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  • 1.
    Expert consensus on clinical pathway of transcatheter left atrial appendage closure in China(2025)
    Heart Disease Group, Chinese College of Cardiovascular Structural
    Chinese Journal of Heart and Heart Rhythm(Electronic Edition) 2025, 13 (01): 1-28. DOI: 10.3877/cma.j.issn.2095-6568.2025.01.001
    Abstract (2820) HTML (106) PDF (9620 KB) (491)

    本共识聚焦左心耳封堵术(LAAC),鉴于心房颤动(房颤)患者增多及LAAC技术进展与临床需求变化,中国医师协会心血管内科医师分会结构性心脏病学组对此进行了更新。房颤发病率随人口老龄化而攀升,房颤引发的脑卒中风险高,而LAAC则是有效预防途径。共识详细阐述LAAC的发展脉络,包括在房颤综合管理中的关键意义、我国的里程碑事件及丰富的循证依据。在团队构建上,明确了涵盖多科室专业人员的配置及精细分工。明确适应证为高脑卒中风险且特定评分达标的非瓣膜性房颤患者,同时列出禁忌证。全面解析方法学,从影像评估[如(经胸超声心动图(TTE)、经食管超声心动图(TEE)、心脏CT血管造影(CTA)作用及要点]、不同封堵器操作(塞式或盘式封堵器的选择、置入、评估及调整流程)到围手术期管理各环节均有涉及。梳理围手术期并发症,涵盖心包积液、脑卒中、封堵器脱落等,分析成因并给出处理策略。术后抗栓治疗依阶段(强化、巩固及特殊患者情形)制订策略,同时详述随访计划(节点、方式、内容及结果判定)。术式选择介绍“一站式”与简化式特点及适用场景,展望未来聚焦适用人群拓展、技术完善、器械创新、联合治疗深化及用药策略优化,为LAAC临床实践与发展提供全方位、精准且具前瞻性的指引,有力推动其规范化、精准化及持续创新。

  • 2.
    Recommendation of the 2024 European Society of Cardiology guidelines on coronary artery bypass grafting and postoperative patient management: focus on chonic coronary syndrome patients and updates of guidelines
    Tengjiao Yang, Fei Xu
    Chinese Journal of Heart and Heart Rhythm(Electronic Edition) 2025, 13 (02): 73-78. DOI: 10.3877/cma.j.issn.2095-6568.2025.02.002
    Abstract (802) HTML (64) PDF (2534 KB) (134)

    冠心病是威胁国人生命健康的主要心血管疾病之一,冠状动脉(冠脉)旁路移植术是其重要的治疗措施。随着诊疗技术的不断进步,冠心病的治疗策略在不断发展变化,2024年欧洲心脏病协会推出新版慢性冠脉综合征的综合诊治指南,对冠心病患者接受冠脉旁路移植术的指征及术后管理给出了相应推荐。

  • 3.
    Interpretation of the updates on 2024 ESC guidelines for the management of elevated blood pressure and hypertension
    Xuhui Zheng, Wenming Yao, Xinli Li
    Chinese Journal of Heart and Heart Rhythm(Electronic Edition) 2025, 13 (01): 29-33. DOI: 10.3877/cma.j.issn.2095-6568.2025.01.002
    Abstract (581) HTML (22) PDF (1512 KB) (153)

    欧洲心脏病学会(ESC)于2024年8月30日发布了《2024年ESC血压升高和高血压管理指南》,对2018年版指南进行了重要更新,吸纳了最新的循证医学证据。新指南继续沿用高血压的定义,但新增了“血压升高”这一分类,定义为诊室收缩压120~139 mmHg或舒张压70~89 mmHg。指南建议所有高血压患者的血压控制在140/90 mmHg以下,耐受性良好的患者应进一步将目标降至130/80 mmHg以下。对于高危患者和老年患者,分别建议将收缩压控制在120~129 mmHg和130~139 mmHg。新指南还强调高血压筛查的重要性并推荐诊室外血压测量,提出新的降压治疗方法,包括盐皮质激素受体拮抗剂、血管紧张素受体-脑啡肽酶抑制剂和钠-葡萄糖共转运蛋白2抑制剂等。本文对新指南的重要推荐进行解读,旨在帮助医务工作者更好地理解和遵循指南。

