Objective:The aim of this study was to assess the frailty status of patients with heart failure undergoing CRT-D and then explore the predictive value of frailty for all-cause mortality and heart failure-related readmissions in these patients.Methods:We retrospectively included 374 patients with chronic heart failure who underwent CRT-D treatment at the First Affiliated Hospital of Xinjiang Medical University between June 2020 and June 2024. Based on the Tilburg Debilitation Assessment Scale, 175 patients (46.8%) were classified as frail while 199 (53.2%) were classified as non-frail. The baseline data between the two groups was compared using Cox regression analysis and Kaplan-Meier curves were used for survival analysis. P-values of <0.05 indicated statistically significant differences. Results:A total of 374 patients aged 25-93 (68±11) years were enrolled in this study, 101 (27.0%) of which were female. Among these, 175 (46.8%) were categorized as frail, and 199 (53.2%) were classified as non-frail. Over a median follow-up time of 23 (5, 45) months, 35 (9.4%) patients experienced all-cause mortality, with 30 (17.1%) deaths occurring in the frail group and 5 (2.5%) in the non-frail group; meanwhile, readmission events due to heart failure occurred in a total of 174 (46.5%) patients, including 122 (70.1%) in the frail group, and 52 (29.9%) in the non-frail group. Cox analysis showed that frailty was a significant determinant of all-cause mortality ( HR=21.25, 95% CI 3.99-113.30, P<0.001) and readmission among heart failure patients receiving CRT-D ( HR=2.52, 95% CI 1.73-3.68, P<0.001). Log-rank tests showed that the survival rate of patients in the frail group was significantly lower than that of patients in the non-frail group ( HR=7.22, 95% CI 2.80-18.60, P<0.001) and the risk of readmission events due to heart failure was significantly higher among patients in the frail group than among those in the non-frail group ( HR=2.75, 95% CI 1.98-3.81, P<0.001). Conclusions:Frailty is an independent predictor of postoperative all-cause mortality and the occurrence of heart failure-related readmissions in patients with heart failure treated receiving CRT-D.

Objective:The aim of this study was to assess the frailty status of patients with heart failure undergoing CRT-D and then explore the predictive value of frailty for all-cause mortality and heart failure-related readmissions in these patients.Methods:We retrospectively included 374 patients with chronic heart failure who underwent CRT-D treatment at the First Affiliated Hospital of Xinjiang Medical University between June 2020 and June 2024. Based on the Tilburg Debilitation Assessment Scale, 175 patients (46.8%) were classified as frail while 199 (53.2%) were classified as non-frail. The baseline data between the two groups was compared using Cox regression analysis and Kaplan-Meier curves were used for survival analysis. P-values of <0.05 indicated statistically significant differences. Results:A total of 374 patients aged 25-93 (68±11) years were enrolled in this study, 101 (27.0%) of which were female. Among these, 175 (46.8%) were categorized as frail, and 199 (53.2%) were classified as non-frail. Over a median follow-up time of 23 (5, 45) months, 35 (9.4%) patients experienced all-cause mortality, with 30 (17.1%) deaths occurring in the frail group and 5 (2.5%) in the non-frail group; meanwhile, readmission events due to heart failure occurred in a total of 174 (46.5%) patients, including 122 (70.1%) in the frail group, and 52 (29.9%) in the non-frail group. Cox analysis showed that frailty was a significant determinant of all-cause mortality ( HR=21.25, 95% CI 3.99-113.30, P<0.001) and readmission among heart failure patients receiving CRT-D ( HR=2.52, 95% CI 1.73-3.68, P<0.001). Log-rank tests showed that the survival rate of patients in the frail group was significantly lower than that of patients in the non-frail group ( HR=7.22, 95% CI 2.80-18.60, P<0.001) and the risk of readmission events due to heart failure was significantly higher among patients in the frail group than among those in the non-frail group ( HR=2.75, 95% CI 1.98-3.81, P<0.001). Conclusions:Frailty is an independent predictor of postoperative all-cause mortality and the occurrence of heart failure-related readmissions in patients with heart failure treated receiving CRT-D.

