• Title/Summary/Keyword: Cardiac Arrhythmias

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A Wireless ECG monitoring System for Application in Life Emergency Event Detection and Analysis (긴급환자 상황인식 및 분석을 위한 무선 ECG모니터링 시스템)

  • Bhardwaj Sachin;Lee Dae-Seok;Chung Wan-Young
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2006.05a
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    • pp.421-425
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    • 2006
  • An ubiquitous healthcare system for the home care of elderly persons was designed and implemented using wireless sensor network technology. The wireless technology for home-care purpose gives new possibilities for monitoring of vital parameter with wearable biomedical sensors, and will give the patient the freedom to be mobile and still be under continuously monitoring and thereby to better quality of patient care. Emphasis is placed on recent advances in wireless ECG system for cardiac event monitoring with particular attention to arrhythmia detection in patient. This paper presents a diagnostic system for cardiac arrhythmias from ECG data, using wireless sensor technology. The system also provides an application for recording activities, events and potentially important medical symptoms. The hardware allows data to be transmitted wirelessly from on-body sensor to the base station and then to PC/PDA. Data is also transmitted to a back-end server for analysis using wireless internet connection. Experiments were conducted using the system for activity monitoring, exercise monitoring and medical screening tests and present preliminary data and results.

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Different effects of prolonged β-adrenergic stimulation on heart and cerebral artery

  • Shin, Eunji;Ko, Kyung Soo;Rhee, Byoung Doo;Han, Jin;Kim, Nari
    • Integrative Medicine Research
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    • v.3 no.4
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    • pp.204-210
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    • 2014
  • The aim of this review was to understand the effects of ${\beta}$-adrenergic stimulation on oxidative stress, structural remodeling, and functional alterations in the heart and cerebral artery. Diverse stimuli activate the sympathetic nervous system, leading to increased levels of catecholamines. Long-term overstimulation of the ${\beta}$-adrenergic receptor (${\beta}AR$) in response to catecholamines causes cardiovascular diseases, including cardiac hypertrophy, stroke, coronary artery disease, and heartfailure. Although catecholamines have identical sites of action in the heart and cerebral artery, the structural and functional modifications differentially activate intracellular signaling cascades. ${\beta}AR$-stimulation can increase oxidative stress in the heart and cerebral artery, but has also been shown to induce different cytoskeletal and functional modifications by modulating various components of the ${\beta}AR$ signal transduction pathways. Stimulation of ${\beta}AR$ leads to cardiac dysfunction due to an overload of intracellular $Ca^{2+}$ in cardiomyocytes. However, this stimulation induces vascular dysfunction through disruption of actin cytoskeleton in vascular smooth muscle cells. Many studies have shown that excessive concentrations of catecholamines during stressful conditions can produce coronary spasms or arrhythmias by inducing $Ca^{2+}$-handling abnormalities and impairing energy production in mitochondria, In this article, we highlight the different fates caused by excessive oxidative stress and disruptions in the cytoskeletal proteome network in the heart and the cerebral artery in responsed to prolonged ${\beta}AR$-stimulation.

Lipid emulsion therapy of local anesthetic systemic toxicity due to dental anesthesia

  • Rhee, Seung-Hyun;Park, Sang-Hun;Ryoo, Seung-Hwa;Karm, Myong-Hwan
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.19 no.4
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    • pp.181-189
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    • 2019
  • Local anesthetic systemic toxicity (LAST) refers to the complication affecting the central nervous system (CNS) and cardiovascular system (CVS) due to the overdose of local anesthesia. Its reported prevalence is 0.27/1000, and the representative symptoms range from dizziness to unconsciousness in the CNS and from arrhythmias to cardiac arrest in the CVS. Predisposing factors of LAST include extremes of age, pregnancy, renal disease, cardiac disease, hepatic dysfunction, and drug-associated factors. To prevent the LAST, it is necessary to recognize the risk factors for each patient, choose a safe drug and dose of local anesthesia, use vasoconstrictor, confirm aspiration and use incremental injection techniques. According to the treatment guidelines for LAST, immediate application of lipid emulsion plays an important role. Although lipid emulsion is commonly used for parenteral nutrition, it has recently been widely used as a non-specific antidote for various types of drug toxicity, such as LAST treatment. According to the recently published guidelines, 20% lipid emulsion is to be intravenously injected at 1.5 mL/kg. After bolus injection, 15 mL/kg/h of lipid emulsion is to be continuously injected for LAST. However, caution must be observed for >1000 mL of injection, which is the maximum dose. We reviewed the incidence, mechanism, prevention, and treatment guidelines, and a serious complication of LAST occurring due to dental anesthesia. Furthermore, we introduced lipid emulsion that has recently been in the spotlight as the therapeutic strategy for LAST.

