QT离散度预测老年冠心病患者室性心律失常的发生

目的探讨QT离散度(QTd)作为预测室性心律失常发生指标的意义.方法对70例冠心病患者,包括34例室性心律失常患者及30例健康者的QTd进行比较.结果冠心痛组的QTd值(61.34±20.17)ms明显大于正常组,P＜0.001.其中室性心律失常患者的QTd值(76.94±22.19)ms明显高于冠心病组,P＜0.005.当QTd≥60ms时,心律失常组的阳性率明显大于冠心痛组.结论QTd可作为预测室性心律失常发生的指标之一.     

QT Dispersion Level and Its Clinical Significance.in Dilated Cardiomyopathy

［1］Richardson CP, Mckenna RM, Bristow CM, et al.Report of the 1995 Word Health Organization/International Society and Federation of Cardiology Task Force on the definition and classification of cardiomyopathies. Circulation, 1996,93: 841 ［2］Barr CS, Naas A, Freeman M, et al. QT dispersion and sudden unexpected death in chronic heart failure. Lancet, 1994,343:327 ［3］Martin AB, Garson A, Perry JC, et al. Prolonged QT interval in hypertropic and dilated cardiomyopathy in children. Am Heart J, 1994,127(1):64 ［4］Pye M, Quinn AC, Cobble SM. QT dispersion: a non-invasive marker of susceptibility to arrhythmia in patients with sustained ventricular arrhythmias?Br Heart J, 1994,71(5):51 ［5］Berger RD, Kasper EK, Baughman KL, et al. Beat to beat QT interval variability: novel evidence for repolarization lability in ischemic and non ischemic dilated cardiomyopathy. Circulation, 1997, 96 (5):1557 ［6］Wolfram G, Ulrike S, Volker M, et al. QT dispersion and arrhythmic events in idiopathic dilated cardiomyopathy. Am J Cardiol, 1997,78: 458 ［7］Fei L, Goldman JH, Prasal K, et al. QT dispersion and RR variations on 12-lead ECGs in patients with congestive heart failure secondary to idiopathic dilated cardiomyopathy. Eur Heart J, 1996,17: 258 ［8］Pan YZ, Guo NS, Xing ZF, et al. The relation between QT dispersion and ventricular arrhythmia of dilated cardiomyopathy. Chin J Inter Medi, 1996,35(11):73 ［9］Galinier M, Vialette JC, Fourcade J, et al. QT interval dispersion as a predictor of arrhythmic events in congestive heart failure. Importance of aetiology. Eur Heart J, 1998,19(7) :1054     

Potentially fatal interaction between azithromycin and disopyramide

A patient on disopyramide developed disopyramide toxicity when treated concurrently with azithromycin. Evidence of toxicity included an elevated serum disopyramide level and ventricular tachycardia requiring cardioversion. The azalide antibiotic presumably inhibited dealkylation of disopyramide to its major metabolite, mono-N-dealkyldisopyramide. Physicians should avoid using azithromycin in patients on disopyramide. If this drug combination is unavoidable, disopyramide levels must be closely monitored.     

心率变异性与冠状动脉病变和室性心律失常的关系

【论文特点介绍】HRV是心血管研究的热点之一，本文在前人对HRV与冠脉病变关系的研究基础上，进一步深入了解心脏植物神经功能失调与冠脉病变范围和程度的关系及其在室性心律失常发生机制中的作用．并筛选HRV预测指标。本研究为临床广泛开展HRV检测提供一定的理论依据，对进一步指导积极的药物或非药物治疗以调节心脏植物神经功能，提高HRV，改善冠心病预后，具有一定的临床意义。     

Use of an insertable loop recorder in a myotonic dystrophy patient

The case of a 66-year-old woman with myotonic dystrophy is presented. This patient underwent implantation of an insertable loop recorder as a participant in a clinical trial. At 1-month follow-up, interrogation of the insertable loop recorder revealed multiple episodes of wide complex tachycardia. She underwent electrophysiologic study, which revealed moderate His-Purkinje disease, focal atrial tachycardia, monomorphic ventricular tachycardia, and ventricular fibrillation. Successful radiofrequency ablation of the focal atrial tachycardia and implantation of a dual-chamber implantable cardioverter defibrillator was performed.     

关于心律失常教学课件的设计制作构想

介绍了一种基于计算机动画和视频剪辑技术的心律失常教学课件的设计思想、课件内容及演示特点。     

Expression of ion-channel subunit mRNA in different regions of canine right atrium

A trial electrophysiological heterogeneity, which plays an important role in the genesis and maintenance of atrial arrhythmia, is a major determinant of atrial reentrant arrhythmias. Recently, many studies on atrial flutter have demonstrated the anatomic architecture in the right atrium plays an important role in the genesis of atrial reentry. The crista terminalis （CT） in the right atrium, which is a unique anatomic structure of the right atrium, provides an area for conduction block and delay, leading to initiation, maintenance, and termination of atrial arrhythmias. Catheter ablation of CT can successfully eliminate these atrial arrhythmias. These literatures contrast with limited knowledge of the basic electrophysiological properties of CT and how these promote arrhythmia generation. Compared to pectinate muscles （PM） and right atrial appendage （RAA）, CT have distinct electrophysiological properties related to different densities of several ionic currents, the transient outward current （Ito） and L-type Ca^2＋ current （Ica-L） underlie the bulk of the different densities of several ionic currents. Cardiac Ito and Ica-L play a major role in action potential repolarization. Ito is particularly important in early （phase 1） repolarization and influences the participation of other currents. It is generally believed that Ica-L plays an important role in the plateau phase of repolarization. However, the mechanisms for these ionic current differences are unknown. One possible is a difference in ion channel subunit expression, but virtually no data are available regarding ion-channel subunit expression in CT, PM, and RAA. The Kv4.3 channel underlies the bulk of the α-subunit of Ito in canine and human heart.     

INSTRUCTIONS TO AUTHORS

<正>GENERAL INFORMATIONWorld Journal of Hepatology(World J Hepatol,WJH,online ISSN 1948-5182,DOI:10.4254)is a peer-reviewed open access(OA)academic journal that aims to guide clinical practice and improve diagnostic and therapeutic skills of clinicians.Aim and scopeWJH covers topics concerning arrhythmia,heart failure,vascular