参松养心胶囊治疗窦缓并室早疗效分析

目的观察参松养心胶囊治疗窦性心动过缓伴室性期前收缩的临床疗效及安全性。方法将65例窦缓伴室早患者随机分为治疗组35例和对照组30例,在基础治疗上,治疗组服参松养心胶囊,3次/d,3粒/次;对照组常规治疗。观察和记录治疗4周前后患者的心律变化、临床疗效和不良反应。结果两组患者心电图疗效间差异有统计学意义（P〈0.05）。两组患者临床症状改善疗效间差异有统计学意义（P〈0.05）。结论参松养心胶囊用于治疗窦缓并室早有效,无致心律失常作用。     

参松养心胶囊治疗缓慢心律失常疗效分析

目的观察参松养心胶囊治疗缓慢心律失常的疗效。方法将90例患者随机分为两组,两组在原发病治疗的基础上,治疗组口服参松养心胶囊4粒,3次/d,疗程4周。结果治疗组临床症及心律失常疗效均显著优于对照组。结论参松养心胶囊治疗缓慢心律失常安全有效。     

参松养心胶囊对急性心肌梗死溶栓后室性早搏的影响

目的观察参松养心胶囊对急性心肌梗死(AMI)溶栓后室性早搏的影响。方法选择符合诊断标准并有溶栓指征的AMI患者128例,随机分为治疗组68例及对照组60例,对照组在常规药物基础上行溶栓治疗,治疗组在上述治疗上加用参松养心胶囊,疗程均为2周。结果治疗组室性早搏有效率62.5%及总有效率87.5%,疗效均优于对照组。结论参松养心胶囊对急性心肌梗死溶栓治疗后室性心律失常有较好治疗作用。     

参松养心胶囊联合辛伐他汀治疗持续性心房颤动

目的探讨参松养心胶囊联合辛伐他汀治疗持续性房颤的临床疗效及安全性。方法将75例持续性心房颤动患者随机分为两组,对照组给予地高辛和倍他乐克治疗,治疗组给予参松养心胶囊及辛伐他汀治疗。比较治疗8周后两组主要临床症状、体征、心室率（动态心电图监测的平均心室率）、心功能改善及不良反应情况。结果两组主要临床症状、体征、心室率、心功能改善方面差异均无统计学意义（P〉0.05）,而不良反应的发生率,治疗组低于对照组（P〈0.05）。结论参松养心胶囊联合辛伐他汀治疗持续性心房颤动有较好临床疗效,且不良反应发生率低。     

参松养心胶囊治疗冠心病合并焦虑症的临床观察

目的：探讨参松养心胶囊治疗冠心病合并焦虑症的效果。方法：将52例患者分为参松养心胶囊组及劳拉西泮组,在冠心病的基本治疗下,比较4周后两组抗焦虑药物的治疗效果。结果：两组治疗有焦虑症效率差别无统计学意义,但劳拉西泮组出现药物依赖及不良反应。结论：参松养心胶囊治疗焦虑症与劳拉西泮治疗焦虑症有效率无差别,且前者更安全、可靠。     

氯沙坦联合胺碘酮与参松养心胶囊治疗高血压伴阵发性心房颤动的疗效观察

【目的】观察氯沙坦联合胺碘酮与参松养心胶囊治疗高血压伴阵发性心房颤动（AF）的疗效。【方法】105例高血压伴阵发性AF患者给予常规降压药物（除外ACEI和ARB类药物）,AF转复后随机分为3组：A组胺碘酮治疗组;B组氯沙坦＋胺碘酮治疗组;C组参松养心胶囊＋氯沙坦＋胺碘酮治疗组。疗程12个月。治疗前后均行动态心电图和超声心动图（UCG）检查。【结果】B组和c组左房内经明显小于A组（P〈0．05）,窦性心律维持率B纽和C组明显高于A组（P〈o．05,P〈0．01）,尤以C纽更为明显（P〈0．01）。【结论】胺碘酮联合氯沙坦治疗高血压伴阵发性AF,可在降低血压的同时,有效维持窦性心律,加服参松养心胶囊疗效更佳。     

参松养心胶囊对冠心病心肌梗死患者室性心律失常及心率变异性的影响

我院2005-07～2005-12联合应用参松养心胶囊治疗冠心病患者心肌梗死136例,观察其对心肌梗死患者心律失常及心率变异性的影响.总结如下.     

