OBJECTIVE: To observe the clinical efficacy of wrist-ankle acupuncture in the treatment of functional frequent premature ventricular contractions (PVCs). METHODS: A total of 64 patients with functional frequent PVCs were randomly divided into an observation group and a control group, 32 cases in each group. The observation group was treated with wrist-ankle acupuncture at bilateral upper 1 and upper 2 on the wrist. The control group received sham acupuncture at the same points as the observation group. Both groups were treated once every day from Monday to Friday, with the needles retained for 60 min each time, for a total of 4 weeks. The TCM syndrome score, the 24-hour PVC count, and MOS 36-item short form health survey (SF-36) score were compared between the two groups before and after treatment, and the clinical efficacy was evaluated after treatment. RESULTS: After treatment, the TCM syndrome scores and the 24-hour PVC counts in both groups were reduced compared with those before treatment (P<0.01), and the above indexes in the observation group were lower than those in the control group (P<0.01). After treatment，scores of all SF-36 items in the observation group were increased compared with those before treatment (P<0.01); in the control group, the scores of general health (GH), social function (SF) and role-emotional (RE) were increased compared with those before treatment (P<0.05). After treatment, scores of all SF-36 items in the observation group were higher than those in the control group (P<0.01). The total effective rate in the observation group was 90.6% (29/32), which was higher than 46.9% (15/32) in the control group (P<0.01). CONCLUSION Wrist-ankle acupuncture has a significant clinical efficacy in the treatment of functional frequent PVCs. It can effectively improve symptoms such as chest tightness and palpitations, reduce 24-hour PVC count, and improve patients' quality of life.
Humans ; Acupuncture Therapy ; Male ; Female ; Middle Aged ; Adult ; Ventricular Premature Complexes/physiopathology* ; Ankle/physiopathology* ; Wrist/physiopathology* ; Acupuncture Points ; Treatment Outcome ; Aged ; Young Adult

OBJECTIVETo compare the safety, feasibility, and efficacy of a completely nonfluoroscopic approach to radiofrequency catheter ablation (RFCA) using CARTO3 and ablation with conventional fluoroscopic guidance for treatment of idiopathic premature ventricular contractions from the aortic sinus cusp (ASC-PVCs).

METHODSFrom April 2013 to October 2015, we prospectively enrolled 52 consecutive patients with ASC-PVCs scheduled for either CARTO3 mapping-guided zero-fluoroscopy ablation (group A, n=23) or conventional fluoroscopic ablation (group B, n=29). The success rates, rates of complications, rates of recurrences, number of radiofrequency applications, procedure time, mapping time and fluoroscopy time were compared between the 2 groups.

RESULTSs No significant differences were found in the success rates between the 2 groups [22/23 (96%) vs 24/29 (83%), P=0.21]. No major complications occurred during the procedures in either group. There was no significant difference with regard to the procedure time between the two groups (79.6∓8.8 vs 77.4∓7.2 min, P=0.332). The procedure was completed without any fluoroscopy use in group A, while the mean fluoroscopy time in group B was 23.1∓6.0 min. Group A showed a shorter mapping time than group B (4.3∓1.7 vs 7.8∓2.6 min, P<0.01) with significantly fewer radiofrequency applications (4.8∓1.1 vs 7.9∓3.2, P<0.01). The recurrence rates were comparable between the two groups over a follow-up period of 5 to 20 months.

CONCLUSIONCompared with the conventional fluoroscopic technique, the zero-fluoroscopy approach can shorten the total procedure time and the ablation time with significantly reduced RF applications to eliminate ionizing radiation exposure in RFCA. RFCA guided by CARTO3 system without fluoroscopy is feasible, safe, and effective for treatment of ASC-PVCs.

Catheter Ablation ; Fluoroscopy ; Humans ; Radio Waves ; Recurrence ; Sinus of Valsalva ; physiopathology ; Treatment Outcome ; Ventricular Premature Complexes ; surgery

The present paper is to analyze the trend of sinus heart rate RR interphase sequence after a single ventricular premature beat and to compare it with the two parameters, turbulence onset (TO) and turbulence slope (TS). Based on the acquisition of sinus rhythm concussion sample, we in this paper use a piecewise linearization method to extract its linear characteristics, following which we describe shock form with natural language through cloud model. In the process of acquisition, we use the exponential smoothing method to forecast the position where QRS wave may appear to assist QRS wave detection, and use template to judge whether current cardiac is sinus rhythm. And we choose some signals from MIT-BIH Arrhythmia Database to detect whether the algorithm is effective in Matlab. The results show that our method can correctly detect the changing trend of sinus heart rate. The proposed method can achieve real-time detection of sinus rhythm shocks, which is simple and easily implemented, so that it is effective as a supplementary method.
Algorithms ; Arrhythmias, Cardiac ; physiopathology ; Electrocardiography ; Heart Rate ; Humans ; Ventricular Premature Complexes ; physiopathology

OBJECTIVETo investigate the significance of Tp-Te interval for risk stratification of ventricular premature contractions (VPC) in children.