Ginsenoside Re inhibits myocardial fibrosis by regulating miR-489/myd88/NF-κB pathway

  • Jinghui Sun;Ru Wang;Tiantian Chao;Jun Peng;Chenglong Wang;Keji Chen
    • Journal of Ginseng Research
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    • v.47 no.2
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    • pp.218-227
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    • 2023
  • Background: Myocardial fibrosis (MF) is an advanced pathological manifestation of many cardiovascular diseases, which can induce heart failure and malignant arrhythmias. However, the current treatment of MF lacks specific drugs. Ginsenoside Re has anti-MF effect in rat, but its mechanism is still not clear. Therefore, we investigated the anti-MF effect of ginsenoside Re by constructing mouse acute myocardial infarction (AMI) model and AngII induced cardiac fibroblasts (CFs) model. Methods: The anti-MF effect of miR-489 was investigated by transfection of miR-489 mimic and inhibitor in CFs. Effect of ginsenoside Re on MF and its related mechanisms were investigated by ultrasonographic, ELISA, histopathologic staining, transwell test, immunofluorescence, Western blot and qPCR in the mouse model of AMI and the AngII-induced CFs model. Results: MiR-489 decreased the expression of α-SMA, collagenI, collagen III and myd88, and inhibited the phosphorylation of NF-κB p65 in normal CFs and CFs treated with AngII. Ginsenoside Re could improve cardiac function, inhibit collagen deposition and CFs migration, promote the transcription of miR-489, and reduce the expression of myd88 and the phosphorylation of NF-κB p65. Conclusion: MiR-489 can effectively inhibit the pathological process of MF, and the mechanism is at least partly related to the regulation of myd88/NF-κB pathway. Ginsenoside Re can ameliorate AMI and AngII induced MF, and the mechanism is at least partially related to the regulation of miR-489/myd88/NF-κB signaling pathway. Therefore, miR-489 may be a potential target of anti-MF and ginsenoside Re may be an effective drug for the treatment of MF.

Molecular Signatures of Sinus Node Dysfunction Induce Structural Remodeling in the Right Atrial Tissue

  • Roh, Seung-Young;Kim, Ji Yeon;Cha, Hyo Kyeong;Lim, Hye Young;Park, Youngran;Lee, Kwang-No;Shim, Jaemin;Choi, Jong-Il;Kim, Young-Hoon;Son, Gi Hoon
    • Molecules and Cells
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    • v.43 no.4
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    • pp.408-418
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    • 2020
  • The sinus node (SN) is located at the apex of the cardiac conduction system, and SN dysfunction (SND)-characterized by electrical remodeling-is generally attributed to idiopathic fibrosis or ischemic injuries in the SN. SND is associated with increased risk of cardiovascular disorders, including syncope, heart failure, and atrial arrhythmias, particularly atrial fibrillation. One of the histological SND hallmarks is degenerative atrial remodeling that is associated with conduction abnormalities and increased right atrial refractoriness. Although SND is frequently accompanied by increased fibrosis in the right atrium (RA), its molecular basis still remains elusive. Therefore, we investigated whether SND can induce significant molecular changes that account for the structural remodeling of RA. Towards this, we employed a rabbit model of experimental SND, and then compared the genome-wide RNA expression profiles in RA between SND-induced rabbits and sham-operated controls to identify the differentially expressed transcripts. The accompanying gene enrichment analysis revealed extensive pro-fibrotic changes within 7 days after the SN ablation, including activation of transforming growth factor-β (TGF-β) signaling and alterations in the levels of extracellular matrix components and their regulators. Importantly, our findings suggest that periostin, a matricellular factor that regulates the development of cardiac tissue, might play a key role in mediating TGF-β-signaling-induced aberrant atrial remodeling. In conclusion, the present study provides valuable information regarding the molecular signatures underlying SND-induced atrial remodeling, and indicates that periostin can be potentially used in the diagnosis of fibroproliferative cardiac dysfunctions.

A Treatment Case of Endoscopic Removal of Left Ventricular Thrombus, During Coronary Artery Bypass Graft

  • Park, Hyun-Seok;Ryu, Se-Min;Cho, Seong-Joon;Park, Sung-Min;Lim, Sun-Hye
    • Journal of Chest Surgery
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    • v.47 no.4
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    • pp.434-436
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    • 2014
  • Left ventricular thrombus is a common complication related to acute myocardial infarction. Removing this with an incision of the free wall of the left ventricle may cause fatal cardiac dysfunction or arrhythmias. Furthermore, performing incision and suture on the fragile myocardium of an acute myocardial infarction patient may cause serious bleeding complications. If there is a patient with left ventricular thrombus who needs thoracotomy for another reason, the case is attempted with the thought that if effective intraventricular visualization and manipulation can be done, fatalities caused by incision and suture may be reduced. For patients undergoing cardiopulmonary bypass, if intracardiac manipulation is required, an endoscope can be used, and given the potential complications after the incision and suturing of the infarcted tissue, the benefits are deemed sufficient.

