Objective To analyze the prevalence of complications following catheter ablation for atrial fibrillation and to describe the characteristics of transition of complications.Methods From October 2004 to December 2008,2 260 cases(1 265 males)with atrial fibrillation(AF)were admitted for catheter ablation.AF was paroxysmal in 1 449 cases and chronic in 811 cases.Circumferential pulmonary vein isolation(CPVI)was carried out alone for paroxysmal AF and in combination with fractionated electrograms ablation for chronic AF.Complications were summarized and analyzed by dividing the whole duration into three sections:Year 2004-2006,Year 2007 and Year 2008.Results Complications occurred in 61 cases(2.70%).Cardiac tamponade developed in 11 cases,embolism in 18 cases,pulmonary vein stenosis in 14 cases,and vessel access related complications in 18 cases.In Year 2004-2006,cardiac tamponade occurred in 5 cases,cerebral embolism in 3 cases,mesenteric artery embolism in 1 case,pulmonary vein stenosis in 6 cases,and vessel access related complications in 6 cases.In Year 2007,cardiac tamponade occurred in 4 cases,cerebral embolism in 3 cases,Mesenteric artery embolism in 1 case,pulmonary vein stenosis in 4 cases,and vessel access related complications in 5 cases.In Year 2008,cardiac tamponade occurred in 2 cases,cerebral embolism in 7 cases,mesenteric artery embolism in 3 cases,pulmonary vein stenosis in 4 cases,and vessel access related complications in 7 cases.There was no significant difference in the prevalence of complications among three sections.The prevalence of cardiac tamponade was lower in Year 2008 compared with that in the other two sections,P=0.5.However,the prevalence of embolism was higher in Year 2008 compared with that in the other two the sections,P=0.2.Conclusion It is safe to perform catheter ablation for the treatment of AF.Despite the improvement of technical skills,the prevalence of severe complications such as cardial tamponade,pulmonary vein stenosis or stroke did not decrease.

AIM: To investigate the effect of sodium ferulate on phosphorylation of heat shock protein 27(HSP27) in vascular smooth muscle cells(VSMCs) induced by angiotensin Ⅱ(AngⅡ) and platelet derived growth factor-BB(PDGF-BB).METHODS: Cultured VSMCs derived from rat thoracic aorta were used.The activity of HSP27 was evaluated by Western blotting with specific phospho-HSP27 antibody.RESULTS: The phosphorylation of HSP27 in response to AngⅡ and PDGF-BB was suppressed by sodium ferulate in a dose-dependent manner,with maximal inhibition rates of 39.0%(P

Objective To observe the effect of triamcinolone acetonide(TA) on activation and barrier function of human retinal pigment epithelium (RPE). Methods ARPE-19 cells were cultured in 96-well tissue culture plate. Four weeks later, TA with different concentration (0.02 and 0.05 mg/ml)was added to the cells and culture for 3 or 7 days. The activation of ARPE-19 cells was assessed by methyl thiazolyl tetrazolium (MTT). ARPE-19 cells were cultured on polyester microporous filters for 4 weeks, and the transepithelial resistance (TER) was recorded. TA (0.02 and 0.05 mg/ml) was added to the culture fluid respectively, and after cultured for 1 week TER was measured again. The RPE permeability was detected by enzyme-linked immunosorbent assay (ELISA) with horse radish peroxidase as the tracer. [WTHZ]Results In the culture fluid with 0.02 mg/ml TA cultured for 3 or 7 days, the average survival rate of ARPE-19 cells was 93.70% and 90.63% respectively, without statistic difference compared with the control (P=0.147, 0.091). While in the 0.05 mg/ml TA group after cultured for the same duration, the activation of ARPE-19 cells decreased significantly compared with the control (with the average survival rate of 87.75% and 88.98%; P=0.025, 0.043). One week after cultured with TA, TER decreased significantly while permeability improved obviously in the 2 TA groups compared to the control (P

Objective To investigate the clinical features of polypoidal choroidal vasculopathy. Methods The clinical manifestations and the findings of fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) of 7 eyes in 6 patients with polypoidal choroidal vasculopathy were analyzed retrospectively. Results The ophthalmoscopic examination of PCV in this series of patients revealed orange-red lesions mainly in macular region in early stage, and then hemorrhage, exudation, edema, serous and (or) hemorrhagic detachment of retinal pigment epithelium in affected portions in advanced stage, and retinal and choroidal atrophy in late stage. FFA discovered the vascular dilation at the border of the choroidal vascular network in 1 eye, dotted hyperfluorescence in 6 eyes, and patches of hyperfluorescence in late phase. ICGA disclosed a vascular branching network in choroid with polypoid pattern of the terminal path of the vessels of network in early phase in 5 eyes, and the typical dotted or clustered polypoidal hyperfluorescence in 7 eyes in late phase. Conclusion The characteristic findings of FFA and ICGA are very diagnostic for PCV.

