• Title/Summary/Keyword: Ventricular Fibrillation

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A Study on Reperfusion Arrhythmia II. Relationship between Occlusive Arrhythmia and Reperfusion Arrhythmia (Reperfusion Arrhythmia에 관한 연구 II. 폐색성 부정맥과 Reperfusion Arrhythmia와의 관계)

  • Choi In-Hyuk
    • Journal of Veterinary Clinics
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    • v.6 no.2
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    • pp.281-290
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    • 1989
  • To gain insight into the relationship between the occurrence of occlusive arrhythmia(OA) and the incidence of reperfusion arrhythmia(RA), this study used 25 open-chest dogs anesthetized with halothan, these were ligated between anterior ventricular branch and marginal branch of left circumflex artery for 30 minutes and occlusive arrhythmia were observed during the ligation. After releasing of the ligation, TA were observed during 5 minutes. The results were summerized as follow; 1. Such arrhythmias as ventricular fibrillation(VF), short run type VPC Premature contraction(VPC), Venticular tachycardia(VT), ventricularc and trigeminy VPC(TVPC) were observed during occlusion and reperfusion. 2. The cases occurred VT, SRVPC and TVPC during occlusion necessarily were Incidence of RA. 3. RA never occurred without appearence of occlusive arrhythmias. 4. The occurrence rate of OA showed 55.5% in the incidence group of RA and 24.6% in the non incidence group of RA. 5. The occurrence rate of VPC during occlusion showed 9.9+5.85(episode/min) in the incidence group of RA and 4.46+5.88(episode/min) in the non-incidence group of RA. These results may be estimated that the occurrence of VT, SRVPC and TVPC, and the high occurrence rate of VPC during occlusion can be predicted the incidence.

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Ventricular pacing with screw-in sutureless myocardial electrode (무봉합심근전극을 사용한 인공심박조정기 설치40례 보고)

  • Sim, Yeong-Mok;No, Jun-Ryang
    • Journal of Chest Surgery
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    • v.16 no.1
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    • pp.115-120
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    • 1983
  • We implanted pacemakers using screw-in sutureless myocardial electrode in 40 patients between February, 1980 and November, 1982 at Seoul Nation University Hospital. Mean age of total patient who received the pacemaker implantation was 39.9 years, but excluding the patient who received the open heart surgery, mean age was 49.3 years. Cause of pacemaker implantation was complete A-V block in 13 patients, symptomatic sick sinus syndrome in 12 patients, complete A-V block after open heart surgery in 12 patients, second degree A-V block with dizziness in one patient, and atrial fibrillation with slow ventricular response in two patients. In thirty nine cases, electrodes were implanted by subxiphoid approach, on the diaphragmatic surface of right ventricle. I n one case, electrode was implanted through the left anterior thoracotomy. Acute stimulation threshold, measured in 35 patients, varied from 0.1 to 2.5 mA [mean 0.85 mA.], and R-wave amplitude [sensitivity], measured in 19 patients, varied from 2.9 mV to 11.5 mV [mean 7.6 mV]. There was no hospital death. The postoperative complications included wound seroma in two patients [5%], wound hematoma in three patients [7.5%], and pacing failure in one patient [2.5%]. The subxiphoid implantation of the pacemaker using sutureless myocardial lead was valuable in obtaining safe, reliable and long-term impulse generation.

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Defibrillator(AED) in prehospital care (병원전 처치에서 자동제세동기의 사용)

  • Koh, Bong-Yeun
    • The Korean Journal of Emergency Medical Services
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    • v.9 no.1
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    • pp.25-32
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    • 2005
  • Purpose: There has been an increase in the number of prehospital cardiac arrests due to increases in both cardiovascular diseases and the average age of the population, We performed this study to identify the proper resuscitation technique and AED to be used to increase the survival rate in prehospital cardiac arrest. Methods: We studied 57 victims with prehospilal cardiac arrest by EMT's Reports form January to December, 2004. Results: Fifty-seven of 92 victims were trasported with ECG in prehospital cardiac arrest. Ventricular fibrillation(VF)/ ventricular tachycardia was 56.2%, asystole was 33,3%, and pulseless electrical activity(PEA.) was 10.5% in initial rhythm analysis, There weren't attempt CPR in 14.0%. Twenty of the 32(62.5%) were shocked by AED for the adequacy method. There were no statistical differences the transportation time. Conclusion: With the increase in cardiovascular disease and old age, the number out-of-hospital cardiac arrests has risen accordingly. However, there were lack of CPR by bystander, defibrillation, advanced cardiac life support(ACLS) in prehospital stage. To improve the adequancy of basic life support and to increase the performance of ACLS, especially AED, we must create challenges to develop new protocols in prehospital care.

