Discovery of the novel HLA-C*01:143N allele, a variant of HLA-C*01:02:01:01, in a Taiwanese individual.

HLA-C*01:143N differs from HLA-C*01:02:01:01 by one nucleotide substitution at position 585 (C → A) in exon 3.

The novel HLA-A*02:672Q allele, identified by Sanger dideoxy nucleotide sequencing in a Taiwanese individual.

HLA-A*02:672Q differs from HLA-A*02:06:01:01 by one nucleotide substitution at position 563 (G → A) in exon 3.

Quality of life and its influencing factors in patients with schizophrenia. / ç²¾ç¥žåˆ†è£‚ç—‡æ‚£è€ ç”Ÿæ´»è´¨é‡åŠå ¶å½±å“å› ç´ .

Schizophrenia is a chronic mental disease. With the change of medical model, quality of life has gradually become an important prognostic indicator for patients with schizophrenia. People with schizophrenia have a lower quality of life than the general population or people with other chronic diseases, Sociodemographic factors such as age, gender, employment, education level, income and living situation; clinical factors such as psychiatric symptoms, medication compliance and insight; and psychosocial factors such as social support, cognition, stigma, self-esteem and needs are the main influencing factors for schizophrenia patients. Medication and psychological interventions such as social skills training, family intervention, cognitive correction and cognitive behavioral therapy can be used to improve the quality of life of patients with schizophrenia. Understanding the factors affecting the quality of life of schizophrenia patients and the improvement measures helps to provide reference for improving their quality of life.

Medication Nonadherence and Risk of Violence to Others Among Patients With Schizophrenia in Western China.

Importance: Reducing violence to others in community-based patients with schizophrenia has important implications for public health. Increasing medication adherence is often used to reduce the risk of violence, yet little is known about the association between medication nonadherence and violence to others in this population. Objective: To examine the association between medication nonadherence and violence to others among community-based patients with schizophrenia. Design, Setting, and Participants: This large, naturalistic, prospective cohort study was performed in western China from May 1, 2006, to December 31, 2018. The data set was from the integrated management information platform for severe mental disorders. As of December 31, 2018, 292 667 patients with schizophrenia were registered in the platform. During follow-up, patients could enter or leave the cohort at any time. Maximum follow-up was 12.8 years, with a mean (SD) of 4.2 (2.3) years. Data analysis was conducted from July 1, 2021, to September 30, 2022. Exposures: Medication nonadherence. Main Outcomes and Measures: Violence to others throughout the follow-up period was the outcome, including minor nuisances, violating the Law of the People's Republic of China on Penalties for Administration of Public Security (APS law), and violating criminal law. Information about these behaviors was provided by the public security department. Directed acyclic graphs were used to identify and control confounders. Propensity score matching and generalized linear mixed-effects models were used for analysis. Results: The final study sample included 207 569 patients with schizophrenia. The mean (SD) age was 51.3 (14.5) years, and 107 271 (51.7%) were women; 27 698 (13.3%) perpetrated violence to others, including 22 312 of 142 394 with medication nonadherence (15.7%) and 5386 of 65 175 with adherence (8.3%). In 112 710 propensity score-matched cases, risks of minor nuisances (odds ratio [OR], 1.82 [95% CI, 1.75-1.90]; P < .001), violating APS law (OR, 1.91 [95% CI, 1.78-2.05]; P < .001), and violating criminal law (OR, 1.50 [95% CI, 1.33-1.71]; P < .001) were higher in patients with nonadherence. However, the risk did not increase with higher medication nonadherence. There were differences in risk of violating APS law between urban and rural areas. Conclusions and Relevance: Medication nonadherence was associated with a higher risk of violence to others among community-based patients with schizophrenia, but the risk did not increase as medication nonadherence increased.

Joint modeling strategy for using electronic medical records data to build machine learning models: an example of intracerebral hemorrhage.