Clinical study of endocardial cushion defect: 37 cases report (심내막상 결손증에 대한 임상고)

  • Jo, Jae-Il;Seo, Gyeong-Pil
    • Journal of Chest Surgery
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    • v.17 no.4
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    • pp.657-665
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    • 1984
  • Thirty-seven patients had undergone repair of a endocardial cushion defect between 1977 and Aug. 1983 in Seoul National University Hospital. Twenty eight had a partial defect, one intermediate defect and eight complete endocardial cushion defect. Tricuspid cleft was found in 4 cases and mitral cleft was in all p-ECD. Seven patients were of type C anatomy in c-ECD. Four patients had associated major anomalies, including three TOF in c-ECD, one coarctation in p- ECD. In p-ECD patients, the septal defect was closed with patch in all cases and the atrioventricular valvular insufficiency was corrected with MVR in 4 cases, TVR in 1 case and simple interrupted sutures in remainders. In c-ECD patients the septal defect was closed with single patch except one case. The atrioventricular valve was repaired with simple interrupted sutures except one MVR and TVR case. The operative mortality was 14.2% in p-ECD, 44.4% in c-ECD, but recent 3 years [1980-1983] mortality was 8.7% in p-ECD, 20% in c-ECD. More than grade III systolic regurgitant murmur was oted postoperatively in 4 cases of c-ECD and 3 cases of p-ECD. The operative risk factors were preoperative NYHA classification, cyanosis, Rp/Rs, systolic pressure of main pulmonary artery and the degree of regurgitation of atrioventricular valves. The causes of death were low cardiac output syndromes, pulmonary complications and arrhythmias.

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PVC Classification Algorithm Through Efficient R Wave Detection

  • Cho, Ik-Sung;Kwon, Hyeog-Soong
    • Journal of Sensor Science and Technology
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    • v.22 no.5
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    • pp.338-345
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    • 2013
  • 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 the prevention of possible life threatening cardiac diseases. Most methods for detecting arrhythmia require pp interval, or the diversity of P wave morphology, but they are difficult to detect the p wave signal because of various noise types. Thus, it is necessary to use noise-free R wave. So, the new approach for the detection of PVC is presented based on the rhythm analysis and the beat matching in this paper. For this purpose, we removed baseline wandering of low frequency band and made summed signals that are composed of two high frequency bands including the frequency component of QRS complex using the wavelet filter. And then we designed R wave detection algorithm using the adaptive threshold and window through RR interval. Also, we developed algorithm to classify PVC using RR interval. The performance of R wave and PVC detection is evaluated by using MIT-BIH arrhythmia database. The achieved scores indicate average detection rate of 99.76%, sensitivity of 99.30% and specificity of 98.66%; accuracy respectively for R wave and PVC detection.

The Senning Operation for Transition of the Great Arteries -a 7-year prospective study - (대혈관전위증의 Senning 수술요법)

  • Kim, Gi-Bong;No, Jun-Ryang
    • Journal of Chest Surgery
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    • v.22 no.5
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    • pp.753-759
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    • 1989
  • Recently, the arterial switch operation has received more interest and increased application for many patients with TGA [Transposition of the Great Arteries]. Not all patients, however, are suitable candidates for this approach, and its success will be measured against the Senning procedure. From June 1982 through June 1989, 48 consecutive patients underwent correction of TGA by a modification of the Senning procedure in our hospital. 34 were males and 14 females, with ages ranging from 3 months to 99 months [mean age 14 months]. The patients were divided into two groups, group I [TGA with intact ventricular septum or without significant pulmonary hypertension] and group II [TGA with significant pulmonary hypertension]. The hospital mortality was 9.5 % in group I and 55.6 % in group lI. 31 patients were discharged from the hospital after a Senning operation and have been followed a mean of 31.2 months. There were 5 late deaths, 3 in group I and 2 in group II. All patients were followed up with EKG, echocardiogram, and in several cases, Holter monitor and cardiac catheterization and angiography were also performed. There have been arrhythmias in 7, superior vena caval obstruction in 5, pulmonary venous obstruction in 2 and tricuspid insufficiency and/or right ventricular dysfunction in 16 patients. The Senning operation for Simple TGA can be performed with a low operative mortality and morbidity, but tricuspid insufficiency and/or depressed right ventricular function can be a problem with prolonged follow up.

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Congenital Left Atrial Appendage Aneurysm - A case report- (선천성 좌심방이류 - 1례 보고 -)

  • 김근직;이응배;전상훈;장봉현;이종태;김규태
    • Journal of Chest Surgery
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    • v.32 no.9
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    • pp.827-830
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    • 1999
  • Congenital left atrial appendage aneurysm is a very rare congenital cardiac abnormality. That is postulated to arise from a developmental weakness in the atrial wall in utero. Clinically, patients are often asymptomatic and are diagnosed incidentally, but supraventricular arrhythmias and systemic thromboembolism have also been reported in some cases. Surgical resection at the time of diagnosis is recommended because of the propensity for thromboembolic complications. A 13-month-old female, who was suspected preoperatively as having partial absence of pericardium with left atrial herniation through the defect, underwent surgical resection of the left atrial appendage aneurysm. Exposure through a median sternotomy showed an intact pericardium. The postoperative course was uneventful.

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