Clinical features of idiopathic ventricular tachycardia of various types and their radiofrequency ablation therapy / 南方医科大学学报

<p><b>OBJECTIVE</b>To analyze the clinical features idiopathic ventricular tachycardia (IVT) and evaluate the effect of radiofrequency ablation therapy for their management.</p><p><b>METHODS</b>An retrospective analysis was conducted in 165 IVT patients who received radiofrequency ablation therapy. IVT was classified into 3 types according to the site of origin, namely the right ventricular outflow tract (RVOT-IVT, 86 cases), left ventricular septum (LV-IVT, 75 cases), and left Valsalva sinus (4 cases).</p><p><b>RESULTS AND CONCLUSION</b>RVOT-IVT was more frequent in female patients than in male patients (60 vs 26, M/F ratio of 0.43). In LV-IVT, male patients prevailed (54 vs 21, M/F ratio of 2.57), suggesting a gender difference in the incidence of IVT. IVT occurred mainly in young and middle-age patients. Most RVOT-IVT occurred in the third to fourth decade of life (mean 36-/+12 years), and LV-IVT occurred at a younger age than did RVOT-IVT (mean 26-/+15 years, P<0.01). Twelve-lead ECGs revealed left bundle branch block morphology in RVOT-IVT, and most of them presented with frequent premature ventricular contraction and/or non-sustained ventricular tachycardia. All the RVOT-IVT patients were successfully ablated by radiofrequency energy in pace mapping. LV-IVT patients with right bundle branch block morphology presented sustained ventricular tachycardia for most of the time, and 97% of the patients were successfully managed with radiofrequency ablation in activation mapping. Four IVT patients were characterized by atypical bundle branch block, an inferior axis, and an R/S ratio >1 in lead V3 or V2, and their tachycardia was ablated successfully in the left sinus of Valsalva using pace mapping. Radiofrequency ablation is currently an effective procedure for IVT management.</p>

Ethical Discussion on Living-related Donor Kidney Transplantation / 中国医学伦理学

It is an obvious contradiction between the shortage of kidney donors and the increasing demand for kidney transplantation.Living- related donor kidney transplantation may be a proper resolution,which has been academically proved to be superior to cadaveric kidney transplantation.However,there are still many ethical problems unsolved.Based on ethical theory and the"Seven Principles",we explore possible solutions to the ethical problems of living - related donor kidney transplantation.