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

The concept of benefit finding, the assessment tools and the status quo of benefit finding for family caregivers of stroke patients were elaborated, the influencing factors of benefit finding of family caregivers of stroke patients were summarized, the current problems and the development direction of future research were pointed out, aiming to provide a reference for clinical staff to conduct research on benefit finding of family caregivers of stroke patients in China.

Objective To compare biomechanical effects of Zero-Profile anterior cervical intervertebral fusion system and Cage-Plate fusion system on the adjacent segments, so as to provide references for the long-term clinical efficacy of single segment cervical spondylosis. Methods The finite element model of cervical spine C1-7 was established based on CT scan data of normal people. After the validity of the model was validated, two finite element models of C5-6 segment implanted with Zero-P fusion system and Cage-Plate fusion system were built. The physiological torque 1.5 N·m was loaded respectively on the normal model, Zero-P implanted model and Cage-Plate implanted model to simulate cervical flexion, extension, lateral bending and rotation. Changes in the ranges of motion (ROMs) of adjacent segments and stresses on nucleus pulposus, endplate and annulus, facet joints of intervertebral disc were compared for the three models. Results After the two kinds of anterior cervical intervertebral fusion systems were implanted, ROMs of C4-5 segments increased by 20%, but ROMs of C6-7 segments increased up to 120%. The stresses on C4-5 nucleus increased by 78%, while the stresses on C6-7 nucleus increased up to 110%. The stresses on the adjacent endplates and the fiber ring also increased. Conclusions The implantation of Cage-Plate and Zero-P fusion system both increased the ROMs of the adjacent segments, and the stresses on annulus, fiber rings and facet joints of the adjacent discs increased as well, which would cause lesions of the adjacent segments in the long run. However, there was no essential difference in biomechanical effects of the Cage-Plate and Zero-P cage fusion system on the adjacent segments.