• 제목/요약/키워드: Tachycardia, ventricular

검색결과 114건 처리시간 0.023초

Cardiac Resynchronization Therapy Defibrillator Treatment in a Child with Heart Failure and Ventricular Arrhythmia

  • Kim, Hak Ju;Cho, Sungkyu;Kim, Woong-Han
    • Journal of Chest Surgery
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    • 제49권4호
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    • pp.292-294
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    • 2016
  • Cardiac resynchronization therapy (CRT) is a new treatment for refractory heart failure. However, most patients with heart failure treated with CRT are adults, middle-aged or older with idiopathic or ischemic dilated cardiomyopathy. We treated a 12-year-old boy, who was transferred after cardiac arrest, with dilated cardiomyopathy, left bundle-branch block, and ventricular tachycardia. We performed cardiac resynchronization therapy with a defibrillator (CRT-D). After CRT-D, left ventricular ejection fraction improved from 22% to 4 4% assessed by echocardiogram 1 year postoperatively. On electrocardiogram, QRS duration was shortened from 206 to 144 ms. The patient's clinical symptoms also improved. For pediatric patients with refractory heart failure and ventricular arrhythmia, CRT-D could be indicated as an effective therapeutic option.

웨어러블 디바이스를 위한 실시간 부정맥 검출 및 BLE기반 데이터 통신 알고리즘 개발과 적용 (Development of Real-Time Arrhythmia Detection and BLE-based Data Communication Algorithm for Wearable Devices)

  • 맹수훈;김대관;이현석;문효정
    • 대한의용생체공학회:의공학회지
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    • 제43권6호
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    • pp.399-408
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    • 2022
  • Because arrhythmia occurs irregularly, it should be examined for at least 24 hours for accurate diagnosis. For this reason, this paper developed firmware software for arrhythmia detection and prevented consumption of temporal and human resources and enabled continuous management and early diagnosis. Prior to the experiment, the interval between the R peaks of the QRS Complex was calculated using the Pan-Tompkins algorithm. The developed firmware software designed and implemented an algorithm to detect arrhythmia such as tachycardia, bradycardia, ventricular tachycardia, persistent tachycardia, and non-persistent tachycardia, and a data transmission format to monitor the collected data based on BLE. As a result of the experiment, arrhythmia was found in real time according to the change in BPM as designed in this paper. And the data quality for BLE communication was verified by comparing the sensor's serial communication value with the Android application reception value. In the future, wearable devices for real-time arrhythmia detection will be lightweight and developed firmware software will be applied.

119구급대원의 심폐소생술 성적 분석 - 병원전 심정지를 중심으로 - (Factors Affecting the Survivals of Out-of-hospital Cardiac Arrests by 119 Fire Service)

