BACKGROUND Irregular heart rhythms are a primary manifestation of cardiovascular disease,considerably contributing to global morbidity and mortality rates.Moreover,patients with cardiac arrhythmias often experience a ...BACKGROUND Irregular heart rhythms are a primary manifestation of cardiovascular disease,considerably contributing to global morbidity and mortality rates.Moreover,patients with cardiac arrhythmias often experience a higher prevalence of sleep disorders,anxiety,and depression owing to various factors.AIM To investigate the epidemiological characteristics and psychological factors associated with arrhythmia in the elderly and to establish a theoretical foundation for its prevention and treatment in older adults.METHODS A retrospective analysis was performed on 169 elderly patients admitted to the Shangqiu First People’s Hospital from December 2022 to December 2023.All subjects underwent 24-hour electrocardiogram monitoring to record heart rate,heart rate variability,and 24-hour ambulatory electrocardiogram data.Additionally,patients’medical records were reviewed to gather information on their general condition,including age,gender,underlying diseases,and other relevant factors.Patients were divided into four groups based on their Hamilton Anxiety(HAMA)and Hamilton Depression Rating Scale(HAMD)scores:Group A(HAMA scores≥7),Group B(HAMD scores≥7),Group C(both HAMA and HAMD scores≥7),and Group D(HAMA and HAMD scores<7).Psychological factors such as depression,anxiety,sleep status,and quality of life were analyzed.Pearson correlation was used to examine the relationship between scores from the Pittsburgh Sleep Quality Index(PSQI),HAMA/HAMD scales,and the Short Form 36-item Health Survey(SF-36)with the presence of arrhythmia.RESULTS Among the 169 patients,87(51.5%)had concurrent arrhythmia.Atrial arrhythmias constituted the largest proportion at 34.8%(30 out of 87),followed by sinustachycardia at 24.1%(21 out of 87),and ventricular arrhythmias at 9.2%(8 out of 87).Factors such as advanced age,coronary heart disease,hypertension,smoking,exposure to secondhand smoke,and residing in rural areas significantly increased the risk of developing arrhythmia.There was a statistically significant difference between the two groups regarding PSQI,HAMA-14,HAMD-17,and SF-36 scores.Pearson correlation analysis revealed that PSQI,HAMA-14,and HAMD-17 scores were positively correlated with arrhythmia in the elderly,while the SF-36 score was negatively correlated.The anxiety,depression,and combined anxiety–depression groups exhibited significantly higher PSQI,HAMA-14,and HAMD-17 scores compared to the nonanxiety and non-depression group.CONCLUSION Arrhythmia among the elderly is primarily found in individuals with advanced age and existing health conditions.It is also linked to psychological factors such as depression,anxiety,reduced quality of life,and sleep disturbances.展开更多
Transcutaneous renal artery denervation （RND） has beeninitially developed for destruction of efferent nerve fireswith luminal delivery of radiofrequency or ultrasonic energyaiming blood pressure reduction in patient...Transcutaneous renal artery denervation （RND） has beeninitially developed for destruction of efferent nerve fireswith luminal delivery of radiofrequency or ultrasonic energyaiming blood pressure reduction in patients with refractoryhypertension. However, other positive results of RNDwere described afterwards, and they include suppression ofatrial fibrillation and ventricular tachycardia （VT） storm.展开更多
Objective To evaluate the PR to RR interval ratio (PR/RR,heart rate-adjusted PR) as a prognostic marker for long-term ventricular arrhythmias and cardiac death in patients with implantable cardioverter defibrillator (...Objective To evaluate the PR to RR interval ratio (PR/RR,heart rate-adjusted PR) as a prognostic marker for long-term ventricular arrhythmias and cardiac death in patients with implantable cardioverter defibrillator (ICDs) and cardiac resynchronization therapy with defibrillators (CRT-D).Methods We retrospectively analyzed data from 428 patients who had an ICD/CRT-D equipped with home monitoring.Baseline PR and RR interval data prior to ICD/CRT-D implantation were collected from standard 12-lead electrocardiograph,and the PR/RR was calculated.The