Objective To observe the characteristics of fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) in juvenile retinoschisis. Methods The photochromes of the ocular fudus of 7 cases (14 eyes) who were diagnosed as juvenile retinoschisis were taken, among whom, 5 (10 eyes) were examined by FFA, and 6 (12 eyes) by OCT. Results In 8 eyes with cystiform stellate maculopathy under ophtalmoscope, the result of FFA showed granular fluorescence in different density and shape without exact connection of the configuration between these granules and the cystlike maculopathy. In 2 eyes with pigment disorder in the macula under ophthalmoscope, blocky fluorescence was found in FFA. In 3 eyes with peripheral schisis, FFA discovered distorted and dilated retinal capillaries with different extent, and flecks of non-perfusion area. OCT images revealed thickening of the macular neuroepithelium with laminal seperation, and cystic low-reflect areas in the inner layer. Conclusions In juvenile retinoschisis, pigment proliferation and degeneration in the macular area could be found. Granular fluorescence and cystic low-reflect areas could be seen in FFA and OCT, respectively.

Objective: To discuss the application value with two-dimensional ultrasound speckle tracking technique in the evaluation of left ventricular function in patients with OSAS. Methods: Selected 110 cases of hospital patients with OSAS in recent years, used STI technical analysis of left ventricular myocardium using different directions overall resilience, Left ventricular torsion and systolic mitral annular midpoint of the maximum displacement (MAD) and left ventricular ejection fraction (LVEF) relationship, performed using SPSS 17.0 statistical correlation analysis. Results: MAD had a significant correlation with LVEF(r=0.81, P<0.01); GLS(r=-0.74, P<0.01),GRS GRS(r=0.57, P<0.01),GCS (r=-0.55, P<0.01) and LVtw(r=0.65, P<0.01)were significantly associated with LVEF;MAD and GLs(r=-0.69, P<0.01),GRs (r=0.49, P<0.01), LVtw (r=0.45, P<0.01)were significantly associated;MAD and GCs (r=-0.39, P<0.05)with a negative correlation. Conclusion:STI resilience through the myocardium, ventricular torsion and systolic mitral annular maximum displacement at the midpoint of the analysis, can accurately evaluate left ventricular longitudinal, radial and torsional motion synchronization, highly correlated with left ventricular ejection fraction, good consistency, with a very broad application prospects.

Objective To compare the clinical outcomes of 2 different catheter ablation strategies for patients with chronic atrial fibrillation(CAF).Methods One hundred and thirty four consecutive patients(77 males,mean age 56.8?12.3 yrs)were randomized into 2 groups of different catheter ablation strategies.All the patients suffered from frequent attacks(more than 3 times per month),drug refractory and symptomatic CAF.One group received circumferential pulmonary rein ablation(CPVA group,n=68)and the other group received complex fractionated electrogram ablation additional to CPVA(CPVA+CFEA group,n=66).All ablation was guided by 3 dimensional mapping system(CARTO).Follow-up ECG,Holter and clinical outcomes of the 2 groups within 6 months after the procedures were analyzed.Results The baseline characteristics were comparable between the 2 groups.The mean procedure time in the CPVA+CFEA group was longer than that in the CPVA group but the mean fluoroscopy time between two groups had no significant difference.After the first procedure,60%of patients in the CPVA group and 77% of patients in the CPVA +CFEA group were free from symptomatic atrial tachycardia without any use of antiarrhythmic drugs for at least 3 months(P

