• Title/Summary/Keyword: 심장전기도

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A study on the development of 64 channels computerized cardiac mapping system (64채널 심장전기도 시스템 구현에 관한 연구)

  • Chang, Byung-Chul;Kim, Nam-Hyun;Jung, Sung-Hun;Ra, Sang-Weon;Cho, Bum-Koo
    • Proceedings of the KOSOMBE Conference
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    • v.1994 no.12
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    • pp.88-91
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    • 1994
  • It is well known that multipoint and computerized intraoperative mapping systems improve the results of surgery for Wolff-Parkinson-White syndrome and show tremendous potential for opening an entirely new era of surgical intervention for the more common and lethal types of supraventricular tachyarrhythmias such as atrial flutter and atrial fibrillation. In addition, the ability to map and ablate the sometimes fleeting automatic atrial tachycardia is greatly enhanced by computerized mapping systems. In this study, we have developed 64 channel computerized data analysis system using microcomputer (Macintosh IIx) for basic research of electrophysiology and electrical propagation. The bipolar electrogram information is acquired from 64 cardiac sites simultaneously at a sampling rate of 1ksamples/sec with continuous and total data storage of up to 30 seconds. When the reference electrogram is selected and reference point is picked up, delay time from the reference point in displayed on two dimensional diagram of the heart. System design permits easy expansion to almost 256 simultaneous sites, This system is expected to enable us to study pathophysiology of cardiac arrhythmia and to improve the results of diagnosis and surgical treatment for cardiac arrhythmia.

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Computational analysis of the reentrant wave propagation in three-dimensional cardiac tissue (3차원 심근조직에서의 회귀성 파동에 대한 수치적 해석)

  • Kim, Hun-Young;Leem, Chae-Hun;Shim, Eun-Bo
    • Proceedings of the Korean Society for Bioinformatics Conference
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    • 2004.11a
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    • pp.57-63
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    • 2004
  • 본 연구에서는 3차원 심근조직에서의 회귀성파동에 대한 수치적 해석결과를 제시한다. 심근 조직에서의 회귀성파동은 심실세동(ventricular fibrillation)의 원인으로 지목되고 있으며 심근세포 이온채널 또는 전기전도시스템 등과 같은 여러 가지 요소들이 관련된 복합적 현상으로 생각되고 있다. 지금까지 이에 관한 많은 연구가 전기생리학적 모델을 이용하여 이루어진바 있으며, 주로 동물 심근세포모델에 기반으로 균일한 2차원 또는 3차원 모델에서의 전기전도 현상 해석을 한 바 있다. 그러나 실제 심장조직의 경우, 두께를 가진 3차원적 형상을 지니고 있으며 층을 따라서 전기생리학적으로 상이한 특성을 가진 세포들로 구성된다. 즉 심근은 층을 가로질러 Epi-cardiac, mid-cardiac, endo-cardiac cell들로 구성되며 각기 다른 APD(action potential duration)을 가지고 있다. 따라서 본 연구에서는 이러한 세가지 종류의 인체 심근세포모델을 사용한 3차원 심근조직에서의 활동전위 전도현상에 대한 결과를 제시한다. 이를 위하여 기존의 인체 3가지 종류의 심근세포 모델을 구현하여 그 타당성을 검토한다. 그리고 이를 바탕으로 3차원 조직모델을 구현하는데, simplified bidomain방법을 사용하였다. 3차원 공간상에서 심근세포에 의한 활동전위 전달현상을 해석하기 위하여 유한요소법을 도입한다. 최종적으로는 3가지의 심근세포층을 가진 3차원 심근조직을 구성하고, 여기에 회귀성 파동을 유도한다. 그리고 단일층으로 이루어진 3차원조직에서의 결과와 비교 분석하여 다세포층에 의한 불균일 효과를 분석하였다.

