 2018 were analyzed.All the patients were examined by dynamic ECG.The t－RR scatter plot was used to diagnose arrhythmia ,and the diagnosis results were compared between the dynamic ECG and ECG scatter plot.The efficacy of ECG scatter plot in the diagnosis of arrhythmia was analyzed.Results By ECG scatter plot , 22 cases of premature beat ,18 cases of ventricular premature beat,14 cases of atrial fibrillation,15 cases of atrial flutter,8 cases of atrial fibrillation with ventricular early,7 cases of atrial fibrillation with indoor differential transmission ,5 cases of atrial fibrillation combined with atrial flutter,89 cases of correct diagnosis ,and the total coincidence rate was 89.00%.The B line slope of the supraventric－ular premature beat point map was (0.45 ±0.13),which was the largest in each type of arrhythmia ,and the minimum ventricular premature beat was (0.08 ±0.03).The difference in the slope of the supraventricular premature beat and the ventricular premature beat B line was statistically significant (F＝5.031,P＜0.05).The atrial fibrillation,atrial flutter,atrial fibrillation and ventricular early ,atrial fibrillation accompanied with indoor had no statistically significant differences in the slope of B line (all P＞0.05).The sensitivity,specificity and accuracy of ECG in the diagnosis of arrhythmia were 82.05%,90.51%,92.57%, respectively, and the area under the curve was 0.833 (95% CI:0.271－0.942).Conclusion ECG scatter plot has a high application value in the diagnosis of arrhythmias ,and can realize the accurate diagnosis of complex arrhythmias.

Treadmill test for premature ventricular contraction / 国际儿科学杂志

Premature ventricular contraction is one of the most common arrhythmias in pediatric.Its incidence increases with age.The clinical symptoms of children's premature ventricular beats vary greatly,and the pediatric patients may have no discomforts,while the serious patients may have life-threatening events such as malignant ventricular arrhythmia and cardiac arrest.How to evaluate premature ventricular contraction and to guide the life and activities of children with premature ventricular contraction is of great significance.By adjusting the speed and slope of the plate,the motion of the subject is adjusted to increase the work and increase the heart rate,then the arrhythmia that is absent in the static state can be found or the original arrhythmia can be changed or disappeared.Treadmill test has been carried out in China for more than 30 years.Though some clinical experience has been accumulated,but there are still a lot of problems.This article reviews the present state and precision management of treadmill test's effect on children with ventricular premature contraction.

Clinical research of heart rate variability and deceleration capacity in children with idiopathic ventricular premature ;contraction / 临床儿科杂志

Objective To explore the relationship between heart rate variability (HRV) and deceleration capacity (DC) in children with idiopathic ventricular premature contraction of different origins. Methods The clinical data from 155 children with idiopathic ventricular premature contraction were retrospectively analyzed. According to the age, the children were divided into young children group (

Circadian Variation of Ventricular Premature Complex in Hypertension and Ischemic Heart Disease Patients

BACKGROUND: Circadian rhythms have been described for acute myocardial infarction, sudden cardiac death, cerebrovascular disease, ischemic heart disease, and ventricular arrhythmia. Most of studies reported that the frequency of ventricular permature contractions(VPC's) shows a peak in day time. We tried to see that the circadian rhythm of VPC's in hypertension and ischemic heart disease(IHD) patients. And we will also studied the relationship between heart rate and frequencey of VPC's. METHOD: Twenty four hour holter monitoring was performed in hypertensive patients (N=23), ischemic heart disease patients(N=25), and normal control group(N=30). We tested the circadian pattern of VPC's and heart rates and the relationships of the frequency of VPC's and heart rates. RESULT: In hypertension group, a peak incidence of heart rate is between 5 and 8 P.M., in ischemic heart disease group, between 3 and 6 P.M.. In control group, the heart rate shows a peak beteen 1 and 3 P.M.. The frequency of VPC's in hypertension group shows the first peak between 4 and 10 P.M., and the second peak beteen 7 and 10 A.M.. In ischemic heart disease group, they show a peak between 2 and 8 P.M..In control group, there was no circadian variation for the frequency of VPC;s. Both in hypertension and IHD patients group, there was significant correlation between the frequency of VPC's and the heart rates. CONCLUSION: It seemed that VPC' were more frequently occurred in relation to the increase of heart rate in the afternoon, in hypertensive and ischemic heart disease patients.

Evaluation of late arrhythmia and exercise performance in patients after intracardiac repair of tetralogy of Fallot / 体力科学

Treadmill exercise test and cold water face-immersion test were performed in 50 patients with tetralogy of Fallot at a mean age of 11.9 years, an average of 8.2 years after intracardiac repair. Cardiac catheterization was also performed in 45 patients 0.5-11 years after the repair.<BR>Exercise performance and results of catheterization were compared in patients with and without ventricular premature contraction (VPC) . In 22 (44%) of the 50 patients, VPC was induced by treadmill and/or cold water face-immersion test. Compared with the other 28 patients, the patients who had VPC during the tests, 1) were older (13.6 versus 10.6 years, p< 0.05, t-test) and were tested at a longer interval after repair of tetralogy of Fallot (9.5 versus 7.3 years, p<0.05), 2) showed no difference in the results of catheterization, and 3) had lower exercise performance.<BR>Cold water face-immersion test is therefore considered to be useful for evaluation of patients after intracardiac repair of tetralogy of Fallot.