Atypical Form of the Fourth Criterion for Transient Entrainment

The typical fourth criterion for transient entrainment is defined when both a sudden shortening in conduction interval to and a distinct change in electrogram morphology at a bipolar recording site are demonstrated while performing overdrive pacing of a reentrant tachycardia from a single pacing site at two different constant rates. The purpose of this article was to test the hypothesis that if an intracardiac recording site showing both orthodromic and antidromic capture with entrainment pacing is located suitably distant from the circuit, sudden shortening in conduction interval to that site may occur without any significant change in the bipolar electrogram morphology (i.e., atypical form of the fourth criterion). Atrial overdrive pacing of orthodromic tachycardia was performed in 20 patients with either left anterior (12 patients) or left posterior (8 patients) accessory pathways. We investigated the effects of overdrive pacing from the proximal or distal coronary sinus, specifically effects on the electrogram interval and the electrogram morphology at the right atrial appendage. Overdrive pacing of orthodromic tachycardia from the proximal coronary sinus was performed in 10 of the 12 patients with left anterior accessory pathways; those 10 patients demonstrated the first entrainment criterion at the right atrial appendage site. Overdrive pacing of orthodromic tachycardia at still shorter cycle lengths demonstrated a sudden shortening in conduction interval to the right atrial appendage site. Despite shortening in conduction interval the morphology of the right atrial appendage electrogram was completely or almost identical to that during orthodromic tachycardia, indicating an atypical form of the fourth criterion. This criterion was not demonstrated in patients with left posterior accessory pathways. Thus, atypical fourth entrainment criterion was demonstrated during overdrive pacing of orthodromic tachycardia from the proximal coronary sinus only in patients with left anterior accessory path ways. Demonstration of atypical fourth criterion seems largely dependent on the location of the accessory pathway, the pacing, and the recording sites.     

Intra-Hisian Block Associated with Unusual Etiologies

One hundred and sixty-nine patients underwent electrophysiologic study for atrioventricular block. Forty-five (27%) had intra-Hisian block. Four of these 45 patients had unusual etiologies: rheumatoid arthritis, cysticercosis cellulosae, Behcet's disease, and Takayasu aorto-arteritis. Their clinical and electrophysiologic features are described in detail.     

房室传导阻滞的希氏束电图研究

研究了19例AVB的希氏束电图(HBE)。经皮穿刺股静脉将三极导管送至心脏希氏束部位,记录HBE。一度AVB5例,其中4例阻滞于房室结内,1例在希氏束内;二度AVB4例,3例阻滞于房室结,1例在希浦系;三度AVB10例,5例阻滞于房室结内,4例在希氏束,1例在希浦系。HBE能确定房室传导的阻滞部位,对指导安装起搏器和判断预后有一定意义。     

Perceived parental rearing behaviour in unipolar and bipolar depressed patients. A verification study in an Italian sample

Two groups of former depressed Italian patients comprising 54 bipolars and 52 unipolars completed the Italian version of the EMBU, a Swedish instrument aimed at assessing the experience of parental rearing behaviour. As in a previous study of Swedish depressives, three factors, "rejection", "emotional warmth", and "over-protection", have been taken into account. The results obtained in the patient group have been compared with those obtained in Italian healthy controls. Depressed patients rated both parents significantly lower than the controls on the factor "emotional warmth". The present results cross-validate those obtained previously in the Swedish depressives and strengthen, together with other findings in the literature, the assumption that the lack of emotional warmth in the parents' rearing practices might be a crucial variable in the pathogenesis of depressive illnesses.     

3-MHPG as a non-predictor of antidepressant response to imipramine and electroconvulsive therapy

The urinary excretion of 3-methoxy, 4-hydroxyphenyl-glycol, (3-MHPG) was measured in 20 unipolar depressed patients before treatment with imipramine and electroconvulsive therapy (ECT) to investigate the relationship between pretreatment urinary excretion of 3-MHPG and clinical response. There was no difference in 3-MHPG excretion for depressed patients and controls. There was no significant difference between the mean percentage reduction of Hamilton Depression Rating Scale Scores in "low" and "high" excretors of 3-MHPG in the imipramine and ECT group of patients after four weeks of treatment.     

血浆异钩藤碱浓度对兔心率及希氏束电图的影响

目的 观察血浆异钩藤碱浓度对兔心率及希氏束电图的影响。方法 心房起博及希氏束电图方法。结果 血浆异钩藤碱浓度在0．73－3．68mg/L范围内呈剂量依赖性减慢心率、延长窦房结传导时间、窦房结恢复时间、心房－希氏束间期、希氏束－心室间期、以及心电图的P－R间期,其中对心率和房室传导抑制明显。结论 异钩藤碱用于对抗扩血管药引起的加快的心率的副作用时,血药浓度控制在1－2mg/L为宜。     

心房按需起搏时心内电图的形态与起搏参数的关系

目的： 观察心房按需起搏（ＡＡＩ）时心内电图的形态与起搏阈值等参数的关系。　方法：对３６ 例ＡＡＩ起搏时记录的心内电图的Ａ 波形态、振幅、Ａ－Ｖ段上抬幅度进行详细测定,并与起搏阈值、心肌阻抗等参数进行相关分析。　结果：Ａ波形态、振幅与起搏阈值、心肌阻抗均无显著相关（Ｐ＞ ０．０５）,而Ａ－Ｖ 段上抬的幅度与起搏阈值呈明显负相关（ｒ＝ － ０．５４８ ６, Ｐ＜ ０．０５）。Ａ－Ｖ段高抬组的起搏阈值（０．６８±０．１７）Ｖ,显著低于Ａ－Ｖ段低抬组的（１．１±０．２４）Ｖ （Ｐ＜ ０．０１）。　结论：心内电图Ａ－Ｖ段上抬的足够幅度（＞ ０．３ ｍ Ｖ）可作为ＡＡＩ起搏时的一个重要技术指标,对避免电极脱位、保证较低的起搏阈值水平均具重要的临床意义。     

2种不同微创手术方法治疗良性前列腺增生症的临床观察

目的:观察经尿道前列腺等离子双极电切(TUPKP)与经尿道前列腺单极电切术(TURP)治疗良性前列腺增生症患者的临床效果。方法:回顾性分析我院自2009年10月～2011年10月住院的130例良性前列腺增生症患者,随机分为实验组和对照组,每组各65例。实验组采用TUPKP,对照组采用TURP。结果:实验组和对照组术中、术后手术时间、术中出血量、术后平均住院天数、膀胱冲洗时间以及留置尿管时间,差异有统计学意义(P<0.05);实验组和对照组术后半年IPSS评分、QOL评分、残余尿和并发症等指标,差异无统计学意义(P>0.05)。结论:TUPKP与TURP治疗良性前列腺增生症患者的临床效果相当,经尿道前列腺等离子双极电切术相对更安全,值得临床推广应用。