  • 강병우
    • 한국응급구조학회지
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    • 제9권2호
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    • pp.111-128
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    • 2005
  • Background: Cardiac arrest is one of the most critical diseases which can likely lead to severe cerebral disability or brain death when the cases can not recover their circulation within 10 minutes. Saving out-of-hospital cardiac arrest cases is a recent concern in Korea. Resuscitation has become an important multidisciplinary branch of medicine, demanding a spectrum of skills and attracting a plethora of specialities and organizations. The best survival can be achieved if all the following links have been optimized : rapid access, and early CPR, defibrillation and ACLS, Since the "Utstein Style" was advocated in 1991, many reports about out-of-hospital cardiac arrest have been published based on this guideline. These differences prevent valid inter-hospital and international comparisons. However, it is not known how effective resuscitation has become to the patients. In other words, there are no guidelines for reviewing, reporting, and conducting research on resuscitation in Korea. This dissertation aims to provide the basic data for a unified reporting guideline of resuscitation in Korea and evaluating the out-of-hospital factors associated with survival discharge of out-of-hospital cardiac arrest. Methods: As for this study, uses the collected data about Out-of-hospital cardiac arrests at 4 area, from January, 2005 to April. 2005. With a retrospective study, 174 cases were analyzed. The data was recorded based on the Out-of-Hospital Utstein Style. Results: Resuscitation was performed on 174 out-of-hospital cardiac arrest cases at the 4 area 14 patients(8.1%) recovered their spontaneous circulation. Overall, the ROSC of the out-of-hospital cardiac arrest patients was 8.1%, which was poorer than that of western countries. Gender distribution was 50 females(28.7%) and 124 males(71.3%), approximately twice as many males as females. ROSC of witnessed arrests was found out to be 97.7%. The ratio of the witnessed arrest groups showed higher results than that of unwitnessed arrest groups in the above-examined cases. Cardiac etiology consisted of cardiac(33.5%), non-cardiac(45.7%), trauma(20.1%), and unknown(6.0%). Cardiac was the best performance. Initial rhythm showed Ventricular Tachycardia/pulseless Ventricular Fibrillation in 8 patients(6.0%), asystole in 100(75.2%) and unknown in 25(18.8%). The results of the Ventricular Tachycardia/pulseless Ventricular Fibrillation showed higher results than the others cases, The proportion of the cardiogenic cause was 33.5%, which was only half of western countries. Ventricular Tachycardia/pulseless Ventricular Fibrillation is relatively rare. These differences were due to the prevalent pattern of Out-of-hospital cardiac arrest as well as prematurity of the EMSS. Bystander CPR was practiced on 13 patients(7.52%). ROSC was shown in 46.2% cases. CPR by EMT was carried out on 167 cases(96.5%). ACLS by EMf was rare. From collapse, 4 cases(2.6%) arrived to ED within 6 minutes. 13 (8.6%) within 10 minutes, and 49(32.5%) over 31 minutes. The sooner the patients arrived, the greater the ratio of ROSC and discharged alive became, and the same with collapse time to ROSC. As the results of the logistic regression analysis, ROSC was found out to be highly influenced by the time of ED arrival from collapse and Ventricular Tachycardia/pulseless Ventricular Fibrillation. Therefore, the ratio of ROSC depends on not any single factor but various intervention factors. Conclusion: This dissertation presents the following suggestions and directions of the study hereafter. First, the first step for a chain of survival should be taken to activate EMSS early with a phone as soon as cardiac arrests are witnessed. Second, it is keenly needed that emergency medical technicians should be increased through emergency education for living. Third, it is necessary to establish the emergency transportation system. Fourth, most of the Koreans have little understanding of EMT and the present operation systems have many problems, which should be fundamentally changed. Fifth, it is required to have an active medical control over Out-of-hospital CPR, And proper psychological supports should be given not only to patients themselves and their family but also individuals who are engaged in emergency situation. Finally, through studies hereafter on nationwide, comprehensive, and standard forms, it is needed to examine into the biological figures of human body, causes and trends of cardiac arrests, and then, to enhance the survival rate of Out-of-hospital cardiac arrests. Korean guidelines for Cardiopulmonary resuscitation need to be made.

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심계항진을 호소하는 소아에서 경식도 심전도 검사의 유용성 (Role of Transesophageal Pacing in Evaluation of Palpitation in Infants and Children)

  • 류수정;고재곤;김영휘;박인숙
    • Clinical and Experimental Pediatrics
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    • 제46권1호
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    • pp.51-55
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    • 2003
  • 목 적 : 심전도상 빈맥이 확인되지 않은 상태로 심계 항진을 호소하는 소아에서 빈맥의 유무를 확인하고 그 기전을 밝히는데 있어서 경식도 심전도 검사의 유용성을 검토해 보고자 하였다. 방 법 : 1997년 1월 1일부터 2001년 12월 31일까지 심계 항진을 호소하는 소아에서 심실 조기 흥분 증후군이 없고 심장이 정상이면서 경식도 심전도 검사 전까지 심전도상 빈맥이 기록되지 않았던 67명을 대상으로 경식도 심전도 기록을 후향적으로 다시 검토하여 경식도 심방 조율을 통해서 빈맥이 유발되는 정도와 유발된 경우에는 그 기전에 대하여 검토하였다. 결 과 : 심계항진을 호소하는 소아의 70.1%에서 경식도 심방조율을 통해서 빈맥을 유도할 수 있어서 빈맥이 심계항진의 원인임을 알 수 있었다. 빈맥은 대부분 빠른 심방 조율로 유도되었으며 21.3%에서는 isoproterenol을 사용한 후에 빈맥이 유발되었다. 6세 이상에서 보다 6세 미만의 소아에서 빈맥이 유도되는 경우가 유의하게 많았다(P<0.05). 빈맥이 유발된 경우에는 그 기전을 검토해 보았고 빈맥의 기전은 부전도로로 인한 방실 회귀성 빈맥이 53.2%, 방실결절 회귀성 빈맥은 34.0%이었고, 나머지는 특발성 좌심실 빈맥이 12.8%이었다. 이들 중 10명에서 전기 생리 검사가 시행되었는데 빈맥의 기전은 1명을 제외하고 경식도 심전도 검사와 그 기전이 일치하였다. 결 론 : 경식도 심전도 검사는 심계항진을 호소하는 소아에서 빈맥의 유무를 확인하고 그 기전을 밝혀 치료에 대한 방침을 정할 수 있는 침습적이지 않고 간편하고 유용한 검사이다.

