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Zhang HD, Yang M, Xing YB, Weng SX, Ding L, Ding XT, Hu LX, Qi YJ, Yu FY, Zhang JT, Fang PH, Hua W, Zhang S, Tang M. Occluding morphologically complicated left atrial appendage using the small-umbrella LAmbre device. BMC Cardiovasc Disord 2022; 22:326. [PMID: 35869446 PMCID: PMC9308203 DOI: 10.1186/s12872-022-02770-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 07/15/2022] [Indexed: 11/19/2022] Open
Abstract
Background Percutaneous left atrial appendage (LAA) occlusion is effective for stroke prevention in patients with atrial fibrillation. LAA can have a complex anatomy, such as multiple lobes or a large orifice, which may render it unsuitable for occlusion using regular devices. We aimed to investigate the feasibility, safety, and short-term efficacy of the small-umbrella LAmbre device for morphologically complicated LAA. Methods We retrospectively enrolled 129 consecutive patients who underwent LAA occlusion using the LAmbre device; the small-umbrella LAmbre device was used in 30 of these patients. We analyzed patients’ characteristics, procedural details, and outcomes. Results Twenty-two patients (73.3%) had multilobed (≥ 2) LAA. The umbrella of the occluder was anchored in the branch in 9 patients and in the common trunks of branches in 13 patients. The landing zone and orifice diameters were 19.0 ± 4.39 mm and 27.4 ± 3.95 mm, respectively. The sizes of the umbrella and occluder cover were 22.0 ± 3.42 mm and 34.3 ± 2.75 mm, respectively. At 3-month follow-up transesophageal echocardiography in 24 patients, no peri-device residual flow was reported. Device thrombosis was detected in one patient at 3 months and disappeared after 3 months of anticoagulation. Ischemic stroke occurred in one patient; no other adverse events were reported. Conclusions Occlusion of morphologically complicated LAA using the small-umbrella LAmbre device was feasible, safe, and effective in patients with atrial fibrillation in this study. This occluder provides an alternative for patients who cannot be treated with regular-sized LAA occlusion devices. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-022-02770-y.
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Zhang HD, Ding L, Weng SX, Zhou B, Ding XT, Hu LX, Qi YJ, Yu FY, Feng TJ, Zhang JT, Fang PH, Hua W, Zhang S, Tang M. Characteristics and Long-Term Ablation Outcomes of Supraventricular Arrhythmias in Hypertrophic Cardiomyopathy: A 10-Year, Single-Center Experience. Front Cardiovasc Med 2021; 8:766571. [PMID: 34869680 PMCID: PMC8632865 DOI: 10.3389/fcvm.2021.766571] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 10/21/2021] [Indexed: 11/13/2022] Open
Abstract
Background: A variety of supraventricular arrhythmias (SVAs) may occur in patients with hypertrophic cardiomyopathy (HCM). The characteristics and long-term ablation outcomes of different types of SVAs in HCM have not been comprehensively investigated. Methods: We retrospectively enrolled 101 consecutive patients with HCM who were referred to the electrophysiology and arrhythmia service from May 2010 to October 2020. The clinical features and ablation outcomes were analyzed. Results: Seventy-eight patients had SVAs, which comprised 50 (64.1%) cases of atrial fibrillation (AF), 16 (20.5%) of atrial flutter (AFL), 15 (19.2%) of atrioventricular reentrant tachycardia (AVRT), 11 (14.1%) of atrial arrhythmia (AT), and 3 (3.8%) of atrioventricular nodal reentrant tachycardia (AVNRT). Thirty-four patients underwent catheter ablation and were followed up for a median (interquartile range) of 58.5 (82.9) months. There was no recurrence in patients with non-AF SVAs. In patients with AF, the 1- and 7-year AF-free survival rates were 87.5 and 49.5%, respectively. A receiver operator characteristic analysis showed that a greater left ventricular end-diastolic dimension (LVEDD) was associated with a higher recurrence of AF, with an optimum cutoff value of 47 mm (c-statistic = 0.91, p = 0.011, sensitivity = 1.00, specificity = 0.82). In Kaplan-Meier analysis, patients with a LVEDD ≥ 47 mm had worse AF-free survival than those with a LVEDD <47 mm (log-rank p = 0.014). Conclusions: In this unique population of HCM, AF was the most common SVA, followed in order by AFL, AVRT, AT, and AVNRT. The long-term catheter ablation outcome for non-AF SVAs in HCM is satisfactory. A greater LVEDD predicts AF recurrence after catheter ablation in patients with HCM.