  • 4.
    Electrocardiographic perspective and clinical warning of early repolarization
    Jing Li
    Chinese Journal of Heart and Heart Rhythm(Electronic Edition) 2025, 13 (02): 106-110. DOI: 10.3877/cma.j.issn.2095-6568.2025.02.008
    Abstract (566) HTML (15) PDF (2824 KB) (47)

    既往认为早复极是一种良性心电图表现,近20年来发现早复极可与恶性心律失常乃至猝死相关。本文就早复极相关定义及高危早复极最新进展行系统性综述。

  • 5.
    Interpretation of the updates on the 2025 ESC/EACTS guidelines for the management of valvular heart disease
    Wenzhi Pan, Zilong Weng, Daxin Zhou, Junbo Ge
    Chinese Journal of Heart and Heart Rhythm(Electronic Edition) 2025, 13 (03): 129-135. DOI: 10.3877/cma.j.issn.2095-6568.2025.03.001
    Abstract (387) HTML (35) PDF (2662 KB) (158)

    《2025年ESC/EACTS瓣膜性心脏病管理指南》的发布受到广泛关注。本次更新涵盖经导管主动脉瓣置换(TAVR)适应证的拓展,包括年龄下限调整至70岁,将二叶式主动脉瓣狭窄和单纯性主动脉瓣反流列为适应证;进一步明确了混合性主动脉瓣病变的干预标准;优化了TAVR同期血运重建策略;提升了二尖瓣及三尖瓣介入治疗的推荐级别;首次推荐经导管二尖瓣植入用于二尖瓣瓣环钙化患者;简化了瓣膜术后抗栓方案,强化了左心耳封堵推荐级别等。本文旨在对该指南的核心更新内容进行总结及解读。

  • 6.
    Interpretation of guideline for clinical application of cardiovascular remodeling and function in hypertension (2024)
    Yisheng Shi
    Chinese Journal of Heart and Heart Rhythm(Electronic Edition) 2025, 13 (02): 83-86. DOI: 10.3877/cma.j.issn.2095-6568.2025.02.004
    Abstract (185) HTML (11) PDF (1941 KB) (31)

    高血压是一种常见的心血管疾病,但一直缺乏专注于系统阐述高血压心血管超声检查和诊断方法的指南和共识,2024年7月国家超声医学质量控制中心等组织部分超声专家共同撰写发表了《超声检查高血压心血管重构和功能临床应用指南(2024版)》。该指南就高血压心脏和血管病变的病理生理、高血压心脏及血管结构和功能改变的超声检查要点进行了系统性论述,为医务工作者提供了规范的操作方法和测量标准,可以为临床诊疗提供更大的帮助。

  • 7.
    Interpretation on the Chinese expert consensus for the diagnosis and managemen to diuretic resistancein patients with heart failure
    Xiao Liang, Xiaolin Xue
    Chinese Journal of Heart and Heart Rhythm(Electronic Edition) 2025, 13 (02): 79-82. DOI: 10.3877/cma.j.issn.2095-6568.2025.02.003
    Abstract (172) HTML (24) PDF (2136 KB) (84)

    中国医师协会心血管内科分会、中国老年医学学会心电及心功能分会联合中国心衰中心联盟专家委员会组织心血管领域专家于2024年制定了《心力衰竭患者利尿剂抵抗诊断及管理中国专家共识》(以下简称《共识》)。为更好地帮助读者对该《共识》进行理解,专家组系统地解读和介绍《共识》中的重点、难点,以期帮助读者全面、准确地理解和运用该《共识》,从而提高慢性心力衰竭袢利尿剂抵抗临床诊治的疗效。

