Objective To investigate the clinical and electrophysiological characters of atrial fibrillation(AF) originated from superior vena cava(SVC).Methods Patients with SVC-originated AF admitted into our centre during the past 2 years were retrospectively investigated,and their clinical and electrophysiological characters were systematically analyzed.Results The AF in 16 patients(M/F=12/4 cases,mean age of 53.4?10.6 years old,paroxysmal/persistent AF=11/5 cases) were confirmed to be originated from SVC,who contributed to 2.9%(16/545) of total cases underwent AF ablation during the same period.Among the 16 cases,2 patients were diagnosed as SVC-originated AF by surface ECG,and isolation of SVC terminated AF in these 2 patients.In the remaining 14 patients with non-classic surface ECG,AF or organized atrial tachycardia(Ata) still sustained after initial left atrial(LA) ablation.The sustainable AF and Ata were found to be driven by fast activations within SVC,and were terminated by isolation of SVC.The average applications and procedure time for isolating SVC were 6?2 times and 10?3 minutes respectively.The average muscle connections between SVC and LA were 3?1.After a mean period of 6-month-follow-up,only one patient recurred with organized Ata.Except femoral hematoma in one patient,no other complications were found.Conclusion In addition to pulmonary vein and LA,SVC could be the orgin of AF.Therefore,for patient with sustainable AF or organized Ata after initial LA ablation,SVC origin should be put under consideration.

Objective To explore the role of oxidative stress in the initiation and development of experimental diabetic nephropathy.Methods Levels of MDA and the total SOD activity were tested in the whole kidney at 1 month,3 months and 6 months of experimental rat diabetes induced by streptozotocin.The pathological changes of diabetic rats were examined by light microscopy.Results The MDA level increased significantly in the diabetic group as compared to control group at all time intervals(2.16?0.57 vs 1.18?0.18,P

OBJECTIVE:To compare the efficacy and safety of desloratadine citrate disodium and acrivastine decremental thera-py in the treatment of chronic urticaria. METHODS:132 patients with chronic urticaria were randomly divided into group A(62 cases)and group B(70 cases). Group A was orally given 8.8 mg Desloratadine citrate disodium tablet in 12 2 weeks,once a day;8.8 mg in 3-4 weeks,once every 2 days;8.8 mg in 5-6 weeks,once every 3 days;8.8 mg in 7-8 weeks,once every 4 days;and 8.8 mg in 9-10 weeks,once every 5 days. Group B was orally given 8 mg Acrivastine capsule in 12 2 weeks,3 times a day;8 mg in 3-4 weeks,twice a day;8 mg in 5-6 weeks,once a day;8 mg in 7-8 weeks,once every 2 days;and 8 mg in 9-10 weeks, once every 3 days. The treatment course for both groups was 10 weeks. Clinical efficacy,and plasma histamine levels and total scores of signs and symptoms before and after treatment in 2 groups were observed,and recurrence and incidence of adverse reac-tions after 4 weeks of stopping drugs in 2 groups were followed-up. RESULTS:There were no significant difference in the total ef-fective rate and incidence of adverse reactions between 2 groups(P>0.05). After treatment,the total scores of signs and symptoms in 2 groups were significantly lower than before,the difference was statistically significant(P<0.01),and there was no significant difference between 2 groups(P>0.05). The recurrence rate in group A was significantly lower than group B,the difference was sta-tistically significant(P<0.05). CONCLUSIONS:Both efficacy and safety of desloratadine citrate disodium and acrivastine decre-mental therapy in the treatment of chronic urticaria are good,however,desloratadine citrate disodium is better than acrivastine in re-ducing recurrence rate.

BACKGROUND:Circumferential pulmonary vein antrum ablations guided by CARTO system or integration of a computed tomographic or magnetic resonance imaging scan (CARTO-Merge) are two main locating methods.Theoretically,CARTO-Merge provides a detailed appreciation of the pulmonary vein anatomy,however,whether it can improve the safety and success of catheter ablation of atrial fibrillation remains uncertainly.OBJECTIVE:To explore the effect of CT image integration into three-dimensional (3D) electroanatomical mapping system on clinical outcomes of catheter ablation of atrial fibrillation.DESIGN,TIME AND SETTING:The randomized contrast observation was performed at Department of Cardiology of Beijing Anzhen Hospital from October 2005 to May 2007.PARTICIPANTS:A total of 93 patients with drugs refractory,paroxysmal atrial fibrillation who underwent circumferential pulmonary vein antrum ablation.METHODS:All patients underwent circumferential pulmonary vein antrum ablation using irdgated radiofreguency ablation with the endpoint of electrical isolation.Ablation was guided by 3D mapping alone in 50 patients (CARTO group) or by CT image integration in 43 patients (CARTO-Merge group).MAIN OUTCOME MEASURES:Procedure-related parameters,such as procedure duration,fluoroscopy duration,cumulative success rate and complication,were compared between the two groups.RESULTS:Pulmonary veins were isolated in all patients.After (12.6±2.9) months follow-up,73 (78.5%) patients did not have recurrence of atrial fibrillation at 3 month after the procedure.The fluoroscopy time in CARTO group was significant longer than that in CARTO-Merge group (P<0.05).The mean procedure duration,radiofrequency ablation duration,procedure-related complication and cumulative success rate were comparable between the 2 groups.CONCLUSION:Circumferential pulmonary vein antrum ablation guided by 3D mapping alone or by CT integration had similar safety and success rate in paroxysmal atrial fibrillation patients.But CT integration,which facilitated to a detailed representation of the anatomy of left atrium,is associated with reduced fluoroscopy duration.

