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Intramyocardial injection of induced pluripotent stem cells improves left ventricular function and perfusion:a preclinical study in a porcine model of acute myocardial infarction

Intramyocardial injection of induced pluripotent stem cells ...

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中华医学会心电生理和起搏分会第十次全国学术年会

作者： Xiaorong Li,Fengxiang Zhang,Guixian Song,Weijuan Gu,Minglong Chen,Bing Yang,Yingchuan Yan,Linzhong Zhang,Zidun Wang,Daowu Wang,Kejiang Cao The Department of Cardiology,the First Affiliated Hospital of Nanjing Medical University 210029

Objective Induced pluripotent stem(iPS) cells have potential to differentiate to different cardiovascular cells and repair the injured *** potential therapeutic benefits of iPS cells based treatment have been established in small-animal models of myocardial infarction,but it has not been assessed in large animals. Methods Undifferentiated iPS cells or PBS were injected into the ischemic myocardium induced by 90 minutes occlusion of left anterior descending artery in a porcine *** cardiac function, myocardial perfusion,cell differentiation and tumorigenesis were investigated. Results One week after iPS delivery,global left ventricular ejection fraction(LVEF) decreased significantly in both iPS group and PBS group compared with Sham group(P<0.05,respectively).Six weeks after iPS delivery,LVEF of iPS group improved significantly compared with the PBS group(56.68% vs.50.93%,P=0.04) but still lower than Sham ***,the iPS transplantation improved regional perfusion compared with the PBS injection(19.67%vs.13.67%,P=0.02).The infarct area was significantly smaller in iPS group than PBS group(12.04%vs.15.98%P=0.01).iPS cells engrafted into myocardium can differentiated into vessel cells,which result in increased formation of new vessels in infarcted *** tumors were detected in all pigs for any of the major organs after the morphologic and histopathology examination after iPS transplantation. Conclusions This study shows that direct intramyocardial injection of iPS cell can decreases infarct size,improves left ventricular function and perfusion for an immunosuppressed porcine AMI *** cells may have the potential to be used in the treatments of ischemic heart diseases.

关键词： Intramyocardial injection of induced pluripotent stem cells improves left ventricular function and perfusion:a preclinical study in a porcine model of acute myocardial infarction

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A novel mutant atrial natriuretic peptide facilitates atrial fibrillation inducibility by activating intrinsic cardiac autonomic nervous system

A novel mutant atrial natriuretic peptide facilitates atrial...

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中华医学会心电生理和起搏分会第十次全国学术年会

作者： Gang Wu,Xiang Ren,Lilei Yu,He Huang,Wenbo He,Bo He,Hong Jiang, congxin Huang1 Department of Cardiology,Renmin Hospital of Wuhan University 430060

Objective There is increasing evidence that intrinsic cardiac autonomic nervous system(ICANS) and mutant atrial natriuretic peptide(m-ANP) contribute to the pathogenesis of atrial fibrillation(AF). However the interaction between m-ANP and ICANS remains *** the previous study,we have identified a novel mutation p.I138T substitution in ANP in Chinese lone AF *** present study was aimed to investigate the effects of the m-ANP on AF inducibility and ICANS in comparison with wild-type-ANP(w-ANP). Methods In a total of 18 adult mongrel dogs,a right thoracotomy was performed to expose the *** electrode catheters were sutured to the right atrial appendage(RAA),right atrium(RA), right anterior pulmonary vein(RSPV),and right inferior pulmonary vein(RTPV) to allow recording and *** refractory period(ERP),window of vulnerability(WOV),AF threshold and ARGP function(evaluated by the sinus rate slowing responses to high frequency stimulation) were determined before and after m-ANP/w-ANP injection. Results①Both ANP and m-ANP injection caused ERP decreases at all sites and increases in ***,there was a greater decrease in ERP at all sites and an overall greater increase in WOV (25.0±5.0%vs.15.0±4.0%,P<0.05) with m-ANP injection compared to w-ANP *** was no significant change in ERP and WOV in the control group.②There were significantly greater decreases of AF-TH at all sites in m-ANP group compared to w-ANP ***-TH at all sites showed no significant difference in the control group.③There was an overall greater and more sustained decrease in sinus rate slowing with m-ANP compared to *** m-ANP injection,GP stimulation at 35V could cause sinus rate to decrease by more than 50%. Conclusions The mutation of p.I138T in atrial natriuretic peptide facilitates AF inducibility at least in part by activating the intrinsic cardiac autonomic nervous system.

