• Title/Summary/Keyword: 심실수

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Detinitive Repair of Tetralogy of Fallot in Infancy - Transventricular approach - (유아기에 시행한 팔로씨 사증의 심실절개를 통한 완전교정술)

  • 이정렬;김준성;김용진;노준량;배은정;노정일;윤용수;안규리
    • Journal of Chest Surgery
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    • v.37 no.2
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    • pp.139-145
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    • 2004
  • This study describes our surgical results of transventricular complete repair of tetralogy of Fallot in infants. Material and Method: Eight hundred and forty children underwent complete repair of TOF between January 1990 and April 2002 in our institute. One hundred sixty infants of them were included to this survey. Mean age at repair was 8.1$\pm$2.6 months (3∼12). Correction was accomplished through a short right ventriculotomy less than 30% of ventricular height in all patients. A transannular patch was necessary in 78 patients (49%). Result: There were four early deaths. There were no late deaths. Follow-up with mean duration of 66 months was completed in all survivors, All patients are currently in New York Heart Association functional class I or II. Twenty patients required late reoperations. Actuarial freedom from reoperation at 1 and 10 years were 94% and 87% respectively. Two-dimensional and Doppler echocardiographic follow-up studies showed good right ventricular function in all patients except three. Conclusion: Our results suggested that early complete repair of TOF yield the acceptable results with low mortality and morbidity. Transventricular repair of intracardiac pathology can be safely applied to these patient population, yielding good postoperative right ventricular function.

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.

Intracardiac Metastasis of Testicular Embryonal Carcinoma That Presented with a Right Ventricular Mass (우심실 종괴로 나타난 고환 태생암의 심장 전이)

  • Shim, Man-Shik;Kim, Wook-Sung;Sung, Ki-Ick;Lee, Young-Tak;Park, Pyo-Won;Lim, Ho-Yeong
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.81-85
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    • 2010
  • Metastases to the heart are rarely diagnosed before the patient dies. A 26-year-old man was admitted with multiple metastasis of a testicular embryonal carcinoma and he was found to have intracardiac metastasis. Echocardiography showed that he had a mass rising from the interventricular septum and it was floating through the right ventricular outflow tract. The histology of the mass we removed from the right ventricle was consistent with testicular embryonal carcinoma. The patient made a smooth recovery after surgical intervention and chemotherapy. We believe this is the first reported case of testicular embryonal carcinoma that metastasized to the heart and that was successfully removed via surgery in Korea.

Premature Contraction Arrhythmia Classification through ECG Pattern Analysis and Template Threshold (ECG 패턴 분석과 템플릿 문턱값을 통한 조기수축 부정맥분류)

  • Cho, Ik-sung;Cho, Young-Chang;Kwon, Hyeog-soong
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.20 no.2
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    • pp.437-444
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    • 2016
  • Most methods for detecting arrhythmia require pp interval, diversity of P wave morphology, but it is difficult to detect the p wave signal because of various noise types. Therefore it is necessary to use noise-free R wave. In this paper, we propose algorithm for premature contraction arrhythmia classification through ECG pattern analysis and template threshold. For this purpose, we detected R wave through the preprocessing method using morphological filter, subtractive operation method. Also, we developed algorithm to classify premature contraction wave pattern using weighted average, premature ventricular contraction(PVC) and atrial premature contraction(APC) through template threshold for R wave amplitude. The performance of R wave detection, PVC classification is evaluated by using 6 record of MIT-BIH arrhythmia database that included over 30 PVC and APC. The achieved scores indicate the average of 99.77% in R wave detection and the rate of 94.91%, 95.76% in PVC and APC classification.

Echocardiographic Diagnosis of Pulmonary Arterial Hypertension in Chronic Lung Disease with Hypoxemia (만성 저산소성 폐질환의 폐동맥 고혈압에 대한 심초음파 검사)

  • Chang, Jung-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.6
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    • pp.846-855
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    • 1999
  • Background : Secondary pulmonary hypertension is an important final endpoint in patients with chronic hypoxic lung disease, accompanied by deterioration of pulmonary hemodynamics. The clinical diagnosis of pulmonary hypertension and/or cor pulmonale could be difficult, and simple noninvasive evaluation of pulmonary artery pressures has been an relevant clinical challenge for many years. Doppler echocardiography might to be a more reliable method for evaluating pulmonary hemodynamics in such patients in terms of the accuracy, reproducibility and easiness for obtaining an appropriate echocardiographic window than M-mode echocardiography. The aim of this study was to assess echocardiographic parameters associated with pulmonary arterial hypertension, defined by increasing right ventricular systolic pressure(RVSP), calculated from trans-tricuspid gradient in patients with chronic hypoxic lungs. Method : We examined 19 patients with chronic hypoxic lung disease, suspected pulmonary hypertension under the clinical guidelines by two dimensional echocardiography via the left parasternal and subcostal approach in a supine position. Doppler echocardiography measured RVSP from tricuspid regurgitant velocity in continuous wave with 2.5MHz transducer and acceleration time(AT) on right ventricular outflow tract in pulsed wave for the estimation of pulmonary arterial pressure. Results : On echocardiography, moderate to severe degree of pulmonary arterial hypertension was defined as RVSP more than 40mmHg, presenting tricuspid regurgitation. Increased right ventricular endsystolic diameter and shortened AT were noted in the increased RVSP group. Increased RVSP was correlated negatively with the shortening of AT. Other clinical data, including pulmonary functional parameters, arterial blood gas analysis and M mode echocardiographic parameters were not changed significantly with the increased RVSP. Conclusion : These findings suggest that shortened AT on pulsed doppler can be useful when quantifying pulmonary arterial pressure with increased RVSP in patients with chronic lung disease with hypoxemia. Doppler echocardiography in pulmonary hypertension of chronic hypoxic lungs is an useful option, based on noninvasiveness under routine clinical practice.