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Affiliation(s)
- Hong-Da Zhang
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lei Ding
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Si-Xian Weng
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bin Zhou
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiao-Tong Ding
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Li-Xing Hu
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ying-Jie Qi
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Feng-Yuan Yu
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Tian-Jie Feng
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing-Tao Zhang
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Pi-Hua Fang
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wei Hua
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shu Zhang
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Min Tang
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Yang YB, Li XF, Guo TT, Jia YH, Liu J, Tang M, Fang PH, Zhang S. Catheter ablation of premature ventricular complexes associated with false tendons: A case report. World J Clin Cases 2020; 8:325-330. [PMID: 32047781 PMCID: PMC7000933 DOI: 10.12998/wjcc.v8.i2.325] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/09/2019] [Accepted: 12/13/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND False tendon is a common intraventricular anatomical variation. It refers to a fibroid or fibromuscular structure that exists in the ventricle besides the normal connection of papillary muscle and mitral or tricuspid valve. A large number of clinical studies have suggested that there is a significant correlation between false tendons and premature ventricular complexes. However, few studies have verified this correlation during radiofrequency catheter ablation of premature ventricular complexes.
CASE SUMMARY A 45-year-old male was admitted to receive radiofrequency ablation for symptomatic premature ventricular complexes. A three-dimensional model of the left ventricle was established by intracardiac echocardiography using the CartoSoundTM mapping system. In addition to the left anterior papillary muscle, the posterior papillary muscle was mapped. False tendons were found at the base of the interventricular septum, and the other end was connected to the left ventricular free wall near the apex. An irrigated touch force catheter was advanced into the left ventricle via the retrograde approach. The earliest activation site was marked at the interventricular septum attachment of the false tendons and was successfully ablated.
CONCLUSION This case verified that false tendons can cause premature ventricular complexes and may be cured by radiofrequency ablation guided by intracardiac echocardiography with the CartoSoundTM system.
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Affiliation(s)
- Ya-Bing Yang
- Cardiovascular Medicine Department, Beijing Renhe Hospital, Beijing 102600, China
| | - Xiao-Feng Li
- Center for Cardiac Arrhythmia, Fuwai Hospital, National Center for Cardiovascular Diseases, State Key Laboratory of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Ting-Ting Guo
- Center for Cardiac Arrhythmia, Fuwai Hospital, National Center for Cardiovascular Diseases, State Key Laboratory of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Yu-He Jia
- Center for Cardiac Arrhythmia, Fuwai Hospital, National Center for Cardiovascular Diseases, State Key Laboratory of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Jun Liu
- Center for Cardiac Arrhythmia, Fuwai Hospital, National Center for Cardiovascular Diseases, State Key Laboratory of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Min Tang
- Center for Cardiac Arrhythmia, Fuwai Hospital, National Center for Cardiovascular Diseases, State Key Laboratory of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Pi-Hua Fang
- Center for Cardiac Arrhythmia, Fuwai Hospital, National Center for Cardiovascular Diseases, State Key Laboratory of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Shu Zhang
- Center for Cardiac Arrhythmia, Fuwai Hospital, National Center for Cardiovascular Diseases, State Key Laboratory of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
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Guo LL, Shun XL, He B, Fang PH, Bo P, Zhu Y, Zhang ZW. Cooperation between galanin and insulin in facilitating glucose transporter 4 translocation in adipose cells of diabetic rats. J BIOL REG HOMEOS AG 2019; 33:1327-1335. [PMID: 31487982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The glucose transporter 4 (GLUT4) translocation is a vital link of insulin-induced glucose uptake in adipose tissue and skeletal muscle. It is an important topic in anti-diabetic research to explore novel agents to facilitate the role of insulin. The aim of this study was to verify the hypothesis that neuropeptide galanin may enhance insulin-induced GLUT4 translocation to increase glucose uptake in adipose tissue of type 2 diabetic models. Insulin and/or galanin were injected respectively or cooperatively into type 2 diabetic rats once a day for fifteen days. The results showed that administration of galanin significantly enhanced insulin-induced GLUT4 and vesicle-associated membrane protein 2 (VAMP2) translocation, Akt phosphorylation and glucose uptake, but not GLUT4 mRNA and protein expression levels in adipose cells. The beneficial roles of galanin on insulin-induced events may be blocked by MK-2206, an Akt inhibitor, indicating that the Akt phosphorylation is essential for promoting impact of galanin on the insulin-induced events. These results suggest that galanin may benefit insulin-induced GLUT4 and VAMP2 translocation, and subsequent glucose uptake via the activated Akt-VAMP2-GLUT4 pathway in adipose cells. These findings deepen our understanding of the anti-diabetic effect of galanin and its mechanism.
