• 제목/요약/키워드: 심실성 부정맥

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항부정맥 치료의 기본 원칙

  • Kim, Seong-Su
    • Journal of the korean veterinary medical association
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    • v.43 no.9
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    • pp.825-832
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    • 2007
  • 모든 부정맥이 치료를 필요로 하는 것은 아니지만, 다양한 부정맥들이 허약 (weakness), 실신 (syncope)을 유발하거나 울혈성 심부전을 악화시키며 일부의 부정맥들은 치명적인 심장 이상을 일으킨다. 일반적으로 임상증상을 유발하는 부정맥들과 급사의 지표가 될 수 있는 부정맥들은 치료한다. 불행하게도, 수의학 분야의 심장전문의들 사이에서 어떤 부정맥들을 치료해야만 하고 어떻게 관리하는 것이 최선인가에 관한 내용이 명확하게 일치하고 있지는 않다. 사실은 어떤 항부정맥 약물을 우선적으로 선택해야 하는가에 관해서 명확한 합의점이 없을 뿐만 아니라 어떤 범주의 약물이 효과적인가에 대해서도 논란의 여자기 있다. 예를 들어, 심각한 심실성 부정맥이 성공적으로 치료되지 않으면 현저한 이소성 박동(ectopy)이 지속적으로 남을 수도 있다. 또한 만일 임상증상들 (실신 등)이 해소되고 지속적인 심실성 부정맥이 잘 통제된 이러한 류의 질문들에 대한 대답은 대부분 명확하지 않고 신중하게 숙고한 의견에 불과할 수도 있다.

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Assessment of PVC (Premature Ventricular Contraction) Arrhythmia by R-R Interval in ECG (심전도 R-R 간격 정보를 이용한 심실조기수축 부정맥 검출)

  • Yoon, Tae-Ho;Lee, Sun-Ju;Kim, Kyeong-Seop;Lee, Jeong-Whan
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.2 no.2
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    • pp.15-21
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    • 2009
  • This paper proposes a novel algorithm to assess the abnormal heart beats such as PVC (Premature Ventricular Contraction) and its subsequent RUNs. Our Arrhythmic detection scheme is based on only the R-R Interval features extracted from ECG waveforms and MIT-BIH arrhythmia database is evaluated to validate the efficiency of our algorithm in terms of sensitivity, specificity, FPR(%) and FNR(%).

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Assessment of PVC-RUNs Arrhythmia by R-R Interval (R-R 간격을 이용한 PVC-RUNs 부정맥 검출)

  • Lee, Sun-Ju;Yoon, Tae-Ho;Kim, Kyeong-Seop;Lee, Jeong-Whan;Kim, Dong-Jun
    • Proceedings of the IEEK Conference
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    • 2009.05a
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    • pp.393-395
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    • 2009
  • 심장의 활성 근육의 움직임에 의하여 발생되는 전기적 변화량을 나타내는 심전도는 부정맥 또는 허혈성 심장질환을 진단하는데 널리 활용되고 있다. 특히 심실빈맥(Ventricular Tachycardia) 또는 심실세동(Ventricular Fibrillation)과 같이 치명적인 심장리듬이 발생하기 이전에, 심실조기수축(Ventricular Premature Contraction)을 검출하여 생명을 위협할 수 있는 부정맥을 조기에 진단할 수 있는 연구들이 일부 진행되고 있다. 이에 따라서 본 연구에서는 심전도 신호의 R-R 간격 정보와 R-peak 정보의 진위성을 판단하여 PVC 부정맥 패턴뿐만 아니라 PVC 파형이 연속적으로 진행되는 PVC-RUNs을 효율적으로 검출할 수 있는 부정맥 진단 알고리즘을 제안하고자 하였다.

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Inherited Malignant Ventricular Tachyarrhythmia in a German Shepherd (져먼 셰퍼드종 개에서 발생한 유전성 악성 심실성 부정맥증)

  • Lee, Joon-Seok;Lee, Seung-Gon;Park, In-Chul;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.23 no.3
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    • pp.329-333
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    • 2006
  • A 9-month-old neutered male German Shepherd dog was referred with the primary complaint of episodic collapse. Apparent abnormal findings were not observed in physical examination, routine biochemistry, and diagnostic imaging studies. In the 12-lead surface ECG after collapse, the dog showed frequent ventricular premature contractions (VPCs) with torsade de pointes. The frequency of VPCs was reduced after lidocaine infusion. Based on the history, findings in event recordings oi the ECG and lidocaine response test, the dog was diagnosed as inherited malignant ventricular tachyarrhythmia. Although the dog was initially responded to oral sotalol therapy, the dog was died suddenly. This report described the first case of malignant ventricular tachyarrhythmia of German Sheperd in Korea.