Concomitant Right Ventricular Outflow Tract Cryoablation during Pulmonary Valve Replacement in a Patient with Tetralogy of Fallot

  • Shin, Hong Ju;Song, Seunghwan;Shin, Yu Rim;Park, Han Ki;Park, Young Hwan
    • Journal of Chest Surgery
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    • 제50권1호
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    • pp.41-43
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    • 2017
  • A 38-year-old female patient with a history of tetralogy of Fallot repair at 10 years of age underwent pulmonary valve replacement with a mechanical prosthesis, tricuspid annuloplasty, and right ventricular outflow tract cryoablation due to pulmonary regurgitation, tricuspid regurgitation, and multiple premature ventricular contractions with sustained ventricular tachycardia. After surgery, she had an uneventful postoperative course with arrhythmia monitoring. She was discharged without incident, and a follow-up Holter examination showed a decrease in the number of ventricular ectopic beats from 702 to 41.

R-R 간격을 이용한 PVC-RUNs 부정맥 검출 (Assessment of PVC-RUNs Arrhythmia by R-R Interval)

  • 이선주;윤태호;김경섭;이정환
    • 대한전자공학회:학술대회논문집
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    • 대한전자공학회 2009년도 정보 및 제어 심포지움 논문집
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    • pp.393-395
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    • 2009
  • 심장의 활성 근육의 움직임에 의하여 발생되는 전기적 변화량을 나타내는 심전도는 부정맥 또는 허혈성 심장질환을 진단하는데 널리 활용되고 있다. 특히 심실빈맥(Ventricular Tachycardia) 또는 심실세동(Ventricular Fibrillation)과 같이 치명적인 심장리듬이 발생하기 이전에, 심실조기수축(Ventricular Premature Contraction)을 검출하여 생명을 위협할 수 있는 부정맥을 조기에 진단할 수 있는 연구들이 일부 진행되고 있다. 이에 따라서 본 연구에서는 심전도 신호의 R-R 간격 정보와 R-peak 정보의 진위성을 판단하여 PVC 부정맥 패턴뿐만 아니라 PVC 파형이 연속적으로 진행되는 PVC-RUNs을 효율적으로 검출할 수 있는 부정맥 진단 알고리즘을 제안하고자 하였다.

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Personalized Specific Premature Contraction Arrhythmia Classification Method Based on QRS Features in Smart Healthcare Environments

  • Cho, Ik-Sung
    • 전기전자학회논문지
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    • 제25권1호
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    • pp.212-217
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    • 2021
  • Premature contraction arrhythmia is the most common disease among arrhythmia and it may cause serious situations such as ventricular fibrillation and ventricular tachycardia. Most of arrhythmia clasification methods have been developed with the primary objective of the high detection performance without taking into account the computational complexity. Also, personalized difference of ECG signal exist, performance degradation occurs because of carrying out diagnosis by general classification rule. Therefore it is necessary to design efficient method that classifies arrhythmia by analyzing the persons's physical condition and decreases computational cost by accurately detecting minimal feature point based on only QRS features. We propose method for personalized specific classification of premature contraction arrhythmia based on QRS features in smart healthcare environments. For this purpose, we detected R wave through the preprocessing method and SOM and selected abnormal signal sets.. Also, we developed algorithm to classify premature contraction arrhythmia using QRS pattern, RR interval, threshold for amplitude of R wave. The performance of R wave detection, Premature ventricular contraction classification is evaluated by using of MIT-BIH arrhythmia database that included over 30 PVC(Premature Ventricular Contraction) and PAC(Premature Atrial Contraction). The achieved scores indicate the average of 98.24% in R wave detection and the rate of 97.31% in Premature ventricular contraction classification.