BACKGROUND: Outliers and class imbalance in medical data could affect the accuracy of machine learning models. For physicians who want to apply predictive models, how to use the data at hand to build a model and what model to choose are very thorny problems. Therefore, it is necessary to consider outliers, imbalanced data, model selection, and parameter tuning when modeling. METHODS: This study used a joint modeling strategy consisting of: outlier detection and removal, data balancing, model fitting and prediction, performance evaluation. We collected medical record data for all ICH patients with admissions in 2017-2019 from Sichuan Province. Clinical and radiological variables were used to construct models to predict mortality outcomes 90 days after discharge. We used stacking ensemble learning to combine logistic regression (LR), random forest (RF), artificial neural network (ANN), support vector machine (SVM), and k-nearest neighbors (KNN) models. Accuracy, sensitivity, specificity, AUC, precision, and F1 score were used to evaluate model performance. Finally, we compared all 84 combinations of the joint modeling strategy, including training set with and without cross-validated committees filter (CVCF), five resampling techniques (random under-sampling (RUS), random over-sampling (ROS), adaptive synthetic sampling (ADASYN), Borderline synthetic minority oversampling technique (Borderline SMOTE), synthetic minority oversampling technique and edited nearest neighbor (SMOTEENN)) and no resampling, seven models (LR, RF, ANN, SVM, KNN, Stacking, AdaBoost). RESULTS: Among 4207 patients with ICH, 2909 (69.15%) survived 90 days after discharge, and 1298 (30.85%) died within 90 days after discharge. The performance of all models improved with removing outliers by CVCF except sensitivity. For data balancing processing, the performance of training set without resampling was better than that of training set with resampling in terms of accuracy, specificity, and precision. And the AUC of ROS was the best. For seven models, the average accuracy, specificity, AUC, and precision of RF were the highest. Stacking performed best in F1 score. Among all 84 combinations of joint modeling strategy, eight combinations performed best in terms of accuracy (0.816). For sensitivity, the best performance was SMOTEENN + Stacking (0.662). For specificity, the best performance was CVCF + KNN (0.987). Stacking and AdaBoost had the best performances in AUC (0.756) and F1 score (0.602), respectively. For precision, the best performance was CVCF + SVM (0.938). CONCLUSION: This study proposed a joint modeling strategy including outlier detection and removal, data balancing, model fitting and prediction, performance evaluation, in order to provide a reference for physicians and researchers who want to build their own models. This study illustrated the importance of outlier detection and removal for machine learning and showed that ensemble learning might be a good modeling strategy. Due to the low imbalanced ratio (IR, the ratio of majority class and minority class) in this study, we did not find any improvement in models with resampling in terms of accuracy, specificity, and precision, while ROS performed best on AUC.

Characterization of the novel HLA-C*03:294 allele by sequencing-based typing in a Taiwanese individual.

HLA-C*03:294 differs from HLA-C*03:04:01:01 by one nucleotide substitution at position 727 (T → C) in exon 4.

Identification of the novel HLA-C*07:446 allele in a volunteer bone marrow donor.

HLA-C*07:446 differs from HLA-C*07:02:01:01 by one nucleotide substitution at position 809 (C → T) in exon 4.

Persistent pollution episodes, transport pathways, and potential sources of air pollution during the heating season of 2016-2017 in Lanzhou, China.

As one of the most important industrial cities in Northwest China, Lanzhou currently suffers from serious air pollution. This study analyzed the formation mechanism and potential source areas of persistent air pollution in Lanzhou during the heating period from November 1, 2016 to March 31, 2017 based on the air pollutant concentrations and relevant meteorological data. Our findings indicate that particulate pollution was extremely severe during the study period. The daily PM2.5 and PM10 concentrations had significantly negative correlations with daily temperature, wind speed, maximum daily boundary layer height, while the daily PM2.5 and PM10 concentrations showed significantly positive correlations with daily relative humidity. Five persistent pollution episodes were identified and classified as either stagnant accumulation or explosive growth types according to the mechanism of pollution formation and evolution. The PM2.5 and PM10 concentrations and PM2.5/PM10 ratio followed a growing "saw-tooth cycle" pattern during the stagnant accumulation type event. Dust storms caused abrupt peaks in PM10 and a sharp decrease in the PM2.5/PM10 ratio in explosive growth type events. The potential sources of PM10 were mainly distributed in the Kumtag Desert in Xinjiang Uygur Autonomous Region, the Qaidam Basin and Hehuang Valley in Qinghai Province, and the western and eastern Hexi Corridor in Gansu Province. The contributions to PM10 were more than 120 µg/m3. The important potential sources of PM2.5 were located in Hehuang Valley in Qinghai and Linxia Hui Autonomous Prefecture in Gansu; the concentrations of PM2.5 were more than 60 µg/m3.

[Responses of Different Degradation Stages of Alpine Wetland on Soil Microbial Community in the Yellow River Source Zone].