关键词： ERP A novel mutant atrial natriuretic peptide facilitates atrial fibrillation inducibility by activating intrinsic cardiac autonomic nervous system

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Mapping and isolation of pulmonary veins using a novel cryoballoon technique:short-and mid-term outcomes

Mapping and isolation of pulmonary veins using a novel cryob...

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中华医学会心电生理和起搏分会第十次全国学术年会

作者： Jin-Hong Gerds-Li Eckard Fleck artment of Internal Medicine/Cardiology German Heart Institute BerlinBerlinGermany

Objective To investigate the feasibility and efficacy of a simplified cryoballoon technique in which a microcircular mapping guide wire is was introduced into the central lumen of the cryoballoon catheter to record real time PV potentials during and after cryoablation without interchanging or exchanging catheters. Methods and Results 52 patients(aged 60±11 years) with symptomatic atrial fibrillation(AF),of them 41 cases with paroxysmal AF and 11 cases with persistent AF were enrolled.A single transseptal puncture was made and a 28-mm cryoballoon catheter(Arctic Front,Medtronic,AF Solutions) was inserted through a steerable sheath(FlexCath,Medtronic,AF Solutions) into the left atrium.A mapping catheter(6-pole or 10-pole) with a 0.035-inch shaft diameter(ProMAP,ProRhythm Inc.) was introduced into the PV through the central lumen of the cryoballoon catheter serving as a recording tool and a "guide-wire." A three-dimensional reconstruction atriography(3D-ATG) of left atrium(LA) and PVs was obtained based on rotational angiography(3D-RA) during the procedure.A total of 184 PVs (184/208,88.5%) were completely isolated using this novel cryoballoon *** total procedural time was 157.8±42.6 minutes;the fluoroscopy time was 36.6±14.2 *** cryoablation time was 38.9±13.8 minutes per *** follow-up(mean 12±8 months,range 3-39 months),49(94.2%) patients had significantly improved symptoms or were entirely asymptomatic and 31(59.6%) patients were free from atrial *** was one occurrence of phrenic nerve palsy during the cryoablation in the right superior pulmonary vein,which fully recovered after three months. Conclusion The use of a single cryoballoon catheter in combination with a 6-pole(or 10-pole) micromapping catheter inserted through the central lumen and visually guided via a 3D-ATG during mapping and ablation appears to be safe and *** and validation of the targeted PVI can be performed simultaneously and allows PVI to

关键词： Mapping and isolation of pulmonary veins using a novel cryoballoon technique:short-and mid-term outcomes

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Increased ventricular repolarization dynamicity in patients with hyperthyroidism

Increased ventricular repolarization dynamicity in patients ...