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Affiliation(s)
- L L Guo
- Department of Physical Education, Chuzhou College, Chuzhou, Anhui, China
| | - X L Shun
- Department of Cardiovascular and Intensive Care Unit, First People's Hospital, Yangzhou University, Yangzhou, China
| | - B He
- Department of Endocrinology, Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu, China
| | - P H Fang
- Department of Endocrinology, Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu, China
| | - P Bo
- Department of Endocrinology, Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu, China
| | - Y Zhu
- Department of Endocrinology, Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu, China
| | - Z W Zhang
- Department of Endocrinology, Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu, China
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He J, Liu Z, Fang PH, Chen XB, Liu J, Tang M, Jia YH, Zhang S. Long-term efficacy of empirical slow pathway ablation in non-inducible and suspected atrioventricular nodal reentry tachycardia. Acta Cardiol 2017. [DOI: 10.1080/ac.71.4.3159699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Jia He
- State Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Zheng Liu
- State Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Pi-Hua Fang
- State Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Xiong-Biao Chen
- Department of Cardiology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, People’s Republic of China
| | - Jun Liu
- State Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Min Tang
- State Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Yu-He Jia
- State Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Shu Zhang
- State Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
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He J, Fang PH, Liu Z, Chen XB, Liu J, Tang M, Jia YH, Zhang S. Reversible tachycardia mediated cardiomyopathy after radiofrequency ablation of idiopathic left ventricular tachycardia. Int J Cardiol 2014; 176:e5-8. [PMID: 25042664 DOI: 10.1016/j.ijcard.2014.06.060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2014] [Accepted: 06/28/2014] [Indexed: 11/19/2022]
Affiliation(s)
- Jia He
- Center for Arrhythmia Diagnosis and Treatment, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Pi-Hua Fang
- Center for Arrhythmia Diagnosis and Treatment, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
| | - Zheng Liu
- Center for Arrhythmia Diagnosis and Treatment, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Xiong-Biao Chen
- Center for Arrhythmia Diagnosis and Treatment, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Jun Liu
- Center for Arrhythmia Diagnosis and Treatment, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Min Tang
- Center for Arrhythmia Diagnosis and Treatment, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Yu-He Jia
- Center for Arrhythmia Diagnosis and Treatment, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Shu Zhang
- Center for Arrhythmia Diagnosis and Treatment, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
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Hou Y, Fang PH, Li HJ, Lei S, Bao JR, Hu JQ, Yu J, Zhang S. Clinical analysis of arrhythmia in 297 Ebstein's anomaly patients. Chin Med J (Engl) 2012; 125:3587-3588. [PMID: 23044331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Affiliation(s)
- Yu Hou
- Department of Cardiology, Inner Mongolia International Mongolian Medical Hospital, Hohhot, Inner Mongolia 010020, China
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Lei S, Fang PH, Liu J, Hou Y. Effect of fat pad ablation on the spatial and temporal stability of complex fractionated atrial electrogram in acetylcholine-induced atrial fibrillation. Acta Cardiol 2012; 67:79-85. [PMID: 22455093 DOI: 10.1080/ac.67.1.2146569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The objective of this study was to investigate the effect of selective fat pad ablation on the spatial and temporal stability of the complex fractionated atrial electrogram (CFAE) in acetylcholine (ACh)-induced atrial fibrillation (AF). METHODS AND RESULTS ACh was applied to fat pads in 10 dogs. Effective refractory periods (ERPs) at 5 different sites, AF inducibility and AF duration were obtained before and after fat pad ablation. During the first two induced AFs, the number of sites with continuous CFAEs and the duration of continuous CFAEs at every site were measured before and after fat pad ablation. The average ERP was shortened by ACh application (138 14 vs 100 15 ms, P < 0.001) and increased after fat pad ablation (100 +/- 15 vs. 115 +/- 14 ms, P < 0.001). AF inducibility (76 +/- 9% vs. 4 +/- 6%, P < 0.001) and AF duration (56 +/- 11 vs. 187 +/- 56 s, P = 0.01) increased after ACh application compared to baseline; while fat pad ablation reduced AF inducibility (76% +/- 9% vs. 54% +/- 6%, P < 0.001) and AF duration (187 +/- 56 vs. 144% +/- 35 s, P = 0.015). The percentage of sites with continuous CFAE decreased after fat pad ablation compared with that before fat pad ablation (24% vs. 82%, P < 0.001). On average, fat pad ablation reduced the duration of continuous CFAEs (188 +/- 63 vs. 139 +/- 31 s, P < 0.001). CONCLUSION Selective fat pad ablation can affect the spatial and temporal stability of CFAEs in ACh-induced atrial fibrillation in dogs.