参松养心胶囊治疗室性早搏疗效观察

目的观察参松养心胶囊对室性早搏的效果。方法 168例室性早搏患者随机分成参松养心胶囊组（参组）和乙胺碘呋酮组（乙组）,每组各84例,观察两种药物的治疗效果。结果参组总有效率82.6%,略低于乙组87.0%,差异无统计学意义（P〉0.05）。结论参松养心胶囊控制室性早搏效果较好,不良反应少。     

参松养心胶囊治疗缓慢性心律失常疗效观察

我们自2005—06／2007—06选用参松养心胶囊治疗缓慢性心律失常患者，取得了满意的疗效，报道如下。 1 对象和方法     

参松养心胶囊联合硝酸酯类治疗心绞痛疗效观察

心绞痛（Angina Pectoris）是冠状动脉供血不足,心肌急剧的、暂时缺血与缺氧所引起的以发作性胸痛或胸部不适为主要表现的临床综合征。笔者2008—03～2009-12采用参松养心胶囊联合硝酸酯类治疗心绞痛患者84例,疗效确切,报告如下。     

Hemodynamics of Idiopathic Paroxysmal Atrial Fibrillation

The hemodynamics of induced atrial fibrillation (AF) was investigated in 15 patients (ages 58 ± 11 years) with paroxysmal AF presenting without organic heart disease or hypertension. A hemodynamic study was performed both during sinus rhythm and after the induction of AF. The mean heart rate increased from 73 ± 11 to 128 ± 18 beats/min (P < 0.001) after AF. Systolic and mean aortic pressures did not significantly change, and diastolic aortic pressure increased (78 ± 11 vs 89 ± 12 mmHg, P < 0.01). Left ventricular enddiastolic pressure decreased during AF (9 ± 3 vs 6 ± 2.6 mmHg, P < 0.005), whereas mean pulmonary wedge pressure increased (8 ± 2 vs 12 ± 4 mmHg, P < 0.001). Systolic pulmonary arterial pressure did not show significant variations, and there was a slight but statistically significant increase in the diastolic and mean pulmonary arterial pressures (P < 0.01). The right ventricular end-diastolic pressure decreased during AF (5.6 ± 2 vs 3.8 ± 2 mmHg, P < 0.01 j, whereas mean right atrial pressure showed a trend toward an increase. Stroke volume markedly decreased (P < 0.001) while the cardiac index did not significantly change. Systemic vascular resistance, pulmonary arteriolar resistance, and the arteriovenous O₂ difference showed no significant variations after the induction of AF. These results suggest that in subjects without organic heart disease, paroxysmal AF is well tolerated hemodynamicaily, and the rise in the atrial pressures during AF is not related to an increase in the ventricular end-diastolic pressure.     

Left Atrial Voltage during Atrial Fibrillation in Paroxysmal and Persistent Atrial Fibrillation Patients

Background: Left atrial (LA) endocardial voltage characteristics assessed during atrial fibrillation (AF) have not been previously compared in different AF types. This study was aimed at investigating the LA voltages and volumes in patients with paroxysmal and persistent AF. Methods: LA electroanatomic voltage maps acquired during AF were compared between consecutive patients without major structural heart disease undergoing first catheter ablation for paroxysmal AF (n = 100) or persistent AF (n = 100). The groups were comparable in baseline clinical characteristics. Results: Patients with persistent AF presented with lower median LA voltage (median 0.41, interquartile range [IQR] 0.31–0.51 mV versus median 0.99, IQR 0.47–1.56 mV; P < 0.001), and maximum LA voltage (4.07 ± 1.76 vs 6.42 ± 2.16 mV; P < 0.001). They also had a higher proportion of the LA points exhibiting voltage <0.2 mV (30 ± 20 vs 12 ± 11%; P < 0.001) and voltage 0.2–1.0 mV (55 ± 15 vs 42 ± 19%; P < 0.001). They further displayed higher LA volume/body surface area (75 ± 16 vs 58 ± 13 mL/m²; P < 0.001). In the multivariate regression model, both LA voltage (P < 10^?9) and LA volume (P < 10^?5) were significant determinants of AF type. Conclusion: Patients with persistent AF had significantly lower LA voltage compared with patients with paroxysmal AF even after adjustment for differences in indexed LA volume. LA voltage represents an independent covariate of clinical manifestation of AF. (PACE 2010; 541–548)     