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심실근세포 계산모델을 활용한 지질산화물의 전기생리학적 영향 평가 및 예측

  • Choe, Seong-U;Kim, Seong-Jun;Yeom, Jae-Beom
    • Proceeding of EDISON Challenge
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    • 2017.03a
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    • pp.643-649
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    • 2017
  • 심장 이온통로의 변화는 활동전압의 모양과 길이에 영향을 주어 심부정맥을 유발한다. 산화적 스트레스의 증가로 인해 생체에 침착이 증가하는 지질산화물 (4-HNE, 4-ONE)는 여러 단백질 및 이온통로에 영향을 주는 독성이차전달자로 알려져 있다. 본 연구자는 선행 연구를 통해 4-HNE와 4-ONE의 단기간 노출이 심실근세포에 발현되는 3종류의 이온통로 ($I_{Kr}$, $I_{Ks}$, $I_{Ca,L}$)의 전류감소와 kinetics변화를 일으키고, 심실근세포의 활동전압길이가 증가하는 것을 확인하였다. 두 물질이 이온통로들에 준 영향은 유사하였으나, 활동전압길이의 증가 정도가 4-ONE에서 더 크게 나타났다. 활동전압의 연장에 차이가 나는 원인과, 두 지질산화물이 또 다른 이온통로에 미치는 영향 유무를 예측하기 위해서 Grandi and Bers human ventricular model[1]을 적용한 Integrated human ventricular myocyte model 프로그램 (developed by prof. Youm)을 활용하였다. 시뮬레이션으로 재현한 4-HNE와 4-ONE에 의한 활동전압은 실험으로 기록된 것보다 연장 정도가 작았다. 시뮬레이션 모델의 background $Na^+$ 전류의 크기를 크게 하였을 경우, 실험에서 기록된 활동전압 길이에 상응하는 연장을 가져왔다. 그러므로, 4-HNE와 4-ONE는 실험으로 확인한 $I_{Kr}$, $I_{Ks}$, $I_{Ca,L}$ 이외에 심장세포에 존재하는 내향전류 (Late $Na^+$ current)의 크기를 증가하는 효과가 있음을 예측할 수 있으며, 실험적 검증이 요구된다.

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Low-Power ECG Detector and ADC for Implantable Cardiac Pacemakers (이식형 심장 박동 조율기를 위한 저전력 심전도 검출기와 아날로그-디지털 변환기)

  • Min, Young-Jae;Kim, Tae-Geun;Kim, Soo-Won
    • Journal of IKEEE
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    • v.13 no.1
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    • pp.77-86
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    • 2009
  • A wavelet Electrocardiogram(ECG) detector and its analog-to-digital converter(ADC) for low-power implantable cardiac pacemakers are presented in this paper. The proposed wavelet-based ECG detector consists of a wavelet decomposer with wavelet filter banks, a QRS complex detector of hypothesis testing with wavelet-demodulated ECG signals, and a noise detector with zero-crossing points. To achieve high-detection performance with low-power consumption, the multi-scaled product algorithm and soft-threshold algorithm are efficiently exploited. To further reduce the power dissipation, a low-power ADC, which is based on a Successive Approximation Register(SAR) architecture with an on/off-time controlled comparator and passive sample and hold, is also presented. Our algorithmic and architectural level approaches are implemented and fabricated in standard $0.35{\mu}m$ CMOS technology. The testchip shows a good detection accuracy of 99.32% and very low-power consumption of $19.02{\mu}W$ with 3-V supply voltage.

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Minimal Skin Incision with Full Sternotomy for Congenital Heart Surgery (최소 피부 절개술을 이용한 선천성 심장 질환 수술)