primary endpoint was appropriate ICD/CRT-D treatment of ventricular arrhythmias (VAs),and the secondary endpoint was cardiac death.Results During a mean follow-up period of 38.8 ± 10.6 months,197 patients (46%) experienced VAs,and 47 patients (11%) experienced cardiac death.The overall PR interval was 160 ± 40 ms,and the RR interval was 866 ± 124 ms.Based on the receiver operating characteristic curve,a cut-off value of 18.5% for the PR/RR was identified to predict VAs.A PR/RR ≥ 18.5% was associated with an increased risk of VAs [hazard ratio (HR)= 2.243,95% confidence interval (CI)= 1.665–3.022,P < 0.001) and cardiac death (HR = 2.358,95%CI = 1.240–4.483,P = 0.009) in an unadjusted analysis.After adjustment in a multivariate Cox model,the relationship remained significant among PR/RR ≥ 18.5%,VAs (HR = 2.230,95%CI = 1.555–2.825,P < 0.001) and cardiac death (HR = 2.105,95%CI = 1.101–4.025,P = 0.024.Conclusions A PR/RR ≥ 18.5% at baseline can serve as a predictor of future VAs and cardiac death in ICD/CRT-D recipients.展开更多
Atrial fibrosis is common in atrial fibrillation （AF）. Experimental studies have provided convincing evidence that fibrotic transformation of atrial myocardium results in deterioration of atrial conduction, increasi...Atrial fibrosis is common in atrial fibrillation （AF）. Experimental studies have provided convincing evidence that fibrotic transformation of atrial myocardium results in deterioration of atrial conduction, increasing anisotropy of impulse propagation and building of boundaries that promote re-entry in the atrial walls that maybe directly relevant for the mechanisms responsible for maintaining AF. Whether or not fibrosis is a result of structural remodelling caused by persistent AF or a manifestation of occult myocardial process that leads to development of arrhythmia is less clear. Human data indicate the presence of association between persistency of AF and the extent of structural changes in atrial myocardium. The role atrial fibrosis plays in the mechanisms of AF, however, may differ between patients with structurally normal hearts, such as lone AF, and those with advanced cardiovascular comorbidities.展开更多
Advances in clinical and fimdamental research, which have been promoted over last decades have led to a well- established understanding of atrial fibrillation （AF） as an epiphenomenon that despite similar manifestat...Advances in clinical and fimdamental research, which have been promoted over last decades have led to a well- established understanding of atrial fibrillation （AF） as an epiphenomenon that despite similar manifestations may have different underlying mechanisms and thus require in- dividualized treatments. With rare exceptions of AF caused by mutations in genes coding ion channels in pa- tients with structurally normal atria, fibrotic replacement of atrial myocardium remains the comer stone of atrial pa- thology in patients with AF.展开更多
Background Cardiac implantable electronic devices （CIEDs） greatly improve survival and life quality of patients. However, there are gender differences regarding both the utilization and benefit of these devices. In ...Background Cardiac implantable electronic devices （CIEDs） greatly improve survival and life quality of patients. However, there are gender differences regarding both the utilization and benefit of these devices. In this prospective CIED registry, we aim to appraise the gender differences in CIED utilization in China. Methods Twenty centers from 14 provinces in China were included in our registry study. All patients who underwent a CIED implantation in these twenty centers between Jan 2015 and Dec 2016 were included. Results A total of 8570 patients were enrolled in the baseline cohort, including 7203 pacemaker, 664 implantable cardiac defibrillators （ICD） implants and 703 cardiac resynchronization therapy device （CRT/D）. Totally, 4117 （48.0%） CIED patients were female, and more than 59% pacemaker patients were female, but women account only one third of ICD or CRT/D implantation in this registry. There were significant differences between genders at pacemaker and ICD indications. Female was more likely received a pacemaker due to sick sinus syndrome （SSS） （63.9% vs. 51.0%, P 〈 0.001）. Female patients receiving an ICD were more likely due to cardiac