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中华医学会心电生理和起搏分会第十次全国学术年会

作者： Mingwei Bao Renmin Hospital of Wuhan University 430060

Objective It is well known that thyroid hormone exerts profound effects on *** analysis provides a promising tool for evaluating the heart rate variability(HRV) and repolarization dynamicity, which have shown value in predicting ventricular arrhythmias and sudden death in patients with heart failure,cardiomyopathy,or myocardial *** HRV has been reported in hyperthyroidism patients ***,ventricular repolarization dynamicity is rarely studied in those *** hypothesis is that thyroid hormone affects ventricular repolarization dynamicity in hyperthyroidism patients. Methods The RR,start of Q wave to T wave apex(QTa),start of Q wave to T wave end(QTe) interval were measured using utomated measurement software(MARS 7.2,GE Company,USA) in holter recordings f 29 patients with hyperthyroidism(age 27.6±7.7ys) and age-,sex-matched ontrols(n=30,age 29.4±5.8ys).HRV was assessed by measuring standard eviation of normal RR intervals(SDNN),very low frequency(VLF),low requency(LF),high frequency(HF),and total power(TP).The repolarization dynamicity index considered was:the slope of the regression line between QT and RR intervals during 24 hours. Results No ventricular arrhythmia was observed in all hyperthyroidism patients and controls. Comparing with controls,QTe/RR slope(0.284±0.122 vs 0.169±0.032,P<0.05) and QTp/RR slope (0.299±0.120 vs 0.179±0.033,P<0.05) were significantly higher in hyperthyroidism *** [(77.6±20.5) ms vs(136.2±17.8) ms,P<0.05],VLF[(15.7±6.6) ms vs(29.9±4.9) ms,P<0.05], LF[(8.8±4.3) ms vs(21.8±6.0) ms,P<0.05],HF[(6.5±3.9) ms vs(17.1±6.4) ms,.P<0.05),and TP[(20.1±8.6) ms vs(41.5±9.7) ms,P<0.05]were significantly lower in hyperthyroidism patients. Conclusions In conclusion,higher QT/RR slope indicates that thyroid hormone docs not shorten QT correspondingly with shortening of RR,especially when heart rate is relatively *** in patients with dilated cardiomyopathy or heart failure,higher QT/RR slope and

关键词： Increased ventricular repolarization dynamicity in patients with hyperthyroidism

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Analysis of SCN5A mutation and antiarrhythmic drug in Chinese patients with short QT syndrome

Analysis of SCN5A mutation and antiarrhythmic drug in Chines...

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中华医学会心电生理和起搏分会第十次全国学术年会

作者： Ramon Brugada Cardiology Department the Second Affiliated Hospital of Nanchang University

Objective We present,for the first time,that loss-of-function mutations in the SCN5A gene encoding for the strong depolarization channel Nav1.5 contribute to SQTS. Methods and Results We recruited nine probands having QTc≤370 ms and no acquired causes of abbreviated QT *** mutations in previously known SQTS genes were identified in DNA screening of these ***,two individuals were found to have one of the following heterozygous missense mutations in SCN5A:E428G（c.l283A>G） and V1951L（c.5851G>T）.Both individuals displayed short QT intervals（QTc:270 ms and 347 ms）,a high predisposition to sudden cardiac death,and no underlying structural heart disease consistent with the robust phenotype of SQTS.A co-inherited synonymous polymorphism S1653S（c.4959C>A） in SCN5Awas found in V1951Lcarriers. Whole-cell patch clamp analysis of HEK 293 cells expressing a mutated channel showed that E428Gproduced significant reduction of I density,indicating a loss-of-function.I in cells expressing V1951Lor S1653S alone was not statistically different from that of wild-type（WT）.However, co-expression of V1951Lwith S1653S in Nav1.5 produced a significant reduction of I density, indicating a *** data suggest that the S1653S synonymous polymorphism has a noteworthy synergistic modulatory effect on the biophysical function of the V1951Lmutation and acts as a genetic modifier of *** peak I of the E428Gchannel in vitro was increased significantly in the presence of propafenone（30μM）,whereas there was no effect of amiodarone（50μM） or mexiletine（50μM）. Conclusion This is the first study to show that loss-of-function mutations in the SCN5A gene contribute to SQTS and cause a new variant of *** synonymous polymorphism S1653S in the SCN5Agene significantly modifies the biophysical function of the V1951Limitation and causes loss-of-function in *** is a drug with the potential to treat SQTS caused by the E428Gmutation.

关键词： SCN Analysis of SCN5A mutation and antiarrhythmic drug in Chinese patients with short QT syndrome

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Catheter ablation for atrial fibrillation:comparison between multielectrode catheter and cryoballoon ablation with real-time recordings from the pulmonaryveins-short-and mid-term outcomes

Catheter ablation for atrial fibrillation:comparison between...

