ABSTRACT
Objective: We aimed to determine the epidemiological characteristics of asymptomatic AF in elder community population (≥65 years old) to analyze the detection rate of different screening methods. Methods: The study was a prospective cohort study. The elder (≥65 years old) residents who voluntarily participated in free physical examination in Dalian community were selected. The participants were randomly divided into screening group (including intensive screening group and single screening group) and control group. The control group received interrogation, medical history collection and routine 12-lead electrocardiogram (ECG) examination. Screening group received an additional single-lead ambulatory ECG equipment worn for 5-7 days. Intensive screening group received two equal-length wearings in 2020 and 2021 respectively, while one screening group only wore once in 2020. Results: Finally 3 340 residents ((70.7±5.0) years old) which consisted of 1 488 males (44.55%) were enrolled. There were 1 945 residents in screening group, including 859 in intensive screening group and 1 086 in one-time screening group. The control group included 1 395 people. Detection rate of asymptomatic AF was significantly higher in screening group than control group (79(4.06%) vs. 24(1.72%), P<0.001). Higher detection rate was found in screening group than control group in AF risk factors (1 or 2-3) subgroups and CHA2DS2-VASc score (2-3 or≥4) subgroups (P<0.05). Additionally, no difference was found between intensive screening group and single screening group (42(4.89%) vs. 37(3.41%), P=0.100). Intensive screening increased detection rate (7(6.93%) vs. 1(0.58%), P=0.009) only in residents those with low thrombosis risk (CHA2DS2-VaSc<2). Conclusions: Screening in elderly (≥65 years old) can significantly improve the detection rate of asymptomatic AF by wearing single lead dynamic ECG device. The rate increased significantly with the increase of risk factors associated with AF by single screening. In addition, repeat screening of the same method may only improve detection rates in the group with low risk thrombotic scores and non-combination of AF risk factors.Screening methods that are appropriate for different populations may require further exploration.
Subject(s)
Male , Humans , Aged , Atrial Fibrillation/epidemiology , Prospective Studies , Electrocardiography , Risk Factors , Stroke , Risk Assessment , Mass Screening/methodsABSTRACT
Objective: We aimed to determine the epidemiological characteristics of asymptomatic AF in elder community population (≥65 years old) to analyze the detection rate of different screening methods. Methods: The study was a prospective cohort study. The elder (≥65 years old) residents who voluntarily participated in free physical examination in Dalian community were selected. The participants were randomly divided into screening group (including intensive screening group and single screening group) and control group. The control group received interrogation, medical history collection and routine 12-lead electrocardiogram (ECG) examination. Screening group received an additional single-lead ambulatory ECG equipment worn for 5-7 days. Intensive screening group received two equal-length wearings in 2020 and 2021 respectively, while one screening group only wore once in 2020. Results: Finally 3 340 residents ((70.7±5.0) years old) which consisted of 1 488 males (44.55%) were enrolled. There were 1 945 residents in screening group, including 859 in intensive screening group and 1 086 in one-time screening group. The control group included 1 395 people. Detection rate of asymptomatic AF was significantly higher in screening group than control group (79(4.06%) vs. 24(1.72%), P<0.001). Higher detection rate was found in screening group than control group in AF risk factors (1 or 2-3) subgroups and CHA2DS2-VASc score (2-3 or≥4) subgroups (P<0.05). Additionally, no difference was found between intensive screening group and single screening group (42(4.89%) vs. 37(3.41%), P=0.100). Intensive screening increased detection rate (7(6.93%) vs. 1(0.58%), P=0.009) only in residents those with low thrombosis risk (CHA2DS2-VaSc<2). Conclusions: Screening in elderly (≥65 years old) can significantly improve the detection rate of asymptomatic AF by wearing single lead dynamic ECG device. The rate increased significantly with the increase of risk factors associated with AF by single screening. In addition, repeat screening of the same method may only improve detection rates in the group with low risk thrombotic scores and non-combination of AF risk factors.Screening methods that are appropriate for different populations may require further exploration.