参松养心胶囊治疗缺血性心律失常临床观察

目的：观察参松养心胶囊治疗缺血性心律失常的疗效。方法;将120例患者随机分为两组,治疗组加用参松养心胶囊治疗,对照组加用胺碘酮口服,观察4周后进行比较。结果：两组组内比较治疗前后早搏均显著减少（P〈0．01）,治疗组与对照组组间比较无统计学差异（P〉0．05）。结论：参松养心胶囊治疗缺血性心律失常疗效确切,起到标本兼治的作用,不良反应轻微,可以广泛应用。     

Cost Analysis of Catheter Ablation for Paroxysmal Atrial Fibrillation

WEERASOORIYA, R., et al. : Cost Analysis of Catheter Ablation for Paroxysmal Atrial Fibrillation . RF ablation for paroxysmal atrial fibrillation (PAF) is a curative treatment, which when successful, eliminates the need to take antiarrhythmic drugs, be anticoagulated, and have recurrent physician visits or hospital admissions. The authors performed a retrospective cost comparison of RF ablation versus drug therapy for PAF. The study population consisted of 118 consecutive patients with symptomatic, drug refractory PAF who underwent   1.52 ± 0.71   RF ablation procedures (range 1–4) for PAF. During a follow-up of 32 ± 15 weeks, 85 (72%) patients remained free of clinical recurrence in absence of antiarrhythmic drugs. The cost of RF ablation was calculated in the year 2001 euros on the basis of resource use. The mean cost of pharmacologic treatment prior to ablation was 1,590 euros/patient per year. The initial cost of RF ablation for PAF was 4,715 euros, then 445 euros/year. After 5 years, the cost of RF ablation was below that of ongoing medical management, and continued to diverge thereafter. RF catheter ablation may be a cost-effective alternative to long-term drug therapy in patients with symptomatic, drug refractory PAF. (PACE 2003; 26[Pt. II]:292–294)     

Regional Disparities of Endocardial Atrial Activation in Paroxysmal Atrial Fibrillation

Previous experimental data suggest that atrial activity is homogeneously distributed during paroxysmal atrial fibrillation (AFib). Little is known about this in human paroxysmal AFib. Methods : Twenty-five men and two women (mean age 49 ± 11 years; five with structural heart disease) with paroxysmal AFib for a mean 5 ± 6.2 years despite the use of a mean of 3.6 ± 1.7 antiarrhythmic drugs underwent atrial mapping. The right atrium was divided into four regions: posterior (intercaval), lateral, anterior, and septal. A 14-pole catheter was positioned to assess complex electrical activity defined as the duration of continuous electrical activity or electrograms with FF intervals < 100 ms for 60 seconds (expressed as percentage of time). In addition, the left atrium (divided into three regions: posterior, anterior, and septal) was explored in 12 patients with a multipolar catheter. Results : The complex electrical activity time between all the regions explored was significantly different. In the right atrium, the septa] (74%± 32%; P = 0.02) and the posterior (63%± 32%; P = 0.04) areas were significantly more disorganized than the lateral (22%± 23%) and anterior (21 %± 26%) regions. In the left atrium, complex electrical activity was predominant and widely distributed (posterior: 87%± 11%; septal: 65%± 27%) except in the appendage area (anterior region: 18%± 14%). Conclusions : Quantitative assessment of complex electrical activity in both atria in humans shows heterogeneous temporal and spatial distribution. This may have implications for guiding catheter ablation of AFib.     