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中华医学会心电生理和起搏分会第十次全国学术年会

作者： Jin-hong Gerds-li Eckard Fleck Department of Cardiology First Affiliated Hospital of Jinan University Department of Internal Medicine/Cardiology German Heart Institute BerlinBerlinGermay

Objective To compare the efficacy,safety of atrial fibrillation ablation using PVAC device and simplified cryoballoon catheter via three-dimensional rotational angiography(3D-RTA). Methods 98 patients with symptomatic,medically refractory AF were recruited.52 patients underwent simplified cryoablation and 46 patients underwent PVAC *** age was 60±11 years for patients underwent cryoablation and 62±11 years for patients underwent PVAC ablation(P=NS). Results Mean procedural and fluoroscopic times were 157.8±42.6 minutes and 36.6±14.2 minutes respectively for cryoablation,and 125.2±28.7 minutes and 30.5±11.3 minutes respectively for PVAC ablation(P<0.05).184/208(88.5%) PVs of patients underwent cryoablation and 175/184(95.1%) PVs of patients underwent PVAC ablation were isolated(P=0.018).One case of transient PNP was observed in patients underwent cryoablation,one case of air embolism and two cases of mild pericardial effusions were detected in patients underwent PVAC ablation(1.9%vs.6.5%,P=0.034).No incidence of PV stenosis was observed during the follow-up checks in all *** follow-up was 10±7 months (3-39months).74.5%patients reported significantly improved symptoms or were entirely asymptomatic, and no significant difference between patients in both groups.31/52(59.6%) patients undergoing cryoablation and 31/46(67.4%) patients undergoing PVAC ablation were re(?)ed free from AF at the end of follow-up(P=NS). Conclusion Both achiev(?) acute and short-tern efficacy rates,with relatively lower success *** both also achieved low(?) procedural time and(?) roscc py *** rates of complications are relatively low in both techniqu(?)(1.9%in cryoballo(?) technique and 6.5%in PVAC technique, respectively.P=0.034),include transient PNP and air *** with cryoballoon technique, PVAC technique achieved even lower procedural time and fluoroscopy time,but higher acute efficacy rate and complication *** technique was more conv

关键词： Catheter ablation for atrial fibrillation:comparison between multielectrode catheter and cryoballoon ablation with real-time recordings from the pulmonaryveins-short-and mid-term outcomes

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Impact of right ventricular septal pacing on cardiac function and cardiac remodeling

Impact of right ventricular septal pacing on cardiac functio...

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中华医学会心电生理和起搏分会第十次全国学术年会

作者： Nan Wang,YanzongYang,Yingxue Dong,Lianjun Gao,Shulong Zhang,Yunlong Xia,Yingqi Wang, Xiaomeng Yin,DongChang The First Affiliated Hospital of Dalian Medical University 116000

Objective This study was aimed to investigate the impact of the different right ventricular pacing sites on cardiac remodeling and cardiac function and choose the favorite pacing site. Methods Patients with the third degree atrioventricular block(Ⅲ°AVB) or sick sinus syndrome (SSS) were selected in our hospital from January 2008 to December *** patients received their first dual chamber pacemaker(DDD).Exclusion criteria:myocardial infarction and persistent atrial fibrillation before pacemaker *** firstly tried y to plant the lead in the right ventricular septum(RVS).The RVS group was further subdivided into three sub-groups,high,medium and low *** RVS lead positioning can not be successfully achieved,we put the lead in the right ventricular apex(RVA).The pacemaker programming performed every three months at the specialist out-patient department and Echocardiography was performed every year to evaluate heart function and structure remodeling. Results Total 68 patients met the inclusion criteria,among them,30 patients withⅢ°AVB and 38 patients with *** implantation,the RVA(21 patients) and RVS(47 patients) group had no difference in clinical features *** the following up(14.0±9.2 vs.20.6±5.8m) there were no significant differences in LVEF(left ventricular ejection fraction)(57.25±1.5 vs 62.0±4.6%, P=0.09),LV end-diastolic diameter(LVEDD)(46.3±5.7 vs.45.8±1.7ms,P=0.87),left atrial diameter (LAD)(38.0±3.4 vs.36.0±4.2mm,P=0.47),right ventricular diameter(RVD)(19.0±0.8 vs.18.0±2.0mm, P=0.38),septal thickness(SEP)(10.5±1.9 vs.11.0±1.8mm,P=0.80) and left ventricular posterior wall thickness(LV POST WALL)(10.3±1.5 vs.10.5±1.5mm,P=0.68) between RVA and *** RVS subgroup results show that,-LVEF in high septal subgroup(13 patients) was significantly higher than that in the low pacing group(14 patients)(66.0±1.4 vs.62.0±4.2%,P=0.04);high septal subgroup was significantly higher than that in the medium pacing group(20 patients)(66