ion channel disease （29.2% vs. 4.2%, P 〈 0.001）. The percentage of utilization of dual-chamber pacemaker in female patients was significantly higher than male （85.3% vs. 81.1%, P 〈 0.001）. But male patients were more likely received a cardiac resynchronization therapy devices with defibrillator than female （56.5% vs. 41.9%, P = 0.001）. In pacemaker patient, male was more likely to have structure heart disease （31.3% vs. 28.0%, P = 0.002）. In ICD patient, male patients were more likely to have ischemic heart disease （48.2% vs. 29.2%, P 〈 0.001）. The mean age of women at the time of CRT/D implantation was older than men （P = 0.014）. Nonischemic cardiomyopathy （70.9%） was the most common etiology in the patients who underwent the treat？ment of CRT/D, no matter male or female. Conclusions In real-world setting, female do have different epidemiology, pathophysiology and clinical presentation of many cardiac rhythm disorders when compared with male, and all these factors may affect the utilization of CIED implantation. But it also possibility that cultural and socioeconomic features may play a role in this apparent discrimination.展开更多
Background Implantable cardioverter defibrillator （ICD） is the only effective therapy in patients with life threatening ventricular arrhythmias. Inappropriate detection and therapy by ICDs are the most common causes...Background Implantable cardioverter defibrillator （ICD） is the only effective therapy in patients with life threatening ventricular arrhythmias. Inappropriate detection and therapy by ICDs are the most common causes of side effects that affect the quality of life in ICD recipients. This study evaluated the incidence and causes of inappropriate detection and therapy by ICDs in patients in our hospital. Methods From January 2000 to December 2005, fifty patients who received ICD implantation for ventricular arrhythmias for prevention of sudden cardiac death were evaluated in this study. Each ICD was programmed using clinical arrhythmic and cardiac data of the patient before discharge. Patients were followed up by standard schedule after implantation and all data retrieved from each device were collected and saved for further analysis. Results No arrhythmic event was detected in 12/50 （24%） patients during the period of follow-up. Among the remaining patients, 11 （22%） experienced inappropriate detections and therapies during follow-up in this study. ICD detected 383 ventricular tachyarrhythmia （VT） and 108 ventricular fibrillation （VF） episodes and delivered 678 therapies. In VT group, ICD delivered 413 antitachycardiac pacings （ATPs） and 118 shocks, among which 78 ATPs and 9 shocks were initiated by 55/383 （14.3%） inappropriate detections. In VF group ICD delivered 147 shocks, among which 56 shocks were initiated by 28/108 （26.9%） inappropriate detections. Overall, more than 50% of these episodes were caused by atrial fibrillation （AF） with rapid ventricular response, followed by electromagnetic or myopotential interference. In addition, most inappropriate therapies occurred within one year after ICD implantation. Conclusions About one fifth of patients experienced ICD inappropriate detection and therapy after implantation. The main cause was AF with rapid ventricular response, followed by electromagnetic or myopotential interference.展开更多
Cardiac arrhythmias are among the most common causes of death in the world. Foundational studies established the critical role of ion channel disorders in arrhythmias, yet defects in ion channels themselves, such as m...Cardiac arrhythmias are among the most common causes of death in the world. Foundational studies established the critical role of ion channel disorders in arrhythmias, yet defects in ion channels themselves, such as mutations, may not account for all arrhythmias. Despite the progress made in recent decades, the antiarrhythmic drugs currently available have limited effectiveness,and the majority of these drugs can have proarrhythmic effects. This review describes novel knowledge on cellular mechanisms that cause cardiac arrhythmias, focuses on the dysfunction of subcellular organelles and intracellular logistics, and discusses potential strategies and challenges for developing novel, safe and effective treatments for arrhythmias.展开更多