MiSeq sequencing technology was used to analyze the microbial community diversity of soil in alpine wetlands to understand the degradation processes and environmental factors in these areas. The results showed that the severity of soil degradation changed the species diversity of soil microorganisms at the level of OTUs, and grass patches contained more species than frozen-thawing patches. The soil fungi species of OTUs changed significantly. The diversity indexes of bacteria (between the frozen-thawing patches and the grass patches) were higher than that of fungi. The dominant microbial species were consistent among different degradation stages. The dominant species of bacteria and fungi were Proteobacteria and RB41, and Ascomycota and Mortierella, respectively. The abundance of dominant microorganisms was significantly between un-degraded and heavily degraded areas, except for RB41 (P<0.05). The dominant microorganisms in the grass patches were more sensitive than those in the frozen-thawing patches. It was found that the main factors affecting the microbial community structure of soil were water content, organic carbon, microbial biomass carbon, microbial biomass nitrogen, and sedge coverage. Microbial diversity may decrease in heavily degraded alpine wetlands. Thus, the frozen-thawing patches and sedge species should be first protected, and the supplements of soil water content, soil organic carbon, microbial biomass carbon, and nitrogen should be strengthened for alpine wetland restoration.

Cardiometabolic Risk Factors and Preclinical Target Organ Damage Among Adults in Ghana: Findings From a National Study.

Background Although sub-Saharan Africa has a high prevalence of cardiovascular diseases (CVDs), there remains a lack of systematic and comprehensive assessment of risk factors and early CVD outcomes in adults in sub-Saharan Africa. Methods and Results Using a stratified multistage random sampling method, we recruited 1106 men and women, aged >18 years, from the general population in Ghana to participate in a national health survey from 2016 to 2017. In Ghanaian adults, the age-standardized prevalence of known CVD risk factors was 15.1% (95% CI, 12.9%-17.3%) for obesity, 6.8% (95% CI, 5.1%-8.5%) for diabetes mellitus, 26.1% (95% CI, 22.9%-29.4%) for hypertension, and 9.3% (95% CI, 7.1%-11.5%) for hyperuricemia. In addition, 10.1% (95% CI, 7.0%-13.2%) of adults had peripheral artery disease, 8.3% (95% CI, 6.7%-10.0%) had carotid thickening, 4.1% (95% CI, 2.9%-5.2%) had left ventricular hypertrophy, and 2.5% (95% CI, 1.5%-3.4%) had chronic kidney disease. Three CVD risk factors appeared to play prominent roles in the development of target organ damage, including obesity for peripheral artery disease (odds ratio [OR], 2.22; 95% CI, 1.35-3.63), hypertension for carotid thickening (OR, 1.92; 95% CI, 1.22-3.08), and left ventricular hypertrophy (OR, 5.28; 95% CI, 2.55-12.11) and hyperuricemia for chronic kidney disease (OR, 5.49; 95% CI, 2.84-10.65). Conclusions This comprehensive health survey characterized the baseline conditions of a national cohort of adults while confirming the prevalence of CVD risk factors, and early CVD outcomes have reached epidemic proportions in Ghana. The distinct patterns of risk factors in the development of target organ damage present important challenges and opportunities for interventions to improve cardiometabolic health among adults in Ghana.

A case of acute myelogenous leukemia characterized by arterial and venous thrombosis.

Acute myelogenous leukemia (AML) is a malignant disease of the hematopoietic system, characterized by features of bone marrow insufficiency and organ infiltration by leukemic cells. Venous thrombosis in AML patients is uncommon, compared to bleeding; therefore in patients with AML, simultaneous occurrence of venous and arterial thrombosis is a rather rare presentation. We reported an unusual case of anti-phospholipid antibody syndrome secondary to AML characterized by venous and arterial thrombosis. A 70-year-old man with deep venous thrombosis (DVT) of the left leg confirmed by Doppler was seen in our clinic. During treatment with a Vitamin K antagonist (3 mg daily of Warfarin) and a low molecular weight heparin (LMWH), he developed an acute pulmonary embolism and an acute inferior wall ST elevation myocardial infarction (STEMI), a result of right coronary artery embolism. His full blood count showed leukocytosis and thrombocytopenia. Lupus anticoagulant and anti-cardiolipin antibodies were positive. A bone marrow aspirate test showed results consistent with AML (FAB class M1). A diagnosis of antiphospholipid antibody syndrome secondary to AML characterized by coronary artery embolism, pulmonary embolism and left leg DVT was eventually established. He received anticoagulation with a low dose of warfarin after refusing chemotherapy. He however died of cerebral hemorrhage despite the fact that the INR was in the normal therapeutic range. It is challenging to anticoagulated AML patients complicated by multiple vascular thromboses and thrombocytopenia.

