• Title/Summary/Keyword: Cardiac arrhythmias

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Atrial pacemaker implantation through left subclavian vein puncture (쇄골하정맥을 이용한 J 형의 전극도자를 가진 심방 Pacemaker 이식치험 2예)

  • Lee, Du-Yeon;Hong, Seung-Rok;Lee, Ung-Gu
    • Journal of Chest Surgery
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    • v.16 no.2
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    • pp.190-198
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    • 1983
  • The management of cardiac arrhythmias by cardiac pacing has increased greatly since the treatment of complete heart block with an external transcutaneous pacemaker in 1952, followed by the use of myocardial wires connected to an external pulse generation, by external transvenous pacing, and then by transvenous pacing with implantable components in thoracic wall.By now, the three bases of modern cardiac pacing for bradyarrhythmias had been established [1] an implantable device [2] the transvenous approach [3] the ability of the pacemaker to sense cardiac activity and modify its own function accordingly. In transvenous implantation of a pacemaker, any one of four vessels at the root of the neck is suitable for passage of the electrode - cephalic vein, external jugular vein, internal jugular vein, costo-axillary branch of the axillary vein. The new technique of direct puncture of the subclavian vein, either percutaneously or after skin incision only has been made, is invaluable & is used routinely. We have experienced one 25 years old patient who had rheumatic mitral stenosis & minimum aortic regurgitation with sinus bradycardia associated with premature atrial tachycardia & another 54 years old female patient who was suffered from sick sinus syndrome with sinus bradycardia & sinus arrest. The 1st patient was taken open mitral commissurotomy & aortic valvuloplasty and then was taken atrlal pace-maker implantation through If subclavian puncture method in post-op 14 days, and the second patient was taken atrial pacemaker implantation through If subclavian puncture method. Their postop course was in uneventful & were discharged, without complication. Their condition have been good to now.

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A case of various clinical aspects associated with cardiotoxicity after glufosinate poisoning (글루포시네이트 중독 후 심장독성의 다양한 임상경과를 보인 1례)

  • Kim, Seon Tae
    • Journal of The Korean Society of Clinical Toxicology
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    • v.19 no.2
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    • pp.133-138
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    • 2021
  • Glufosinate-containing herbicides is a non-selective herbicide commonly used worldwide. As the use of them increased gradually since paraquat was banned in 2012, the number of suicides by their ingestion is also increasing continuously. Complications of glufosinate-containing herbicide poisoning include various central nervous system (CNS) toxicities such as convulsions, loss of consciousness, memory impairment, and respiratory depression, which may be accompanied by hemodynamic changes such as bradycardia and hypotension. However, it is very rare that arrhythmias other than bradycardia occurred and Takotsubo cardiomyopathy was combined due to cardiotoxicity. A 71-year-old female patient was transferred to our hospital after ingesting 500 mL of glufosinate-containing herbicide and receiving 5 L of gastric lavage at a local hospital. A few hours later, she presented stuporous mentality, respiratory depression, and convulsions, and was accompanied by hypotension and bradycardia. On the second day of admission, electrocardiogram (ECG) showed bradycardia and QTc prolongation with hemodynamic Instability. Accordingly, we conducted the early treatment with continuous renal replacement therapy (CRRT) and the application of temporary cardiac pacemaker. An echocardiogram demonstrated decreased ejection fraction (EF) and Takotsubo cardiomyopathy on the third day of admission. Then, she was discharged safely with conservative treatment. At the follow-up after 1 year, Takotsubo cardiomyopathy, EF and QTc prolongation were recovered on echocardiogram and ECG. Because cardiac toxicity after glufosinate-containing herbicide poisoning may cause life-threatening consequences, caution is required while treating the patient. Therefore, if electrocardiogram changes are seen in the elderly with a large amount of glufosinate herbicide ingestion, additional cardiac function test through echocardiography should be concerned, and early treatment through CRRT or artificial cardiac pacing should be considered.