  • Park, Choung-Kyu;Park, Pyo-Won;Jun, Tae-Gook;Park, Kay-Hyun;Chae, Hurn
    • Journal of Chest Surgery
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    • v.32 no.4
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    • pp.368-372
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    • 1999
  • Background: Although there have been few reports about minimal skin incision for the repair of congenital heart lesions, minimizing an unsightly scar is a particularly important factor in growing children. We have adopted a technique that permits standard full sternotomy, conventional open chest cardiopulmonary bypass, aortic cross-clamping, left atrial vent, and antegrade cardioplegia with minimal surgical scar. Material and Method: With minimal skin incision and full sternotomy, 40 patients with congenital heart disease underwent open heart surgery from April 1997 through September 1997. Defects repaired included 30 ventricular septal defects, 4 atrial septal defects, and 1 sinus Valsalva aneurysm in 35 children(M:F=17: 18), and 3 Atrial septal defects, 1 ventricular septal defect, and 1 partial atrioventricular septal defect in 5 adults(M:F=1:4). Midline skin incision was performed from the second intercostal space to 1 or 2 cm above the xiphoid process. For full sternotomy, we used the ordinary sternal saw in sternal body, and a special saw in manubrium under the skin flap. During sternal retraction, surgical field was obtained by using two retractors in a crossed direction. Result: The proportion of the skin incision length to the sternal length was 63.1${\pm}$3.9%(5.2∼11cm, mean 7.3cm) in children, and 55.0${\pm}$3.5%(10∼13.5cm, mean 12cm) in adults. In every case, the aortic and venous cannulations could be done through the sternal incision without additional femoral cannulation. There was no hospital death, wound infection, skin necrosis, hematoma formation, or bleeding complication. Conclusion: We conclude that minimal skin incision with full sternotomy can be a safe and effective alternative method for the repair of congenital heart diseases in children and adults.

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Clinical Experiences of Continuous Warm Blood Cardioplegia ; Valvular Heart Surgery (연속 온혈 심정지액의 임상경험 - 심장 판막 수술 환자 대상 -)

  • 이종국;박승일;조재민;원준호
    • Journal of Chest Surgery
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    • v.31 no.4
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    • pp.353-361
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    • 1998
  • Hypothermia is widely acknowledged as fundamental component of myocardial protection during cardiac operations. Although it prolongs the period of ischemic arrest by reducing oxygen demands, hypothermia is associated with a number of major disadvantages, including its detrimental effects on enzymatic function, energy generation, and cellular integrity. The ideal way to rotect the heart is to electromechanically arrest it and perfus it with blood that is aerobic arrest. However alternative technique has been developed, based on the principles of electromechanical arrest and normothermic aerobic perfusion using continuous warm blood cardioplegia. To determine if continuous warm blood cardioplegia was beneficial in clinical practice during valvular surgery, we studied two groups of patients matched by numbers and clinical characteristics. Group included is 31 patients undergoing valvular surgery who received intermittent cold crystalloid cardioplegia. Group II included 30 patients undergoing valvular surgery who received continuous warm blood cardioplegia. Our results suggest that the heartbeat in 100% of patients treated with continuous warm blood cardioplegia converted to normal sinus rhythm spontaneously after the removal of the aortic cross-clamp, compared to only 31% of the cold cardioplegia group. After operation, pericardial closure rate was 90% area in the warm group, compared to 35% area in the cold group. 12 hours after the operation, the total amount of urine output in the warm group was greater than that in the cold group(2863${\pm}$127 ml versus 2257${\pm}$127 ml; p<0.05). After the operation, left diaphragmatic elevation developed in 55% of the cold group but in 0% of the warm group. CK-MB level in the warm group was significantly lower than cold group(2.28${\pm}$0.62 versus 9.96${\pm}$2.12; p<0.01) 1 hour after operation and CK-MB level in the warm group was significantly lower than cold group(1.80${\pm}$1.01 versus 6.00${\pm}$1.74; p<0.05) 12hours after operation. Continuous warm blood cardioplegia is at least as safe and effective as hypothermic technique in patients undergoing cardiac valvular surgery. Conceptually, this represents a new approach to the problem of maintaining myocardial preservation during cardiac operations.

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The Assessment of Dynamic Mental Stress with Wearable Heart Activity Monitoring System (착용형 심장활동 모니터링 시스템을 활용한 정신적 스트레스 평가)

  • Kim, Kyeong-Seop;Shin, Seung-Won;Lee, Jeong-Whan;Choi, Hee-Jung
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.57 no.6
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    • pp.1109-1115
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    • 2008
  • In the ubiquitous health monitoring environments, it is quite important not only to evaluate the physiological health condition but also mental stress condition. In order to achieve this goal, a heart activity monitoring system utilizing a wearable bipolar electrode is devised and the heart rate variability(HRV) is extracted and interpreted in both frequency and time feature domains. Consequently, to evaluate the emotional stress condition of the subjects, a stress-induced experimental protocol was applied to healthy subjects and the time and frequency features of heart activity were analyzed in terms of the ratio of low frequency components v.s., high frequency components and the relevant the moving average distributions compromising the successive RR peaks intervals in the ambulatory ECG measurement system.

