Electrocardiogram (ECG) is the primary basis for the diagnosis of cardiovascular diseases. However, the amount of ECG data of patients makes manual interpretation time-consuming and onerous. Therefore, the intelligent ECG recognition technology is an important means to decrease the shortage of medical resources. This study proposes a novel classification method for arrhythmia that uses for the very first time a three-heartbeat multi-lead (THML) ECG data in which each fragment contains three complete heartbeat processes of multiple ECG leads. The THML ECG data pre-processing method is formulated which makes use of the MIT-BIH arrhythmia database as training samples. Four arrhythmia classification models are constructed based on one-dimensional convolutional neural network (1D-CNN) combined with a priority model integrated voting method to optimize the integrated classification effect. The experiments followed the recommended inter-patient scheme of the Association for the Advancement of Medical Instrumentation (AAMI) recommendations, and the practicability and effectiveness of THML ECG data are proved with ablation experiments. Results show that the average accuracy of the N, V, S, F, and Q classes is 94.82%, 98.10%, 97.28%, 98.70%, and 99.97%, respectively, with the positive predictive value of the N, V, S, and F classes being 97.0%, 90.5%, 71.9%, and 80.4%, respectively. Compared with current studies, the THML ECG data can effectively improve the morphological integrity and time continuity of ECG information and the 1D-CNN model of ECG sequence has a higher accuracy for arrhythmia classification. The proposed method alleviates the problem of insufficient samples, meets the needs of medical ECG interpretation and contributes to the intelligent dynamic research of cardiac disease.

Objectives: Our aim was to investigate the diagnostic challenges and management of relapsing polychondritis (RP) with airway involvement, highlighting the need for accurate diagnosis and effective intervention to prevent severe complications. Methods: In this retrospective study, medical records from January 2011 through June 2024 at a single tertiary-care institution were reviewed. This study was approved by the institutional review board. A total of 34 patients were diagnosed with RP, among whom 4 presented with significant airway complications. This study focused on these four patients, detailing their clinical presentations, diagnostic processes, and outcomes following various interventions. Results: All patients were initially misdiagnosed with asthma and later developed severe airway issues necessitating interventions such as tracheotomy and endotracheal intubation. Diagnostic imaging, microlaryngoscopy and bronchoscopy (MLB) were crucial for identifying subglottic stenosis and other airway alterations. Treatments included high-dose steroids, rituximab, and surgical interventions such as balloon dilation and tracheostomy. Only one patient could be decannulated; the other three remained dependent on tracheostomy and experienced significant complications due to emergency medical interventions. Conclusions: RP can manifest with nonspecific respiratory symptoms similar to asthma, which may delay correct diagnosis and appropriate treatment, leading to critical airway complications. The early, precise identification of RP, particularly with airway involvement, is vital. MLB and dynamic expiratory CT scans play significant roles in clinical diagnosis and management. A multidisciplinary approach involving otolaryngologists, rheumatologists, and pulmonologists is essential for optimizing patient outcomes and minimizing complications.

Airway injury is a life-threatening condition requiring immediate intervention. Tracheal perforation in patients with relapsing polychondritis (RP) and tracheobronchomalacia (TBM) is extremely rare, posing significant management challenges. Here, we describe the successful placement of a silicone Y-stent via rigid bronchoscopy under venovenous extracorporeal membrane oxygenation (ECMO) to address this complex clinical scenario. We present the case of a 29-year-old female with RP and tracheostomy tube dependence who developed tracheal rupture, resulting in acute respiratory failure. To stabilize her condition, venovenous ECMO was initiated, and a silicone Y-stent was successfully placed via rigid bronchoscopy. The patient achieved full recovery, and the stent was removed 10 months later, revealing complete airway healing. This case highlights the effectiveness of silicone Y stenting and venovenous ECMO as viable salvage strategies for severe airway injuries in RP patients. Our findings demonstrate the safety and feasibility of this approach in managing complex airway conditions, offering a potential treatment option for similar cases.

Vocal cord dysfunction (VCD) encompasses diverse etiologies in pediatric patients, causing various symptoms that can even be life-threatening. Although existing literature often categorizes VCD by side of involvement, exploring underlying etiologies may offer a more comprehensive understanding of the disorder. A total of 65 pediatric patients diagnosed with VCD via flexible bronchoscopy between January 2018 and December 2022 were enrolled, with follow-up extending from diagnosis until December 2022. Characteristics including demographic data, precursor events, clinical and imaging presentations, along with interventions and prognostic outcomes, were analyzed and compared across various potential etiology groups of VCD. Patients were classified into four groups based on potential etiologies of VCD. Patients with central nervous system (CNS) comorbidities (n = 11), mainly hypoxic-ischemic encephalopathy (HIE) (n = 8), had the highest rate of tracheostomy (72.7 %). In contrast, most with peripheral nervous system (PNS) conditions (n = 27), including iatrogenic events and cardiovocal syndrome, were managed conservatively (70.4 %). Those with local events (n = 17), such as intubation history and granulations, had significantly higher rates of undergoing surgical interventions and achieving clinical recovery (both P < 0.05). Among idiopathic cases, sedation medication was considered a potential contributing factor in half (n = 5 out of 10) of the patients. Mortality rates did not differ significantly among the groups. Etiology-based clinical evaluation and management are essential for promoting long-term outcomes in these patients. Conservative treatment is recommended in patients with consistent respiratory health.