关键词： Impact of right ventricular septal pacing on cardiac function and cardiac remodeling

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The effects of Shen Song Yang Xin Jiao Nang on heart rate turbulence and heart rate variation in patients with chronic heart failure

The effects of Shen Song Yang Xin Jiao Nang on heart rate tu...

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中华医学会心电生理和起搏分会第十次全国学术年会

作者： Zhen Yang,Shaobin Jia,Xuezhong Wang,Yong Sha,Zhijun Liu,Weina Guo Heart Center,the General Hospital of Ningxia Medical University 750000

Objective To study the antiarrhythmic effects of Shen Song Yang Xin Jiao Nang,atraditional Chinese medicine,as detected by heart rate variation(HRV) and heart rate turbulence(HRT),in patients with chronic heart failure(CHF). Methods Sixty-six CHF patients,with the inclusion criterion of aged>18 years old and let ventricular ejection fraction(LVEF)<0.40,were randomly assigned to the study group(n=32),whic-h were given 4.8g of Shen Song Yang Xin Jiao Nang daily in three divided doses in addition to standard medicine therapy,or the control group(n=34),which were treated only with standard medicine therapy without Shen Song Yang Xin Jiao *** mean time of follow-up was 3 *** and after three months of treatment,continuous ECG monitoring,echocardiography,HRT and HRV were calculated,and clinical end points including all cause mortality,ventricular tachyc-ardia ventricular fibrillation,were recorded. Results After treatment,HR and TO significantly decreased in both groups(P<0.05),and T-S, sNN50 total,pNN50,SDNN,SDNNI,rMSDD,LF,LF/HF significantly increased(P<0.05),while SDANN and HF significantly increased in study group(P<0.05),yet there was no statistically s-ignificant difference in SDANN and HF in control group between before and after treatment(P>0.05). Aftertreatment,there were statistically significant difference in the changes of HR,TO,TS,sNN50 total, pNN50,SDNN,SDNNI,SDANN,LF,HF between two groups(P<0.05),whist the difference in rMSDD and LF/HF between two groups appeared to be insignificant(P>0.05).The occurrence rates of ventricular tachycardia and proxysmal atrial fibrillation in study group were significantly lower than those in control group(P<0.05)。Conclusion Shen Song Yang Xin Jiao Nang can improve the impaired HRT in patients with CHF, which might be one of its anti-arrhythmic mechanisms.

关键词： HRT SDANN The effects of Shen Song Yang Xin Jiao Nang on heart rate turbulence and heart rate variation in patients with chronic heart failure

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Cardiac contractility modulation via CRT lead system in CRT patients

Cardiac contractility modulation via CRT lead system in CRT ...

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中华医学会心电生理和起搏分会第十次全国学术年会

作者： FarongShen,Xiaohong Zhou,Yuanwei Liu,Hongfeng Jin,Gong Chen, Zhejiang Hospital 310000