Enthesitis-related arthritis is the most common category of juvenile idiopathic arthritis in Taiwan and presents persistent active disease.

BACKGROUND: Juvenile idiopathic arthritis (JIA) has been categorized into seven different categories according to the International League of Associations for Rheumatology (ILAR) criteria. Enthesitis-related arthritis (ERA) was found to represent the largest category in a Taiwanese cohort study. The aim in this study was to compare the clinical characteristics, treatments, and outcomes of ERA in a single tertiary center in Taiwan, as compared to those of other categories of JIA. Furthermore, we determined patients' characteristics and risk factors that can help assess the outcomes in ERA. METHODS: A retrospective chart review of all patients with JIA referred to a pediatric rheumatology clinic in the National Taiwan University Hospital between 1993 and 2018 were identified according to ILAR criteria. Outcomes were assessed based on the Wallace criteria to categorize patients into active and non-active, including inactive, remission on medication, and remission off medication, groups. A subset of samples was further tested by DNA sequencing to identify HLA-B27 subtypes. RESULTS: One-hundred and eighty-three patients were included in the study, with a mean of 8 years' follow-up. ERA was the single largest category of JIA (39.9%); psoriasis and undifferentiated JIA were both the least common type (0.5%). ERA was male predominant (86%), had a late age of onset (11.0 ± 3.2 years), and the majority of ERA patients was HLA-B27-positive (97%). Of 25 HLA-B27-positive ERA patients checked by HLA-B27 sequencing, 23 were B*27:04 and 2 were B*27:05. ERA patients were significantly less likely to achieve non-active status compared to patients with persistent oligoarthritis (P = 0.036). In terms of treatment response to TNF-α inhibitors in methotrexate-refractory ERA, 26 patients remained active and only 11 patients (30%) achieved a non-active status. Sacroiliitis was a risk factor contributing to poorer treatment response in ERA (P = 0.006). CONCLUSION: ERA represented the most common category of JIA in Taiwan. Those ERA patients with sacroiliitis were likely to have persistent active disease and may require a more aggressive treatment strategy to improve their outcomes.

Assessment of Permanent Selective His Bundle Pacing in Left Ventricular Synchronization Using 3-D Speckle Tracking Echocardiography.

The study described here aimed to evaluate left ventricular (LV) systolic mechanical synchronization during permanent selective His bundle pacing (SHBP) using 3-D speckle-tracking echocardiography post-operatively and 6 mo after pacemaker implantation in 62 patients randomly assigned to SHBP (n = 32) or right ventricular apical pacing (RVAP, n = 30). A standard apex four-chamber view was exposed and was transformed into full-volume mode under 3-D echocardiography. Three-dimensional speckle-tracking echocardiography was analyzed offline. The primary endpoint was LV mechanical synchronization post-operatively and during the 6-mo follow-up. Significant LV dyssynchrony was detected while evaluating the maximum time difference and standard deviation of 16-segment systolic time to peak 3-D strain at 1 wk and 6 mo. The pacing thresholds were significantly higher in the SHBP than in the RVAP group throughout follow-up. The R-wave amplitude was significantly lower in the SHBP group than with RVAP. The pacing parameters during SHBP were as stable as during conventional RVAP during the mid-term follow-up. In conclusion, 3-D speckle-tracking echocardiography is feasible and provides a more convenient method for evaluating LV synchrony.

Association of Parenteral Anticoagulation Therapy With Outcomes in Chinese Patients Undergoing Percutaneous Coronary Intervention for Non-ST-Segment Elevation Acute Coronary Syndrome.

