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中国循环杂志 1999年第S1期14卷 132-133页

作者：陈新王方正华伟中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院电生理研究室!100037

The Chinese society of cardiac pacing and electrophysiology organized nationalsurvey on cardiac pacinginthe period from January 1 ,1995 to December31 ,1997- There are 182 hospitals alloverthe country participated inthe survey- Followingisthe result ofthe survey- There were atotal number of5 000 new implanted pacemakersin Chinain 1997- It wasincreased rapidly ( > 15% ) annually compared with thatin 1994 (3 000)- There were about700 pacemakers replacement- Itis estimated there were about6 000 pacemakersimplanted in 1998- The single chamber ventricular(VVI) pacing accountedfor79-6 % oftotalpacemakerimplantation- However,the percentage of Dual chamberand rate responsive pacingisincreasing in 1997 (20-4 % ) ,compared with thatin 1996 (16-1% ) and in 1995 (14-5 % )- The indication for pacemaker implantation wassicksinussyndromein 50% ～53 % patientsand atrialventricular blockin41% ～44 % patients,othersin5 % ～7 % patientsfrom 1995 to 1997- coronary heart disease wasfoundin 50 % ～57 % patients- 66-8 % patients were over60 years old and male was 71-4 % in patientsreceived pacingtherapy- The new pacing technique,including automatic mode switch ,auto capture, mutisite pacing to treat atrialfibrillation and congestive heartfailure ,have been usedin China- SincetransvenousImplantable Cardioverter Defibrillators (ICD) were applied in China in 1996 ,there are a total of 71 ICDimplanted before 1998- Allthe devices werethethird generationICDincluded MedtronicJewel,CPIVantak seriesand Pacesetter Angstrom- The mean age ofpatients was48-7 years,61 males and 10 females- Most ofthem suffered from coronary heart disease and dilated cardiomyopathy- Allthe patients had syncope outof hospital and ventricular fibrillation was found in 27 patients and ventricular tachycardia was found in other 44 patients- Allthe implantation were performed inthe catheterlaboratory without complication- There are total about 20 000 cases were undertaken catheter ablation in China- The arrhythmias for ablation i

关键词：心脏起搏电生理恶性室性心律失常射频导管消融起搏器置入中国医学科学院中国协和医科大学心血管病研究所现状概况

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超声消融犬心肌的实验研究(摘要)

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中国循环杂志 1999年第S1期14卷 129-130页

作者：姚焰王方正张奎俊王崇慧田瑞国孙瑞龙陈新中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院临床电生理研究室!100037

Objective : Ultrasound is considered as an alternative enedrgy for post myocardial infarction ventricular tachycardia due to its good penetration through tissues- This study was designed to observe the effects of acoustic power, duration , repetitive ablations , tissue transducer interface temperature and different sites ofthe ultrasound ablation in vitro- The histological and electrical damages of ultrasound ablation and the feasibility of using ultrasound energy for chronic myocardial infarction scar ablation were also evaluated in vivo- Methods : At 1-8 MHz frequency , Ultrasound ablation were conducted with : ①Different acoustic powers (3-0 ～9-67 W/cm 2) , duration (20 ～90 sec) and repetitive times (1 ～4) ; ②Lesion volume and depth were compared between right and left ventricular muscles ; ③Two different types oftransducers with (model A) and without (model B) direct tissue contact were used in vitro and ①Ultrasound ablation was applied on the epicardium to compare the histological and electrophysiological damages in ten canines ; ②After chronic myocardial infarction , ultrasound ablation was applied on the scar regions in 5 canines in vivo- Results : In vivo : ①While the acoustic powerincreased from 3-0 W/cm 2to 9-67 W/cm 2 ,the lesion depth and volume increased from 1-96 ± 0-18 m m and 64 ±11-40 m m 3to 6-31 ±0-58 m m and 538-51 ±82-63 m m 3, respectively , and there were also significant differences between different powere levels ;Similarly , while the ablation time was prolonged from 30 s to 90 s at fixed acoustic powere levels , the lesion depth and volume significantly increased from 1-93 ±0-22 m m and 58-79 ±13-94 m m 3to 5-75 ±0-45 m m and 445-78 ±82-46 m m 3,respectively ; Repetitive ablations resulted in larger lesion size but such increase was not significant after the fourth time ablation ; Tissue transducerinterface temperature did not displayed a close relationship with thelesion size as acoustic power and ablation time did ; ②Both the lesion dept

关键词：中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院电生理北京阜外医院超声消融心肌实验研究摘要

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射频导管消融右心房后位峡部和间隔峡部治疗典型心房扑动方法的对比研究(摘要)