参松养心胶囊治疗低血压性眩晕疗效观察

目的：探讨参松养心胶囊治疗低血压性眩晕的疗效。方法：选择低血压性眩晕患者100例,随机分为参松养心胶囊治疗组60例,对照组40例。参松养心胶囊治疗组给予参松养心胶囊治疗,对照组给予谷维素治疗。观察两组治疗方法对低血压性眩晕患者的疗效。结果：参松养心胶囊治疗组在治疗低血压性眩晕患者的痊愈率、有效率、总有效率方面明显优于对照组。结论：参松养心胶囊可有效治疗低血压性眩晕患者。     

阵发性室上性心动过速并发阵发性房颤危险因素的临床研究

目的:筛选阵发性室上性心动过速(PSVT)患者中并发房颤的临床危险因素。了解PSVT患者中房颤的患病率及PSVT患者房颤发生的可能机制。方法:回顾研究经电生理检查证实为PSVT的患者共630例,其中依据临床记录同时有房颤发作的患者编为房颤组,其余无临床房颤发作的患者为对照组。制订调查表格并详细记录患者人口学资料、临床疾病相关资料、心脏超声检查结果、24h动态心电图结果、电生理检查中确定的PSVT折返机制、旁道数目等资料。利用SPSS进行t检验、χ2检验及Logistic回归分析PSVT患者并发房颤的危险因素。结果:630例(年龄13~79岁,平均年龄44.2±14.3岁男性326人,女性304例)中电生理检查房室结折返性心动过速256例(均为慢-快型),房室折返性心动过速374例,单因素分析表明男性、左房内径大及术前频发房性早搏(在AVRT亚组心电图表现为显性预激)为PSVT患者并发房颤的临床危险因素,多因素分析证明性别为PSVT患者并发房颤的独立临床危险因素。结论:PSVT并发房颤的患者常有一定的临床特征:男性居多,左房内径相对较大。     

预测特发性阵发性房颤的心电图标志

目的：通过体表心电图的指标预测特发性阵发性房颤（IPAF）。方法：对确诊IPAF病例和年龄匹配的健康人各40例,测量体表心电图12导联最大P波时限及P波离散度。结果：最大P波时限和P波离散度在IPAF组明显高于正常对照组,以P波时限110ms和P波离散度40ms作为区别IPAF和正常健康人,敏感性和特异性分别为87.5%、85%和82.5%、85%。结论：最大P波时限和P波离散度是预测IPAF的一种有用的心电图指标。     

Atrial Vulnerability in Patients with Paroxysmal "Lone" Atrial Fibrillation

Little is known about the electrophysiological properties of the atrium predisposing to paroxysmal atrial fibrillation (AF), especially in patients without structural heart disease. This study was conducted to analyze intraatrial conduction, atrial refractoriness, and arrhythmia inducibility in patients with lone paroxysmal AF. An electrophysiological study was performed in 24 patients with a documented history of lone paroxysmal AF but in sinus rhythm at the time of the electrophysiological study. Twelve patients without any history of atrial arrhythmias served as controls. The patients with lone paroxysmal AF showed a significant prolonged local conduction time S1A1 (70 ± 21 ms vs 36 ± 12 ms, P < 0.0001), a lack of rate adaptation of the functional refractory period (FRP changes/cycle length changes < 10% in 15 of 24 patients with lone paroxysmal AF vs 1/12 controls, P = 0.002) and a higher incidence of inducible AF with only one extrastimulus (13/24 vs 0/12, P = 0.0014). The total P wave duration in the surface ECG (89 ± 14 ms vs 83 ± 8 ms, P = 0.15), the intraatrial conduction time (36 ± 14 ms vs 28 ± 8 ms, P = 0.07), the presence of a fragmented atrial electrogram (16/24 vs 7/12, P = 0.62), the absolute value of the effective refractory period (204 ± 28 ms vs 212 ± 23 ms, P = 0.42), and the vulnerability index (3.0 ± 1.5 vs 3.6 ± 1.5, P = 0.26) were not statistically different between the two groups. The presence of a prolonged (> 50 ms) S1A1 and/or the presence of a lack of rate adaptation of the FRP and/or the presence of inducible AF identified patients with spontaneous lone paroxysmal AF with a sensitivity of 96%, a specificity of 67%, a positive predictive value of 85%, and a negative predictive value of 89%. In patients with lone paroxysmal AF. the electrophysiological study using conventional techniques allows not only to detect AF inducibility using a nonaggressive protocol, but also to reveal several electrophysiological abnormalities related to the atrial substrate itself. This atrial vulnerability may explain the high incidence of recurrences in patients with lone paroxysmal AF.