Background: The efficacy of angiotensin converting enzyme (ACE) inhibitors in treatment of renovascular disease has been controversial. It is possible that some patients with incidental atherosclerotic renal artery stenosis (ARAS) are treated with ACE inhibitors before being considered for renal revascularization. It has been reported that patients with incidental atherosclerotic renal artery stenosis (ARAS) are sometimes treated with ACE inhibitors before being considered for renal revascularization. This study was designed to describe the frequency and the characteristics of patients with incidental ARAS, and to examine the frequency of ACE inhibitor usage in such patients. Methods: We studied a cohort of consecutive patients undergoing abdominal aortography at the time of cardiac catheterization. Patients were stratified and compared based on the presence and severity of ARAS. Results: ARAS (≥50%) was present in 146 (17.0%) of 859 evaluable patients. Factors independently related to the presence of ARAS were age (OR = 1.07, P<0.001), severity of coronary artery disease (OR=2.13, P<0.001) and peripheral vascular disease (OR=1.79, P=0.021). Among all patients with ARAS, the percentage of ACE inhibitor usage was 74.7% (109/146). Among patients with severe ARAS, moderate ARAS, mild ARAS, insignificant ARAS and normal renal arteries, the percentage of ACE inhibitor usage was 85.7% (95% CI: 69%-100%), 82.9% (95% CI: 71%-95%), 68.5% (95% CI: 59%-78%), 68.6% (95% CI: 55%-82%) and 53.9% (95% CI: 50%-58%), respectively (contingency coefficient=0.17, P<0.001). In patients with severe ARAS, ACE inhibitor use, calcium channel blocker use and diuretic use were shown to correlate significantly with serum creatinine levels after controlling for potential confounding factors. Conclusion: In this study, ACE inhibitors were used commonly in patients with incidental ARAS; the frequency of ACE inhibitor use correlated with the severity of ARAS.

对26例病人行穿间隔法射频消蚀左侧房室旁路，原因分别为：尝试经动脉逆行法失败或操作困难者14例，同次完成穿间隔二尖瓣球囊成形术者4例，旁路偏左前或病人年龄大于60岁而直接选择穿间隔法8例。旁路部位距冠状窦口O.5～6cm，全部消蚀成功，无并发症，随访5±3个月无复发病例。操作时间75±19分钟，X线投照时间13±5分钟，放电次数3±2次。本文结果表明：穿间隔法消蚀左侧旁路的安全性与成功率高，可作为经动脉逆行法消蚀的重要补充。

对561例快速心律失常患者进行射频导管消蚀治疗，其中房室旁路折返性心动过速（AvRT）413例（429条旁路），房室结折返性心动过速（AVNRT）142例，房性心动过速3例，心房扑动2例，心脏正常的室性心动过速1例。显性旁路消蚀成功靶点心电图特征为：AV<40ms，V波较体表心电图最早的delta波提前>20ms，A/V<1。隐匿旁路成功的靶点心电图特征为：心室起搏时VA<40ms，A/v<1。对左前旁路患者、合并主动脉瓣狭窄者、动脉迂曲的老年人或需同时行二尖瓣球囊扩张术者，导管经股动脉逆行放入左室不易到位，可采用房间隔穿刺法，本组6例均获成功。房室结改良患者采用下位法较后位法消蚀的平均放电次数、时间及操作时间均少（P值<0.05）。本组2例（0.4%）发生三度房室传导阻滞，置入永久性心脏起搏器。平均随访6.1±4.9个月，14例（2.6%）复发，均再次消蚀成功。