• Title/Summary/Keyword: Fibrillation-control

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Outcome of Concomitant Cox Maze Procedure with Narrow Mazes and Left Atrial Volume Reduction

  • Choi, Jong Bum;Kim, Jong Hun;Cha, Byong Ki
    • Journal of Chest Surgery
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    • v.47 no.4
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    • pp.358-366
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    • 2014
  • Background: To improve sinus rhythm conversion, the Cox maze III procedure with narrow mazes (width: ${\leq}3.0cm$) was performed in combination with left atrial volume reduction. Methods: From October 2007 to April 2013, 87 patients with atrial fibrillation (paroxysmal in 3, persistent in 14, and permanent in 70) underwent the Cox maze procedure concomitant with another cardiac procedure. They were followed-up with serial electrocardiographic and echocardiographic studies. We used 24-hour Holter monitoring tests to evaluate postoperatively symptomatic patients. Results: At the mean follow-up time of 36.4 months, 81 patients (94.2%) had sinus rhythm and two were on anti-arrhythmic medication (one on a beta-blocker and the other on amiodarone). Five patients (5.8%) with postoperative recurrent and persistent atrial fibrillation never experienced sinus rhythm conversion; however, they did not require any medication for rate control. On postoperative echocardiography, the left atrial A waves were more frequently observed after concomitant mitral valve repair than after concomitant mitral valve replacement (82.4% vs. 40.4%, respectively; p<0.001). Conclusion: For the Cox maze procedure, narrow mazes and atrial volume reduction resulted in excellent sinus rhythm conversion without the preventive use of anti-arrhythmic drugs, and they did not affect the presence of the left atrial A waves on echocardiography.

Amyloid Polymorphism of α-Synuclein Induced by Active Firefly Luciferase

  • Yang, Jee Eun;Hong, Je Won;Kim, Jehoon;Paik, Seung R.
    • Bulletin of the Korean Chemical Society
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    • v.35 no.2
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    • pp.425-430
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    • 2014
  • Amyloidogenic proteins often exhibit fibrillar polymorphism through alternative assembly processes, which has been considered to have possible pathological implications. Here, firefly luciferase (LUC) is shown to induce amyloid polymorphism of ${\alpha}$-synuclein, the major constituent of Lewy bodies found in Parkinson's disease, by acting as a novel template. The drastically accelerated fibrillation kinetics of ${\alpha}$-synuclein with LUC required the nucleation center produced by the active enzyme of LUC. Fluorescent dye binding, transmission electron microscopy, and Fourier transformed infrared spectroscopy revealed the morphologically distinctive amyloid fibrils of ${\alpha}$-synuclein prepared in the absence or presence of LUC. As the altered morphological characteristics became inherent to the mature fibrils, those properties were inherited to next-generations via nucleation-dependent fibrillation process. The seed control, therefore, would be an effective means to modify amyloid fibrils with different biochemical characteristics. In addition, the LUC-directed amyloid fibrillar polymorphism also suggests that other cellular biomolecules including enzymes in general are able to diversify amyloid fibrils, which could be self-propagated with diversified biological activities, if any, inside cells.

Signal-Averaged P Wave Analysis in Patients with Paroxysmal Atrial Fibrillation (발작성 심방세동 환자의 신호평균 P파 분석)

  • 김인영;이종연;이병채;이용희;이종민;김선일;김준수
    • Journal of Biomedical Engineering Research
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    • v.23 no.1
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    • pp.1-8
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    • 2002
  • Atrial fibrillation(AF). chronic or paroxysmal is the most frequent arrhythmia in human subjects Duration of P wave in signal-averaged electrocardiography(SAECG) reflects intra-atrial conduction time and therefore. could be used as an electrophysiological marker for atrial conduction chance at the earthy stave. So we apply the analysis method using SAECG to diagnose Paroxysmal atrial fibrillation(PAF) . Subjects Participated for the study consisted of two groups: a control group(n=34) of normal healthy volunteers and a group of AF Patients(n=38) with a documented history of PAF but no other history of cardiac disease. We evaluated the effect of several filtering and determination methods to find the starting and ending feints of the P wavy on its duration. To increase the measurement reliability of P wave duration. the automatic detection method was proposed. Also. to increase the detection rate for PAF risk, the decision threshold value was optimized using receiver operation characteristics(ROC) curve. Results showed that the highest statistical difference (p〈0.001) of the P wane duration between controls and subjects was obtained at the Processing condition, using absolute threshold vague(8.75 $\mu N$) , a least mean square(LMS) high pass filter and 30 Hz cutoff frequency. The most outstanding difference(sensitivity 88 % specificity 64.4 %) between controls and subjects was obtained at the decision threshold value of 112 ms.

