简介：ObjectivesToevaluatethesafetyandefficacyoftransradialcoronaryprocedures(TRCP).MethodsThedataof83caseswhoacceptedtransradialcoronaryangiography(CAG)andtransradialpercutaneouscoronaryintervention(PCI)inourdepartmentweresummarized.Thesuccessrates,proximalcoronarycomplications,peripheralvascularcomplications,severevagalreflex,meanoperationtime(MOT),meanrecumbenttime(MRT),meanhospital-stayingtime(MHT)wereanalyzed.Thedatawerecomparedwiththatof420casesoftransfemoralcoronaryprocedures(TFCP)inthesameperiod.ResultsSuccessratesandproximalcoronarycomplicationsweresimilarinbothgroups.SeverevagalreflexeswerelessinTRCPgroupthaninTFCPgroup.MOTwaslongerinTRCPgroup.MRTandMHTwereshorterinTRCPgroup.12(14.5%)radialarteryspasm,3(3.6%)radialarteryobstruction,1suddenrespiratoryarrestcausedbyjugularhematomawereobservedinTRCPgroup.ConclusionsTheefficacyandsafetyofTRCParedefinite.TRCPismoreeconomical.ForthepurposeofproperlyevaluatetheperipheralvascularcomplicationsofTRCP,itisnecessarytopayspecialattentiontoradialarteryocclusion,radialarterystenosis,andjugularhematoma.

简介：BackgroundBasedonpreviousstudies,afragmentedQRS(fQRS)complex,asapredictivebiomarkerofmyocardialscarringcondition,couldbeusedtopredicttheoutcomesofcardiacresynchronizedtherapy(CRT).However,thisconclusionisstilldebatable.MethodsFiftyischemicornon-ischemiccardiomyopathypatientsfailure(aged65±10yrs,34males,16females)withrefractoryheart,diagnosedbythecriteriaofNewYorkHeartAssociationreceivedCRT.TheECGsof18patientswithafQRScomplex(dividedbyDas)werecomparedwiththoseof32patientswithoutafQRScomplex,whowereevaluatedby12-leadECGbeforeCRT.Thepatientswerefollowedupforsixmonths,and12-leadECGandechocardiographywerereviewed.Atleast15%reductionintheleftventricularend-systolicvolume(LVESV)wasdefinedasrespondersaccordingtothedataobtainedforbetween-groupandintra-groupanalysis.ResultsSixpatients(33.3%)inthefQRSgroupand24patients(75%)inthenon-fQRSgrouprespondedwell.Inaddition,comparisonsofindicatorsfromsurfaceECGandechocardiography6monthsafterCRTshowedthatthenon-fQRSgroupbenefitedfromCRTsignificantlymorethanthefQRSgroup.ConclusionsThefQRScomplexhasgoodpredictivevalueforresponsivenesstoCRT.Non-fQRScomplexpatientswithrefractoryheartfailuremaybenefitmorefromCRT,andthesepatientsneedtoreceivethistreatmentasearlyaspossible.