  • 8.
    Transcatheter aortic valve replacement annual report 2024
    Shasha Chen, Jie Li, Fei Li, Zhenfei Fang, Wenzhi Pan, Daxin Zhou, Yongjian Wu, Junbo Ge
    Chinese Journal of Heart and Heart Rhythm(Electronic Edition) 2025, 13 (02): 65-72. DOI: 10.3877/cma.j.issn.2095-6568.2025.02.001
    Abstract (172) HTML (26) PDF (3774 KB) (84)

    近年来,经导管主动脉瓣置换术(TAVR)发展迅猛。2024年,除应用迅速普及外,国内外大量新研究、新器械和新技术在该领域涌现,使其不断突破瓶颈、拓展应用。本文拟从国际重大研究进展、国内应用与研究进展、国内新器械研发三方面回顾本年度TAVR领域的亮点,并对2025年该领域的发展作一展望。

  • 9.
    Research on the correlation factors of thrombus formation in non-valvular atrial fibrillation patients after standard anticoagulation
    Jianhua Wang, Weili Fan, Haihan Guo, Lu Sun, Meng Zhang, Jian Xu, Shufeng Li, Wei Cao
    Chinese Journal of Heart and Heart Rhythm(Electronic Edition) 2025, 13 (01): 38-46. DOI: 10.3877/cma.j.issn.2095-6568.2025.01.004
    Abstract (159) HTML (8) PDF (3731 KB) (24)

    Objective

    To identify risk factors for thrombus formation in the left atrial appendage post-standard anticoagulation treatment by multiple dimensions including the morphology of the left atrial appendage and adjacent structures, echocardiographic imaging, and clinical laboratory indicators.

    Methods

    This single-center case-control study enrolled patients with non-valvular atrial fibrillation (AF) scheduled for radiofrequency ablation on The Second Affiliated Hospital of Harbin Medical University from January 2021 to October 2022. All patients underwent standardized anticoagulation therapy for at least three weeks before admission.Preoperative examinations included transthoracic echocardiography, transesophageal echocardiography, and pulmonary vein CT angiography. Three-D rendering post-processing techniques to construct three-dimensional structures of the left atrial appendage and pulmonary veins, and multiplanar reconstruction technology to observe the morphology of the left atrial appendage opening were utilized. It also measured the opening's length, diameter, circumference,and area. Clinical datas were collected included patient demographics, comorbidities, liver and kidney function, coagulation parameters, and echocardiographic parameters such as atrial and ventricular diameter and valvular flow velocity. Patients were divided into two groups based on the presence or absence of thrombus in the left atrial appendage as detected by transesophageal echocardiography, and the data differences between the groups were compared.

    Results

    All of 203 patients were included, averaging (58.13±10.67) years in age, with males comprising 64.5% (131/203). Among them, 21 patients (10.3%, 21/203) had thrombi in the left atrial appendage, and were classified into the thrombus group, while the remaining 182 (89.6%, 182/203) formed the non-thrombus group. There was no significant statistical difference in the proportions of the four left atrial appendage morphologies (chicken wing, windsock, cactus, and cauliflower) between the two groups. The thrombus group had significantly larger left atrial appendage openings and anteroposterior diameters of the left atrium (P<0.05). Binary Logistic regression analysis revealed that increased levels of alanine aminotransferase [odds ratio(OR)=1.039, 95% confidence interval(CI) 1.009-1.070, P=0.010)], uric acid (OR=1.005, 95%CI 1.001-1.010, P=0.023), a decrease in activated partial thromboplastin time (OR=0.919, 95%CI 0.858-0.984, P=0.015), and an enlarged left atrial appendage opening area (OR=1.793, 95%CI 1.234-2.604, P = 0.003) were independent predictive factors for thrombus formation in the left atrial appendage.

    Conclusion

    The formation of thrombi in the left atrial appendage of patients with non-valvular AF post-standard anticoagulation during the perioperative period is not related to the morphology of the left atrial appendage. Impaired liver and kidney function are independent risk factors for the formation of thrombi in the left atrial appendage. Maintaining activated partial thromboplastin time at a higher level within the normal range may reduce the risk of thrombus formation. Structural changes in the atrium are also potentially linked to the formation of thrombi in the left atrial appendage.

