Objective To investigate the basic situation and rationality of guideline-directed medical therapy(GDMT)in hospitalized patients with chronic heart failure with reduced ejection fraction(HFrEF),and to provide a reference for clinical medication.Methods The clinical date of HFrEF patients admitted to Wenling Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University and the application of GDMT-related medications[including angiotensin receptor neprilysin inhibitor(ARNI)/angiotensin converting enzyme inhibitor(ACEI)/angiotensin Ⅱ receptor blocker(ARB),β-blocker(BB),mineralocorticoid receptor antagonist(MRA)and sodium-glucose linked transporter 2 inhibitor(SGLT2i)]were retrospectively analyzed from January 2022 to December 2024.The rationality of medicates was evaluated according to relevant guidelines/consensus and drug instructions.Results A total of 117 patients were included,among which 73.50％were male,and the average age was(69.62±14.39)years old.The proportion of patients receiving ARNI/ACEI/ARB,BB,MRA and SGLT2i was 77.78％,63.25％,97.44％and 68.38％,respectively.The rates of reaching target dose were 2.20％,0,100.00％and 98.75％,respectively.Single,double,triple and quadruple anti-heart failure drugs accounted for 5.98％,23.08％,29.06％and 41.88％,respectively.Conclusion There is still a certain gap between clinical practice and guideline in the utilization of the GDMT-realted medications in patients with chronic HFrEF in this hospital.The usage rate of BB is low,and the dosage of ARNI/ACEI/ARB and BB are seriously insufficient,while MRA is overused.The standardization of GDMT medication needs further improvement.

Objective To investigate the basic situation and rationality of guideline-directed medical therapy(GDMT)in hospitalized patients with chronic heart failure with reduced ejection fraction(HFrEF),and to provide a reference for clinical medication.Methods The clinical date of HFrEF patients admitted to Wenling Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University and the application of GDMT-related medications[including angiotensin receptor neprilysin inhibitor(ARNI)/angiotensin converting enzyme inhibitor(ACEI)/angiotensin Ⅱ receptor blocker(ARB),β-blocker(BB),mineralocorticoid receptor antagonist(MRA)and sodium-glucose linked transporter 2 inhibitor(SGLT2i)]were retrospectively analyzed from January 2022 to December 2024.The rationality of medicates was evaluated according to relevant guidelines/consensus and drug instructions.Results A total of 117 patients were included,among which 73.50％were male,and the average age was(69.62±14.39)years old.The proportion of patients receiving ARNI/ACEI/ARB,BB,MRA and SGLT2i was 77.78％,63.25％,97.44％and 68.38％,respectively.The rates of reaching target dose were 2.20％,0,100.00％and 98.75％,respectively.Single,double,triple and quadruple anti-heart failure drugs accounted for 5.98％,23.08％,29.06％and 41.88％,respectively.Conclusion There is still a certain gap between clinical practice and guideline in the utilization of the GDMT-realted medications in patients with chronic HFrEF in this hospital.The usage rate of BB is low,and the dosage of ARNI/ACEI/ARB and BB are seriously insufficient,while MRA is overused.The standardization of GDMT medication needs further improvement.

Objective::This study is aimed to analyze the long-term safety and effectiveness of second-generation cryoballoon (CB2) ablation in the treatment of atrial fibrillation (AF).Methods::Data from 760 consecutive patients in the Department of Cardiology, General Hospital of Northern Theater Command from August 2016 to December 2018 with drug-refractory symptomatic AF undergoing pulmonary vein isolation (PVI) using CB2 were assessed. Procedure-related safety and freedom from AF and atrial flutter/atria tachycardia through 3 years were determined. The risk factors related to atrial tachyarrhythmia recurrence were analyzed.Results::Acute PVI was achieved in 100% of the 760 patients. Radiofrequency application for additional focal ablation was needed in 11 (1.4%) patients and for 14 pulmonary veins (0.5%, 14/(760×4)) to achieve PVI. A total of 748 patients, including 539 with paroxysmal AF (PAF) and 209 with persistent AF (SAF) completed the follow-up, and only 12 (1.6%) patients were lost. The mean follow-up duration was (19±8) months. The rate of major complications was 0.9%, including 0.8% of right phrenic nerve injury, which resolved before discharge. Freedom from all tachyarrhythmias was achieved in 75.0%, 69.4%, and 63.2% of patients with PAF, respectively, at 12-, 24-, and 36-month follow-up, and in 75.1%, 67.4%, and 60.9% for SAF, with no significant differences between the PAF and SAF groups. AF course and the rate of body weight gain were independent risk factors for recurrence at 12 months after ablation ( P = 0.001 and P = 0.009, respectively). Conclusion::PVI using CB2 has a high acute success rate and good safety in the treatment of PAF and SAF. Long course of AF and weight gain after ablation were independent risk factors for recurrence.

Objective::This study is aimed to analyze the long-term safety and effectiveness of second-generation cryoballoon (CB2) ablation in the treatment of atrial fibrillation (AF).Methods::Data from 760 consecutive patients in the Department of Cardiology, General Hospital of Northern Theater Command from August 2016 to December 2018 with drug-refractory symptomatic AF undergoing pulmonary vein isolation (PVI) using CB2 were assessed. Procedure-related safety and freedom from AF and atrial flutter/atria tachycardia through 3 years were determined. The risk factors related to atrial tachyarrhythmia recurrence were analyzed.Results::Acute PVI was achieved in 100% of the 760 patients. Radiofrequency application for additional focal ablation was needed in 11 (1.4%) patients and for 14 pulmonary veins (0.5%, 14/(760×4)) to achieve PVI. A total of 748 patients, including 539 with paroxysmal AF (PAF) and 209 with persistent AF (SAF) completed the follow-up, and only 12 (1.6%) patients were lost. The mean follow-up duration was (19±8) months. The rate of major complications was 0.9%, including 0.8% of right phrenic nerve injury, which resolved before discharge. Freedom from all tachyarrhythmias was achieved in 75.0%, 69.4%, and 63.2% of patients with PAF, respectively, at 12-, 24-, and 36-month follow-up, and in 75.1%, 67.4%, and 60.9% for SAF, with no significant differences between the PAF and SAF groups. AF course and the rate of body weight gain were independent risk factors for recurrence at 12 months after ablation ( P = 0.001 and P = 0.009, respectively). Conclusion::PVI using CB2 has a high acute success rate and good safety in the treatment of PAF and SAF. Long course of AF and weight gain after ablation were independent risk factors for recurrence.