Cardiac conduction abnormalities and/or atrioventricular (AV) block have been reported as one of the most frequent complications of transcatheter aortic valve implantation (TAVI). The impairment of AV conduction was resulted from the balloon and valve-induced injury. Patients with right bundle branch block (RBBB) before TAVI operation, receiving the Medtronic CoreValve Revalving System (MCRS) implant and the implantation of valve prosthesis too deep in the left ven-tricular outflow tract have been reported to require permanent pacemaker implantation.

Objective To investigate the expression of Notchl and NUMB in gastric cancer and explore the relationship between two genes and clinicopathologic features. Methods The mRNA and protein expressions of Notchl and NUMB in the gastric cancer tissues and normal gastric tissues were determined by realtime PCR and Western blotting. Results The mRNA expression of Notchl in gastric cancer tissues was 1.67times that of Notchl in normal gastric tissues. The increase of the mRNA expression of Notchl was correlated with tumor differentiation and lymph node metastatis of the patients ( P < 0. 05 ). The mRNA expression of NUMB in gastric cancer tissues was 0.597 times that of Notchl in normal tissues. The decrease of the mRNA expression of NUMB was correlated with tumor differentiation of the patients (P < 0.05). The expression of Notchl was negatively correlated to that of NUMB ( r = - 0.459, P < 0.05 ). The protein expression of Notchl in gastric cancer tissues was (0. 348 ±0. 133) , which was significantly higher than (0. 208 ±0. 140) in normal gastric tissues (P < 0.05 ). The protein expression of NUMB in gastric cancer tissues was (0.490 ±0.440), which was significantly lower than 0.746 ±0.390 in normal gastric tissues (P<0.05).Conclusion Up-regulation of Notchl and down-regulation of NUMB may play an important role in the occurrence and development of gastric cancer.

Objective To investigate circulating level of growth differentiation factor-15 (GDF-15) in patients with non-valvular atrial fibrillation (AF). Methods We enrolled 104 consecutive patients with AF (67 are paroxymal AF and 37 are persistent AF) that presented to our hospital between August 2012 and June 2013. Subjects without AF (n=67) was used as controls who were matched for sex, age and atherosclerotic risk factors enrolled in the same period. Serum GDF-15 con-centration was detected by enzyme linked immunosorbent assay (ELISA). Echocardiography and laboratory parameters were compared among three groups. The correlation of GDF- 15 and hypersensitive c-reactive protein (hs-CRP) as well as the risk factors of development of AF were also analyzed. Results No significant difference in age, history of hypertension, coro-nary heart disease, and stroke was found among three groups (P>0.05). GDF-15 had significant difference between pa-tients with paroxysmal AF and controls [(1 473.14±628.52)μg/L vs (1 233.592±262.76)μg/L, P=0.012]. GDF-15 level was correlated with hs-CRP (rs=0.172,P=0.044). Multivariable analysis demonstrated that high GDF-15 is a risk factor of devel-opment of paroxysmal AF/AF (OR:1.002, 95%CI:1.000-1.003, P<0.05). Conclusion Patients with AF have a higher se-rum level of GDF-15 compared with controls and GDF-15 level is a risk factor of development of paroxysmal AF/AF.

OBJECTIVEDiscrete potentials (DPs) have been recorded and targeted as the site of ablation of the outflow tract arrhythmias. The aim of the present study was to investigate the significance of DPs with respect to mapping and ablation for idiopathic outflow tract premature ventricular contractions (PVCs) or ventricular tachycardias (VTs).

METHODSSeventeen out of 24 consecutive patients with idiopathic right or left ventricular outflow tract PVCs/VTs who underwent radiofrequency catheter ablation between September 2012 and December 2013 in our department were included. Intracardiac electrograms during the mapping and ablation were analyzed.

RESULTSDuring sinus rhythm, sharp high-frequency DPs that displayed double or multiple components were recorded following or buried in the local ventricular electrograms in all of the 17 patients, peak amplitude was (0.51 ± 0.21) mV. The same potential was recorded prior to the local ventricular potential of the PVCs/VTs. Spontaneous reversal of the relationship of the DPs to the local ventricular electrogram was noted during the arrhythmias. The DPs were related to a region of low voltage showed by intracardiac high-density contact mapping. At the sites with DPs, unipolar and bipolar ventricular voltage of sinus beats were lower compared with the adjacent regions without DPs (unipolar: (6.1 ± 1.8) mV vs. (8.3 ± 2.3) mV, P < 0.05; bipolar: (0.62 ± 0.45) mV vs. (1.03 ± 0.60) mV, P < 0.05). The targeted DPs were still present in 12 patients after successful elimination of the ectopies. Discrete potentials were not present in seven controls.

CONCLUSIONSDiscrete potentials and related low-voltage regions were common in idiopathic outflow tract ventricular arrhythmias. Discrete potential- and substrate-guided ablation strategy could help to reduce the recurrence of idiopathic outflow tract arrhythmias.

Catheter Ablation ; Electrophysiologic Techniques, Cardiac ; Heart Ventricles ; Humans ; Recurrence ; Tachycardia, Ventricular