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Progress in relationship between pacemaker current and atrial fibrillation

Progress in relationship between pacemaker current and atria...

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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： Juan Wang,Yanmin Yang Emergency Department,Cardiovascular Institute and Fuwai Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College 100037

Objective The pacemaker current(abbreviated as 'If) is the major current in the action potential phase 4 auto-depolarization process,It played a key role in the formation and maintenance of heart rhythmAtrial fibrillation is the most common arrhythmia in clinic,and the pathogenesis of atrial fibrillation was *** conducted a review to understand the relationship between the pacemaker current and atrial fibrillation. Methods A systematic search of electronic databases(PubMed,EMBASE,Google Scholar) for studies published from 1970 to March 2012 was ***,animal studies that related to the pacemaker current on the mechanism of the atrial fibrillation were included. Results The pacemaker current was coded by the hyperpolarization-activatid cyclic mucleotide cation gated channels(HCN)gene *** far,it was known four members in HCN family:HCN1-4,and HCN1,2,4 were the major types expressed in the mammalian *** clinic researches have shown that the the messenger ribonucleic acid(mRNA) of HCNs in the atrial tissue of atrial fibrillation patients was increased,indicated that the overexpress of HCN gene may regulate the generation of atrial *** animal model of paroxysmal atrial fibrillation experiments also suggest that the pacemaker current may lead to the increase of the pulmonary vein(PV) sleeves ectopic self-regulation,and involve in the start mechanism of atrial *** studies demonstrated that ivabradine(an If blocker)decreased the spontaneous activity in PVcardiomyocytes through an inhibition of the If,which may imply the potential use for treating atrial fibrillation. Conclusions The pacemakter current may involve in the genesis and maintain of atrial ***,the exact mechanism of the occurrence and development of the pacemaker current in atrial fibrillation is still need for further researches to confirm.

关键词： HCN Progress in relationship between pacemaker current and atrial fibrillation

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Time course of current of injury is related to acute stability of active-fixation lead in rabbits

Time course of current of injury is related to acute stabili...

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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： Shalai Mai,Tisha Li,Entao Liu,Linjia,Ruiming Yao,Yangang Su,Junbo Ge Department of Cardiology,ZhongShan Hospital of Fudan University,Shanghai,320021

Background Magnitude of current of injury(COI) consequent to pacemaker lead fixation is recognized as predictor of acute lead *** is unclear whether dynamic monitoring of COI after fixation provides additional information beyond single assessment performed at the time of fixation. Objective The aim of this study was to test the hypothesis that the time course of COI is related to acute lead stability. Methods An active fixation lead with fixed screw was anchored to either endocardium of langendorff-perfused rabbit hearts or epicardium of in vivo hearts in manners of contacting the helix with no rotation,half rotation and fully rotation,*** electrogram(EGM) were monitored dynamically from onset to resolution of COI and the magnitude of intrinsic R wave and COI,including ST segment elevation,ST/R and intracardiac EGM duration(IED) were *** digital force gauge was applied to assess lead stability. Results The time course of COI in vitro was significantly longer in the fully rotated leads than half rotated and contacted leads(24.82±3.85 vs.5.25±2.08 and 1.60±1.33 ms,P<0.05) and significantly in half rotated leads than contacted leads(P<0.05).Similar findings were observed in *** time course of COI was significantly correlated with acute lead stability(r=0.81,P<0.001) and so were the dynamic values of ST segment elevation and ST/R. Conclusions Acute lead stability of active-fixation leads was associated not only with the magnitude but also with the time course of COL

关键词： EGM Time course of current of injury is related to acute stability of active-fixation lead in rabbits

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Omega-3 fatty acids for the prevention of atrial fibrillation:a meta-analysis

Omega-3 fatty acids for the prevention of atrial fibrillatio...