  • 10.
    Research progress of painful left bundle branch block syndrome
    Xialing Li, Xiaogang Zhu, Wenze Hu, Ming Yang, Zichuan Tong
    Chinese Journal of Heart and Heart Rhythm(Electronic Edition) 2025, 13 (01): 47-53. DOI: 10.3877/cma.j.issn.2095-6568.2025.01.005
    Abstract (150) HTML (6) PDF (4503 KB) (37)

    胸痛左束支阻滞综合征的特征是在没有潜在心肌缺血的情况下,胸痛与快频率依赖的左束支阻滞同时出现及消失,病理生理机制可能与突发的心室不同步、冠状动脉微循环障碍及心脏内感受器过度敏感有关,治疗上运动及药物治疗效果不佳,近年传导系统起搏治疗进展较大。本文重点论述近年胸痛左束支阻滞综合征的研究进展。

  • 11.
    Inverse decremental conduction in His-Purkinje system
    Tonglian Lyu, Yubin Zhang, Tong Liu
    Chinese Journal of Heart and Heart Rhythm(Electronic Edition) 2025, 13 (01): 34-37. DOI: 10.3877/cma.j.issn.2095-6568.2025.01.003
    Abstract (149) HTML (3) PDF (2030 KB) (48)

    希氏-浦肯野系统(希浦系统)在受损或病理状态下可失去原有的“全或无”传导特性,而发生与房室结递减传导完全相反的“倒递减传导”,即受损的希浦系统激动的传导速度与上游刺激频率呈正相关的心电现象,本文将总结目前已发表的倒递减传导的病例报道,系统介绍这一心电现象的特点。

  • 12.
    Advances in therapeutic applications of β-blocker in cardiovascular diseases
    Panpan Xia, Zhiqiang Xu, Yumin Sun
    Chinese Journal of Heart and Heart Rhythm(Electronic Edition) 2025, 13 (02): 93-98. DOI: 10.3877/cma.j.issn.2095-6568.2025.02.006
    Abstract (141) HTML (12) PDF (2923 KB) (52)

    β受体阻滞剂是传统的心血管疾病治疗药物,具有抑制交感神经活性、抗应激、抗氧化、抑制细胞死亡和保护心肌等作用,可用于治疗多种疾病,包括高血压、心律失常、心力衰竭、心绞痛等。本文对β受体阻滞剂在心血管疾病中的应用最新研究进展作一综述。

  • 13.
    A case of second degree and typeⅠsinoatrial block caused by lacosamide
    Hugen Xu, Jia Wang, Fuchi Zhang, Yunshan Zhou, Xiangsong Shi
    Chinese Journal of Heart and Heart Rhythm(Electronic Edition) 2025, 13 (01): 54-56. DOI: 10.3877/cma.j.issn.2095-6568.2025.01.006
    Abstract (118) HTML (10) PDF (3634 KB) (47)

    拉考沙胺为新型第三代抗癫痫药,主要通过选择性增强电压门控钠离子通道的慢失活来稳定神经细胞膜。临床常见的不良反应为头晕、头痛、恶心、呕吐,对心血管系统的不良反应报道较少。本文报道1例拉考沙胺致二度Ⅰ型窦房传导阻滞,旨在提高拉考沙胺对心血管系统不良反应的识别,避免误诊。

  • 14.
    A case of percutaneous coronary intervention for woven coronary artery guided by optical coherence tomography
    Yuchen Zhang, Haoyu Meng
    Chinese Journal of Heart and Heart Rhythm(Electronic Edition) 2025, 13 (01): 57-60. DOI: 10.3877/cma.j.issn.2095-6568.2025.01.007
    Abstract (115) HTML (3) PDF (3723 KB) (31)

    近年随着腔内影像学的广泛应用,冠状动脉编织样改变被认为是急性冠脉综合征的机制之一。这种冠状动脉畸形曾被认为是先天性的,然而,近年来结合腔内影像学技术的病例报道提示其更可能是继发于血栓机化再通。本文报道光学相干断层成像指导下编织样右冠状动脉成功经皮冠状动脉介入诊疗一例。