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Atrial Fibrillation Waveform Extraction Algorithm for Holter Systems (홀터 심전계를 위한 심방세동 신호 추출 알고리즘)

  • Lee, Jeon;Song, Mi-Hye;Lee, Kyoung-Joung
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.49 no.3
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    • pp.38-46
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    • 2012
  • Atrial fibrillation is needed to be detected at paroxysmal stage and to be treated. But, paroxysmal atrial fibrillation ECG is hardly obtained with 12-lead electrocardiographs but Holter systems. Presently, the averaged beat subtraction(ABS) method is solely used to estimate atrial fibrillatory waves even with somewhat large residual error. As an alternative, in this study, we suggested an ESAF(event-synchronous adaptive filter) based algorithm, in which the AF ECG was treated as a primary input and event-synchronous impulse train(ESIT) as a reference. And, ESIT was generated so to be synchronized with the ventricular activity by detecting QRS complex. We tested proposed algorithm with simulated AF ECGs and real AF ECGs. As results, even with low computational cost, this ESAF based algorithm showed better performance than the ABS method and comparable performance to algorithm based on PCA(principal component analysis) or SVD(singular value decomposition). We also proposed an expanded version of ESAF for some AF ECGs with multi-morphologic ventricular activities and this also showed reasonable performance. Ultimately, with Holter systems including our proposed algorithm, atrial activity signal can be precisely estimated in real-time so that it will be possible to calculate atrial fibrillatory rate and to evaluate the effect of anti-arrhythmic drugs.

Efficient QRS Detection and PVC(Premature Ventricular Contraction) Classification based on Profiling Method (효율적인 QRS 검출과 프로파일링 기법을 통한 심실조기수축(PVC) 분류)

  • Cho, Ik-Sung;Kwon, Hyeog-Soong
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.17 no.3
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    • pp.705-711
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    • 2013
  • QRS detection of ECG is the most popular and easy way to detect cardiac-disease. But it is difficult to analyze the ECG signal because of various noise types. Also in the healthcare system that must continuously monitor people's situation, it is necessary to process ECG signal in realtime. In other words, the design of algorithm that exactly detects QRS wave using minimal computation and classifies PVC by analyzing the persons's physical condition and/or environment is needed. Thus, efficient QRS detection and PVC classification based on profiling method is presented in this paper. For this purpose, we detected QRS through the preprocessing method using morphological filter, adaptive threshold, and window. Also, we applied profiling method to classify each patient's normal cardiac behavior through hash function. The performance of R wave detection, normal beat and PVC classification is evaluated by using MIT-BIH arrhythmia database. The achieved scores indicate the average of 99.77% in R wave detection and the rate of 0.65% in normal beat classification error and 93.29% in PVC classification.

R Wave Detection Algorithm Based Adaptive Variable Threshold and Window for PVC Classification (PVC 분류를 위한 적응형 문턱치와 윈도우 기반의 R파 검출 알고리즘)

  • Cho, Ik-Sung;Kwon, Hyeog-Soong
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.34 no.11B
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    • pp.1289-1295
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    • 2009
  • Premature ventricular contractions are the most common of all arrhythmias and may cause more serious situation like ventricular fibrillation and ventricular tachycardia in some patients. Therefore, the detection of this arrhythmia becomes crucial in the early diagnosis and prevention of possible life threatening cardiac diseases. Particularly, in the healthcare system that must continuously monitor people's situation, it is necessary to process ECG signal in realtime. In other words, design of algorithm that exactly detects R wave using minimal computation and classifies PVC is needed. So, R wave detection algorithm based adaptive threshold and window for the classification of PVC is presented in this paper. For this purpose, ECG signals are first processed by the usual preprocessing method and R wave was detected and adaptive window through R-R interval is used for efficiency of the detection. The performance of R wave detection and PVC classification is evaluated by using MIT-BIH arrhythmia database. The achieved scores indicate 99.33%, 88.86% accuracy respectively for R wave detection and PVC classification.

The Classification of Arrhythmia Using Similarity Analysis Between Unit Patterns at ECG Signal (ECG 신호에서 단위패턴간 유사도분석을 이용한 부정맥 분류 알고리즘)

  • Bae, Jung-Hyoun;Lim, Seung-Ju;Kim, Jeong-Ju;Park, Sung-Dae;Kim, Jeong-Do
    • The KIPS Transactions:PartD
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    • v.19D no.1
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    • pp.105-112
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    • 2012
  • Most methods for detecting PVC and APC require the measurement of accurate QRS complex, P wave and T wave. In this study, we propose new algorithm for detecting PVC and APC without using complex parameter and algorithms. Proposed algorithm have wide applicability to abnormal waveform by personal distinction and difference as well as all sorts of normal waveform on ECG. To achieve this, we separate ECG signal into each unit patterns and made a standard unit pattern by just using unit patterns which have normal R-R internal. After that, we detect PVC and APC by using similarity analysis for pattern matching between standard unit pattern and each unit patterns.

Surgical Management of Postinfarct Posterobasal Left Ventricular Aneurysm -A Case Report- (심근경색 후 좌심실 후방 기저부에서 발생한 좌심실류의 외과적 치료 -1례 보고-)

  • 백완기;윤용한;김정택;김광호
    • Journal of Chest Surgery
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    • v.34 no.9
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    • pp.716-719
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    • 2001
  • The surgical treatment of postinfarct aneurysm on the posterobasal aspect of left ventricle is seldom reported compared aneurysm although the actual incidence is higher than expected, partly because of the complexity of the operation and unpredictable postoperative endoventricular circular patch plasty technique was applied successfully. The methodology is described with review of the relevant literature.

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