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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： Min Huang,Renqiang Yang,Kui Hong,Xiaoshu Cheng Department of Cardiology,Second Affiliated Hospital of Nanchang University 330000

Objectives Experimental animal studies suggest that omega-3 fatty acids（n-3 PUFAs） may reduce the risk of atrial fibrillation（AF）.However,randomized controlled trials（RCTs） have yielded conflicting *** performed a meta-analysis of all RCTs to assess the role of n-3 PUFA in AF prevention. Methods We systematically searched electronic databases including PubMed MEDLINE, EMBASE,CBM and Cochrane Library for RCTs that reported the effects of n-3 PUFAs on the prevention of AF. Results Seven studies for primary prevention and 6 studies for secondary prevention were included in our *** primary prevention of postoperative AF after cardiac surgery,there was significant heterogeneity among the studies（p=0.07,I=49%）.Subgroup analysis showed n-3 PUFAs therapy was associated with a significant decrease in the risk of postoperative AF after isolated coronary artery bypass grafting（CABG）(RR 0.65,95%CI 0.49 to 0.88;P=0.005).For secondary prevention of AF recurrence after direct current electrical cardioversion（ECV） of persistent AF,there was also significant heterogeneity among the studies（p=0.07,I=52%）.In the subgroup analysis stratified by intervention duration（6 months vs.12 months）,6-month n-3 PUFAs supplementation was not associated with a reduction in AF recurrence（P=0.44）,whereas 12-month n-3 PUFAs administration significantly reduced the recurrence of AF（RR 0.77,95%CI 0.68 to 0.87;P<0.0001）. Conclusions This study suggests n-3 PUFAs supplementation may exert beneficial effects on the prevention of AF

关键词： Omega-3 fatty acids for the prevention of atrial fibrillation:a meta-analysis

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循环血二氧化碳水平升高延长心脏动作电位时限并在复极储备降低的心脏诱发尖端扭转性室性心动过速和猝死

循环血二氧化碳水平升高延长心脏动作电位时限并在复极储备降低的...

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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：吴林丁燕生霍勇贺鹏康北京大学第一医院心内科

目的通气不足造成的全身循环血二氧化碳水平增高是临床最常见的病理情况,心肌缺血时局部心肌CO水平可达正常的4倍以上;婴儿猝死综合征和阻塞性睡眠呼吸暂停综合征患者存在呼吸道梗阻,心律失常和猝死发生率高,特别当同时存在钠通道基因... 详细信息

目的通气不足造成的全身循环血二氧化碳水平增高是临床最常见的病理情况,心肌缺血时局部心肌CO水平可达正常的4倍以上;婴儿猝死综合征和阻塞性睡眠呼吸暂停综合征患者存在呼吸道梗阻,心律失常和猝死发生率高,特别当同时存在钠通道基因多型性时,CO的作用未明。本研究的目的在证明循环血CO增高本身可独立的增加心肌复极异常及诱发恶性室性心律失常,特别在合并复极储备降低的心脏,其机制与CO增高导致心肌细胞延迟钠电流的增大有关。方法选择雌性新西兰大耳白兔整体心脏记录多导联单相动作电位和心电图;全细胞膜片钳记录单个心肌细胞离子电流,特别是延迟钠电流。结果细胞外灌流液CO从正常的5%增加到10和20%时（相当于动脉血P CO分别在35,71和144 mm Hg）,血pH值从7.4下降到7.1和6.8,心室肌单相动作电位时限(MAPD)和MAPD的逐搏变异性分别从（174±3）ms增加到（185±3）ms和（195±1）ms（n=6,P<0.01）及从（0.23±0.02）ms增加到（0.34±0.01）ms和（0.38±0.01）ms（n=4,P<0.01）。在低剂量延迟钠电流阻断剂ATX-Ⅱ或钾电流阻断剂E-4031处理过的心脏,复极储备下降。在复极储备下降的心脏,增加循环CO2浓度到10和20%之后,MAPD延长幅度增大,而且分别在50%和33%的心脏诱发了尖端扭转性室性心动过速（TdP）。作为对照,采用完全无CO的PIPES缓冲液,单纯pH值从7.4与下降到上述水平的7.1和6.8时,则不会诱发复极异常且无TdP发生,提示不是单纯细胞外酸中毒,而是循环血二氧化碳水平升高引起细胞复极异常及心律失常。在分离的单个心肌细胞。当细胞外液CO2从5%增加到10%和20%时,延迟钠电流从-0.28±0.07 pA/pF增加到-0.85±0.17和-1.66±0.08 pA/pF（n=7,P<0.01）,同时存在钾电流降低,提示二氧化碳具有离子通道活性,可降低心脏复极的储备。结论循环血CO增加到呼吸衰竭和中毒水平可独立的导致离子通道改变和心脏复极异常,或与其他因素发生协同作用而增加恶性室性心律失常如尖端扭转性室性心动过速和心脏性猝死的可能性。本研究结果可解释多种疾病,如婴儿猝死综合征和阻塞性睡眠呼吸暂停综合征等患者合并的心律失常及猝死发生的可能的新机制。

