A confused ECG with multiple rhythms caused by atrial premature contractions: A case report.

INTRODUCTION: Atrial premature contractions (APCs) are commonly encountered in clinical practice. The APCs may influence heart conduction system and induce other arrhythmia. The disorder of atrioventricular conduction is related to electrophysiological phenomena, difficult to understand and diagnose. CASE REPORT: We presented a 15-year-old male patient whose baseline electrocardiogram (ECG) was confused with multiple rhythms. Electrophysiological study results showed sinus rhythm with nonconducted APCs in bigeminal rhythm. Nonconducted APCs were blocked without H wave. Some APCs conducted to ventricle with longer AH interval and HV interval. When APCs were abolished by radiofrequency ablation, this patient was free from any arrhythmia during follow-up. CONCLUSION: We considered that the basic rhythm of the baseline ECG was sinus rhythm with atrial bigeminy rhythm and narrow QRS extrasystoles (junctional); some APCs were blocked and some APCs conducted to ventricle with aberrant QRS complexes. The phenomenon of baseline ECG was caused by the APCs.

High prevalence of pathogenic Leptospira in wild and domesticated animals in an endemic area of China.

OBJECTIVE: To assess the prevalence of Leptospira detected in wildlife and domesticated animals in Jiangxi Province, China, in. METHODS: Urine samples from 28 buffaloes and kidney samples from 50 pigs, 50 dogs and 38 rats were collected from Fuliang and Shangrao County, Jiangxi Province, China, in October 2009. Polymerase chain reaction(PCR)and culture analyses were used to detect Leptospira. The cultured isolates were typed using the microscopic agglutination test(MAT). RESULTS: The results showed that rats potentially serve as the main reservoir of leptospiral infection, followed by dogs. Although 16% of rats (6/38) were positive using culture analysis, PCR analysis using the diagnostic primers G1/G2 and B64I/B64II or lipL32 showed identification as 50% and 24%, respectively, of the rat samples as positive for the presence of leptospiral DNA. CONCLUSIONS: PCR-based detection of leptospiral DNA in infected kidney tissues of reservoirs is more efficient when using G1/G2 primers than lipL32 primers. However, the latter primers have a potential application for detection in urine samples. The alarmingly high prevalence of leptospiral DNA in the wild rat population near human habitation underscores the utility of routine Leptospira surveillance, preferably using PCR methods, which are more sensitive than traditional culture-based methods.