The Impact of Intrapericardial versus Intrapleural HeartMate 3 Pump Placement on Clinical Outcomes

  • Salna, Michael;Ning, Yuming;Kurlansky, Paul;Yuzefpolskaya, Melana;Colombo, Paolo C.;Naka, Yoshifumi;Takeda, Koji
    • Journal of Chest Surgery
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    • v.55 no.3
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    • pp.197-205
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    • 2022
  • Background: The integrated design of the HeartMate 3 (Abbott Laboratories, Chicago, IL, USA) affords flexibility to place the pump within the pericardium or thoracic cavity. We sought to determine whether the presence of a left ventricular assist device (LVAD) in either location has a meaningful impact on overall patient outcomes. Methods: A retrospective cohort study was conducted of all 165 patients who received a HeartMate 3 LVAD via a median sternotomy from November 2014 to August 2019 at our center. Based on operative reports and imaging, patients were divided into intrapleural (n=81) and intrapericardial (n=84) cohorts. The primary outcome of interest was in-hospital mortality, while secondary outcomes included postoperative complications, cumulative readmission incidence, and 3-year survival. Results: There were no significant between-group differences in baseline demographics, risk factors, or preoperative hemodynamics. The overall in-hospital mortality rate was 6%, with no significant difference between the cohorts (9% vs. 4%, p=0.20). There were no significant differences in the postoperative rates of right ventricular failure, kidney failure requiring hemodialysis, stroke, tracheostomy, or arrhythmias. Over 3 years, despite similar mortality rates, intrapleural patients had significantly more readmissions (n=180 vs. n=117, p<0.01) with the most common reason being infection (n=68/165), predominantly unrelated to the device. Intrapleural patients had significantly more infection-related readmissions, predominantly driven by non-ventricular assist device-related infections (p=0.02), with 41% of these due to respiratory infections compared with 28% of intrapericardial patients. Conclusion: Compared with intrapericardial placement, insertion of an intrapleural HM3 may be associated with a higher incidence of readmission, especially due to respiratory infection.

Real-Time Automated Cardiac Health Monitoring by Combination of Active Learning and Adaptive Feature Selection

  • Bashir, Mohamed Ezzeldin A.;Shon, Ho Sun;Lee, Dong Gyu;Kim, Hyeongsoo;Ryu, Keun Ho
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.7 no.1
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    • pp.99-118
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    • 2013
  • Electrocardiograms (ECGs) are widely used by clinicians to identify the functional status of the heart. Thus, there is considerable interest in automated systems for real-time monitoring of arrhythmia. However, intra- and inter-patient variability as well as the computational limits of real-time monitoring poses significant challenges for practical implementations. The former requires that the classification model be adjusted continuously, and the latter requires a reduction in the number and types of ECG features, and thus, the computational burden, necessary to classify different arrhythmias. We propose the use of adaptive learning to automatically train the classifier on up-to-date ECG data, and employ adaptive feature selection to define unique feature subsets pertinent to different types of arrhythmia. Experimental results show that this hybrid technique outperforms conventional approaches and is therefore a promising new intelligent diagnostic tool.

Cloning and Expression of Human KCNE1 Gene

  • Ye, Qing;Kim, Su-Won;Kim, Jong-Won;Yoo, Min
    • Biomedical Science Letters
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    • v.16 no.4
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    • pp.299-305
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    • 2010
  • KCNE1 is the causal gene of long QT syndrome. KCNE1 gene is located in chromosome 21. In compliance with this KCNE1 gene the proteins come out. KCNE1 is responsible for $K^+$ channel which maintains the normal function of the heart muscle for contraction. Affected individuals manifest prolongation of the QT interval on electrocardiongrams, a sign of abnormal cardiac repolarization. The clinical features of LQT result from episodic cardiac arrhythmias, such as torsade de pointes and ventricular fibrllation. Blood DNA was isolated and kept in $4^{\circ}C$ refrigerator. The KCNE1 gene was amplified by PCR method and about 414 bp band was identified by agarose gel electrophoresis. PCR products were inserted into pGEX-4T-1 vector in order to express KCNE1 protein after treatment with IPTG SDS-PAGE was carried out and the protein band which was about 47 kDa was clearly odserved. Results of this study would contribute to the detailed understanding of KCNE1 protein function and to designing better treatment of Long QT symdrome.

A Combined QRS-complex and P-wave Detection in ECG Signal for Ubiquitous Healthcare System

  • Bhardwaj, Sachin;Lee, Dae-Seok;Chung, Wan-Young
    • Journal of information and communication convergence engineering
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    • v.5 no.2
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    • pp.98-103
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    • 2007
  • Long term Electrocardiogram (ECG) [1] analysis plays a key role in heart disease analysis. A combined detection of QRS-complex and P-wave in ECG signal for ubiquitous healthcare system was designed and implemented which can be used as an advanced warning device. The ECG features are used to detect life-threating arrhythmias, with an emphasis on the software for analyzing QRS complex and P-wave in wireless ECG signals at server after receiving data from base station. Based on abnormal ECG activity, the server will transfer alarm conditions to a doctor's Personal Digital Assistant (PDA). Doctor can diagnose the patients who have survived from cardiac arrhythmia diseases.