A Study of ECG Based Cardiac Diseases Diagnoses (심전도 신호를 이용한 심장 질환 진단에 관한 연구)

  • Kim, Hyun-Dong;Yoon, Jae-Bok;Kim, Hyun-Dong;Kim, Tae-Seon
    • Proceedings of the KIEE Conference
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    • 2004.11c
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    • pp.328-330
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    • 2004
  • In this paper, ECG based cardiac disease diagnosis models are developed. Conventionally, ECG monitoring equipments can only measure and store ECG signals and they always require medical doctor's diagnosis actions which are not desirable for continuous ambulatory monitoring and diagnosis healthcare systems. In this paper, two kinds of neural based self cardiac disease diagnosis engines are developed and tested for four kinds of diseases, sinus bradycardia, sinus tachycardia, left bundle branch block and right bundle branch block. For diagnosis engines, error backpropagation neural network (BP) and probabilistic neural network (PNN) were applied. Five signal features including heart rate, QRS interval, PR interval, QT interval, and T wave types were selected for diagnosis characteristics. To show the validity of proposed diagnosis engine, MIT-BIH database were used to test. Test results showed that BP based diagnosis engine has 71% of diagnosis accuracy which is superior to accuracy of PNN based diagnosis engine. However, PNN based diagnosis engine showed superior diagnosis accuracy for complex-disease diagnoses than BP based diagnosis engine.

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Feature Extraction of ECG Signal for Heart Diseases Diagnoses (심장질환진단을 위한 ECG파형의 특징추출)

  • Kim, Hyun-Dong;Min, Chul-Hong;Kim, Tae-Seon
    • Proceedings of the KIEE Conference
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    • 2004.11c
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    • pp.325-327
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    • 2004
  • ECG limb lead II signal widely used to diagnosis heart diseases and it is essential to detect ECG events (onsets, offsets and peaks of the QRS complex P wave and T wave) and extract them from ECG signal for heart diseases diagnoses. However, it is very difficult to develop standardized feature extraction formulas since ECG signals are varying on patients and disease types. In this paper, simple feature extraction method from normal and abnormal types of ECG signals is proposed. As a signal features, heart rate, PR interval, QRS interval, QT interval, interval between S wave and baseline, and T wave types are extracted. To show the validity of proposed method, Right Bundle Branch Block (RBBB), Left Bundle Branch Block (LBBB), Sinus Bradycardia, and Sinus Tachycardia data from MIT-BIH arrhythmia database are used for feature extraction and the extraction results showed higher extraction capability compare to conventional formula based extraction method.

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PVC(Premature Ventricular Contraction) Arrhythmia Detection Using R-R Interval (R-R 간격 정보를 이용한 심실조기수축 부정맥 검출)

  • Lee, Sun-Ju;Yoon, Tae-Ho;Shin, Seung-Won;Lee, Seong-Taek;Kim, Kyeong-Seop;Lee, Jeong-Whan;Kim, Dong-Jun
    • Proceedings of the KIEE Conference
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    • 2008.10b
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    • pp.472-473
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    • 2008
  • 심실조기수축(PVC: Premature Ventricular Contraction)은 성인에게서 가장 흔하게 발생되는 심장 부정맥 증상 중의 하나이다. 심실조기수축 부정맥이 자주 발현되는 사람의 경우 관상 동맥질환, 고혈압 등의 심혈관계 질환이 진행되고 있을 가능성이 많고, 심실빈맥이나 심실세동으로 전이되는 경우 심정지 등을 유발하여 사망에 이르기 때문에 지속적으로 관찰이 필요한 증상이다. 따라서 본 연구에서는 R-R 간격 정보를 이용하여 심실조기수축 부정맥 증상을 실시간으로 검출할 수 있는 신호처리 알고리즘을 구현하고자 하였다.

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