Objective To study the effect of RF catheter ablation of verapamil-sensitive idiopathic left ventricular tachycardia according to the re-entrant route mapped during electrophysiologic test. Methods 6 patients (4 male & 2 female) suffered from the ioliopathic left venticulan tachycondia (ILVT). After placing the catheter in the right ventricular apex and the coronary sinus, a radiofrequency (RF) catheter and a octapolar catheter (mapping catheter) with an interval of 2-8-2 min were introduced through the right and left femoral arteries. The mapping catheter recorded the His potential (HP), the left bundle potential (LBP), the left posterior fascicle Purkinje potential (PP) and V electrogram sequentially, PP was the first potential to be detected with the RF catheter during TV, we searched for the earliest PP recording site near the couple of electrodes of the mapping catheter recording PP and ablated it. Results In the first 3 cases, ablation didn′t have effect at sites recording the earliest V electrogram without PP and it was finally successful at the sites recording the earliest PP. Since the fourth case all patients needed only one application because ablation was carried out only at the site recorded the earliest PP. Patients have been followed for 6-20 months without antiarrhythmic drugs, and none of them has had a recurrence of VT. Conclusion The mapping on the left ventricular septum is not only important to study the reentrant route in ILVT, but also helpful for clinical treatment of ILVT. It shortens the operation time and minimizes injury of cardiac muscle due to noneffective ablation.

Glycemic variability is closely related to diabetes complications,and might play a more valuable role in clinical risk assessment.The glycemic variability could effect the prognosis of cardiovascular disease and ischemic stroke.Meanwhile,it has a close relationship with the presence, development and severity of diabetic nephropathy.Moreover,as an independent risk factor for the damage of macro- and microvessels,it has a positive relationship with the severity of target organ.Therefore,the strategy to regulate glycemic variability is a valuable measure of glycemic control,and may be of great significance to strengthen the effect of diabetes treatment and reduce the damage on target organs.

Objective To investigate the role of phosphatidyl inositol 3 kinase (PI3K)/Akt pathway in the protection of focal cerebral ischemia reperfusion injury in rats with limb ischemic postconditioning (LIP) by detecting the expression levels of p-Akt protein, and caspase-9 and Bcl-2 mRNAs after remote LIP. Methods Forty-two Wistar rats were randomly assigned to 3 groups: sham operation, ischemia-reperfusion (IR) and LIP groups. The middle cerebral artery ischemia-reperfusion injury model was induced by the suture method in the IR group and the LIP group. In the LIP group, three circulatory LIP ( 5 min ischemia/5 min reperfusion) in the contralateral femoral artery were performed before reperfusion 2 h after cerebral ischemia. Infarct volume was measured by 2,3,5-triphenyltetrazolium chloride staining. The expression of p-Akt protein was detected by immunohistochemical staining and the expression levels of cystin-9 and Bcl-2 mRNAs were detected by in situ hybridization. Results Compared with the IR group, the infarct volume in the LIP group was significantly reduced ( P<0.05). The expression levels of p-Akt protein and Bcl-2 mRNA significantly increased (all P<0.05), and the expression level of caspase-9 mRNA significantly decreased (P<0.05). Conclusions LIP can reduce the volume of cerebral infarction in focal cerebral ischemia-reperfusion injury in rats. Its mechanism may be involved in up-regulation of p-Akt protein and Bcl-2 mRNA expression and down-regulation of caspase-9 mRNA expression, suggesting that LIP can alleviate cerebral ischemia-reperfusion injury through PI3K/Akt pathway.