关键词：尖端扭转性室性心动过速复极储备循环血心肌细胞钠电流动作电位二氧化碳

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Effects of doxycycline on Cx43 distribution and cardiac arrhythmia susceptibility of rats after myocardial infarction

Effects of doxycycline on Cx43 distribution and cardiac arrh...

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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： Hongjun Zhu1,Xu Wu 1,Ji Yan 1,Jian Xu 1,Min Cheng 1 1.Department of Cardiology,Anhui Provincial Hospital 2.University of Science and Technology of China 3.University of Science and Technology of China 430060

Objective This study aims to observe the effects of doxycycline on gap junction remodeling after MI and the susceptibility of rats to cardiac arrhythmia. Methods The proximal left anterior descending coronary artery of rats was ligated to establish a myocardial infarction animal ***,methylpredmsolone(MP),or vehicle was intraperitoneally injected into the animals for two ***,the heart size and heart function of all animals were determined through *** experimental animals were sacrificed after the electrophysiologic *** tissues were sampled to analyze the distribution of Cx43 using immunofluorescence;the Cx43 content was analyzed using western blot analysis;and the MMP-2 and MMP-9 activity in the myocardium was analyzed using gelatin zymography. Results The distribution of Cx43 in the border of the infarcted myocardia in the MI and MP groups was clearly disrupted and the Cx43 content was significantly *** addition,the distribution of Cx43 inthe border of the infarct in the DOX group was relatively regular,whereas two weeks of DOX treatment significantly inhibited MMP ***,the induction rate of arrhythmia in the rats after DOX treatment was lower than those in the MI and MP groups. Conclusions The results show that DOX treatment after myocardial infarction improves gap junction remodeling in the myocardial tissue near the infarcted area by inhibiting MMP activity and reducing susceptibility to cardiac arrhythmia.

关键词： Effects of doxycycline on Cx43 distribution and cardiac arrhythmia susceptibility of rats after myocardial infarction

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Comparisons of different radiofrequency ablation approaches for persistent atrial fibrillation:atrial fibrillation clinical trial in China

Comparisons of different radiofrequency ablation approaches ...

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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,He Huang,Bo Yang,Hong Jiang,Congxin Huang Department of Cardiology,Renmin Hospital of Wuhan University 430060

Objective Several techniques based on circumferential pulmonary vein isolation(CPVI) have been successfully used in persistent atrial fibrillation(AF),but have not been adequately compared. Methods and Results This study included 315 patients registered in the Atrial Fibrillation Clinical Trial(AFCT) in *** patients had persistent AF and received CPVI,CPVI plus linear lesion(LL), or CPVI combined with ablation of complex fragmented atrial electrograms(CFAEs).Follow-up was conducted at 3,6 and 12 months after *** three protocols did not differ in efficacy at 3 months. At the 1-year follow-up,however,CPVI was inferior to CPVI + LL or CPVI + CFAEs(62.5%sinus rhythm vs.75.6%and 73.8%).CPVI + LL and CPVI + CFAEs were comparable to each *** three treatments increased left ventricle ejection fraction(EF),but did not affect left atrial diameter(LAD) or left ventricular end diastolic diameter(LVEDD).LL and ablation of CFAEs increased the total time of the procedure and the time of radiofrequency applications,but did not increase the time of *** patient in the CPVI arm had cardiac tamponade after ablation;there were no severe complications in any of the other groups. Conclusions CPVI combined with LL or CFAEs is superior to CPVI alone in maintaining sinus rhythm and is comparable in safety profile,but the benefits taked more than 6 months to *** significant difference can be detected between CPVI + LL and CPVI + CFAEs for at least 1 year after follow-up.

