Objective
To evaluate the efficacy and clinical significance of bipolar radiofrequency ablation in the treatment of left ventricular aneurysm with ventricular arrhythmias guided by CARTO mapping system.
Methods
From September 2009 to December 2015, 56 patients with ventricular aneurysm following myocardial infarction were enrolled. All patients suffered different levels of angina pectoris symptoms evaluated by Holter (the frequencies of ventricular arrhythmias more than 3 000 per day). They were divided into two groups according to random ballot and preoperative communication with patients' family members: a bipolar radiofrequency ablation group (n=28, 20 males, 8 females, mean age of 61.21±1.28 years) receiving off-pump coronary artery bypass grafting (OPCABG), ventricular aneurysm surgery combined with bipolar radiofrequency ablation, and a non-bipolar radiofrequency ablation group (n=28, 22 males, 6 females, mean age of 57.46±1.30 years) receiving OPCABG and single ventricular aneurysm surgery. The grade of cardiac function and ventricular arrhythmia was compared between the two groups during pre-operation, discharge and follow-up.
Results
All patients were discharged successfully. There was no in-hospital death in both two groups. One patient in the non-radiofrequency group had cerebral infarction. All patients were re-checked with Holter before discharge and the frequency of ventricular arrhythmias significantly decreased compared to that of pre-operation in both groups, and was more significant in bipolar radiofrequency ablation group (1 197.00±248.20 times/24 h vs. 1 961.00±232.90 times/24 h, P<0.05). There was significant difference in duration of mechanical ventilation and ICU stay between the two groups (P<0.05). The left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD) significantly improved (P<0.05) after operation in both groups.
Conclusion
The clinical efficacy of bipolar radiofrequency ablation in the treatment of ventricular aneurysm with ventricular arrhythmia guided by CARTO mapping is safe and effective, but its long-term outcomes still need further follow-up.
Sepsis-associated organ dysfunction arises from uncontrolled inflammation and immune dysregulation, causing microcirculatory impairment and multi-organ failure. Stellate ganglion block (SGB) may confer organ protection by regulating the sympathetic nervous system and hypothalamic-pituitary-adrenal axis to suppress excessive inflammation and oxidative stress. Available evidence, mainly from experimental and small clinical studies, suggests potential benefits of SGB in sepsis-induced acute lung injury, ventricular arrhythmias, and limb ischemia, which require confirmation in multicenter randomized controlled trials. This review outlines the mechanisms and clinical advances of SGB in sepsis-related organ dysfunction, providing a theoretical basis for its application in critical care.
ObjectiveTo systematically evaluate risk prediction models for ventricular arrhythmia (VA) following percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI), aiming to provide references for the development, optimization, and application of the models. MethodsDatabases including CNKI, Wanfang, VIP, Chinese Biomedical Literature Database, PubMed, Embase, and Cochrane Library were searched for studies on VA prediction models after PCI in AMI patients from inception to September 2025. Two researchers independently screened the literature, extracted data, and assessed the quality of included studies using the prediction model risk of bias assessment tool. Meta-analysis of common predictors was performed using Stata 18.0 software, and the area under the curve (AUC) of the models was statistically analyzed using MedCalc software. ResultsA total of 12 studies were included, establishing 12 models involving 3411 patients. The incidence of VA ranged from 11.0% to 50.8%, with an overall incidence of approximately 24.5%. The AUC values of the 12 models ranged from 0.717 to 0.983, indicating good predictive performance. However, the overall risk of bias in the included studies was high. Statistical analysis yielded a pooled AUC of 0.853 [95%CI (0.807, 0.899)]. Meta-analysis results showed that Killip class, left ventricular ejection fraction, thrombolysis in myocardial infarction flow grade, number of diseased coronary vessels, troponin levels, diabetes mellitus, J-wave on electrocardiogram, and serum potassium level were independent predictive factors for VA after PCI in AMI patients (P<0.05). ConclusionThe risk prediction models for VA after PCI in AMI patients demonstrate good overall discrimination. However, existing studies generally suffer from a high risk of bias, and the calibration and external validation of the models are severely insufficient, limiting their direct clinical applicability. Future multicenter, large-sample, prospective studies are needed to optimize study design and reporting processes, aiming to develop and validate more robust prediction models suitable for clinical practice, facilitating early identification and prevention of VA after PCI in AMI patients.