Objective:To investigate the correlation between early recurrence and late recurrence within 48 hours after catheter ablation of atrial fibrillation.Methods:A retrospective analysis was conducted on atrial fibrillation patients who underwent catheter ablation at the Heart Center of the First Affiliated Hospital of Xinjiang Medical University from April 2020 to November 2021. Preoperative examinations and baseline data of patients were collected. After surgery, the patient was given continuous electrocardiogram monitoring for 48 hours to observe whether there was early recurrence of atrial fibrillation. Follow up visits were conducted at 3, 6, 9, and 12 months after surgery to observe whether there were atrial fibrillation events. The impact of extremely early recurrence on late recurrence free atrial fibrillation was analyzed using Kaplan Meier curves, and the predictive value of extremely early recurrence and other indicators for late atrial fibrillation recurrence was evaluated using Cox proportional hazards models and receiver operating characteristic (ROC) curves.Results:A total of 96 patients who underwent catheter ablation for atrial fibrillation for the first time were included in this study, with an age of (60.2±12.6)years. Among them, 46 patients (47.92%) experienced very early recurrence within 48 hours after surgery. During the 1-year follow-up, 16 patients in the very early recurrence group experienced late recurrence, which was statistically significant compared to the very early non recurrence group ( P=0.003). The proportion of persistent atrial fibrillation was higher in patients with very early recurrence (32.6% vs 8.0%, P=0.006), and more patients with late recurrence (34.8% vs 8.0%, P=0.003). The left atrial diameter was larger [(40.28±4.72)mm vs (37.10±4.35)mm, P=0.001]. The Kaplan Meier curve showed that compared with the very early non recurrence group, the late recurrence rate of patients in the very early recurrence group was significantly higher (Long rank P=0.001 6). Cox single factor regression analysis showed that very early recurrence, age increase, increased left atrial diameter, hypertension and diabetes were risk factors for late recurrence (all P<0.2). Multivariate regression analysis suggested that extremely early recurrence was an independent risk factor for late recurrence ( HR=3.99, 95% CI: 1.22-13.06, P=0.021). The area under the ROC curve for predicting late recurrence after catheter ablation of atrial fibrillation with extremely early recurrence was 0.703, and the negative predictive value was 0.920. Conclusions:Early recurrence within 48 hours after catheter ablation of atrial fibrillation is an independent risk factor for late recurrence and has good predictive value.

Hypertrophic obstructive cardiomyopathy (HOCM) is the most common type of hypertrophic cardiomyopathy, which is prone to left ventricular outflow obstruction and causes various adverse effects. It is also the main cause of sudden death in adolescents and athletes. Timely intervention is crucial for the prognosis of patients. Radiofrequency ablation has been widely used in the treatment of various arrhythmias, but it is still a new treatment method in HOCM. This article mainly reviews the clinical application progress of radiofrequency ablation in the treatment of HOCM patients.

Objective:To investigate the association between abnormal left atrial appendage function and thrombotic events in patients with non-valvular atrial fibrillation, and the independent risk factors affecting left atrial appendage function.Methods:Patients with non-valvular atrial fibrillation, who visited the Atrial Fibrillation Center of the First Affiliated Hospital of Xinjiang Medical University from June 1, 2019 to June 1, 2021, were selected. According to left atrial appendage flow velocity (LAAFV), they were divided into normal left atrial appendage function group (297 patients with LAAFV ≥ 40 cm/s) and abnormal left atrial appendage function group (85 patients with LAAFV<40 cm/s). Baseline data and transesophageal echocardiography images were collected from all the patients. The occurrence of thrombotic events was recorded. Univariate and multivariate unconditional logistic regression analyses were conducted to investigate the correlation between abnormal left atrial appendage function and the occurrence of thrombotic events.Results:There were significant differences in gender, type of atrial fibrillation, CHA 2DS 2-VASc score, anticoagulant therapy, total cholesterol, low-density lipoprotein cholesterol, international normalized ratio (INR), left atrial diameter, proportion of patients with right atrial enlargement, left ventricular ejection fraction, inner diameter, sum of inner diameter, depth, and sum of depth of all angles of the left atrial appendage, and incidence of thrombotic events between the two groups (all P<0.05). After adjusting for confounders, multivariate unconditional logistic regression analyses showed that abnormal left atrial appendage function was closely associated with thrombotic events (β=1.168 P=0.002), and left atrial diameter ( OR=1.084, 95% CI 1.019-1.153, P=0.011) and persistent atrial fibrillation ( OR=2.323, 95% CI 1.226-4.403, P=0.010) were independent risk factors affecting left atrial appendage function. Conclusions:Abnormal left atrial appendage function is closely associated with thrombosis. The left atrial diameter and persistent atrial fibrillation were independent risk factors affecting left atrial appendage function.