关键词： Comparisons of different radiofrequency ablation approaches for persistent atrial fibrillation:atrial fibrillation clinical trial in China

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Inhibition of phosphoinositide 3-kinase suppresses the transforming grouth factor-pi-induced transformation of cardiac fibroblast

Inhibition of phosphoinositide 3-kinase suppresses the trans...

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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： Yuchuan Wang1,Lianjun Lin1,Yansheng Ding2,Meilin Liu1 1.Department of Geriatrics 2.Department of Cardiology,The First Hospital of peking University 100000

Objective Phosphoinositide 3-kinasc(PI3K) has been shown to promot the transforming grouth factor(TGF)- β1-induced fibrogenesis in the lungs,liver and ***,in the heart it remains unkowni whether PI3K promots or inhibits TGF- β1-induced cardiac *** this study,LY294002, a specific PI3K inhibitor,was used to inhibit PI3K and the phenotypic transformation and extracellular matrix synthesis of cardiac fibroblasts were *** addition,the effect of PI3K inhibition on TGF- β1-induced Smad2/3 phosphorylation was evaluated in cultured cardiac fibroblasts. Methods Cardiac fibroblasts were isolated from neonatal rat ***294002 was used to inhibit PI3K. Results TGF- β1 increased a-smooth muscle actin expression,the synthesis of fibroncctin and Smad2/3 phosphorylation in the cardiac *** with LY294002 reduced the a-smooth muscle actin expression,the synthesis of fibronectin and Smad2/3 phosphorylation in cardiac fibroblasts treated with TGF- β1. Conclusions PI3K played a vital role in TGF- β1-induced a-smooth muscle actin expression,the synthesis of fibronectin and Smad2/3 phosphorylation of cardiac fibroblasts..Inhibition of PI3K may be a therapeutic target in preventing cardiac fibrogenesis.

关键词： Inhibition of phosphoinositide 3-kinase suppresses the transforming grouth factor-pi-induced transformation of cardiac fibroblast TGF

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Left ventricular 12 segmental strain imaging predicts response to cardiac resynchronization therapy

Left ventricular 12 segmental strain imaging predicts respon...

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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： Jae K Oh Department of Medicine Mayo Clinic College ofMedicineRochesterMinnesotaUSA

Objective Non-response to cardiac resynchronization therapy(CRT) exposed the need for better patient selection criteria for *** study aimed to identify favorable echocardiographic parameters in improving response to CRT. Methods 45 consecutive patients receiving CRT-D implantation for heart failure(HF) were included in this prospective *** class,6-minute walk distance,electrograph character and multi echocardiographic parameters especially in strain patterns were measured and compared before and 6 month after CRT in responder and non-responder *** to CRT was defined as a decrease in LVESV of 15%or more at 6 month follow up. Results 22(48.9%) patients demonstrated response to CRT at 6 month *** improvement in NYHA class(P<0.01),left ventricular diastolic volume(LVEDV)(P<0.01),6-minute walk distance(P<0.01) were shown in this *** the interventricular mechanical delay determined by the difference between left and right ventricular preejection intervals(42.87±19.64 vs 29.43±18.19ms,P=0.02),the standard deviation of time to peak myocardial strain among 12 basal,mid and apical segments(Tε-SD)(119.97±43.32 vs 86.62±36.86ms,P=0.01) and the non-ischemic etiology (P=0.03) were significantly higher in responders than non-responders,only the Te-SD(OR=1.02,95% CI=1.01-1.04,P=0.02) proved to be a favorable predictor of CRT response after multivariate logistic regression analysis. Conclusion The left ventricular 12 segmental strain imaging is a promising and facilitated echocardiographic parameter in predicting CRT response.