Effect of Sodium Hyaluronate on Osteoarthrosis in Rabbit Model (골관절증이 유발된 토끼에서 Sodium Hyaluronate의 효과)

  • 이진원;김창환;박종환;최은실;홍정주;박재섭;박재학
    • Biomolecules & Therapeutics
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    • v.7 no.4
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    • pp.347-353
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    • 1999
  • Osteoarthrosis was induced in rabbit knees through resecton of anterior cruciate ligament. Sodium hyaluronate (1%) was administerated into articular space at the dose levels of 0.1 mg/kg once a week using 1ml sylinge and 26G needle for test groups. Saline was administrated for control groups. After 6 and 12 weeks, animals were sacrificed to conduct macroscopic observation and histopathologic examination. The articular lesions were evaluated and test groups were compared with control groups. No significant differencies were showed between test groups and control groups at macroscopic observation in both 6- and 12- week groups. In histopathologic examination, control groups showed higher osteoarthrosis than test groups. The articular surfaces of control groups showed fibrillation, denudation, pannus formation and hypocellularity. The articular surfaces of test groups showed fibrillaton and hypercellularity. These indicate that sodium hyaluronate has inhibitory effects on osteoarthrosis at least in rabbit and could be used for treatment of osteoarthrosis.

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Comparison of Early Complications of Oral Anticoagulants after Totally Thoracoscopic Ablation: Warfarin versus Non-vitamin K Antagonist Oral Anticoagulants

  • MuHyung Heo;Dong Seop Jeong;Suryeun Chung;Kyoung Min Park;Seung Jung Park;Young Keun On
    • Journal of Chest Surgery
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    • v.56 no.2
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    • pp.90-98
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    • 2023
  • Background: Atrial fibrillation (AF) is the most common type of cardiac arrhythmia. Totally thoracoscopic ablation (TTA) is a surgical treatment showing a high success rate as a hybrid procedure with radiofrequency catheter ablation to control AF. This study compared the early complications of warfarin and non-vitamin K antagonist oral anticoagulants (NOACs) in patients who underwent TTA. Methods: This single-center retrospective cohort study enrolled patients who underwent planned TTA for AF from February 2012 to October 2020. All patients received postoperative anticoagulation, either with warfarin or a NOAC (apixaban, rivaroxaban, dabigatran, or edoxaban). Propensity score matching was performed for both groups. Early complications were assessed at 12 weeks after TTA and were divided into efficacy and safety outcomes. Both efficacy and safety outcomes were compared in the propensity score-matched groups. Results: Early complications involving efficacy outcomes, such as stroke and transient ischemic attack, were seen in 5 patients in the warfarin group and none in the NOAC group. Although the 2 groups differed in the incidence of efficacy outcomes, it was not statistically significant. In safety outcomes, 11 patients in the warfarin group and 24 patients in the NOAC group had complications, but likewise, the between-group difference was not statistically significant. Conclusion: Among patients who underwent TTA, those who received NOACs had a lower incidence of thromboembolic complications than those who received warfarin; however, both groups showed a similar bleeding complication rate. Using a NOAC after TTA does not reduce efficacy and safety when compared to warfarin.