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中国循环杂志 1999年第S1期14卷 114-115页

作者：马坚王方正余培桢王锦志张奎俊华伟楚建民张澍陈新孙瑞龙中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院临床电生理研究室!100037

Objective : To compare posterior isthmus (inferior vena cava tricuspid annulus isthmus) ablation technique and septal isthmus (tricuspid annulus Eustachian ridge isthmus) ablation technique for typical atrialflutter- Methods :Thirty five patients ( mean age 53 ±15 years) with typical atrial flutter were randomly assigned to undergo radiofrequency catheter ablation performed with posterior isthmus ablation technique (PIgroup ,15 patients) or septal isthmus ablation technique (SIgroup ,20 patients)- Radiofrequency energy was used to create linear lesion from tricuspid ring to inferior vena cava in the PIgroup and from tricuspid ring to Eustachian ridge in the SIgroup- The ablation technique was changed to the other,if one of the ablation techniques failed to block the isthmus after eight applications of radiofrequency energy- The endpoint of successful ablation included a complete bidirectional conduction block atisthmus and inability to induce atrial flutter- Results : Atrialflutter was present atthe onset of ablation in 10 patients of the PIgroup and in 15 patients of the SIgroup , however the cycle lengths of atrialflutter between the two groups were 240 ±30 ms and 220 ±23 ms ( p < 0-05) ,respectively- The endpoint of successful ablation was achieved in all of the patients without any complication- The ablation technique was changed for two patientsin both groups afterthe primary ablation technique was unsuccessful- The times ofradiofrequency application and proceduretime were notsignificantly differentin both groups- During a mean follow up of 15-4 ±3-8 months ,one patient (PIgroup) experienced atrialflutter recurrence- Conclusion : Radiofrequency ablation oftypical atrialflutteris safe and effective with eitherthe posterioristhmus ablation technique orthe septal isthmus ablation technique- The ablation success rate can be increased when these two techniques are used alternatively-

关键词：中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院电生理北京阜外医院典型心房扑动峡部射频导管消融右心房对比研究摘要

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血管内反推力牵引法拔除起搏电极导线治疗起搏器术后顽固性感染(摘要)

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中国循环杂志 1999年第S1期14卷 125-126页

作者：马坚王方正余培桢王锦志华伟张奎俊楚建民孙瑞龙陈新中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院临床电生理研究室!100037

Objective: To present an intravascular countertraction technique of lead extraction for treatment of refractory infection after pacemaker implantation- Methods : Eighteen patients (14 men and 4 women , mean age 56 ±13 years) with 28 leads were presented for lead extraction , because of refractory pacemaker pocket infection and erosion- Eleven atrial and seventeen ventricular leads had been implanted for 5-4 ±4-2 years- Alocking stylet was secured atthe distal electrode by counterclockwise rotation to reinforce the lead and facilitate traction ,and telescoping dilator sheaths were used to free the lead from adhesions in the venous system- Results :Twenty fourleads were completely removed and 2 partially removed ,the distal electrodes ofthe latter 2 were detached during extraction and retained in the hepatic vein and subclavian vein ,respectively- The other 2 leads in one patientfailed to be extracted , which were finally taken out by surgical thoracotomy- Afollow up of 11 ±7 months ,the infection was controlled in all patients- Conclusion : With appropriate precautions and patient selection , intravascular countertraction technique allows successful extraction of up to nearly 90 % of permanent pacemakerleads with a relatively low incidence of complications- The extraction ofinfected lead is an effective method for treating refractory infection of pacemaker implantation-

关键词：中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院电生理北京阜外医院牵引法起搏电极导线起搏器血管内反推力顽固性摘要

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我国中年人群的营养素摄入状况与高血压、脑卒中发病关系的前瞻性研究

我国中年人群的营养素摄入状况与高血压、脑卒中发病关系的前瞻性...

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作者：张林峰中国协和医科大学

学位级别：博士

目的探讨我国中年人群营养素摄入状况与高血压、脑卒中发病的关系，为改善人群的膳食结构提供理论依据，为进一步的研究提供线索，并为今后进行更大规模的研究积累经验。方法 1．选取参加中美心血管及心肺疾病流行病学合作研... 详细信息