Objective To evaluate the feasibility and effect of three-points ablation approach in in treatment of typical atrial flutter guided by CARTO. Methods Twenty-six patients with typical atrial flutter diagnosed by ECG and electrophysiological study (EPS) were enrolled in this study. Activation sequence mapping and linear ablation were performed in 11 patients (conventional group) . Three-points guided linear ablation with CARTO system was performed in another15 patients (three-points group) . Results There was no significant difference in the success rate between the two groups. Both the procedure and fluoroscopic time in three-points group were significantly shorter than that in conventional group [(72.66±29.82) vs (102.52±32.61) min;(4.26±2.76) vs (7.32±3.16) min] . Conclusions The three-points ablations approach is as safe and effective as conventional ablation approach in treatment of typical atrial flutter;however,the former can significantly shorten the procedure time and fluoroscopy time.

Objective To evaluate the feasibility of catheter ablation of Para-Hisian Atrial Tachycardia guide by CARTO. Method Catheter ablation guided by CARTO was performed after activation map in three patients with Para-Hisian Atrial Tachycardia. Result Successful ablation was got at right atrial in two patients and at non-coronary in one patient. Conclusion Catheter ablation guided by CARTO is safe and efficient for Para-Hisian Atrial Tachycardia.

Objective To study different effects of control heart rhythm by radiofrequency catheter ablation and control heart beat by drugs on quality of life in patients with paroxysmal atrial fibrillation. Methods Sixty patients with paroxysmal atrial fibrillation were divided into two groups,radiofrequency catheter ablation group and heart beat control group. Quality of life grades were calculated in each group according to SF - 36. Results Quality of life grades were significantly higher in radiofrequency catheter ablation group than heart beat control group. Conclusions Radiofrequency catheter ablation can improve quality of life than heart beat control therapy in patients with paroxysmal atrial fibrillation.

Objective To evaluate the clinical efficacy and safety of catheter ablation for atrial fibrillation in elderly patients.Methods From September 2008 to October 2011,a total of 420 consecutive patients undergoing catheter ablation of atrial fibrillation (AF) were selected.The patients were divided into 3 age groups:30 59 yr group (n=279),60-74 yr group (n=100),and 75-87 yr group (n =41).The effect of operation and complications during operative and postoperative periods were evaluated.Patients were followed up for at least 6 months,and the rate of atrial fibrillation reocurrence and life quality were recorded.Results Among 480 catheter ablation procedures,in 7 (1.5％) patients occurred main complications,while in 5 (1.0％) patients appeared other complications.The incidence of main complications in 3 groups were 1.1％ (3 patients),2.0％ (2 patients) and 4.9％ (2 patients) respectively,other complication rates in 3 groups were 0.7％ (2 patients),1.0％ (1 patient) and 4.9％ (2 patients) respectively and there were no differences between groups (all P＞0.05).During follow-up,the cases without AF relapse were 68.5％ (191 patients),66.0％ (66 patients) and 57.1％ (23 patients) respectively,and the patients with AF paroxysm were 21.1％ (59 patients),21.0％ (21 patients),29.3％ (12 patients) respectively,and there was no significant difference between groups (all P＞0.05).And no difference was found in improvement degree of life quality among three groups (P＞0.05).Conclusions Catheter ablation is safe and effective in elderly patients.For patients over 75 years with many types of cardiovascular diseases,catheter ablation is effective to control the relapse of AF,can significantly improve the quality of life,and has no increased risk of complications.

Objective To investigate the effect of thyroxine replacement therapy with residual subclinical hypothyroidism on the success rate of catheter ablation in elderly patients with atrial fibrillation(AF).Methods Among the consecutive patients with AF who underwent a first AF ablation in our center between 2009 and 2012,we identified 56 patients(41 paroxysmal AF,15 persistent AF)with subclinical clinical hypothyroidism after receiving thyroid hormone replacement therapy as study group.The control group consisted of 56 patients with euthyroidism and no history of thyroid dysfunction.All patients underwent catheter ablation.Results At the end of follow up,37.5%(21/56)patients were AF free after the first procedure in the study group,in comparison to 64.3%(36/56)in control group(χ2=8.655,P=0.003).Last procedure was performed in 27 patients of study group and in 15 patients of control group.After the last performed ablation,62.5%(35/56)study group patients and 80.4%(45/56)controls group patients had no recurrence(χ2=4.653,P=0.031).The major complications rate did not differ between two groups(P=0.642).Conclusions Thyroid hormone replacement therapy with residual subclinical hypothyroidism reduces catheter ablation success rate in elderly patients with atrial fibrillation.

Objective To investigate ablation characteristics of PVC/VT originating from left ventricle anterior papillary muscles.Methods This study included 10 patients of PVC/VT originating from left ventricle anterior papillary muscles from January 2015 to June 2016 in Beijing Anzhen Hospital.Electrophysiological mapping and radiofrequency ablation were completed using three-dimensional anatomical mapping system combined with three-dimensional intracardiac ultrasound technology.ECG and abaltion target diagram characteristics as well as the special anatomy were explored.Results All the 10 patients were successfully ablated and followed up for 12 months.One patient had recurrence within 12 months and no complications were recorded.The target sites localized at the tip (n =1),middle portion(n =4)or the base (n =5) of the LV-APM.Among 7 patients,the target sites were located at the anterior septal papillary muscle and in 3 patients were located in the free papillary muscle.9 patients were successfully ablated via anterograde trans-septal catheterization after the failure of retrograde approach.Premature QRS wave time were 152.80 ± 11.72 ms and 6 patients presented sharp potential at the targets during PVC/VT.Conclusions PVC/VT originating from left ventricle anterior papillary muscles have similar ECG and diagram characteristics that is different from which originating from left anterior fascicle.It is recommended to get the target via transseptalpuncure approach.Ablation target could be clearly positioned by three-dimensional intracardiac ultrasound technology.