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Affiliation(s)
- Sen Lei
- Center for Arrhythmia Diagnosis and Treatment, Fu Wai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Pi-Hua Fang
- Center for Arrhythmia Diagnosis and Treatment, Fu Wai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Jun Liu
- Center for Arrhythmia Diagnosis and Treatment, Fu Wai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Yu Hou
- Center for Arrhythmia Diagnosis and Treatment, Fu Wai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
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Liu J, Liu Y, Lu GY, Li Z, Li XF, Wang YS, Fang PH. [Timing of positive head-up tilt test for patients with suspected vasovagal syncope]. Zhonghua Xin Xue Guan Bing Za Zhi 2011; 39:494-496. [PMID: 21924072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To investigate the time course of positive head-up tilt test (HUTT) for patients with suspected vasovagal syncope. METHODS Consecutive patients referred to the syncope unit of our center for recurrent unexplained syncope were included. The HUTT consisted of a 30 minute passive basic phase and a 20 minute sublingual nitroglycerin provocation phase if syncope did not develop during the passive phase. RESULTS Positive HUTT was observed in 427 out of 773 consecutive patients (55.2%) patients including 43 patients (10.1%) during the passive basic phase and 384 patients (89.9%) during the nitroglycerin provocation phase. During the basic phase, the positive Hutt developed at 7.5 minute (n = 2) and peaked at 22.5th minute (20.9%, n = 9) and then decreased gradually. Most positive reactions (93.0%, n = 40) occurred between the 10 and 25 minutes during the basic phase. During the nitroglycerin provocation phase, the percentage of positive reactions increased rapidly after sublingual nitroglycerin, peaked at the 10th minute (35.7%, n = 137) and decreased thereafter. Most positive reactions (96.1%, n = 369) occurred within the first 15 minutes of provocation phase. CONCLUSION The appropriate duration for HUTT test could be modified to a 25 minutes passive basic phase plus 15 minutes nitroglycerin provocation phase.
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Affiliation(s)
- Jun Liu
- Center for Cardiac Function Test, Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
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Hou Y, Fang PH, Liu J, Li XF, Hu JQ, Zhang S. Single dose of ibutilide for conversion of persistent atrial fibrillation after radiofrequency ablation. Chin Med J (Engl) 2011; 124:710-713. [PMID: 21518563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND Patients with persistent or permanent atrial fibrillation (AF) often need direct current cardioversion after radiofrequency ablation. The aim of this study was to investigate the effectiveness and safety of ibutilide for cardioversion of persistent or permanent atrial fibrillation after radiofrequency ablation and the factors related to conversion. METHODS Patients with persistent or permanent atrial fibrillation were treated with combined ablation strategy including circumferential pulmonary vein isolation, linear ablation and CAFÉ potential ablation. If AF was not terminated after ablation, ibutilide was used for cardioversion (1 mg, intravenous injection in 10 minutes). These patients were divided into a conversion group and a non-conversion group according to whether AF was converted to sinus rhythm within 30 minutes after administration. ECG monitoring was performed during the injection of ibutilide. Atrial waves recorded by coronary sinus electrodes were measured for calculating average wavelength of AF waves in six seconds. The QT interval was measured immediately after conversion and 2 hours after injection of ibutilide. RESULTS Forty patients whose AF was not converted to sinus rhythm after radiofrequency ablation were given an intravenous injection of ibutilide. Of the 40 patients, 29 cases were converted to sinus rhythm, with a conversion rate of 72.5%. The average conversion time was (13.2 ± 5.5) minutes. Compared with the conversion group, patients in the non-conversion group had a longer history of AF (9.4 ± 5.3) years vs. (4.3 ± 2.8) years, P < 0.05), and a markedly enlarged left atrium (47.3 ± 2.9) mm vs. (42.1 ± 4.5) mm, P < 0.05). There were no significant differences in gender, age, body mass index and left ventricular function between the two groups. Ibutilide significantly prolonged the average wavelength of the AF wave (171.8 ± 29.5) ms vs. (242.0 ± 40.0) ms, P < 0.001). Two hours after ibutilide treatment, the QT interval was significantly shortened (421.0 ± 24.7) ms vs. (441.0 ± 37.4) ms, P < 0.05). No cases of serious arrhythmias or other adverse reactions were found. CONCLUSIONS A single dose of ibutilide for conversion of persistent or permanent AF after radiofrequency ablation is safe and effective.