EMD based Cardiac Arrhythmia Classification using Multi-class SVM (다중 클래스 SVM을 이용한 EMD 기반의 부정맥 신호 분류)

  • Lee, Geum-Boon;Cho, Beom-Joon
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.14 no.1
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    • pp.16-22
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    • 2010
  • Electrocardiogram(ECG) analysis and arrhythmia recognition are critical for diagnosis and treatment of ill patients. Cardiac arrhythmia is a condition in which heart beat may be irregular and presents a serious threat to the patient recovering from ventricular tachycardia (VT) and ventricular fibrillation (VF). Other arrhythmias like atrial premature contraction (APC), Premature ventricular contraction (PVC) and superventricular tachycardia (SVT) are important in diagnosing the heart diseases. This paper presented new method to classify various arrhythmias contrary to other techniques which are limited to only two or three arrhythmias. ECG is decomposed into Intrinsic Mode Functions (IMFs) by Empirical Mode Decomposition (EMD). Burg algorithm was performed on IMFs to obtain AR coefficients which can reduce the dimension of feature vector and utilized as Multi-class SVM inputs which is basically extended from binary SVM. We chose optimal parameters for SVM classifier, applied to arrhythmias classification and achieved the accuracies of detecting NSR, APC, PVC, SVT, VT and VP were 96.8% to 99.5%. The results showed that EMD was useful for the preprocessing and feature extraction and multi-class SVM for classification of cardiac arrhythmias, with high usefulness.

KCNH2 돌연변이 L532P와 N588K가 심실세동에 미치는 영향에 대한 심장의 3 차원 전기생리역학 시뮬레이션 연구

  • Kim, Chang-Hyeon;Im, Gi-Mu
    • Proceeding of EDISON Challenge
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    • 2017.03a
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    • pp.708-711
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    • 2017
  • 전기적 신호의 이상으로 발생하는 심방 부정맥은 심방세동으로 발전하는 대표적 심장 질환이다. 이러한 원인에는 세포 내 이온 채널의 유전적 결함으로 인한 기전이 알려져 있다. 지속적인 연구로 밝혀진 대표적인 유전적 질환 중 하나로서 KCNH2 유전자 돌연변이가 있다. 본 연구에서는 KCNH2 유전자 돌연변이가 심방부정맥을 유발하는 연관성연구를 기반으로 심실에서의 심장 질환 발현 연관성을 확인하고 심실부정맥과 심실세동 가능성을 예측하였다. 이를 위해 Ten tusscher 세포 모델에 KCNH2 유전자의 N588K, L532P 변이를 적용하여 2차원과 3차원 시뮬레이션을 진행하였다. wild-type(WT)과 mutant-type(MT)의 전기전도 패턴을 비교했다. 그 결과 WT의 전도파형이 일찍 자가소멸(self-termination) 되는 것과 대조적으로 MT는 회귀성 파형이 유지되었다(WT : 3.6초간 유지, MT : 지속적). 따라서 본 연구를 통해 KCNH2 유전자 돌연변이가 심실 조직의 취약성 (Action Potential Duration 감소, WT : 270 ms, N588K : 130 ms, L532P : 100 ms)을 증가시켜 부정맥의 요인이 됨을 확인하였다.

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Surgical Treatment of Arrhythmias Associated with Congenital Heart Disease (선천성 심장 기형에 동반된 부정맥에 대한 수술적 치료)

  • Hwang, Ui-Dong;Im, Yu-Mi;Park, Jeong-Jin;Seo, Dong-Man;Lee, Jae-Won;Yun, Tae-Jin
    • Journal of Chest Surgery
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    • v.40 no.12
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    • pp.811-816
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    • 2007
  • Background: We analyzed our experience of arrhythmia surgery in patients with congenital heart disease. Material and Method: A retrospective review was performed on 43 consecutive patients with congenital heart disease, who underwent arrhythmia surgery between June 1998 and June 2006. Result: The median age at surgery was 52 years ($4{\sim}75$ years). The most frequent cardiac anomaly was an atrial septal defect (23/43, 53.5%). The types of arrhythmias were atrial flutter-fibrillation, intermittent non-sustainable ventricular tachycardia and others in 37, 2 and 4, respectively. Arrhythmia surgery consisted of a bi-atrial maze operation in 18 patients (modified cox maze III procedure in 5 patients, and a right side maze plus pulmonary vein cryo-isolation in 13), right side maze operation in 18 patients, cavo-tricuspid isthmus cryoablation for benign atrial flutter in 4 patients, right ventricular endocardial cryoablation in 2 patients and extranodal cryoablation for atrioventricular node re-entry tachycardia in 1 patient. The median follow-up was 23.8 months ($1{\sim}95.2$ months). There was no early mortality, and one late non-cardiac related death. The overall rates of restored sinus rhythm before discharge and $3{\sim}6$ months after surgery were 79% and 81%, respectively (bi-atrial maze group: 72% and 83%, right-side maze group: 77%, 77%). Conclusion: Arrhythmias associated with congenital heart disease can be safely treated surgically with an excellent intermediate-term outcome.