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Clinical Application of I-123 MIBG Cardiac Imaging (I-123 MIBG Cardiac SPECT의 임상적 적응증)

  • Kang, Do-Young
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.5
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    • pp.331-337
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    • 2004
  • Cardiac neurotransmission imaging allows in vivo assessment of presynaptic reuptake, neurotransmitter storage and postsynaptic receptors. Among the various neurotransmitter, I-123 MIBG is most available and relatively well-established. Metaiodobenzylguanidine (MIBG) is an analogue of the false neurotransmitter guanethidine. It is taken up to adrenergic neurons by uptake-1 mechanism as same as norepinephrine. As tagged with I-123, it can be used to image sympathetic function in various organs including heart with planar or SPECT techniques. I-123 MIBG imaging has a unique advantage to evaluate myocardial neuronal activity in which the heart has no significant structural abnormality or even no functional derangement measured with other conventional examination. In patients with cardiomyopathy and heart failure, this imaging has most sensitive technique to predict prognosis and treatment response of betablocker or ACE inhibitor. In diabetic patients, it allow very early detection of autonomic neuropathy. In patients with dangerous arrhythmia such as ventricular tachycardia or fibrillation, MIBG imaging may be only an abnormal result among various exams. In patients with ischemic heart disease, sympathetic derangement may be used as the method of risk stratification. In heart transplanted patients, sympathetic reinnervation is well evaluated. Adriamycin-induced cardiotoxicity is detected earlier than ventricular dysfunction with sympathetic dysfunction. Neurodegenerative disorder such as Parkinson's disease or dementia with Lewy bodies has also cardiac sympathetic dysfunction. Noninvasive assessment of cardiac sympathetic nerve activity with I-123 MIBG imaging nay be improve understanding of the pathophysiology of cardiac disease and make a contribution to predict survival and therapy efficacy.

Late Gadolinium Enhancement of Left Ventricular Papillary Muscles in Patients with Mitral Regurgitation

  • Su Jin Lim;Hyun Jung Koo;Min Soo Cho;Gi-Byoung Nam;Joon-Won Kang;Dong Hyun Yang
    • Korean Journal of Radiology
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    • v.22 no.10
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    • pp.1609-1618
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    • 2021
  • Objective: Arrhythmogenic mitral valve prolapse (MVP) is an important cause of sudden cardiac death characterized by fibrosis of the papillary muscles or left ventricle (LV) wall, and an association between late gadolinium enhancement (LGE) of the LV papillary muscles and ventricular arrhythmia in MVP has been reported. However, LGE of the papillary muscles may be observed in other causes of mitral regurgitation, and it is not limited to patients with MVP. This study was to evaluate the association of LGE of the LV papillary muscles or ventricular wall on cardiac magnetic resonance imaging (CMR) and ventricular arrhythmia in patients with mitral regurgitation. Materials and Methods: This study included 88 patients (mean age ± standard deviation, 58.3 ± 12.0 years; male, 42%) with mitral regurgitation who underwent CMR. They were allocated to the MVP (n = 43) and non-MVP (n = 45) groups, and their LGE images on CMR, clinical characteristics, echocardiographic findings, and presence of arrhythmia were compared. Results: LV myocardial wall enhancement was more frequent in the MVP group than in the non-MVP group (28% vs. 11%, p = 0.046). Papillary muscle enhancement was observed in 7 (7.9%) patients. Of the 43 patients with MVP, 15 (34.8%) showed LGE in the papillary muscles or LV myocardium, including 12 (27.9%) with LV myocardial wall enhancement and 4 (9.3%) with papillary muscle enhancement. One patient with bilateral diffuse papillary muscle enhancement experienced sudden cardiac arrest due to ventricular fibrillation. Univariable logistic regression analysis showed that high systolic blood pressure (BP; odds ratio [OR], 1.05; 95% confidence interval [CI], 1.01-1.09; p = 0.027) and ventricular arrhythmia (OR, 6.84; 95% CI, 1.29-36.19; p = 0.024) were significantly associated with LGE of the papillary muscles. Conclusion: LGE of the papillary muscles was present not only in patients with MVP, but also in patients with other etiologies of mitral regurgitation, and it was associated with high systolic BP and ventricular arrhythmia. Papillary muscle enhancement on CMR should not be overlooked.

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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    • v.3 no.4
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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.