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Affiliation(s)
- Yu Hou
- Clinical EP Lab and Arrhythmia Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
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Liu J, Fang PH, Dibs S, Hou Y, Li XF, Zhang S. High-sensitivity C-reactive protein as a predictor of atrial fibrillation recurrence after primary circumferential pulmonary vein isolation. Pacing Clin Electrophysiol 2010; 34:398-406. [PMID: 21091744 DOI: 10.1111/j.1540-8159.2010.02978.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Atrial fibrillation (AF) recurrence after circumferential pulmonary vein isolation (CPVI) is difficult to predict. Inflammation is associated with the development of AF. Inflammatory markers, such as high sensitivity C-reactive protein (hsCRP), are related to AF development via atrial remodeling. However, it is unknown whether plasma hsCRP concentration before CPVI can be used as a predictor for AF recurrence. METHODS A total of 121 patients without structural heart disease who underwent primary CPVI by a single operator were included in the study (paroxysmal/persistent AF: 77/44). Left atrial diameter was measured by transesophageal echocardiography. Plasma hsCRP concentration was determined by enzyme-linked immunosorbent assay. Based on the follow-up outcomes, patients were divided into two groups, a recurrence group and a nonrecurrence group. AF recurrence was defined as AF or atrial flutter or atrial tachycardia episodes lasting for ≥30 s during regular follow-up (>12 months). RESULTS A total of 36 (29.8%) patients (paroxysmal/persistent AF: 19 [24.7%]/17 [38.6%]) had AF recurrence in a mean 23 (range, 12-44) month follow-up period. The plasma hsCRP concentration in the recurrence group was significantly higher than that in the nonrecurrence group for all patients (median [quartile range] 2.22 [1.97] mg/L vs 0.89 [1.30] mg/L, P < 0.001), for patients with paroxysmal AF (2.12 [2.78] mg/L vs 0.84 [1.15] mg/L, P = 0.028), and for those with persistent AF (2.29 [1.08] mg/L vs 0.89 [1.53] mg/L, P = 0.005). Multiple logistic regression analyses showed that the higher level of the plasma hsCRP (P < 0.001) was a significant prognostic predictor of AF recurrence, both for patients with paroxysmal AF (P = 0.012) and those with persistent AF (P = 0.003). CONCLUSION Plasma hsCRP concentration before CPVI was associated with AF recurrence after primary CPVI procedure for both paroxysmal and persistent AF patients. Plasma hsCRP concentration could play a role in prediction of AF recurrence after primary CPVI.
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Affiliation(s)
- Jun Liu
- Center for Arrhythmia Diagnosis and Treatment, Fu Wai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
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Abstract
OBJECTIVES This study was designed to evaluate the correlation between lone atrial fibrillation and inflammation. METHODS A total of 411 subjects were enrolled in this study, including 333 patients with lone atrial fibrillation, and 78 controls. C-reactive protein (CRP) and echocardiography were evaluated, and the electrocardiograph was monitored to identify cardiac rhythm at the time of blood sampling. According to the rhythm, paroxysmal atrial fibrillation was divided into presence and absence of atrial fibrillation. RESULTS Subjects with lone atrial fibrillation had higher CRP levels than controls (media, 1.00 mg/L; IQR, 1.00-2.54 versus media, 1.00 mg/L; IQR, 1.00-1.55; p = 0.016) and subjects with persistent atrial fibrillation had higher CRP levels than those with paroxysmal atrial fibrillation (media, 1.62 mg/L; IQR, 1.00-3.98 versus media, 1.00 mg/L, IQR, 1.00-2.10; p = 0.022), and so did presence of atrial fibrillation rather than absence of atrial fibrillation (media, 2.11 mg/L; IQR, 1.00-3.60 versus media, 1.00 mg/L; IQR, 1.00-1.76; p = 0.000) in paroxysmal atrial fibrillation. However, there was no significant difference in CRP levels between persistent atrial fibrillation and presence of atrial fibrillation in paroxysmal atrial fibrillation (p = 0.992). Neither was there any difference between absence of atrial fibrillation in paroxysmal atrial fibrillation and controls (p = 0.483). In patients with lone atrial fibrillation, atrial fibrillation rhythm (B = 4.85, 95%CI: 2.61-8.99) was the only independent predictor of elevated CRP levels after adjusted covariants. CONCLUSIONS Patients with lone atrial fibrillation had elevated CRP levels only when they were in atrial fibrillation rhythm and an elevated CRP level was not related to duration of time or history of atrial fibrillation.