Subject(s)
Male , Humans , Aged , Atrial Fibrillation/epidemiology , Prospective Studies , Electrocardiography , Risk Factors , Stroke , Risk Assessment , Mass Screening/methodsABSTRACT
BACKGROUND@#Pulmonary vein (PV) occlusion generally depends on repetitive contrast agent injection when cryoballoon ablation for atrial fibrillation (AF). The present study was to compare the effect of cryoballoon ablation for AF guided by transesophageal echocardiography (TEE) vs. contrast agent injection.@*METHODS@#Eighty patients with paroxysmal AF (PAF) were enrolled in the study. About 40 patients underwent cryoballoon ablation without TEE (non-TEE group) and the other 40 underwent cryoballoon ablation with TEE for PV occlusion (TEE group). In the TEE group during the procedure, PVs were displayed in 3-dimensional images to guide the balloon to achieve PV occlusion. The patients were followed up at regularly scheduled visits every 2 months.@*RESULTS@#No differences were identified between the groups in regard to the procedure time and cryoablation time for each PV. The fluoroscopy time (6.7 ± 4.2 min vs. 17.9 ± 5.9 min, P < 0.05) and the amount of contrast agent (3.0 ± 5.1 mL vs.18.1 ± 3.4 mL, P < 0.05) in the TEE group were both less than the non-TEE group. At a mean of 13.0 ± 3.3 mon follow-up, success rates were similar between the TEE group and non-TEE group (77.5% vs. 80.0%, P = 0.88).@*CONCLUSIONS@#Cryoballoon ablation with TEE for occlusion of the PV is both safe and effective. Less fluoroscopy time and a lower contrast agent load can be achieved with the help of TEE for PV occlusion during procedure.
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Atrial Fibrillation , Diagnostic Imaging , General Surgery , Contrast Media , Cryosurgery , Methods , Echocardiography, Three-Dimensional , Methods , Echocardiography, Transesophageal , Methods , Pulmonary Veins , Diagnostic Imaging , General Surgery , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>The outcome of atrial fibrillation patients with genetic mutations post ablation was not well evaluated.</p><p><b>METHODS AND RESULTS</b>Three atrial fibrillation patients with evidence of mutations in KCNA5 and NPPA post successful circumferential pulmonary vein ablation were included. Mutation in KCNA5 was found in one male patient with paroxysmal atrial fibrillation. He was free of atrial fibrillation post ablation after 46 months follow-up. Mutations in NPPA were found in two male patients with persistent atrial fibrillation and they were free from atrial fibrillation after 64 months and 38 months follow-up post circumferential pulmonary vein ablation, roof line and mitral isthmus line ablation.</p><p><b>CONCLUSION</b>Satisfactory long term results are observed in atrial fibrillation patients with KCNA5 and NPPA mutations post circumferential pulmonary vein ablation.</p>
Subject(s)
Aged , Humans , Male , Middle Aged , Atrial Fibrillation , Genetics , General Surgery , Atrial Natriuretic Factor , Genetics , Catheter Ablation , Follow-Up Studies , Genetics , Mutation , Treatment OutcomeABSTRACT
Objective: To investigate the morphology and growth kinetics of the cells derived from the adult normal and herniated nucleus pulposus tissues. Methods: The cells derived from the adult normal and herniated nucleus pulposus were cultured in vitro. Passage 1,3,5 cells were chosen for light microscope and electron microscope observation. The cell growth rate, MTT value, maximal growth density, cellular mitotic index, cloning efficiency, and other parameters were observed in normal and herniated nucleus pulposus and the results were compared. Results: Compared with adult normal nucleus pulposus cells, the cells isolated from herniated nucleus pulposus were irregularly arranged and lost polarization, with rough endoplasmic reticulum slightly dilated. Under the same cellular density and culture conditions, the growth rate of passage 1 cells from adult normal and herinated nucleus pulposus had no significant difference, but the differences of passage 3 cells(P0.05); those of passage 3 cells were respectively 6.96±0.19 and 5.48±0.22, 0.154±0.018 and 0.110±0.009, (22.52±2.16)‰ and (16.68±2.35)‰, and (48.7±3.3)% and (40.7±2.5)%; and of passage 5 cells were respectively 2.42±0.13 and 0.98±0.14, 0.085±0.006 and 0.050±0.007, (15.61±1.96)‰ and (9.34±2.12)‰, and (40.2±2.3)% and (28.34±2.9)%. There were significant differences between the parameters of passage 3 and 5 cells(P<0.05). Conclusion: The adult normal and herinated nucleus pulposus cells are different in cellular morphology when cultured in vitro. The continuous proliferation ability of the herniated nucleus pulposus cells is obviously decreased than that of the adult normal control group, and aging is more easily seen in the herniated ones.