METHODSA total of 120 children with VPC were divided into benign VPC (n=40), organic disease (n=40) and ventricular parasystole groups (n=40) according to the etiology of VPC; another 40 children who underwent physical examination were selected as the normal control group. The four groups were compared in terms of Tp-Te intervals and Tp-Te/QT ratios in leads V3, V4 and V5.

RESULTSThe Tp-Te interval in lead V3 was significantly longer in the organic disease group than in the other groups (P<0.05), the benign VPC group had a significantly shorter Tp-Te interval in lead V4 than the normal control and organic disease groups (P<0.05), and the organic disease group had a significantly longer Tp-Te interval in lead V5 than the benign VPC group (P<0.05). The Tp-Te/QT ratios in leads V3-V5 were significantly higher in the organic disease group than in the other groups (P<0.05). The Tp-Te/QT ratios in leads V4 and V5 showed significant differences between the ventricular parasystole and benign VPC groups (P<0.05).

CONCLUSIONSTp-Te interval is susceptible to changes in heart rate, and it is of little value for the risk stratification of VPC in children. Tp-Te/QT ratio, however, may be used as an important non-invasive index for clinical risk stratification of VPC in children and is worthy of further study.

Adolescent ; Child ; Child, Preschool ; Electrocardiography ; Female ; Heart Rate ; Humans ; Infant ; Male ; Risk ; Ventricular Premature Complexes ; etiology ; physiopathology

BACKGROUNDFrequent premature ventricular complexes from the right ventricular outflow tract (RVOT-PVCs) are associated with left ventricular dysfunction. This study adopted two-dimensional speckle tracking imaging to evaluate global and regional left ventricular myocardial function in patients with frequent RVOT-PVCs.

METHODSThis study included 30 patients with frequent RVOT-PVCs and 30 healthy subjects. Aortic systolic velocity-time integral (AoVTI) and myocardium strain in circumferential (CS), radial (RS) and longitudinal (LS) directions were evaluated by conventional echocardiography and speckle tracking imaging. All values of patients with RVOT-PVCs were recorded during sinus (PVC-S) and PVC beats (PVC-V).

RESULTSSignificant differences were demonstrated in global CS, RS and LS between the control subjects and the PVC-V (CS: (17.46 ± 2.48)% vs. (11.52 ± 3.28)%, RS: (48.26 ± 10.20)% vs. (20.92 ± 9.78)%, LS: (19.89 ± 2.62)% vs. (11.79 ± 3.66)%, P < 0.01), and in segmental RS and LS of nearly all the left ventricular segments. Statistical differences in segmental CS between the PVC-V and the control subjects were only observed in anterior, anteroseptal and septal segments (only seen in anteroseptal and septal segments at apex). Furthermore, V/S AoVTI (AoVTI during the PVC beat divided by AoVTI during the sinus beat, then multiplied by 100%) correlated with coupling interval (r = 0.67, P < 0.001) and global strain (CS: r = 0.48, P = 0.007; RS: r = 0.65, P < 0.001; LS: r = 0.65, P < 0.001).

CONCLUSIONSFrequent RVOT-PVCs can induce global and regional left ventricular systolic dysfunction. The reduction of hemodynamic parameters relates to the coupling interval and the global systolic function.

Adult ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Ventricular Function, Left ; physiology ; Ventricular Premature Complexes ; physiopathology

In this paper, wavelet moudulus maxima based multifractal analysis was used to study the multifractal characteristics of the atrial premature beat (APB) signal, the premature ventricular contraction (PVC) signal and normal ECG signal. By analyzing the multifractal spectrum, it was obtained that three kinds of signals had different multifractal strengths. Normal ECG signals had the strongest singularity strength. The PVC beats had the second stronger singularity strength. And the APB beats had the weakest singularity strength. The T test indicated that above-mentioned analysis could disclose significant differences among these three signals. It has meaningful reference for clinical diagnosing and distinguishing with PVC and APB signals.
Atrial Premature Complexes ; diagnosis ; physiopathology ; Electrocardiography ; methods ; Humans ; Signal Processing, Computer-Assisted ; Ventricular Premature Complexes ; diagnosis ; physiopathology ; Wavelet Analysis