简介：BackgroundClinicalapplicationofimplantablecardioverterdefibrillator(ICD)cansignificantlyreducetheincidenceofsuddencardiacdeath(SCD).However,ICDcannotpreventventriculartachycardia(VT)orventricularfibrillation(VF).PreviousstudiesindicatedthatICDcombinedwithreasonableanti-arrhythmicdrugtherapycanimproveanti-arrhythmiceffect.EMIAT,CAMIAandOPTICtrialsreportedthatcombinedtreatmentofAmiodaroneandβreceptorblockerswassuperiortotheirtreatmentalone.Therefore,itisnecessarytogiveanti-arrhythmictreatmentafterICDimplantation.MethodsTotally180ICDimplantationrecipientsenrolledinourhospitalfromJan2011toMarch2014.Amongthem,39recipientsweretreatedwithAmiodarone(GroupA),89recipientsweretreatedwithβblocker(GroupB),and52recipientsweretreatedwithAmiodaronecombinedwithβblocker(GroupC)afterICDimplantation.Patientswerefollowedupfor3to40monthsbymonitoringtheheartrate,LVEFValueandrapidventriculararrhythmiasevents.ResultsTherewerenosignificantdifferencesonheartratebeforeandafterICDimplantationamongthethreegroups(P=1.28,P=0.85),butthechangeofheartratewasstatisticallyhigher(P=0.04)inGroupBcomparedwithGroupAandGroupC.TherewerenostatisticalsignificanceinLVEFvaluebeforeICDimplantationandafterICDimplantationandthechangeofLVEFvalue(P=0.56,P=0.50,P=0.99).TheoccurrencerateofrapidventriculararrhythmiasinGroupA(10.26%)andGroupB(10.11%)wassignificantlyhigher(P=0.04)thaninGroupC(1.92%).whichwaeslightlyincreasedbyAmiodaroneinGroupAandGroupC.Therewere2casesofthyroiddysfunctioninGroupA,1caseinGroupCandnocaseinGroupB.Nopulmonaryinterstitialfibrosiscaseswerefoundinthisstudy.ConclusionsCombinedtreatmentwithAmiodaroneandβreceptorblockerscouldsignificantlyreducerapidventriculararrhythmiaswhencomparedwithtreatmentofAmiodaroneorβblockeralone.

简介：ObjectiveToevaluatereliabilityandsafetyofAngio-sealhemostasisdeviceappliedtothefemoralarterialpuncturesiteafterpercutaneouscoronaryintervention(PCI).MethodsIn40patientsafterPCIinourinstituteduringtheperiodbetweenMay2002andDecember2003,Angio-sealdevicewereusedtosealthefemoralarterialpuncturesite.ResultsAlltheAngiosealdevicesweresuccessfullydeployedin40patients(successfulrate;100%);themeantimetohemostasiswas45±12sec;themeantimetoambulateafterangiosealclosurewas1.9?.5hours.Nomajorgroinandsystemiccomplicationwasobserved.Therewasminorgroinoozingin2casesandsmallhemotomain1patient.ConclusionsAngio-sealclosuredeviceofthefemoralarterypuncturesiteafterapercutaneouscoronaryprocedureissafe.Itcanshortenthetimetohemostasis,leadstoearlymobilization,andreducegroincomplication.Thedisadvantageisrelativelyexpensive.

简介：BackgroundLeftbundlebranchblock(LBBB)resultsinanalteredpatternofleftventricular(LV)activationandsubsequentcontraction.CardiacsynchronyandcardiacfunctionaredeterioratedbyLBBB.However,theeffectofLBBBhistoryonprogressiveheartdysfunctionandclinicalefficacyofcardiacresynchronizationtherapy(CRT)insuchpatientsarenotclear.InthisstudyweexploretheclinicalefficacyandpredictorofcardiacresynchronizationtherapyinLBBBheartdysfunction.MethodsTwenty-sevenLBBBpatientswithsevereheartfailureweretreatedwithCRT.Twenty-sixLBBBpatientswithoutCRTservedascontrol.During6monthsfollow-up,ECG,plasmaNT-proBNPandechocardiogramindexesweremeasured.ResultsComparedwithbaseline,NYHAfunctionalclassof23patients(85.2%)wasimprovedinCRTgroup.Comparedwithbaselineandcontrol,QRSduration(QRSd)wassignificantlymorenarrow(P=0.023,P=0.019),NT-proBNPwassignificantlylower(P=0.011,P=0.009),ventricularseptaltoleftventricularposteriorwalldelaytimeandleftventriculardyssynchronyindex(Ts-SD)weresignificantlyworse(P<0.05);leftventricularejectionfraction,leftventricularend-systolicvolume,mitralregurgitationareaweresignificantlyimprovedinCRTgroup(P<0.05).whentheLBBBhistorywas≥2yearsandQRSd≥155ms,thesensitivityandspecificityofCRTsuper-responsewere53.4%and85.6%respectively.ConclusionsCRTcanimprovethesynchronizationandhemodynamicofLBBBpatientswithheartdysfunction,theLBBBhistory≥2yearsandQRSd≥155msareoneoftheCRTsuper-responsepredictors.