目的探讨我国中年人群营养素摄入状况与高血压、脑卒中发病的关系，为改善人群的膳食结构提供理论依据，为进一步的研究提供线索，并为今后进行更大规模的研究积累经验。方法 1．选取参加中美心血管及心肺疾病流行病学合作研究4组人群(北京首钢工人、石景山农民、广州船厂工人、广东番禹农民)的基线膳食小样本中未曾患过脑卒中的1038人作为本研究的研究对象，以1983-1984年的膳食资料为研究因素、以1983-1984年到2002年12月20年间新发的脑卒中为终点事件前瞻性地研究基线的营养素摄入状况与随访脑卒中发病的关系。 2．选取上述4组人群基线膳食小样本中基线无高血压且在1993-1994年参加过重复调查的654人作为本研究的研究对象，以1983-1984年的膳食资料为研究因素、以1983-1984年到1993-1994年10年间新发生的高血压为终点事件前瞻性地研究我国中年人群的营养素摄入状况与高血压发病的关系。结果 1．营养素与脑卒中发病的关系截止2002年底研究人群共发生脑卒中57例，其中男性36例，女性21例。将研究对象按经热量校正后的营养素摄入量3分位数分为3组，对多种营养素摄入量与脑卒中发病关系的分析结果表明：膳食蛋白质与脑卒中发生的危险之间存在显著的负关联，而膳食钠与脑卒中发生的危险之间存在显著的正关联，但膳食蛋白质和钠与脑卒中发病之间的关联在控制了基线SBP后即明显削弱；其余营养素与脑卒中发病之间的关联则不具有统计学显著性。在模型中同时控制吸烟、膳食蛋白质和膳食钠摄入量的情况下，不同蛋白质摄入量各组发生脑卒中的相对危险分别为1.0，1.07(95％可信区间0.61-1.91)和0.40(95％可信区间0.19-0.86)，

关键词：高血压收缩压摄入状况中国医学科学院中国协和医科大学心血管病研究所摄入量发病关系前瞻性研究

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儿童血压与左心室质量的五年随访对比研究（摘要）

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中国循环杂志 1996年第9期 31-32页

作者：王静郑德裕王燕武中国医学科学院中国协和医科大学心血管病研究所

儿童血压与左心室质量的五年随访对比研究（摘要）中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院高血压研究室王静郑德裕王燕武１临床资料本文旨在研究有或无高血压病家族史的健康儿童血压与左心室质量的动态变化规... 详细信息

儿童血压与左心室质量的五年随访对比研究（摘要）中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院高血压研究室王静郑德裕王燕武１临床资料本文旨在研究有或无高血压病家族史的健康儿童血压与左心室质量的动态变化规律。对１２２名有或无高血压病家族史...

关键词：儿童血压质量指数心血管病心脏血管疾病左心室高血压病家族史对比研究中国医学科学院中国协和医科大学心血管病研究所摘要

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先天性二瓣型肺动脉瓣并缩窄性心包炎外压型肺动脉瓣狭窄一例

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中国循环杂志 1995年第12期 753-754页

作者：谭慧琼朱俊中国医学科学院中国协和医科大学阜外心血管病医院内科中国医学科学院中国协和医科大学心血管病研究所内科

先天性二瓣型肺动脉瓣并缩窄性心包炎外压型肺动脉瓣狭窄一例中国医学科学院中国协和医科大学心血管病研究所内科，中国医学科学院中国协和医科大学阜外心血管病医院内科谭慧琼，朱俊肺动脉瓣狭窄常见为先天性，获得性肺动脉瓣狭窄很少... 详细信息

先天性二瓣型肺动脉瓣并缩窄性心包炎外压型肺动脉瓣狭窄一例中国医学科学院中国协和医科大学心血管病研究所内科，中国医学科学院中国协和医科大学阜外心血管病医院内科谭慧琼，朱俊肺动脉瓣狭窄常见为先天性，获得性肺动脉瓣狭窄很少见。我们收治了１例因缩窄性心包炎外...

关键词：肺动脉瓣狭窄缩窄性心包炎中国医学科学院中国协和医科大学心血管病研究所压型

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先天性心脏憩室临床特点分析(摘要)

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中国循环杂志 1999年第S1期14卷 113-113页

作者：尤士杰姚民李琳杨跃进高润霖乔树宾秦学文姚康宝陈纪林徐义枢陈在嘉中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院冠心病研究室!100037

