0. 05), the mean effective discharge time was 3. 4+ 3. 2 (P0. 05), the mean effective discharge time was 2. 6+1. 7 (P

Objective To evaluate the safety and possibility of transesophageal emergency ventricular pacing with esophageal balloonelectrode catheter.Methods Sixty four patients with critical bradyarrhythmias were divided randomly to receive either transesophagealventricular pacing with esophageal balloon electrode catheter(balloon.catheter group,n=32),or transesophageai ventricular pacing withnormal esophageal electrode catheter(normal catheter group,n=32).Pulse width(ms),current output(mA),and the success rate werecompared between the 2 groups.Results Success rate in the balloon catheter group was 87.5%,which was significantly higher thanthat in the nodal catheter group(18.7%,X2=27.7,P＜0.01).The success rate oftransesophageal ventricular pacing with esophagealballoon electrode catheter was 87.5%.The average current output(mA)was significantly lower in the balloon catheter group than thatin the normal catheter group (24.5+2.5 mA VS 53±3.4mA,P＜0.05).Conclusions Esophageal balloon electrode catheter pacing couldbecome an available teclmiqBe for transesophageal emergency ventricular pacing.

OBJECTIVETo determine the feasibility and efficiency of terminating atrial flutter (AFL) and atrial fibrillation (AF) using synchronous low-energy shocks delivered through a novel transesophageal electric balloon electrode system.

METHODSBy using a novel electric balloon electrode system, we attempted 91 transesophageal cardioversions in 52 patients, to treat 53 episodes of AFL and 38 episodes of AF.

RESULTSOf the 40 patients of AFL that failed to respond to drug therapy, 37 (92.5%) were successfully countershocked to sinus rhythm by transesophageal cardioversion, with a mean energy of (22.70 +/- 4.50) J (20 - 30 J). Of the 19 patients in AF, transesophageal cardioversion was successful in 16 (84.2%) cases, requiring a mean delivered energy of (17.38 +/- 8.58) J (3 - 30 J). There were no complications such as heart block or ventricular fibrillation, and no evidence of esophageal injury.

CONCLUSIONSTransesophageal cardioversion using an electric balloon electrode system is an effective and feasible method for the treatment of AFL and AF. It requires low energy and no anesthesia, leads to less trauma, and shows a high cardioversion success rate that may prove valuable in the management of tachyarrhythmias.

Atrial Fibrillation ; therapy ; Atrial Flutter ; therapy ; Electric Countershock ; instrumentation ; methods ; Electrodes ; Esophagus ; Humans ; Treatment Outcome

Objective:To investigate the characteristics of thymus in patients with COVID-19, and to analyze the CT features and dynamic changes of thymus.Methods:Data of 241 patients diagnosed with COVID-19 admitted to Chongqing Three Gorges Central Hospital from Jan. to Mar. 2020 were retrospectively analyzed, and 242 consecutive subjects were selected as the control group from Nov. to Dec. 2019. The thymus classification, size, and average CT values between COVID-19 patients and the control group were compared, as well as those among different clinical types for COVID-19 patients, before and after treatment, were analyzed.Results:① The attenuation of the thymus: 64.7% (156/241) complete fatty replacement thymus, 17.8% (43/241) predominantly fatty thymus, 11.2% (27/241) approximately one-half fatty and one-half soft-tissue-attenuation thymus, and 6.2% (15/241) predominantly soft-tissue thymus in COVID-19 patients were found. 48.3% (117/242) complete fatty replacement thymus, 25.6% (62/242) predominantly fatty thymus, 10.3% (25/242) approximately one-half fatty and one-half soft-tissue-attenuation thymus, and 15.7% (38/242) predominantly soft-tissue thymus were found in the control group. Complete fatty replacement thymus was an independent factor affecting COVID-19 in 40 to 59 years old patients ( OR=3.071, P=0.000) . The rate of complete fatty replacement thymus: severe or critical type > common type > mild type. ② Size: There was no statistical difference of the thymus size between COVID-19 patients and the control group ( P>0.05) , no statistical difference among the mild type, common type and severe or critical type ( P>0.05) , no statistical difference between before and after treatment ( P>0.05) , and there was no correlation with treatment duration ( r=0.047, r=0.071) . ③ Density: There was no statistical difference of the CT value of thymus between COVID-19 patients and the control group ( P>0.05) , no statistical difference among the mild, common and severe type ( P>0.05) . One patient had a 17 HU increase in thymus density after treatment, but there was no statistical difference in 78 patients in thymus CT values between before and after treatment ( P>0.05) , and there was no correlation with treatment duration (r=0.013) . Conclusions:COVID-19 patients have a high rate of complete fatty replacement thymus. And the heavier the clinical classification, the higher the rate of complete fatty replacement thymus. Complete fatty replacement thymus is a risk factor for COVID-19 patients in 40 to 59 years old.