Ebstein＇s anomaly is a kind of congenital heart disease ＇with part or all leaflets of tricuspid valve notnormally attaching to the tricuspid annulus in the normal position, but spirally shifting downward and abnorma...Ebstein＇s anomaly is a kind of congenital heart disease ＇with part or all leaflets of tricuspid valve notnormally attaching to the tricuspid annulus in the normal position, but spirally shifting downward and abnormally attaching to the right ventricular wall. Ebstein＇s anomaly patients often suffer from arrhythmias, featured by paroxysmal fibrillation and supraventricular tachycardia, atrial atrial flutter, etc.展开更多
Background The impact of home monitoring system in the early detection of ventricular arrhythmia and inappropriate shock in daily work is not clear. The aim of this study was to investigate the impact of home monitori...Background The impact of home monitoring system in the early detection of ventricular arrhythmia and inappropriate shock in daily work is not clear. The aim of this study was to investigate the impact of home monitoring system on the early detection of ventricular arrhythmia and inappropriate shock in daily clinical practice. Methods Cases of implantable cardioverter defibrillator （ICD） implantation with or without the home monitoring system from June 2010 to October 2011 at our center were reviewed. Follow-up was scheduled after implantation. Data relating to the home monitoring ICD were retrieved using a remote transmitter system. Data relating to the other devices were obtained during scheduled follow-up or unscheduled visits. Results Our study involved 69 patients （mean age （68.4＋17.6） years, 64.3% males, 26 in the home monitoring group vs. 43 in the non-home monitoring group）. In all, 561 ventricular arrhythmia episodes were detected in 17 patients （39.5%） in the non-home monitoring group： 495 episodes were ventricular tachycardia and 66 episodes were ventricular fibrillation; among these, 476 episodes of ventricular tachycardia and 45 episodes of ventricular fibrillation were appropriately diagnosed （96.1% and 68.2%, respectively）. In the home monitoring group, 389 ventricular arrhythmia episodes were transmitted by the home monitoring system in nine patients （34.6%）： 348 ventricular tachycardia episodes and 41 ventricular fibrillation episodes. Device detection was appropriate in 348 ventricular tachycardia episodes （100.0%） and 36 ventricular fibrillation episodes （87.8%）. The home monitoring group showed a higher appropriate detection rate of ventricular tachycardia （P 〈0.01） and ventricular fibrillation （P=0.02）. The proportion of inappropriate shock was comparable in the two groups （6/11 in the non-home monitoring group vs. 1/7 in the home monitoring group; m=0.08）. Conclusions The home monitoring ICD was able to provide information relating to inappropriate detection and shock earlier than conventional devices. It proved to be a reliable tool and has a strong potential to provide greater reaction time in the case of inappropriate shock.展开更多
文摘BACKGROUND Irregular heart rhythms are a primary manifestation of cardiovascular disease,considerably contributing to global morbidity and mortality rates.Moreover,patients with cardiac arrhythmias often experience a higher prevalence of sleep disorders,anxiety,and depression owing to various factors.AIM To investigate the epidemiological characteristics and psychological factors associated with arrhythmia in the elderly and to establish a theoretical foundation for its prevention and treatment in older adults.METHODS A retrospective analysis was performed on 169 elderly patients admitted to the Shangqiu First People’s Hospital from December 2022 to December 2023.All subjects underwent 24-hour electrocardiogram monitoring to record heart rate,heart rate variability,and 24-hour ambulatory electrocardiogram data.Additionally,patients’medical records were reviewed to gather information on their general condition,including age,gender,underlying diseases,and other relevant factors.Patients were divided into four groups based on their Hamilton Anxiety(HAMA)and Hamilton Depression Rating Scale(HAMD)scores:Group A(HAMA scores≥7),Group B(HAMD scores≥7),Group C(both HAMA and HAMD scores≥7),and Group D(HAMA and HAMD scores<7).Psychological factors such as depression,anxiety,sleep