Objective To evaluate the safety and effectiveness of catheter ablation for atrial fibrillation(AF)therapy guided by 3-D mapping systems.Methods Eight hundred cases(482 male,mean age 62.1?15.6 years)were enrolled.AF was paroxysmal in 611 cases,and persistent in 189 cases.The mean left atrium diameter was 38.4 9.2 mm.Ablation was guided by EnSite-NavX in 260 cases and by CARTO in 540 cases.Circumferential pulmonary vein isolation(CPVI)was performed for paroxysmal AF,and CPVI combined with complex fractionated atrial electrograms(CFAEs)and mitral isthmus ablation was applied for persistent AF.Every case received oral anticoagulation with warfarin and class IC and class III antiarrhythmic drugs for 1 to 3 months.ECG and Holter were applied every month during follow-up.Results Seven hundred and ninty-five cases underwent the procedure successfully,with the mean procedural time 161 33 min and fluoroscopic time 17 13 min.PV isolation was achieved in 96.5% of cases for left-sided PVs,and in 98.6% of cases for right-sided PVs.Radiofrequency application terminated paroxysmal AF in 90 out of 98 cases.AF recurred in 137 cases within 2 weeks post-ablation,and subsided in 103 cases during subsequent follow-up.Fifty-seven cases underwent re-ablation and 6 cases required third ablation.Persistent AF was terminated in 30 cases(16.1%)and was converted to atrial tachycardia in 15 cases(8.1%)by CPVI.For patients receiving CFAEs ablation,persistent AF was terminated in 20 cases(10.8%)and was converted to atrial tachycardia in 23 cases(12.4%).AF recurred in 78 cases(41.9%)early after ablation and 65 cases underwent re-ablation(10 cases received third ablation).Atrial tachycardia/flutter developed in 104 cases(13.1%)after ablation,and remitted in 68 cases.Atrial tachycardia/flutter was mapped and ablated in 30 cases,and was eliminated in 23 cases.Complications:Cardiac tamponade developed in 5 cases,requiring pericardiocentesis in 3 cases and surgical repair in 2 cases.PV stenosis was present in 6(0.7%)cases,TIA in 1 case,cerebral embolism in 2 cases,mesentery artery embolism in 1 case,hemothorax in 1 case and pneumothorax in 1 case.There were femoral artery pseudo-aneurysm in 3 cases and femoral artery-vein fistula in 1 case.All the patients were cured by conservative therapy.During a mean follow-up of 16.2?5.7 months,550 cases(9.4% of them received re-ablation and 11.5% received antiarrhythmic drugs)with paroxysmal AF and 159 cases(34.9% of them received re-ablation and 28.5% received antiarrhythmic drugs)with persistent AF were free of atrial tachyarrhythmias recurrence.Conclusion Catheter ablation guided by 3-D mapping systems were safe and effective for AF therapy.CPVI alone was enough for paroxysmal AF treatment,while CPVI combined with CFAEs and isthmus ablation were preferable for persistent AF treatment,and re-ablation were needed in 40% of the patients to improve effectiveness.

Objective To analyze the distribution of key target sites(KTSs) during initial circumferential pulmonary vein isolation(CPVI) for atrial fibrillation(AF) and during re-ablation.Methods Forty eight cases(30 males,average age 54.3?10.2 years) with recurrent AF were enrolled.AF was paroxysmal in 24 cases and persistent in 24 cases.Re-ablation was performed 37.2?7.4 days after initial CPVI.KTS was defined as the target sites where pulmonary vein potentials(PVPs) delayed,conduction sequence changed,PVPs slowed down or PV isolated during ablation.Circumferential pulmonary vein(PV) lesions were divided eaqually into 8 segments.KTSs were analyzed during initial CPVI and re-ablation.Results One hundred and forty five KTSs were identified during initial CPVI.The mean KTSs per case were 3.02?1.08,compared with 1.58?1.09 during re-ablation,P

Objective To evaluate the electrophysiological mechanism of early recurrence of atrial tachyarrhythmias(ATa) after initial ablation for paroxysmal atrial fibrillation(AF)and the feasibility of early re-ablation.Methods Forteen cases(8 males,average age of 61.8?8.4 years) presented with early recurrent ATa within 1 month after initial ablation were included.Early recurrence was observed after a mean of 4.9?3.7 days post-ablation.During re-ablation,all pulmonary vein(PV) reconnection was re-isolated,and AF induction was applied to map and ablate non-PV triggers.ECG and Holter monitor was applied to evaluate the effect.Results Re-ablation was performed after a mean follow-up of 24.7?5.5 days after the first ablation.PV re-connection was identified in 13 cases(92.9%) and was re-isolated by closing conduction gaps along initial lesion lines.By AF induction,superior vena cava(SVC) originated AF was detected in 3 cases and was terminated by SVC isolation.Upper crista terminalis(CT) foci was found in 1 case which was eliminated by focal ablation.Typical atrial flutter(AFL) in 3 cases and left atrial AFL in 1 case were terminated by linear ablation.At the end of follow-up of 5.8?1.4 months,13 cases were free from ATa recurrence and anti-arrhythmic drugs.Paroxymal ATa was observed in 1 case which could be suppressed by verapamil.Conclusion PV re-connection is the main influencing factor of early recurrence of ATa after initial ablation for paroxysmal AF.Other factors include foci located in SVC and CT.Early re-ablation is feasible and effective.