Importance: The association of parenteral anticoagulation therapy with improved outcomes in patients with non-ST-segment elevation acute coronary syndrome was previously established. This benefit has not been evaluated in the era of dual antiplatelet therapy and percutaneous coronary intervention. Objective: To evaluate the association between parenteral anticoagulation therapy and clinical outcomes in patients with non-ST-segment elevation acute coronary syndrome undergoing percutaneous coronary intervention. Design, Setting, and Participants: This cohort study included 8197 adults who underwent percutaneous coronary intervention for non-ST-segment elevation acute coronary syndrome from January 1, 2010, to December 31, 2014, at 5 medical centers in China. Patients receiving parenteral anticoagulation therapy only after percutaneous coronary intervention were excluded. Exposures: Parenteral anticoagulation therapy. Main Outcomes and Measures: The primary outcome was in-hospital all-cause death and in-hospital major bleeding as defined by the Bleeding Academic Research Consortium definition (grades 3-5). Results: Of 6804 patients who met the final criteria, 5104 (75.0%) were male, with a mean (SD) age of 64.2 (10.4) years. The incidence of in-hospital death was not significantly different between the patients who received and did not receive parenteral anticoagulation therapy (0.3% vs 0.1%; P = .13) (adjusted odds ratio, 1.27; 95% CI, 0.38-4.27; P = .70). A similar result was found for myocardial infarction (0.3% vs 0.3%; P = .82) (adjusted odds ratio, 0.77; 95% CI, 0.29-2.07; P = .61). In-hospital major bleeding was more frequent in the parenteral anticoagulation group (2.5% vs 1.0%; P < .001) (adjusted odds ratio, 1.94; 95% CI, 1.24-3.03; P = .004). At a median (interquartile range) follow-up of 2.96 years (1.93-4.46 years), all-cause death was not significantly different between the 2 groups (adjusted hazards ratio, 0.87; 95% CI, 0.71-1.07; P = .19), but the incidence of major bleeding was higher in the parenteral anticoagulation group (adjusted hazards ratio, 1.43; 95% CI, 1.01-2.02; P = .04). The propensity score analysis confirmed these primary analyses. Conclusions and Relevance: In the patients undergoing percutaneous coronary intervention for non-ST-segment elevation acute coronary syndrome, parenteral anticoagulation therapy was not associated with a lower risk of all-cause death or myocardial infarction but was significantly associated with a higher risk of major bleeding. These findings raise important safety questions about the current practice of routine parenteral anticoagulation therapy while we await randomized trials of this practice.

Detection of a novel HLA-B*46:01 variant, HLA-B*46:01:19, in a Taiwanese individual.

One nucleotide replacement at residue 369 of HLA-B*46:01:01 results in a new allele, HLA-B*46:01:19.

Comparison of enoxaparin and unfractionated heparin in patients with non-ST-segment elevation acute coronary syndrome undergoing percutaneous coronary intervention: a systematic review and meta-analysis.

BACKGROUND: No randomized trial has been conducted to directly compare enoxaparin with unfractionated heparin (UFH) in patients undergoing percutaneous coronary intervention (PCI) for non-ST-segment elevation acute coronary syndrome (NSTE-ACS). In an era where early invasive strategies are recommended in high risk patients, the effect of enoxaparin and UFH needs to be re-evaluated. The authors performed a meta-analysis to determine whether enoxaparin is superior to UFH in patients with NSTE-ACS undergoing PCI. METHODS: The composite efficacy end point included all-cause mortality and myocardial infarction (MI) in the hospital or within 60 days. Major bleeding, as defined in the individual clinical trials evaluated, was the main safety endpoint within the same time period. Pooled estimates of the difference in outcome between enoxaparin and UFH were calculated using fixed or random effects models. RESULTS: A total of 8,861 patients from 4 trials were included. In the pooled analysis, rates of death or MI were similar in patients treated with enoxaparin and UFH [risk ratio (RR), 0.89, 95% confidence interval (CI): 0.77-1.02, P=0.09; I2 =50%]. Major bleeding was also similar between enoxaparin and UFH (RR, 1.21, 95% CI: 0.94-1.56, P=0.15, I2=39%). A subgroup analysis, including randomized trials only or trials with a large sample size, and a leave-one-out sensitivity analysis, demonstrated similar results with above, respectively. CONCLUSIONS: In patients undergoing PCI for NSTE-ACS, rates for both death/MI and major bleeding were similar between patients treated with enoxaparin and UFH.

Electrocardiographic predictors of validated right ventricular outflow tract septal pacing for correct localization of transthoracic echocardiography.

