Atrial fibrillation is one of the most common arrhythmia. Cardiac mapping technology, an important method to study the electrophysiological mechanism of atrial fibrillation, can determine the abnormal origin and record the distribution and transmission way of these atrial electrical signals. This technology offers a new way for research the electrophysiological mechanism of atrial fibrillation. The purpose of this study is to review the research progress of cardiac mapping in the electrophysiological mechanism of atrial fibrillation and clinical application.
Objective To explore the impact of the women taking warfarin throughout pregnancy after mechanical valve replacement on the children’s physical and mental development.Methods A total of 12 children whose mothers had taken mechanical valve replacement before pregnancy were enrolled in the experimental group in this study, for determination of their physical and mental development. The following indicators were measured: a) Physical development indexes: height, weight, sitting height, head circumference, chest circumference; b) Mental development indexes: intelligence quotient (IQ), and development quotient (DQ) which included adaptability, big movement, fine motor, language, and individual-society. According to the 1?∶?2 matching ratio, 24 children of the healthy women were selected in the control group, and then the difference of each index between the two groups was analyzed. Results In the aspects of both physical development indexes and mental development indexes, there were no significant differences in the children aged 0 to 3 yrs, 4 to 6 yrs, and 6 to 12 yrs in the two groups (Pgt;0.05). Conclusion After mechanical valve replacement, women taking oral anticoagulant warfarin in daily dose not exceeding 5mg are safe, and there are no negative effects on children’s physical and mental development.
Objective To investigate long-term echocardiography characteristics and their clinical significance of patients after mitral valve replacement （MVR）. Methods We retrospectively analyzed clinical data of 204 patients who underwent prosthetic MVR and finished echocardiography examination at least 5 years after surgery in West China Hospital of Sichuan University. There were 44 male patients and 160 female patients with their age of 23 to 73 （50.9±10.6）years. Postoperatively， all the patients were followed up for 5-15 （7.9±2.3）years and regularly received echocardiography examination at the outpatient department. Analysis variables included left atrium （LA） dimension， left ventricle （LV） dimension，right atrium （RA） dimension， right ventricle （RV） dimension， left ventricular ejection fraction （LVEF） and effective orificearea （EOA） of the mitral valve. Results Long-term echocardiography showed that LA and LV dimensions were signifi-cantly smaller than preoperative dimensions （P＜0.05）， while RA and RV dimensions were not statistically different from preoperative dimensions （P＞0.05）. Long-term LVEF was significantly higher than preoperative value （P＜0.05）. Long-term EOA was 1.1-4.8 （2.3±0.5）cm2， including EOA of 1.1-1.4 cm2 in 7 patients （3.4%，7/204），and 1.6-1.9 cm2in 42 patients （20.6%，42/204）. During long-term follow-up， 7 patients underwent their second heart surgery， including2 patients with prosthetic valve dysfunction， 1 patient with prosthetic perivalvular leak and severe hemolytic anemia，3 patients with severe tricuspid regurgitation which were not improved after medication treatment， and 1 patient with moderateaortic valve stenosis and regurgitation. Two patients had left atrial thrombosis during follow-up， including 1 patient who died of endocarditis 7 years after surgery， and another patient who was still receiving conservative therapy and further follow-up. Conclusion Concomitant tricuspid or aortic valve disease should be actively treated during MVR， and postoperative patients need better follow-up. Many patients after MVR need long-term cardiovascular medication treatment during follow-up in order to improve their heart function and long-term survival rate.