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Affiliation(s)
- Shu-Yuan Yao
- Center of Arrhythmias, Fuwai Cardiovascular Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100037, People's Republic of China
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Yao SY, Chu JM, Fang PH, Zhang KJ, Ma J, Zhang S. The morphology changes in limb leads after ablation of verapamil-sensitive idiopathic left ventricular tachycardia and their correlation with recurrence. J Cardiovasc Electrophysiol 2007; 19:238-41. [PMID: 18031513 DOI: 10.1111/j.1540-8167.2007.01023.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This study was designed to explore the morphology changes in limb leads of ECGs after successful ablation of verapamil sensitive idiopathic left ventricular tachycardia (ILVT) and their correlation with tachycardia recurrence. METHODS Between January 2001 and December 2006, 116 patients who underwent successful ablation of ILVT were included in the study. Twelve-lead surface ECG recordings during sinus rhythm were obtained in all patients before and after ablation to compare morphology changes in limb leads. RESULTS The ECG morphology changes after ablation were divided into two categories: one with new or deepening Q wave in inferior leads and/or disappearance of Q wave in leads I and aVL, and the other without change. The changes in any Lead II, III, or aVF after ablation occurred significantly more in patients without recurrence of ventricular tachycardia (VT) (P < 0.0001, 0.002, and 0.0001, respectively). The patients with recurrence of VT tended to have no ECG changes, compared with those without recurrence of VT (P = 0.009). The sensitivity of leads II, III, and aVF changes in predicting nonrecurrence VT were 66.7%, 78.7%, and 79.6%, specificity were 100%, 75%, and 87.5%, and nonrecurrence predictive value of 100%, 97.7%, and 98.9%, respectively. When inferior leads changes were combined, they could predict all nonrecurrence patients with 100% specificity. CONCLUSIONS Successful radiofrequency ablation of ILVT could result in morphology changes in limb leads of ECG, especially in inferior leads. The combined changes in inferior leads can be used as an effective endpoint in ablation of this ILVT.
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Affiliation(s)
- Shu-Yuan Yao
- Center of Arrhythmia, Fuwai Cardiovascular Hospital, Peking Union Medical College, Beijing
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Zhang CM, Wang SW, Fang PH. [Zingg's classification and treatment for zygomatic fractures]. Shanghai Kou Qiang Yi Xue 2000; 9:51-2. [PMID: 15014856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Affiliation(s)
- C M Zhang
- Department of Dentistry, First People's Hospital of Shanghai. Shanghai 200080, China
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Zhang CM, Fang PH, Niu XY. [Clinical analysis of malignant lymphomas in the face and neck misdiagnosed as space infections]. Shanghai Kou Qiang Yi Xue 1999; 8:180. [PMID: 15048258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Affiliation(s)
- C M Zhang
- Department of Dentistry, Shangahi First People's Hospital. Shangahi 200085, China
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Lawler JW, Chao FC, Fang PH. The effect of ultraviolet light on platelets: platelet activation and inhibition of thrombin-mediated functions. Thromb Res 1979; 14:489-94. [PMID: 442018 DOI: 10.1016/0049-3848(79)90256-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Lawler JW, Chao FC, Fang PH. Observation of a high molecular weight platelet protein released by thrombin. Thromb Haemost 1977; 37:355-7. [PMID: 577633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Fang PH. Effect of molecular oxygen on the formation of radicals in irradiated polymethyl methacrylate. Radiat Res 1972; 50:1-5. [PMID: 5021830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Fang PH. Analysis of dose-rate dependence of radiation injury. Radiat Res 1970; 44:1-3. [PMID: 5536175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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