In this paper, the multifractal detrended fluctuation analysis method was used to study the multifractal characteristics of atrial premature beat (APB) signals, of premature ventricular contraction (PVC) signals and of normal ECG signals. By analyses of Hurst index, Renyi index and multifractal spectrum, three kinds of signals were noted to have different degrees of long-range correlation and multifractal characteristics. Normal ECG signals had the strongest fractality, the PVC beats had stronger fractality and the APB beats had the weakest fractality. When the fluctuations function order was positive, the three kinds of signals showed distinct long-range correlation properties. These findings are of good reference to diagnosing and distinguishing between PVC and APB signals in clinical medicine.
Atrial Premature Complexes ; diagnosis ; physiopathology ; Diagnosis, Differential ; Electrocardiography ; methods ; Humans ; Signal Processing, Computer-Assisted ; Ventricular Premature Complexes ; diagnosis ; physiopathology

Electrocardiogram (ECG) beat classification is essential for timely diagnosis of serious heart disorders. Premature ventricular contraction (PVC) and atrial premature contraction (APC) are serious threats against human lives. In order to cope with difficulties in diagnosis, a mode entropy based technique is herein proposed to classify normal sinus rhythm (NSR), APC and PVC, As is well known that the accuracy of most methods for detecting NSR, APC, PVC, etc is now between 90% to 98%, but most of them need large data sets. After calculation of the mode entropy value of NSR, PVC and APC, the results were analyzed and compared. The detection method based on the mode entropy technique is proven to be rational and accurate, and it does not need large data sets.
Algorithms ; Atrial Premature Complexes ; diagnosis ; physiopathology ; Diagnosis, Computer-Assisted ; methods ; Electrocardiography ; methods ; Entropy ; Humans ; Signal Processing, Computer-Assisted ; Ventricular Premature Complexes ; diagnosis ; physiopathology

OBJECTIVETo explore the therapeutic effects of amiodarone and metoprolol, either alone or in combination, on chronic heart failure (CHF) complicated by ventricular arrhythmia.

METHODSA total of 110 NYHA class II-III patients with CHF complicated by ventricular arrhythmia were randomly divided into amiodarone group, metoprolol group and amiodarone + metoprolol group. The therapeutic effects was evaluated at the end of the 1-year follow-up.

RESULTSAmiodarone, metoprolol and their combination produced statistically different therapeutic effects (P<0.05). Compared with amiodarone and metoprolol used alone, amiodarone combined with metoprolol resulted in significant cardiac function improvement (P<0.05) and ventricular arrhythmia control (P<0.01). During the 1-year follow-up, the readmission rate and cardiac event rate in the amiodarone + metoprolol group were significantly lower than those in amiodarone group (P<0.01) and metoprolol group (P<0.05). The adverse reaction rates in the 3 groups were similar (P>0.05).

CONCLUSIONThe combination of amiodarone and metoprolol produces better effect than amiodarone or metoprolol alone in the treatment of CHF complicated by ventricular arrhythmia.

Adrenergic beta-Antagonists ; therapeutic use ; Adult ; Amiodarone ; therapeutic use ; Anti-Arrhythmia Agents ; therapeutic use ; Chronic Disease ; Drug Therapy, Combination ; Female ; Heart Failure ; complications ; drug therapy ; physiopathology ; Humans ; Male ; Metoprolol ; therapeutic use ; Tachycardia, Ventricular ; drug therapy ; etiology ; physiopathology ; Treatment Outcome ; Ventricular Premature Complexes ; drug therapy ; etiology

OBJECTIVETo investigate the correlation between heart rate turbulence (HRT) and coronary lesion and the effects of percutaneous transluminal coronary angioplasty (PTCA) on HRT.

METHODSThis study involved 150 patients undergoing 24-hour ambulatory electrocardiography (AECG) and elective coronary angiography (CAG). AECG was monitored on the first day and 7 days after PTCA in 108 patients with positive CAG findings, and the variation of HRT and cardiac functions were observed. The turbulence onset (TO), turbulence slope (TS) and turbulence timing (TT) of each section of HRT were calculated, analyzed and compared.

RESULTSThe values of TO and TT were significantly higher and TS significantly lower in CAG-positive group than in CAG-negative group (P<0.05 or 0.001). Significant difference was found in TO, TS and TT between patients with single and multiple coronary lesions (P<0.05 and 0.001). The values of TO, TS and TT on the first day after PTCA improved significantly in comparison with the those before PTCA in patients with single and multiple coronary lesions (P<0.001). Postoperative follow-up of the patients revealed obviously attenuated HRT in patients with left cardiac insufficiency compared with the patients with normal cardiac function (P<0.05).

CONCLUSIONHRT is correlated to the severity of the coronary lesions and shows significant improvement after PTCA. Cardiac function insufficiency is an important factor affecting the HRT attenuation.

Adult ; Aged ; Angioplasty, Balloon, Coronary ; Arrhythmias, Cardiac ; complications ; Coronary Angiography ; Coronary Artery Disease ; complications ; physiopathology ; therapy ; Electrocardiography, Ambulatory ; Female ; Heart Rate ; physiology ; Humans ; Male ; Middle Aged ; Ventricular Premature Complexes ; complications