Epidemiology of anaphylaxis in Korean children (소아청소년에서 아나필락시스의 역학)

  • Lim, Dae Hyun
    • Clinical and Experimental Pediatrics
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    • v.51 no.4
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    • pp.351-354
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    • 2008
  • Anaphylaxis is an acute systemic reaction caused by IgE-mediated immunological release of mediators from mast cells and basophils to allergenic triggers, such as food, insect venoms, and medications. An alternative definition was recently proposed as follows: anaphylaxis is a "condition caused by an IgE mediated reaction" that is "often life threatening and almost always unanticipated." The reaction can be severe enough to lead to the rapid onset of symptoms, including dizziness, upper airway occlusion, bronchial constriction, hypotension, urticaria, cardiovascular arrhythmias and possible cardiac arrest. The incidence or prevalence of anaphylaxis in Korean pediatrics has not known. Thus, Epidemiology of Anaphylaxis in Pediatrics based on the data from Korean Health Insurance Review and Assessment Service (KHIRA) from 2001 to 2007 and questionnaire to the member of Korean Academy of Pediatric Allergy and Respiratory Disease (KAPARD) who are working at the training hospitals was studied. The incidence of anaphylaxis under age 19 is 0.7-1.0 per 100,000 year-person. The causes of anaphylaxis based on data from KHIRA were unknown (61.7%), food (24.9%), medications (12.4%), and serum (1.0%).

Tumour Lysis Syndrome: Implications for Cancer Therapy

  • Mika, Denish;Ahmad, Sabrina;Guruvayoorappan, C.
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.3555-3560
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    • 2012
  • The tumour lysis syndrome (TLS) is a group of metabolic abnormalities caused by rapid and unexpected release of cellular components into the circulation as a result of massive destruction of rapidly proliferating malignant cells. It usually develops in patients with hematologic malignancies like acute lymphoid leukemia, non-Hodgkin and Burkitt's lymphoma after initiation of chemotherapy or may, rarely, occur spontaneously. Though TLS is seldom observed in relation to solid tumours, there have been reports of connections with examples such as lung, liver, breast, gastric carcinomas. The clinical manifestations of TLS include hyperuricemia, hyperkalemia, hyperphosphatemia and hypocalcemia. These indications if untreated lead to life-threatening complications such as acute renal failure, cardiac arrhythmias, seizures, and eventually death due to multiorgan failure. Therefore early detection of TLS is of vital importance. This can be accomplished by identification of high risk patients, implementation of suitable prophylactic measures andmonitoring of the electrolyte levels in patients undergoing chemotherapy.

Korean Rosebay Intoxication -2 Case Reports- (진달래꽃과 관련된 중독 2례)

  • Kim Ho Kwon;Jeong Tae O;Jin Young Ho;Lee Jae Baek
    • Journal of The Korean Society of Clinical Toxicology
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    • v.3 no.1
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    • pp.52-55
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    • 2005
  • The plant Korean rosebay are members of the Ericaceae(Heath) family and may contain grayanotoxins, which exert toxic effects by binding to sodium channels in cell membranes. We had experience of 2 cases of Korean rose bay intoxication, who exposed to Rhododendron mucronulatum. Patients were presented to our ED with nausea and vomiting, hypotension, and dizziness or depressed mentation. The patients were performed monitoring and supportive treatment and were fully recovered within 48hours. Korean rose bay intoxication should be considered in patients with clinical evidence of gastrointestinal irritation, cardiac arrhythmias, and/or neurologic signs without identifiable causes, especially in spring or early summer.

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Modified Monopole Antenna for Microwave Thermal Therapy (마이크로파 에너지를 이용한 열 치료용 링-모노폴 안테나)

  • 문명호;곽상태
    • Proceedings of the Korea Electromagnetic Engineering Society Conference
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    • 2001.11a
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    • pp.86-90
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    • 2001
  • Modified coaxial-slot antenna for minimally invasive microwave thermal therapy for liver tumor is studied in this paper. Minimally invasive microwave antenna in medicine are applied for hyperthermia for medical treatment for cancer, cardiac catheter ablation for ventricular arrhythmias treatments, microwave treatment of Benign prostatic hypertrophy, and so on. Microwave hyperthermal ablation for liver tumors is expected for enthusiasts as an alternative to curative surgical resection. Tumors have to heated up to 60 degree C to coagulate .cancer cells but less than 100 degree C to avoid evaporation. Temperature dependence of properties of the tissues should be considered for wide range of treatment. Electrical properties of liver tissue were measured for different temperatures. SAR distribution around the antenna into the liver are simulated using Remcom's XFDTD.

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