Golden autumn october, meet the "Great Wall"; on the heart of the Tao, wisdom is full of halls! The 32nd Great Wall/Asian Cardiology Congress (GW-ICC/AHS.21) in 2021 was held online as a webcast. On October 31, the Arrhythmia Case Discussion Forum II was officially opened, and the forum was chaired by Professor Xie Ruiqin of the Second Hospital of Hebei Medical University and Professor Guo Zhifu of the First Affiliated Hospital of the Naval Military Medical University, which was divided into four sections: pacing technology and confusion, electrophysiology and left atrial appendage occlusion, rare cases of arrhythmias, electrophysiological technology and clinical.
In the first section of "Pacing Techniques and Confusion", Zhu Haojie of Fuwai Hospital of the Chinese Academy of Medical Sciences shared "Pacing Treatment in a Patient with Massive Reflux of Atrial Fibrillation Large Right Atrial Tricuspid Valve", he pointed out that crT treatment is recommended in patients with persistent atrial fibrillation complicated with heart failure and expected high ventricular pacing ratio. Such patients with large right atrium and a large number of tricuspid regurgitations may be considered for implanting the 3830 electrode from the right side.
Bai Yu of the First Affiliated Hospital of Harbin Medical University shared the "CRT implantation complicated by CS perforation case", he believes that complicated coronary sinus rupture or can continue surgery, if the operation is terminated during surgery, the elective period is changed to left bundle pacing, patients may benefit.
Wang Zhongkai of the First Affiliated Hospital of naval military medical university shared that "a case of loss of biventricular pacing caused by T wave oversensitivation" should be actively sought out for possible causes when the proportion of CRT pacing decreased, and the presence of T wave oversensitivation should first correct the reversible cause, and when it cannot be solved, a new pacing/sensing wire can be considered to be implanted in the ventricles. Professor Huang Weijian of the First Affiliated Hospital of Wenzhou Medical University and Professor Duan Jiangbo of Peking University People's Hospital participated in the discussion.
In the second section of "Electrophysiology and Left Atrial Appendage Sealing", Professor Zou Yu of Shanghai Oriental Hospital shared that "a case of atrial septal puncture for patients with atrial fibrillation after atrial septal sealing", a room septal puncture after transcatheter atrial septal sealing surgery is an unconventional operation, there is a certain risk, and a puncture room septum blocker or a bioresorbable blocker may be a better choice for patients with atrial septal defect.
Professor Wang Lianxia of the Second Hospital of Hebei Medical University explained the "catheter ablation of slow and fast syndrome", with the advancement of technology, catheter ablation is considered to be an alternative method for the treatment of slow and fast syndrome by pacemaker implantation, and the sinus node function of patients needs to be fully assessed before surgery.
Professor Wang Lei of Xiangtan Central Hospital shared the "three games with atrial fibrillation - a case of cardiogenic cerebral embolism diagnosis and treatment", the risk of atrial fibrillation complicated stroke is huge, and "stroke management" is the primary treatment plan for patients with atrial fibrillation. In this section, Professor Zhou Jing of Peking University First Hospital and Professor Wang Qunshan of Shanghai Xinhua Hospital commented on the wonderful case sharing.
In the third section of "Rare Cases of Arrhythmias", Xu Xiaofeng of the Second Hospital of Yinzhou District of Ningbo City shared the "Suspected Case of Frequent Incidence Chamber Caused by Calcifification of The Right Ventricular Regulatory Bundle", and all experts participated in the discussion, answered some questions, and explained the treatment of ventricular premature beats in different situations.
Liu Aihua of Qilu Hospital of Shandong University shared the "case of early diagnosis of atrial esophageal fistula with modified transesophageal endoscopy", traditional gastrointestinal endoscopy is contraindicated in patients with suspected atrial esophageal fistula, and improved esophageal endoscopy replaces air with carbon dioxide, which is a successful attempt to diagnose atrial esophageal fistula early, but its feasibility in clinical application needs further practical testing.
Professor Chen Yangang of Liangzhou Hospital in Wuwei City shared that "congenital inferior vena cava liver segment deficiency is like a case of ablation of atrioventricular nodal re-entrant tachycardia through the right subclavian vein pathway", and the lack of hepatic segment of the lower limb vein is a hypovading malformation of the inferior vena cava in the embryonic stage, and the blood flow below the hepatic segment of the malformation of the inferior vena cava is drained through the odd vein connected by the inferior vena cava to the right upper vena cava to the right atrium, and ablation is taken through the right subclavian vein pathway.
Professor Zhong Jingquan of Qilu Hospital of Shandong University and Professor Jia Yuhe of Fuwai Hospital of Chinese Academy of Medical Sciences participated in the discussion throughout the discussion.
In the fourth section of "Electrophysiology Technology and Clinical", Professor Huang Xinmiao of the First Affiliated Hospital of the Naval Military Medical University shared "a special case of tricuspid isthmus-dependent atrial apocalypse radiofrequency ablation", and patients with atrial atrophy should pay attention to finding trigger lesions, which is of great significance for subsequent diagnosis and treatment.
Professor Bei Zidong of the Affiliated Hospital of Shandong Medical College shared the "diagnosis and treatment of a special case of J wave syndrome", ischemic J wave is a relatively new concept, severe myocardial ischemia can be manifested as ischemic J wave, giant R wave syndrome, lambda wave, the three are easy to misdiagnose, we should pay attention to identification.
Professor Shi Zhazha of longyan first hospital affiliated to Fujian Medical University shared that "seeing the sun in the clouds, looking for the truth behind repeated syncope - a case of sudden loss of consciousness", when assessing the common syncope symptoms of patients, rare and serious causes should be considered, the diagnosis and treatment of long QT syndrome should not be limited to symptomatic treatment, and the search for causes is also very important.
Professor Jiang Chenyang of Run Run Shaw Hospital affiliated to Zhejiang University School of Medicine and Professor Liao Dening of The Long March Hospital of naval military medical university respectively expressed their unique views on the above cases.
The forum has a total of four major sections, a total of 12 topics, each speaker and experts from all over the country shared their own years of clinical practice in the process of encountered wonderful cases, broadened the horizons, for the diagnosis and treatment of arrhythmias to open up new ideas.
Author: Zhang Hao Beijing Anzhen Hospital affiliated to Capital Medical University
Golden autumn October, "in the air" there is an appointment!