Follow-up in Adult after Total Repair of Tetralogy of Fallot (수술 후 성인 Fallot 4징 환자의 임상적 고찰)

  • Jang, Gi Young;Kim, Sun Young;Moon, Joo Ryung;Huh, Joon;Kang, I-Seok;Park, Seung Woo;Jun, Tae Gook;Park, Pyo Won;Lee, Heung Jae
    • Clinical and Experimental Pediatrics
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    • v.46 no.7
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    • pp.661-667
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    • 2003
  • Purpose : This study was performed to find the chief clinical problems associated with the ages of adult patients of tetralogy of Fallot(TOF) who had undergone total correction. Methods : Of the 30 patients who were registered at the Grown-Up Congenital Heart Disease (GUCH) Clinic of Samsung Medical Center for TOF, a retrospective investigation was carried out on 28 patients who underwent total correction. Results : Mean age at retrospective study was 30.8(range : 16-53) years old. Age at total correction was 15.8(range : 2-49) years old. Problems after corrective surgery were assessed. They were arrhythmia, pulmonary valve regurgitation, left pulmonary artery stenosis, residual ventricular septal defect, mitral valve regurgitation, tricuspid valve regurgitation, right ventricle outflow tract obstruction, aortic valve regurgitation, infective endocarditis and protein losing enteropathy. After repair of TOF, such arrhythmias as atrial arrhythmia and AV conduction disturbances were observed in some patients. Cardiomegaly was found significantly in the subjects with arrhythmia(P<0.05), and arrhythmia was less observed in patients who underwent surgery at a young age. Eight patients required a reoperation; the main indications were residual ventricular septal defect, right ventricle outflow tract obstruction and peripheral pulmonary artery stenosis. Conclusion : The majority of the patients seemed to live normal lives after Tetralogy of Fallot repair. However, as residual anatomic and functional abnormalities exist postoperatively, continued careful follow-up is needed to detect and correct structural and functional abnormalities.

A Case of Repeated Ventricular Tachycardia Caused by Cardiac Rhabdomyomas in an Infant with Tuberous Sclerosis (반복되는 심실성 빈맥을 보인 대동맥판하 횡문근종을 동반한 결절성 경화증 1례)

  • Joo, Hee Jung;Song, Min Seob;Hwang, Tae Gyu;Kim, Chul Ho
    • Clinical and Experimental Pediatrics
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    • v.46 no.9
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    • pp.913-917
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    • 2003
  • Cardiac rhabdomyomas are relatively uncommon and associated with tuberous sclerosis in 40-50% cases. We report a 10-month-old infant with tuberous sclerosis who presented with ventricular arrythmias and status epilepticus. There were hypopigmented macules on the body, periventricular calcifications, renal cyst and cardiac rabdomyomas just below the aortic valve. The patient required resection of left ventricular subaortic masses due to sustained arrythmia in spite of intravenous amiodarone therapy. The pathologic examination confirmed the diagnosis of rhabdomyoma. The patient had no more arrythmia during the 14 month follow up period. Although cardiac rhabdomyomas may spontaneously regress, surgery is often necessary and frequently resolves the underlying arrythmia.

Successful Rescue of Refractory Ventricular Tachycardia after One and a Half Repair in Ebstein's Anomaly by Extracorporeal Membrane Oxygenation (부분 양심실 교정을 받은 엡스타인 기형에서 발생한 심실성 빈맥에 대해 체외막 산소화 장치를 이용한 성공적인 구출)

  • Seo, Hong-Joo;Whang, Sung-Wook;Lee, Cheul;Lim, Hong-Gook;Yu, Jai-Kun;Lee, Chang-Ha
    • Journal of Chest Surgery
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    • v.40 no.3 s.272
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    • pp.220-224
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    • 2007
  • Extracorporeal membrane oxygenation (ECMO) provides mechanical cardiopulmonary support and has been used for children with severe respiratory failure, intractable heart failure, sepsis, pulmonary hypertension, and as a bridge to heart transplantation. There have been few reports of the use of ECMO to provide cardiac support in children with low cardiac output as a result of arrhythmias. We report the case of a 15-year-old female with circulatory collapse due to refractory ventricular arrhythmia after one and a half repair in Ebstein's anomaly, who was successfully resuscitated using ECMO.