Objective:Toelucidatethe differentclinicalfeaturesbetween adultsand children with congenitalcardiac diverticulum- Methods:The clinicalcharacteristicofpatients with congenitalcardiacdiverticulum confirmed by ventriculograpyhyorsurgicaloperationin nine casesinourhospitalwereanalyzedretrospectively-Fourcaseswereadultswith a mean ageof59-3±7-6 years(50～68 years);and5 were children ofage6-5±4-4years(2-5～14 years)- Results: ①Four adults with the left ventricular diverticulum were allincidentally discovered and confirmed by left ventriculography for differential diagnosis- Five children were confirmedin corrected operationforotherseverecongenitalheart malformation- ②The averagediameterof the diverticulum were36-3±11-8 mm (20～48 mm) andthe neck of diverticulum were14-0 ±2-9 mm (10～17 mm) in 4 adults;while the average diameterofthediverticulum were42-0 ±22-0 mm (25 ～80 mm) and the neck ofdiverticulum were 8-6 ±3-9 mm (4 ～12 mm) in 5 children- ③Alladult patients had isolated left ventricular muscular diverticulum with no related complications thus did not been operated- All children,1 with isolateralleft ventricular muscular diverticulum , with bioverticular muscular diverticulum ,2 with right ventricular muscular diverticulum ,and 1 withleftatrialfibrous diverticulum ,underwentsurgicaloperationsuch assuturationofthediverticulum andrepairing ofatrialor verticularseptum ,valvuloplastyoftricuspid valve,replacementof mitralvalve orligation ofartery duct,accordingtothetypes of congenital heart anomales- Conclusion:There are many differentclinicalfeaturesbetweenadults (olderand middle) and children with congenitalcardiacdiverticulum-

关键词：中国医学科学院中国协和医科大学心血管病研究所冠心病冠状动脉病憩室北京阜外医院阜外心血管病医院临床特点分析心脏摘要

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埋藏式心脏复律除颤器治疗快速室性心律失常随访观察(摘要)

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中国循环杂志 1999年第S1期14卷 125-125页

作者：华伟王方正陈新中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院临床电生理研究室!100037

Objective : To observe the efficacy of implantable cardioverter defibrillator to treat ventricular tachyarrhythmias- Methods : Twenty six patients ,23 males and 3 females , mean age of 48-08 years were implanted nonthoracotomy ICDsystems- The indications for implantation were VFin 18 patients and refractory VTin 8- All patients had syncope out of hospital- The device is the third generation ICD with multitherapies including antitachycardia pacing (ATP) , cardiovertion and defibrillation and data storing functions- All patients were followed up at least once after ICDimplantation- Results :In the follow up of 9-4 (2 ～26) months ,13 out of 26 patients (50 % ) received ICD therapy- The data stored in ICD showed that totally 187 episodes were detected by the devices- 54 of them were nonsustained VT which spontaneously terminated- 133 VT/ VF episodes were treated by ICD- 110 ofthem were VT,42 were terminated by ATPand 61 by low energy cardiovertion- 2 episodes were sinus tachycardia- Another 5 VT were accelerated to VFand terminated by high energy shocks- There were 23 VFepisodes diagnosed by the devices , however 4 of them were confirmed VT with rate over VFdetection criterion by reviewing the stored electrocardiogram- Allthe episodes were terminated by shocks- 2 patients died of heartfailure during the follow up- Conclusion : The third generation ICD with multitherapy function has high efficacy in the termination of ventricular tachyarrhythmias- It is importantto follow up the patients and set appropriate parameters for diagnosis and therapy by ICD-

关键词：室性心律失常埋藏式心脏复律除颤器随访观察中国医学科学院中国协和医科大学心血管病研究所心动过速心搏过速心律失常心律转复除颤器摘要

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双心腔起搏治疗肥厚性梗阻型心肌病血液动力学观察(摘要)

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中国循环杂志 1999年第S1期14卷 117-117页

作者：华伟王方正杨跃进张奎俊余培贞王锦志李一石马坚孙瑞龙陈新中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院临床电生理研究室!100037

Objective:We report our clinical use of dual chamber pacing in patients with hypertrophic obstructive cardiomyopathy (HOCM) and its hemodynamiceffects- Methods:Twenty three patients,16 males and 7 females, mean age of 39 years, with HOCM, were implanted permanent dual chamber pacemaker- Allpatients had clinicalsymptomsrefractoryto medicaltherapy (βblockersand/orCa2 + blockers) and12 ofthem hadsyncope- Mean thickenessoftheventricularseptum was2-1 cm- Results:Thesymptoms weresignificantlyimprovedin20 patientsafter pacing withshort A Vdelay comparedtothose before pacing- Theleft ventricularoutfolwtract(LVOT) pressure gradients werereducedfrom 51-05to 19-07 mmHgafterpacing(p<0-05)-In afollow up of9 months (5～23 months),no patients had syncope- Conclusion:Dual chamberpacingisan effective new methodtotreatpatients with HOCM

关键词：双心腔起搏阜外心血管病医院电生理北京阜外医院肥厚性梗阻型心肌病中国医学科学院中国协和医科大学心血管病研究所循环生理学血液动力学摘要

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