status,and quality of life were analyzed.Pearson correlation was used to examine the relationship between scores from the Pittsburgh Sleep Quality Index(PSQI),HAMA/HAMD scales,and the Short Form 36-item Health Survey(SF-36)with the presence of arrhythmia.RESULTS Among the 169 patients,87(51.5%)had concurrent arrhythmia.Atrial arrhythmias constituted the largest proportion at 34.8%(30 out of 87),followed by sinustachycardia at 24.1%(21 out of 87),and ventricular arrhythmias at 9.2%(8 out of 87).Factors such as advanced age,coronary heart disease,hypertension,smoking,exposure to secondhand smoke,and residing in rural areas significantly increased the risk of developing arrhythmia.There was a statistically significant difference between the two groups regarding PSQI,HAMA-14,HAMD-17,and SF-36 scores.Pearson correlation analysis revealed that PSQI,HAMA-14,and HAMD-17 scores were positively correlated with arrhythmia in the elderly,while the SF-36 score was negatively correlated.The anxiety,depression,and combined anxiety–depression groups exhibited significantly higher PSQI,HAMA-14,and HAMD-17 scores compared to the nonanxiety and non-depression group.CONCLUSION Arrhythmia among the elderly is primarily found in individuals with advanced age and existing health conditions.It is also linked to psychological factors such as depression,anxiety,reduced quality of life,and sleep disturbances.
文摘Transcutaneous renal artery denervation （RND） has beeninitially developed for destruction of efferent nerve fireswith luminal delivery of radiofrequency or ultrasonic energyaiming blood pressure reduction in patients with refractoryhypertension. However, other positive results of RNDwere described afterwards, and they include suppression ofatrial fibrillation and ventricular tachycardia （VT） storm.
文摘Objective To evaluate the PR to RR interval ratio (PR/RR,heart rate-adjusted PR) as a prognostic marker for long-term ventricular arrhythmias and cardiac death in patients with implantable cardioverter defibrillator (ICDs) and cardiac resynchronization therapy with defibrillators (CRT-D).Methods We retrospectively analyzed data from 428 patients who had an ICD/CRT-D equipped with home monitoring.Baseline PR and RR interval data prior to ICD/CRT-D implantation were collected from standard 12-lead electrocardiograph,and the PR/RR was calculated.The primary endpoint was appropriate ICD/CRT-D treatment of ventricular arrhythmias (VAs),and the secondary endpoint was cardiac death.Results During a mean follow-up period of 38.8 ± 10.6 months,197 patients (46%) experienced VAs,and 47 patients (11%) experienced cardiac death.The overall PR interval was 160 ± 40 ms,and the RR interval was 866 ± 124 ms.Based on the receiver operating characteristic curve,a cut-off value of 18.5% for the PR/RR was identified to predict VAs.A PR/RR ≥ 18.5% was associated with an increased risk of VAs [hazard ratio (HR)= 2.243,95% confidence interval (CI)= 1.665–3.022,P < 0.001) and cardiac death (HR = 2.358,95%CI = 1.240–4.483,P = 0.009) in an unadjusted analysis.After adjustment in a multivariate Cox model,the relationship remained significant among PR/RR ≥ 18.5%,VAs (HR = 2.230,95%CI = 1.555–2.825,P < 0.001) and cardiac death (HR = 2.105,95%CI = 1.101–4.025,P = 0.024.Conclusions A PR/RR ≥ 18.5% at baseline can serve as a predictor of future VAs and cardiac death in ICD/CRT-D recipients.
文摘Atrial fibrosis is common in atrial fibrillation （AF）. Experimental studies have provided convincing evidence that fibrotic transformation of atrial myocardium results in deterioration of atrial conduction, increasing anisotropy of impulse propagation and building of boundaries that promote re-entry in the atrial walls that maybe directly relevant for the mechanisms responsible for maintaining AF. Whether or not fibrosis is a result of structural remodelling caused by persistent AF or a manifestation of occult myocardial process that leads to development of arrhythmia is less clear. Human data indicate the presence of association between persistency of AF and the extent of structural changes in atrial myocardium. The role atrial fibrosis plays in the mechanisms of AF, however, may differ between patients with structurally normal hearts, such as lone AF, and those with advanced cardiovascular comorbidities.