  • 15.
    Surgical treatment of complete atrioventricular septal defect combined with tetralogy of Fallot or double outlet of right ventricular
    Juntao Qiu, Kai Ma, Huaping Jiang, Yumeng Ji, Shoujun Li, Keming Yang
    Chinese Journal of Heart and Heart Rhythm(Electronic Edition) 2025, 13 (02): 99-105. DOI: 10.3877/cma.j.issn.2095-6568.2025.02.007
    Abstract (111) HTML (6) PDF (3256 KB) (24)
    Objective

    To explored the surgical treatment strategy for complete type endocardial cushion defect (TECD) combined with tetralogy of Fallot (TOF) or double outlet of right ventricular (DORV) by summarizing the data of patients with these malformations in single-center.

    Methods

    The clinical data of patients with TECD combined with TOF or DORV from January 2001 to December 2021 in Fuwai Hospital were retrospectively collected. The patients were divided into single ventricular appliance group and double ventricular appliance group. The single ventricular correction group included superior vena-pulmonary artery connection subgroup (Glenn subgroup) and total vena-pulmonary artery connection subgroup. The preoperative baseline data, intraoperative cardiopulmonary bypass time, aortic cross-clamp time, differences in postoperative mitral regurgitation, tricuspid regurgitation, and mortality differences between the single ventricular correction group and the double ventricular correction group were compared. Additionally, the differences in severe atrioventricular valve regurgitation, other complications, and mortality between the single ventricular and double ventricular patients in the two time periods from 2001 to 2010 (the first 10 years subgroup) and from 2011 to 2021 (the second 10 years subgroup) were compared.

    Results

    From January 2001 to December 2021, there were a total of 184 patients with TECD combined with TOF or DORV [median age 45 (16-84) months, male 64.1% (118/184)] in our center. There was no significantly difference was found between the biventricular correction group (26.6%, 49/184) and the total cava subgroup (26.6%, 49/184) and Glenn subgroup (46.8%, 86/184) (38 months vs. 60 months vs. 35 months, P=0.058). There were 109 patients in the first 10 years subgroup, including 22 patients (20.2%, 22/109) in the biventricular correction group and 87 patients (79.8%, 87/109) in the single ventricular correction group. There were 75 patients in the second 10 years subgroup, including 27 patients (36.0%, 27/75) in the biventricular correction group and 48 patients (64.0%, 48/75) in the single ventricular correction group. Compared with the first and second 10 years subgroup, there was a statistically significant difference in the proportion of severe atrioventricular regurgitation in the biventricular correction group [27.3% (6/22) vs. 14.8% (4/27), P=0.01], the operative mortality rate of biventricular correction and single ventricular correction in the first 10 years subgroup was higher than that in the second 10 years subgroup [biventricular correction operative mortality rate:13.6% (3/22) vs. 3.7% (1/27), P=0.02; single-ventricular corrective operative mortality rate: 5.7% (5/87) vs. 2.1% (1/48), P=0.06].

    Conclusion

    TECD combined with TOF or DORV is a rare congenital complex malformation. With the advancement of technology and the selection of individualized surgical strategies, patients with TECD combined with TOF or DORV can obtain a good prognosis.

  • 16.
    Key points of the expert consensus on the prevention and treatment of sudden death from coronary atherosclerotic heart disease (2024)
    Yonghua Zhang
    Chinese Journal of Heart and Heart Rhythm(Electronic Edition) 2025, 13 (03): 136-139. DOI: 10.3877/cma.j.issn.2095-6568.2025.03.002
    Abstract (110) HTML (7) PDF (1678 KB) (38)

    中国冠状动脉粥样硬化性心脏病(冠心病)患者数量众多,引发心脏性猝死比例极高。2024年10月我国首部《冠状动脉粥样硬化性心脏病猝死防治专家共识(2024)》发布,从冠心病猝死的流行病学、发生机制、预测和筛查、识别与紧急处理、一级及二级预防策略、公众教育及急救体系建设等方面进行论述,为基层医务人员早期识别和防治冠心病猝死提供参考。

