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Objective@#To analyze pre- and post-operation electrocardiograms (ECGs) features of patients underwent orthotopic heart transplantation (OHT), and provide evidences for identifying and analyzing post OHT ECGs.@*Methods@#Nine hundreds and ninty-eight pre- and post- OHT standard 12-leads ECGs from 110 consecutive patients, who underwent OHT in our hospital from May 2008 to May 2014, were analyzed.@*Results@#The mean heart rate(HR)was (86.9±16.4) beats per minute before OHT, and (100.0±0.4) beats per minute after OHT. P wave′s amplitude, duration, amplitude multiplied by duration of donor heart in lead Ⅱ were (0.124±0.069)mV, (111.1±17.2)ms, (14.34±9.51)mV·ms before OHT; (0.054±0.037)mV, (86.9±27.0)ms, (5.02±4.03)mV·ms at 1 month after OHT; (0.073±0.049)mV, (93.9±17.5) ms, (7.00±4.81)mV·ms at 6 years after OHT. ECGs rotation occurred in 83.64%(92/110) patients after OHT, and prevalence of clockwise rotation was 76.36%(84/110). Sinus tachycardia was evidenced in 99.09%(109/110) patients after OHT, and incomplete right bundle branch block was present in 60.91%(67/110) patients after OHT. Pseudo complete atrioventricular block mostly occurred at 2 days after OHT. Prevalence of double sinus rhythm was 27.95%(263/941) post OHT, 40% of them occurred between the 1st and the 2nd month post OHT; the atrial rate of recipient hearts was (104.0±10.2) beats per minucte between the 3rd and the 6th month post OHT, and was (95.3±4.2) beats per minucte between the 4th year and the 5th year. P wave′s amplitude, duration, amplitude multiplied by duration of recipient heart in lead Ⅱ were (0.066±0.055) mV, (52.8±34.7) ms, (4.67±4.95) mV·ms at 1 month after OHT, (0.043±0.040)mV, (44.4±40.5) ms , (3.11±3.61) mV·ms between the 1st year and 2nd year after OHT. The absolute value of P-wave(originating from the donor heart) terminal force in chest leads increased in 48.99%(461/941) patients post OHT, the P-wave terminal force of V1 , V2 and V3 were -0.044(-0.066, -0.028), -0.060(-0.087, -0.038), -0.035(-0.056, 0) mm·s. Notched P wave in chest leads was presented in 10.31%(97/941) patients post OHT. PR segment depression in chest leads occurred in 60.24%(100/166) patients between the 3rd month and the 6th month, the incidence of PR segment depression in V1 , V2 and V3 was 21.04%(198/941), 37.41%(352/941) and 28.69%(270/941), respectively.@*Conclusions@#OHT is related to significantly changed ECGs. The mean HR increased significantly after OHT, then decreased gradually after half a year to one year, but it was still higher than preoperative mean HR after five or six years; the P waves of donor heart were usually inconspicuous or small in first month after OHT, and they became bigger after 2 months, and their duration and amplitude then became relatively steady afterwards. ECGs rotation, especially the clockwise rotation, was common post OHT. A variety of arrhythmias originating from the donor heart including sinus tachycardia and incomplete right bundle branch block could be found. Pseudo complete atrioventricular block could also be found in the early phase after OHT. With the extension of time, the incidence of double sinus rhythm reduced gradually. The atrial rate and P wave of recipient heart presented with a tendency to become lower. The absolute value of P-waves(originating from the donor heart) terminal force in chest leads (mainly V1, V2 and V3) increased, notched P waves in chest leads (mainly V1, V2) and PR segments depression in chest leads (mainly V2, V3 and V4) also belong to typical post OHT ECGs features.
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Focusing on the heart rate control mode of acceleration sensor based rate responsive pacemakers, this paper implemented the design of activity--heart rate prediction system. Bluetooth module was used as communication means in activity--heart rate prediction system, and the slave computer was used to complete the acceleration signal acquisition and processing, map from acceleration signal to the pacing rate signal, and achieve real-time transmission of acceleration signal and heart rate signal. The master computer fulfilled real-time display and recording of acceleration signal and heart rate signal, moreover, it achieved control function to the slave computer algorithm through classification of 6 parameters. The results of verification experiment showed that there was a significant relation between mapping heart rate and actual heart rate using linear mapping algorithm (R2 = 0.787, P < 0.001).
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Humanos , Algoritmos , Estimulação Cardíaca Artificial , Métodos , Frequência Cardíaca , Fisiologia , Atividade Motora , Marca-Passo Artificial , Processamento de Sinais Assistido por ComputadorRESUMO
Objective To survey the epidemiology of chronic kidney disease (CKD) among elderly people in two districts of Jiangsu province, China. Methods A total of 1404 residents aged 60 years or older in Huaian and Suzhou city in Jiangsu province were randomly recruited from the community population. All the people were screened for albuminuria (increased morning spot urine albumin-to-creatinine ratio, UACR) and reduced renal function (decreased eGFR by simplified MDRD equation). Urinary creatinine and albumin, serum creatinine, uric acid, cholesterol,triglyceride, low density lipoprotein-cholesterol, high-density lipoprotein cholesterol and fasting blood (1.73 m2) -1] and/or albuminuria (UACR ≥30 mg/g). The associations between healthy characteristics and indicators of kidney damage were examined. Results A total of 1316 (93.7%) elderly people completed the study. The prevalence of CKD was 32.3% and the awareness rate was only 9.6%. Albuminuria and reduced renal function were found in 30.2% and 3.2% of subjects respectively. The Logistic regression model showed that age, gender, hypertension,hypercholesterinemia and hyperuricaemia were independently associated with CKD. Systolic blood pressure (SBP) of 140-159 mm Hg exhibited a lower adjusted OR value (0.675) for CKD, while SBP of 160-179 mm Hg and of at least 180 mm Hg exhibited higher adjusted OR values (1.330 and 1.146). Similarly, FBG of 5.6-6.9 mmol/L exhibited a lower adjusted OR value for CKD as compared to FBG of at least 7.0 mmol/L (0.628 vs 1.941). Conclusions The prevalence of CKD in elderly people of Jiangsu province is quite high. Age, gender, hypertension,hypercholesterinemia and hyperuricaemia are independent risk factors for the development of CKD.
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Surface-activated LTIA carbon endocardial pacing electrode has outstanding electrical properties, which has proved by experiments in vitro and animals. This paper reports its results of clinical application. The statistical analysis is given by comparing parameters of electrical properties between LTIA carbon electrode and Pt electrode, which were measured in the operations. The results showed that LTIA carbon endocardial pacing electrode has a lower pacing thresholt, a better sensing characteristic, and is easy to be lixedin