文摘Advances in clinical and fimdamental research, which have been promoted over last decades have led to a well- established understanding of atrial fibrillation （AF） as an epiphenomenon that despite similar manifestations may have different underlying mechanisms and thus require in- dividualized treatments. With rare exceptions of AF caused by mutations in genes coding ion channels in pa- tients with structurally normal atria, fibrotic replacement of atrial myocardium remains the comer stone of atrial pa- thology in patients with AF.
文摘Background Cardiac implantable electronic devices （CIEDs） greatly improve survival and life quality of patients. However, there are gender differences regarding both the utilization and benefit of these devices. In this prospective CIED registry, we aim to appraise the gender differences in CIED utilization in China. Methods Twenty centers from 14 provinces in China were included in our registry study. All patients who underwent a CIED implantation in these twenty centers between Jan 2015 and Dec 2016 were included. Results A total of 8570 patients were enrolled in the baseline cohort, including 7203 pacemaker, 664 implantable cardiac defibrillators （ICD） implants and 703 cardiac resynchronization therapy device （CRT/D）. Totally, 4117 （48.0%） CIED patients were female, and more than 59% pacemaker patients were female, but women account only one third of ICD or CRT/D implantation in this registry. There were significant differences between genders at pacemaker and ICD indications. Female was more likely received a pacemaker due to sick sinus syndrome （SSS） （63.9% vs. 51.0%, P 〈 0.001）. Female patients receiving an ICD were more likely due to cardiac ion channel disease （29.2% vs. 4.2%, P 〈 0.001）. The percentage of utilization of dual-chamber pacemaker in female patients was significantly higher than male （85.3% vs. 81.1%, P 〈 0.001）. But male patients were more likely received a cardiac resynchronization therapy devices with defibrillator than female （56.5% vs. 41.9%, P = 0.001）. In pacemaker patient, male was more likely to have structure heart disease （31.3% vs. 28.0%, P = 0.002）. In ICD patient, male patients were more likely to have ischemic heart disease （48.2% vs. 29.2%, P 〈 0.001）. The mean age of women at the time of CRT/D implantation was older than men （P = 0.014）. Nonischemic cardiomyopathy （70.9%） was the most common etiology in the patients who underwent the treat？ment of CRT/D, no matter male or female. Conclusions In real-world setting, female do have different epidemiology, pathophysiology and clinical presentation of many cardiac rhythm disorders when compared with male, and all these factors may affect the utilization of CIED implantation. But it also possibility that cultural and socioeconomic features may play a role in this apparent discrimination.
文摘Background Implantable cardioverter defibrillator （ICD） is the only effective therapy in patients with life threatening ventricular arrhythmias. Inappropriate detection and therapy by ICDs are the most common causes of side effects that affect the quality of life in ICD recipients. This study evaluated the incidence and causes of inappropriate detection and therapy by ICDs in patients in our hospital. Methods From January 2000 to December 2005, fifty patients who received ICD implantation for ventricular arrhythmias for prevention of sudden cardiac death were evaluated in this study. Each ICD was programmed using clinical arrhythmic and cardiac data of the patient before discharge. Patients were followed up by standard schedule after implantation and all data retrieved from each device were collected and saved for further analysis. Results No arrhythmic event was detected in 12/50 （24%） patients during the period of follow-up. Among the remaining patients, 11 （22%） experienced inappropriate detections and therapies during follow-up in this study. ICD detected 383 ventricular tachyarrhythmia （VT） and 108 ventricular fibrillation （VF） episodes and delivered 678 therapies. In VT group, ICD delivered 413 antitachycardiac pacings （ATPs） and 118 shocks, among which 78 ATPs and 9 shocks were initiated by 55/383 （14.3%） inappropriate detections. In VF group ICD delivered 147 shocks, among which 56 shocks were initiated by 28/108 （26.9%） inappropriate detections. Overall, more than 50% of these episodes were caused by atrial fibrillation （AF） with rapid ventricular response, followed by electromagnetic or myopotential interference. In addition, most inappropriate therapies occurred within one year after ICD implantation. Conclusions About one fifth of patients experienced ICD inappropriate detection and therapy after implantation. The main cause was AF with rapid ventricular response, followed by electromagnetic or myopotential interference.