An SPC-Based Forward-Backward Algorithm for Arrhythmic Beat Detection and Classification

  • Jiang, Bernard C.;Yang, Wen-Hung;Yang, Chi-Yu
    • Industrial Engineering and Management Systems
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    • v.12 no.4
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    • pp.380-388
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    • 2013
  • Large variation in electrocardiogram (ECG) waveforms continues to present challenges in defining R-wave locations in ECG signals. This research presents a procedure to extract the R-wave locations by forward-backward (FB) algorithm and classify the arrhythmic beat conditions by using RR intervals. The FB algorithm shows forward and backward searching rules from QRS onset and eliminates lower-amplitude signals near the baseline using a statistical process control concept. The proposed algorithm was trained the optimal parameters by using MIT-BIH arrhythmia database (MITDB), and it was verified by actual Holter ECG signals from a local hospital. The signals are classified into normal (N) and three arrhythmia beat types including premature ventricular contraction (PVC), ventricular flutter/fibrillation (VF), and second-degree heart block (BII) beat. This work produces 98.54% accuracy in the detection of R-wave location; 98.68% for N beats; 91.17% for PVC beats; and 87.2% for VF beats in the collected Holter ECG signals, and the results are better than what are reported in literature.

Effect of Achyrantis Radixs and Ultrasound in Osteoarthritis Rats Articular Cartilage (우슬과 초음파가 퇴행성관절염 백서의 관절 연골에 미치는 영향)

  • Kim, Eun-Jung;Chung, Hun-Woo;Kim, Gye-Yeop
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.22 no.2
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    • pp.390-396
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    • 2008
  • Osteoarthritis(OA) diseases are characterized by joint pain, tenderness, limitation of movement, crepitus, occasional effusion, and variable degrees of inflammation without systemic effects. We investigated the effects of Achyrantis radixs cream treatment and low intensity ultrasound in monosodium iodoacetate(MIA) induced experimental osteoarthritis rat. Sprague-Dawley 40 rats of 7-8 weeks, weight $250\;{\pm}\;50$ g were divided into four groups including the control group and ostoarthritis group(30 rats). Histopathological examination, Mankin's score, and immunohistochemical were performed. Histological findings in control group that are similar to those observed in human osteoarthritis, such as disorganization of chondrocytes, erosion and fibrillation of cartilage surface, and subchondral bone exposure. Safranin O-fast green staining revealed that marked diffuse reduction of proteoglycans and chondrocyte treated with MIA. The Mankin's score were closely correlated to the grade of histological findings. The level of Bax and caspase-3 expression decreased experimental groups. This study shows that a Acyranthes Radix cream treatment and low intensity ultrasound exerts a beneficial influence on the severity of chondral lesion in osteoarthritis rats. This treatments could related to a reduced level of chondrocyte apoptosis through anti-apoptotoc capacities of MIA-induced apoptotic protein overexpression.

Quality of Anticoagulation and Treatment Satisfaction in Patients with Non-Valvular Atrial Fibrillation Treated with Vitamin K Antagonist: Result from the KORean Atrial Fibrillation Investigation II

  • Oh, Seil;Kim, June-Soo;Oh, Yong-Seog;Shin, Dong-Gu;Pak, Hui-Nam;Hwang, Gyo-Seung;Choi, Kee-Joon;Kim, Jin-Bae;Lee, Man-Young;Park, Hyung-Wook;Kim, Dae-Kyeong;Jin, Eun-Sun;Park, Jaeseok;Oh, Il-Young;Shin, Dae-Hee;Park, Hyoung-Seob;Kim, Jun Hyung;Kim, Nam-Ho;Ahn, Min-Soo;Seo, Bo-Jeong;Kim, Young-Joo;Kang, Seongsik;Lee, Juneyoung;Kim, Young-Hoon
    • Journal of Korean Medical Science
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    • v.33 no.49
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    • pp.323.1-323.12
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    • 2018
  • Background: Vitamin K antagonist (VKA) to prevent thromboembolism in non-valvular atrial fibrillation (NVAF) patients has limitations such as drug interaction. This study investigated the clinical characteristics of Korean patients treated with VKA for stroke prevention and assessed quality of VKA therapy and treatment satisfaction. Methods: We conducted a multicenter, prospective, non-interventional study. Patients with $CHADS_2{\geq}1$ and treated with VKA (started within the last 3 months) were enrolled from April 2013 to March 2014. Demographic and clinical features including risk factors of stroke and VKA treatment information was collected at baseline. Treatment patterns and international normalized ratio (INR) level were evaluated during follow-up. Time in therapeutic range (TTR) > 60% indicated well-controlled INR. Treatment satisfaction on the VKA use was measured by Treatment Satisfaction Questionnaire for Medication (TSQM) after 3 months of follow-up. Results: A total of 877 patients (age, 67; male, 60%) were enrolled and followed up for one year. More than half of patients (56%) had $CHADS_2{\geq}2$ and 83.6% had $CHA_2DS_2-VASc{\geq}2$. A total of 852 patients had one or more INR measurement during their follow-up period. Among those patients, 25.5% discontinued VKA treatment during follow-up. Of all patients, 626 patients (73%) had poor-controlled INR (TTR < 60%) measure. Patients' treatment satisfaction measured with TSQM was 55.6 in global satisfaction domain. Conclusion: INR was poorly controlled in Korean NVAF patients treated with VKA. VKA users also showed low treatment satisfaction.