Objective Cardiac synchronization therapy（CRT） can improve mechanical function of right and left ventricles（RV,LV） in patients（pts） with heart failure（HF）.However,up to 30%pts with CRT failed to clinically *** of CRT remains a major challenge in the device HF *** present study was to investigate whether electrical cardiac contractility modulation（CCM） on top of CRT therapy would provide additional LV mechanical improvement. Methods Five ptsreceiving CRT or CRT-D were enrolled（LVEF:29.8±5.6%,QRS width: 170±22.4ms,NYHA:3±0,and all with beta-blocker）.After the lead system was placed in RV and LV lateral or posterior-lateral vein for CRT,the CRT lead system was connected to an EP stimulator for acutely delivering *** LV pressure catheter was introduced into the LV chamber for pressure *** LV pressure and its dp/dt were offline *** CCM consisting of three electrical pulses（8V,5 msec/pulse,10 msec inter-pulse interval） was delivered during the LV absolutely refractory period with 30 msec between CRT BiV pacing（BiV） and CCM first *** CCM was delivered in eitherLValone orLVand RV *** test was designed as the BiV alone and BiV plus CCM （BiV+CCM） for each cardiac beat. Results A total of 13 BiV+CCM tests were performed in5 *** LV dp/dt was 1896±389 mmHg/sec during BiV and 2072±369 mmHg/sec during BiV+CCM which significantly increased dp/dtby 11±18%（P=0.05）.Of 13 CCM tests,10 BiV+CCM tests were positive with the dp/dW increased by 16±17%over that during BiV only（P=0.007） while 3 tests were negative with the dp/dt decreased by -6±6%compared to BiV only（P=0.115）.There were no significant difference in LV pressure between BiV and BiV+CCM（systolic:129±23 vs.132±23 mmHg,P=0.258;diastolic:14±12 vs. 14±13 mm Hg,P=0.699）. Conclusions The prior studies using the traditional CCM in RV septum moderately improveds LV mechanical *** study demonstrated that CCM,when delivered through the CRT lead system, can

关键词： CRT Cardiac contractility modulation via CRT lead system in CRT patients CCM

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Analysis of risk factors of atrial fibrillation after pacemaker implantation

Analysis of risk factors of atrial fibrillation after pacema...

引用

中华医学会心电生理和起搏分会第十次全国学术年会

作者： Nan Wang,Yingxue Dong,Lianjun Gao,Shulong Zhang,Yunlong Xia, Xiaomeng Yin,Dong Chang,Yanzong Yang The First Affiliated Hospital of Dalian Medical University 116000

Objective Many patients post pacemaker implantation developed into atrial fibrillation (AF).The factors that can lead a greater risk of AF post implantation from different researches are *** the first domestic research in long-term follow-up,we aim to investigate the risk factors of atrial fibrillation(AF)after pacemaker implantation. Methods Retrospectivel reviewed the clinical events and follow-up datas of 99 patients who accepted pacemaker implantation between January,1991 and January,2003 in our *** use univariate logistic regression analysis to evaluate the effects of coronary heart disease,hypertension, mitral regurgitation,LVEDD,LAD,LVEF,types of arrhythmia,pacemaker types,age and follow-up period in atrial fibrillation and then find the leading risk factors from multivariate logistic regression analysis. Results Totally 99 patients enter this research:male 48/99(48.48%),the average age 61.10±12.42y, SSS 49/99(49.49%),coronary heart disease 10/99(10.10%),hypertension 31/99(31.31%),diabetes mellitus 8/99(8.08%),DDD 51/99(51.52%),VVI 48/99(48.48%),average follow-up period is 109.48±*** of atrial fibrillation is 29.3%(29/99).The univariate logistic regression analysis showed that coronary heart disease(P=0.034,OR=4.304,95%CI 1.114-16.624), LVEDD(P=0.021,OR=1.119,95%CI 1.017-1.232),LAD(P=0.016,OR=1.117,95%CI 1.021-1.221), RAD(P=0.043,OR=1.174,95%CI 1.005-1.371),LEVF(P=0.003,OR=0.894,95%CI 0.817-0.996)are related to the occurrence of AF after pacemaker implantation,while the multivariate logistic regression analysis showed that only the LVEF is related to the occurrence of AF after pacemaker implantation(P=0.028,OR=0.895,95%CI 0.810-0.985). Conclusions Compared with other middle-term studies(follow-up l-3y) that suggesting VVI mode tending to AF,our long-term follow-up datas reveal that the impaird LVEF is a predictor for postimplantation AF.

关键词： Analysis of risk factors of atrial fibrillation after pacemaker implantation

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