Support Vector Machine Based Arrhythmia Classification Using Reduced Features

  • Song, Mi-Hye;Lee, Jeon;Cho, Sung-Pil;Lee, Kyoung-Joung;Yoo, Sun-Kook
    • International Journal of Control, Automation, and Systems
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    • 제3권4호
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    • pp.571-579
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    • 2005
  • In this paper, we proposed an algorithm for arrhythmia classification, which is associated with the reduction of feature dimensions by linear discriminant analysis (LDA) and a support vector machine (SVM) based classifier. Seventeen original input features were extracted from preprocessed signals by wavelet transform, and attempts were then made to reduce these to 4 features, the linear combination of original features, by LDA. The performance of the SVM classifier with reduced features by LDA showed higher than with that by principal component analysis (PCA) and even with original features. For a cross-validation procedure, this SVM classifier was compared with Multilayer Perceptrons (MLP) and Fuzzy Inference System (FIS) classifiers. When all classifiers used the same reduced features, the overall performance of the SVM classifier was comprehensively superior to all others. Especially, the accuracy of discrimination of normal sinus rhythm (NSR), arterial premature contraction (APC), supraventricular tachycardia (SVT), premature ventricular contraction (PVC), ventricular tachycardia (VT) and ventricular fibrillation (VF) were $99.307\%,\;99.274\%,\;99.854\%,\;98.344\%,\;99.441\%\;and\;99.883\%$, respectively. And, even with smaller learning data, the SVM classifier offered better performance than the MLP classifier.

항정신병약물들에 의해 유발된 Torsade de Pointes 1례 (Antipsychotic Drugs Induced Torsade de Pointes - A Case Report -)

  • 신유호;오동재;장환일
    • 생물정신의학
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    • 제1권1호
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    • pp.124-128
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    • 1994
  • 항정신병약물 perphenazine 20mg/day, chlorpromazine 100mg/day. trifluoperazine 15mg/day 등을 투여중인 정신분열증 42세 여자 환자에서 심실성 빈맥의 하나인 torsade de pointes이 나타난 사례를 보고한다. 본 환자는 항정신병약물을 복용하여 오던 중 여러차례 실신과 호흡곤란을 경험하였으며, 심전도상에 QT 간격의 연장과 함께 다양한 모양의 QRS 파를 동반한 심실성 빈맥의 소견이 있어 torsade de pointes을 의심할 수 있었다. 심혈관계에 영향이 적은 항정신병약물인 haloperidol로 바꾼 후 부정맥의 소견이 없다가 퇴원 후 haloperidol을 증량하는 과정에 흉부 불편감, 실신의 증상과 함께 QT 간격의 연장이 다시 발생하여 torsade de pointes이 나타난 원인이 항정신병약물 때문이라는 것을 확인할 수 있었다. 항정신병약물을 사용중인 환자에서 발생하는 급사의 원인으로 심실성 빈맥이 가장 흔하게 제기되고 있다. 따라서 항정신병약물을 처방하는 임상의들은 이에 대한 충분한 지식과 주위가 필요할 것으로 생각된다.

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다중 클래스 SVM을 이용한 EMD 기반의 부정맥 신호 분류 (EMD based Cardiac Arrhythmia Classification using Multi-class SVM)

  • 이금분;조범준
    • 한국정보통신학회논문지
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    • 제14권1호
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    • pp.16-22
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    • 2010
  • 심전도 신호 분석 및 부정맥 분류는 환자를 진단하고 치료하는데 중요한 역할을 한다. 부정맥은 맥박이 불규칙한 상태로 심실빈맥(VT)이나 심실세동(VF) 환자에게 심각한 위협이 될 수 있다. 심방조기수축(APC)과 상심실성빈맥(SVT), 심실조기수축(PVC)은 심실빈맥(VT)만큼 치명적이지는 않지만 심장질환을 진단하는데 중요한 부정맥이다. 본 논문은 2~3개의 부정맥 분류만을 고려한 기존의 방법을 극복하고 다양한 부정맥을 분류하기 위한 새로운 방법을 제시한다. 심전도 신호의 특징 추출을 위해서 EMD 방법으로 신호를 분해하여 IMFs를 얻는다. 입력 데이터의 양은 분류기 성능에 영향을 미치므로 신호 데이터의 차원을 감소시키기 위해 Burg 알고리즘을 IMFs에 적용하여 AR 계수를 구하고 여러 개의 이진 분류기를 결합한 다중 클래스 SVM의 입력으로 사용한다. 최적의 SVM 성능 파라미터를 선택하고 부정맥 분류에 적용한 결과 검출의 정확성은 96.8%~99.5%였다. 실험 결과는 제안한 EMD 방법에 의한 전처리 및 특징 추출과 다중 클래스 SVM에 의한 부정맥 분류의 유용성을 보여준다.