  • 17.
    A case report of radiofrequency catheter ablation targeting premature ventricular contraction induced cardiomyopathy originating from the left ventricular epicardium
    Yue Qiu, Caiyi Jin, Hongwu Chen, Minglong Chen
    Chinese Journal of Heart and Heart Rhythm(Electronic Edition) 2025, 13 (02): 116-119. DOI: 10.3877/cma.j.issn.2095-6568.2025.02.010
    Abstract (85) HTML (4) PDF (3198 KB) (46)

    1例20岁男性患者,因频发室性早搏(室早)入院行射频消融治疗。术中分别于左心室低位后间隔和冠状窦内左心室后侧静脉处标测到最早激动点,但两处靶点的消融不能成功消融室早,术后复查动态心电图仍有频发室早。再次手术时行心外膜标测,在心内膜及左心室后侧静脉靶点附近标测到最早心室激动,并在该处成功消融室早。经过1年的随访,患者心功能恢复正常。

  • 18.
    Interpretation of the 2024 ESC clinical consensus on obesity and cardiovascular disease
    Gongyuan Chen, Zhouqing Huang
    Chinese Journal of Heart and Heart Rhythm(Electronic Edition) 2025, 13 (03): 140-148. DOI: 10.3877/cma.j.issn.2095-6568.2025.03.003
    Abstract (83) HTML (5) PDF (3810 KB) (28)

    肥胖是心血管疾病的关键风险因素,给诊疗带来了诸多挑战。欧洲心脏病学会(ESC)发布的《肥胖与心血管疾病:ESC临床共识声明》(以下简称“该共识”),为肥胖与心血管疾病的临床关联以及肥胖管理提供了最新的证据和临床建议,具有重要的指导意义。该共识内容丰富,涵盖了肥胖的定义、流行病学、病因、表型及评估,肥胖对心血管疾病危险因素的影响,肥胖对不同心血管疾病的影响及病理生理机制,现阶段肥胖的干预策略等诸多方面。该共识不仅剖析了肥胖与心血管疾病的复杂关系,还强调了肥胖预防和干预的重要性,尤其是在心血管疾病的发生、治疗及预后管理中的作用。本文旨在对该共识进行简要而精准的解读,以期为临床医生在肥胖患者相应心血管疾病的管理中提供有价值的参考,助力提升肥胖相关心血管疾病的诊疗水平,改善患者的预后。

  • 19.
    The status and progress of cardiac pacing therapy in children
    Xiaomei Li
    Chinese Journal of Heart and Heart Rhythm(Electronic Edition) 2025, 13 (02): 111-115. DOI: 10.3877/cma.j.issn.2095-6568.2025.02.009
    Abstract (80) HTML (2) PDF (2530 KB) (21)

    心脏起搏技术已广泛应用于缓慢性心律失常治疗及心脏再同步治疗。儿童起搏治疗与成人不完全相同,有其特殊性。本文结合国内外指南和最新研究,对儿童起搏治疗适应证、起搏导线植入路径及部位、起搏系统的选择、植入技术、程控策略及再同步治疗等方面进行系统阐述,为儿童起搏治疗临床实践提供参考依据。

  • 20.
    A case report of right atrial insertion ablation to block interatrial connection in the treatment of intractable electrical conduction recovery of right pulmonary vein
    Zheng Liu, Jianjun Zhang, Xingpeng Liu, Lifeng Liu, Wanjing Zhang, Kun Zuo, Xiaoqin Liu
    Chinese Journal of Heart and Heart Rhythm(Electronic Edition) 2025, 13 (02): 120-123. DOI: 10.3877/cma.j.issn.2095-6568.2025.02.011
    Abstract (77) HTML (5) PDF (2743 KB) (43)

    肺静脉隔离术是心房颤动消融术的基石。心房间肌束连接可导致肺静脉电位隔离困难。右心房插入点消融阻断心房间连接辅助肺静脉隔离在国内鲜见病例报道。本文报道1例右心房插入点消融阻断心房间连接治疗顽固性右肺肺静脉电传导恢复病例。

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