Complete A-V Block 3 Months after Total Correction of Tetralogy of Fallot (활로 4징증의 근치수술후의 원격 방실전도 차단)

  • 송요준
    • Journal of Chest Surgery
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    • v.11 no.3
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    • pp.326-332
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    • 1978
  • There appears some conduction defects frequently after total correction of Tetralogy of Fallot. Common defect is right bundle branch block due to surgical intervention. We experienced complete A-V block which occured 3 months later after total correction of Tetralogy of Fallot in a 8 year old boy. The patient was completely free of any A-V block after the operation for 3 months, and sudden onset of A-V block with coupled premature ventricular contractions resulted him in shock state during the attack of severe bronchopneumonia for 4 days prior to the second visit. Emergency implantation of Cordis demand type temporary pacemaker was necessary to control the complete heart block with bradyarrhythmia and frequent ventricular fibrillation. Permanent cardiac pacemaker was implanted two weeks later as indicated with Cordis Stanicor lambda demand pacemaker, and the patient was discharged uneventfully on the 8th post implantation day with the heart rate of 72/min. Another 3 months after the implantation, the patient was transported to this hospital as dead on arrival after an accidental fall from a 2 meter height, and all possible cardiopulmonary resuscitation was performed for 60 minutes at the emergency room in vain. Autopsy was done to find out the cause of sudden death and the etiology of complete heart block. Microscopic focal infarctions with scar formation were noted along the course of conduction system in the interventricular septum, which might be the main cause of complete heart block during the attack of severe bronchopneumonia complicated with acute bacterial endocarditis. The tip of the pacemaker wire was slipped from the granulation scar at the apex of the right ventricular cavity, and this might be the direct cause of pacing failure and death.

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

  • Lee, Geum-Boon;Cho, Beom-Joon
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.14 no.1
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    • pp.16-22
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    • 2010
  • Electrocardiogram(ECG) analysis and arrhythmia recognition are critical for diagnosis and treatment of ill patients. Cardiac arrhythmia is a condition in which heart beat may be irregular and presents a serious threat to the patient recovering from ventricular tachycardia (VT) and ventricular fibrillation (VF). Other arrhythmias like atrial premature contraction (APC), Premature ventricular contraction (PVC) and superventricular tachycardia (SVT) are important in diagnosing the heart diseases. This paper presented new method to classify various arrhythmias contrary to other techniques which are limited to only two or three arrhythmias. ECG is decomposed into Intrinsic Mode Functions (IMFs) by Empirical Mode Decomposition (EMD). Burg algorithm was performed on IMFs to obtain AR coefficients which can reduce the dimension of feature vector and utilized as Multi-class SVM inputs which is basically extended from binary SVM. We chose optimal parameters for SVM classifier, applied to arrhythmias classification and achieved the accuracies of detecting NSR, APC, PVC, SVT, VT and VP were 96.8% to 99.5%. The results showed that EMD was useful for the preprocessing and feature extraction and multi-class SVM for classification of cardiac arrhythmias, with high usefulness.

Resternotomy for Recurrent Aortic Aneurysm Adherent to the Sternum Under Deep Hypothermic Circulatory Arrest (흉골에 접한 재발성 대동맥류에서 초저체온 순환정지하에서의 흉골재절개)

  • Kim, Sang-Heon;Kim, Young-Hak;Kim, Hyuck;Chung, Won-Sang;Kang, Jung-Ho;Jee, Heng-Ok;Lee, Chul-Bum
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.108-111
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    • 2004
  • Reoperation on the recurrent aortic aneurysm adjuvent to sternum remains a challenging problem in regard to the risk of the massive hemorrhage at the time of resternotomy resulting from inadvertent entry into the aneurysmal sac. The cardiopulmonary bypass technique of femoral cannulation and deep hypothermic circulatory arrest can provide a safe resternotomy. The left ventricle is likely to distend due to lack of contraction with ventricular fibrillation during core cooling. To prevent ventricular distention during core cooling, sufficient venous drainage is mandatory, We report a technique in which deep hypothermic circulatory arrest is achieved before resternotomy without left ventricular distention by active venous drainage using centrifugal pump.

PVC Classification by Personalized Abnormal Signal Detection and QRS Pattern Variability (개인별 이상신호 검출과 QRS 패턴 변화에 따른 조기심실수축 분류)

  • Cho, Ik-Sung;Yoon, Jeong-Oh;Kwon, Hyeog-Soong
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.18 no.7
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    • pp.1531-1539
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    • 2014
  • Premature ventricular contraction(PVC) is the most common disease among arrhythmia and it may cause serious situations such as ventricular fibrillation and ventricular tachycardia. Nevertheless personalized difference of ECG signal exist, performance degradation occurs because of carrying out diagnosis by general classification rule. In other words, the design of algorithm that exactly detects abnormal signal and classifies PVC by analyzing the persons's physical condition and/or environment and variable QRS pattern is needed. Thus, PVC classification by personalized abnormal signal detection and QRS pattern variability is presented in this paper. For this purpose, we detected R wave through the preprocessing method and subtractive operation method and selected abnormal signal sets. Also, we classified PVC in realtime through QS interval and R wave amplitude. The performance of abnormal beat detection and PVC classification is evaluated by using MIT-BIH arrhythmia database. The achieved scores indicate the average of 98.33% in abnormal beat classification error and 94.46% in PVC classification.