基金supported by the National Key Basic Research Program of China (2013CB531100 to Yi-Han Chen)the Major International Joint Research Program of China (81120108004 to Yi-Han Chen)+3 种基金the Key Program of National Natural Science Foundation of China (81530017 to Yi-Han Chen)the National Innovative Research Groups Program of the National Natural Science Foundation of China (81221001 to Yi-Han Chen)the General Program of National Natural Science Foundation of China (81170224, 81270313 to Jun Li, 31271214 to Yi-Han Chen)the National Natural Science Foundation of China (81670295 to Li Lin)
文摘Cardiac arrhythmias are among the most common causes of death in the world. Foundational studies established the critical role of ion channel disorders in arrhythmias, yet defects in ion channels themselves, such as mutations, may not account for all arrhythmias. Despite the progress made in recent decades, the antiarrhythmic drugs currently available have limited effectiveness,and the majority of these drugs can have proarrhythmic effects. This review describes novel knowledge on cellular mechanisms that cause cardiac arrhythmias, focuses on the dysfunction of subcellular organelles and intracellular logistics, and discusses potential strategies and challenges for developing novel, safe and effective treatments for arrhythmias.
文摘Ebstein＇s anomaly is a kind of congenital heart disease ＇with part or all leaflets of tricuspid valve notnormally attaching to the tricuspid annulus in the normal position, but spirally shifting downward and abnormally attaching to the right ventricular wall. Ebstein＇s anomaly patients often suffer from arrhythmias, featured by paroxysmal fibrillation and supraventricular tachycardia, atrial atrial flutter, etc.
文摘Background The impact of home monitoring system in the early detection of ventricular arrhythmia and inappropriate shock in daily work is not clear. The aim of this study was to investigate the impact of home monitoring system on the early detection of ventricular arrhythmia and inappropriate shock in daily clinical practice. Methods Cases of implantable cardioverter defibrillator （ICD） implantation with or without the home monitoring system from June 2010 to October 2011 at our center were reviewed. Follow-up was scheduled after implantation. Data relating to the home monitoring ICD were retrieved using a remote transmitter system. Data relating to the other devices were obtained during scheduled follow-up or unscheduled visits. Results Our study involved 69 patients （mean age （68.4＋17.6） years, 64.3% males, 26 in the home monitoring group vs. 43 in the non-home monitoring group）. In all, 561 ventricular arrhythmia episodes were detected in 17 patients （39.5%） in the non-home monitoring group： 495 episodes were ventricular tachycardia and 66 episodes were ventricular fibrillation; among these, 476 episodes of ventricular tachycardia and 45 episodes of ventricular fibrillation were appropriately diagnosed （96.1% and 68.2%, respectively）. In the home monitoring group, 389 ventricular arrhythmia episodes were transmitted by the home monitoring system in nine patients （34.6%）： 348 ventricular tachycardia episodes and 41 ventricular fibrillation episodes. Device detection was appropriate in 348 ventricular tachycardia episodes （100.0%） and 36 ventricular fibrillation episodes （87.8%）. The home monitoring group showed a higher appropriate detection rate of ventricular tachycardia （P 〈0.01） and ventricular fibrillation （P=0.02）. The proportion of inappropriate shock was comparable in the two groups （6/11 in the non-home monitoring group vs. 1/7 in the home monitoring group; m=0.08）. Conclusions The home monitoring ICD was able to provide information relating to inappropriate detection and shock earlier than conventional devices. It proved to be a reliable tool and has a strong potential to provide greater reaction time in the case of inappropriate shock.