Antiinflammatory and Myocardial Protective Effects of Magnesium in Patents Undergoing Valvular Heart Surgery (심장판막 수술 시 마그네슘의 항염증 및 심근보호 효과)

  • Moon, Seong-Min;Kang, Shin-Beum;Hyun, Kyung-Yae;Choi, Seok-Cheol
    • Journal of Life Science
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    • v.17 no.11
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    • pp.1539-1546
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    • 2007
  • We have investigated whether the supplement of magnesium to cold blood cardioplegia improves myocardial protection. Sixty patients scheduled for elective valvular heart surgery were randomly assigned to a control group (n=30) which received conventional cold blood cardioplegia and an Mg group (n=30) which received cold blood cardioplegia supplemented with 2 g of magnesium sulfate. Electrolytes levels including $Mg^{++}$, hematological and biochemical variables, cytokines, myocardial marker levels, and postoperative outcomes were compared between two groups before, during or idler operation. $Mg^{++}\;and\;Ca^{++}$ levels in the Mg group were higher than those of the control group after surgery. The total WBC counts, CK-MB, troponin-I and Interleukin-6 levels in the Mg group were lower than those of the control group after surgery. Postoperative incidence of atrial fibrillation was lower in the Mg group compared with the control group. These results showed that $Mg^{++}$ attenuated inflammatory reaction, myocardial damage, and hypomagnesemia during valvular surgery and reduced postoperative arrhythmia incidence without side effects.

Modulation of Inula racemosa Hook Extract on Cardioprotection by Ischemic Preconditioning in Hyperlipidaemic Rats

  • Arun Kumar Tiwari;Pushpraj S Gupta;Mahesh Prasad;Paraman Malairajan
    • Journal of Pharmacopuncture
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    • v.25 no.4
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    • pp.369-381
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    • 2022
  • Objectives: Hyperlipidemia (HL) is a major cause of ischemic heart diseases. The size-limiting effect of ischemic preconditioning (IPC), a cardioprotective phenomenon, is reduced in HL, possibly because of the opening of the mitochondrial permeability transition pore (MPTP). The objective of this study is to see what effect pretreatment with Inula racemose Hook root extract (IrA) had on IPC-mediated cardioprotection on HL Wistar rat hearts. An isolated rat heart was mounted on the Langendorff heart array, and then ischemia reperfusion (I/R) and IPC cycles were performed. Atractyloside (Atr) is an MPTP opener. Methods: The animals were divided into ten groups, each consisting of six rats (n = 6), to investigate the modulation of I. racemosa Hook extract on cardioprotection by IPC in HL hearts: Sham control, I/R Control, IPC control, I/R + HL, I/R + IrA + HL, IPC + HL, IPC + NS + HL, IPC + IrA+ HL, IPC + Atr + oxidative stress, mitochondrial function, integrity, and hemodynamic parameters are evaluated for each group. Results: The present experimental data show that pretreatment with IrA reduced the LDH, CK-MB, size of myocardial infarction, content of cardiac collagen, and ventricular fibrillation in all groups of HL rat hearts. This pretreatment also reduced the oxidative stress and mitochondrial dysfunction. Inhibition of MPTP opening by Atr diminished the effect of IrA on IPC-mediated cardioprotection in HL rats. Conclusion: The study findings indicate that pretreatment with IrA e restores IPC-mediated cardioprotection in HL rats by inhibiting the MPTP opening.