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Impact of the metabolic syndrome on left atrial size in patients with non-vavular atrial fibrillation

Impact of the metabolic syndrome on left atrial size in pati...

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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： Tong Liu,Meijia Li,Gang Xu,Ruyu Yuan,Guangping Li Department of Cardiology,Second Hospital of Tianjin Medical University 300000

Objective To investigate the impact of the metabolic syndrome(MS) on left atrial diameter (LAD) in patients with non-valvular atrial fibrillation(NVAF). Methods A total of 123 patients with NVAF(paroxysmal AF=61,persistent AF=62) were divided into LA enlargement group(LA≥35mm,n=97) and normal LA group(LA<35mm,n=26) according the LAD assessed by 2-dimensional *** have excluded patients with coronary heart disease,valvular heart disease,congenital heart disease,cardiomyopathy and thyroid dysfunction The baseline characteristics,the incidence of metabolic syndrome,diabetes,hypertension,glucose level,lipid parameters,echocardiogram were recorded clearly. Results The prevalence of MS in LA enlargement group was significantly higher than that in normal LA group(72.9%vs 46.2%,P<0.01).There were significant differences in age,AF type, hypertension,MS,body mass index,serum creatinine and uric acid level,left ventricular end-diastolic diameter(LVEDD),inter-ventricular septum thickness(IVST),left ventricular ejection fraction(LVEF) between the two *** logistic regression analysis showed age,AF type,serum uric acid and MS were independent predictors for the LA enlargement in AF patients(OR:1.087,3.997,1.009, 4.351,all P<0.05). Conclusion We demonstrated MS is an independent predictor for the LA enlargement in NVAF *** may increase the risk of AF by increasing left atrial size.

关键词： Impact of the metabolic syndrome on left atrial size in patients with non-vavular atrial fibrillation

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The effects of cardiac resynchronization therapy on Ca2+ current in dyssynchronous Ischemic heart failure

The effects of cardiac resynchronization therapy on Ca2+ cur...

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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,Yong Sha,Xuezhong Wang,Jingjing Wang,Weina Guo Heart Center,the General Hospital of Ningxia Medical University 750000

Objective To investigate the change in Ca current(I) in dessynchronous ischemic heart failure a nd the electrophysiological consequences of cardiac resynchronization therapy（CRT）. Methods The mode of dessynchronous ischemic heart failure of dogs was established by ablation o f left bundle branch and ligation of left anterior descending artery（n=14）.After cardiac resynchronization t herapy for 6 weeks（n=7）,the myocytes of lateral and anterior left ventricular wall were dissected and the whole cell membranous clamp was used to detect the *** hemodynamic and cchocardiographic param eters were measured during the process. Results CRT reduced the prolonged period of QRS（100±23ms VS 73±11ms,P<0.05） and QTc （433±46ms VS 392±36ms,P<0.05） in dyssynchronous ischemic heart *** was a significant difference in peak ICa density between lateral and anterior myocardium in dyssynchronous ischemic heart failure（-5.2±0.32 vs -3.8±0.22,P<0.01）,whereas no significant difference in peak ICa density was shown between lateral and anterior myocardium in control group and CRT group（-4.7±0.34 vs -4.5±0.30, P>0.01;-4.5±0.24 vs -4.45±0.31,P>0.01）.CRT increased the ICa in lateral myocyte,but have no impact on anterior wall myocardium. Conclusions CRT reversed partially the ICa remodeling in dyssynchronous ischemic heart failure, whereby reduced the regional heterogeneity of ICa.

关键词： CRT The effects of cardiac resynchronization therapy on Ca current in dyssynchronous Ischemic heart failure

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