Evaluation of cardiac-electrophysiological balance according to National Institutes of Health Stroke Scale score at admission and discharge in acute ischemic stroke patients: A pilot study

SUMMARY OBJECTIVE: The main objectives of this investigation were to determine whether there were any relationships between corrected cardiac-electrophysiological balance value and National Institutes of Health Stroke Scale scores at admission and discharge in patients with acute ischemic stroke and to assess whether cardiac-electrophysiological balance value was an independent predictor of high National Institutes of Health Stroke Scale scores (National Institutes of Health Stroke Scale score ≥5). METHODS: In this retrospective and observational study, 231 consecutive adult patients with acute ischemic stroke were evaluated. The cardiac-electrophysiological balance value was obtained by dividing the corrected QT interval by the QRS duration measured from surface electrocardiography. An experienced neurologist used the National Institutes of Health Stroke Scale score to determine the severity of the stroke at the time of admission and before discharge from the neurology care unit. The participants in the study were categorized into two groups: those with minor acute ischemic stroke (National Institutes of Health Stroke Scale score=1-4) and those with moderate-to-severe acute ischemic stroke (National Institutes of Health Stroke Scale scores ≥5). RESULTS: Acute ischemic stroke patients with National Institutes of Health Stroke Scale score ≥5 had higher heart rate, QT, corrected QT interval, T-peak to T-end corrected QT interval, cardiac-electrophysiological balance, and cardiac-electrophysiological balance values compared with those with an National Institutes of Health Stroke Scale score of 1-4. The cardiac-electrophysiological balance value was shown to be independently related to National Institutes of Health Stroke Scale scores ≥5 (OR 1.102, 95%CI 1.036-1.172, p<0.001). There was a moderate correlation between cardiac-electrophysiological balance and National Institutes of Health Stroke Scale scores at admission (r=0.333, p<0.001) and discharge (r=0.329, p<0.001). CONCLUSIONS: The findings of this study demonstrated that the cardiac-electrophysiological balance value was related to National Institutes of Health Stroke Scale scores at admission and discharge. Furthermore, an elevated cardiac-electrophysiological balance value was found to be an independent predictor of National Institutes of Health Stroke Scale score ≥5.

Preliminary study on the mechanism of 2:1 atrioventricular block during atrioventricular node reentrant tachycardia / 中国介入心脏病学杂志

Objective The purpose of this study was to clarify the mechanism of 2:1 atrioventricular block (AVB) during AV node reentrant tachycardia (AVNRT) induced during electrophysioloic study.Methods In consecutive patients with AVNRT referred for electrophysiologic study, the data of 2 : 1 AVB during induced AVNRT was retrospectively analysed. Results The data of 4 patients was excluded from analyzing because of the unsatisfactory recording of His bundle potential during AVNRT. A His bundle deflection was present in the blocked beats in three of the remaining 5 patients and absent in the other two. At the beginning of AVNRT induced in those patients whose His bundle deflection was present in the blocked beats, H-V Wenckebach sequence with a QRS pattern of RBBB or LBBB was seen preceding and following the 2 : 1 AVB. A pattern of H-V Wenckebach phenomenon occurred once during AVNRT with 2:1 AVB in one of the two patients whose His bundle deflection was absent in the blocked beats.Conclusion The induced 2:1 AVB during AVNRT is due to functional block in the His-Purkinje system regardless of the presence or absence of a His bundle deflection in blocked beats.