BACKGROUND: Electrocardiographic (ECG) characteristics of true right ventricular outflow tract (RVOT) septal pacing have not been clearly demonstrated. HYPOTHESIS: We hypothesized that ECG parameters would help operators differentiate true RVOT septum from non-septal septum. METHODS: We analyzed 151 patients who underwent pacemaker implantation with a ventricular lead in the RVOT. Transthoracic echocardiographic (TTE) determination of pacing sites was applied in all patients after implantation. A 12-lead ECG was recorded during forced ventricular pacing. RESULTS: According to TTE orientation, pacing at the RVOT septum was achieved in 94 patients (62.3%). Compared with nonseptal pacing, septal pacing had significantly shorter QRS duration (139.2 ± 18.5 ms vs 155.5 ± 14.7 ms; P < 0.001). More frequent negative or isoelectric QRS vector in lead I (76% vs 32%; P < 0.001), lead II/III R-wave amplitude ratio < 1 (52% vs 25%; P = 0.001), and aVR/aVL QS-wave amplitude ratio < 1 (59% vs 32%; P = 0.001) were observed in septal pacing. Transitional zone (TZ) score (3.8 ± 0.96 vs 4.2 ± 0.90; P = 0.004) and TZ index (0.3 ± 0.5 vs 0.6 ± 0.7; P = 0.008) were significantly lower in septal pacing than in nonseptal pacing, respectively. In multivariate analysis, paced QRS duration and negative or isoelectric QRS vector in lead I independently predicted RVOT septal pacing (P < 0.001). At ROC curve analysis, paced QRS duration ≤145 ms identified RVOT septal pacing with 85.1% sensitivity and 78.9% specificity. CONCLUSIONS: This study reveals the heterogeneity of lead placement within the RVOT. Narrower paced QRS duration and negative or isoelectric QRS vector in lead I independently predict RVOT septal pacing.

A randomized comparison of fluoroscopic techniques for implanting pacemaker lead on the right ventricular outflow tract septum.

Right ventricular outflow tract (RVOT) septal pacing is commonly performed under the standard fluoroscopic positions during procedure. The aim of the prospective, randomized study was to evaluate the accuracy of the combination of standard fluoroscopic and left lateral (LL) fluoroscopic views for determination of RVOT septal position compared with standard fluoroscopic views alone. We prospectively enrolled patients who had indications for implantation of a permanent pacemaker. Patients were randomly assigned into two groups based on intraoperative fluoroscopic views as follows: LL group (three standard fluoroscopic views + LL fluoroscopic view) or standard group (three standard fluoroscopic views). Transthoracic echocardiography (TTE) determination of pacing sites was applied in all patients 3 days after pacemaker implantation. The implantation success rate of RVOT septal pacing was compared between groups. A total of 143 patients (59 males, mean age 57.6 ± 16.3 years) with symptomatic bradyarrhythmia were studied, of whom, 72 patients were randomized to LL group and 71 to standard group. TTE determination of pacing sites was compared with two groups. In the LL group, 60 patients (83 %) were achieved in RVOT septal position. In the standard group, however, the position of RVOT septum was only observed in 48 patients (68 %). The success rate of RVOT septal position in LL group was significantly higher than standard group (p = 0.029). Comparing to traditional views, combining LL view in the procedure will approve the accuracy of RVOT septal pacing site.

Right ventricular outflow tract septal pacing versus apical pacing: A prospective, randomized, single-blind 5-years follow-up study of ventricular lead performance and safety.

Lead placement for ventricular pacing variably impacts the physiological benefit of the patient. This study evaluated the ventricular lead performance and safety of right ventricular outflow tract septal pacing in patients with bradyarrhythmia in South China over 60-month follow-up. Totally, 192 patients (108 males, and 84 females, 63±21 years old) with bradyarrhythmia were randomly divided into two groups. The right ventricular outflow tract septum (RVOTs) group had lead placement near the septum (n=97), while the right ventricular apex (RVA) group had a traditional apical placement (n=95). RV septal lead positioning was achieved with a specialized stylet and confirmed using fluoroscopic projection. All patients were followed up for 60 months. Follow-up assessment included stimulation threshold, R-wave sensing, lead impedance and lead complications. The time of electrode implantation in both the ROVTs and RVA groups were significantly different (4.29±0.61 vs. 2.16±0.22 min; P=0.009). No differences were identified in threshold, impedance or R-wave sensing between the two groups at 1st, 12th, 36th and 60th month during the follow-up period. No occurrence of electrode displacement, increased pacing threshold or inadequate sensing was found. The long-term active fixation ventricular electrode performance in RVOTs group was similar to that in RVA group. RVOTs pacing near the septum using active fixation electrodes may provide stability during long-term follow-up period.