• Biomolecules & Therapeutics
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• 제14권1호
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• pp.19-24
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• 2006

Atrial chambers serve as mechanosensory systems during the haemodynamic or mechanical disturbances, which initiates arrhythmia. Atrial myocytes, lacking t-tubules, have two functionally separate sarcoplasmic reticulums (SRs): those at the periphery close to the surface membrane, and those at the cell interior (center) not associated with the membrane. To explore possible role of fluid pressure (FP) in the regulation of atrial local $Ca^{2+}$ signaling we investigated the effect of FP on subcellular $Ca^{2+}$ signals in isolated rat atrial myocytes using confocal microscopy. FP was applied to whole area of single myocyte with pressurized automatic micro-jet (200-400 $mmH_2O$) positioned close to the cell. Application of FP enhanced spontaneous occurrences of peripheral and central $Ca^{2+}$ sparks with larger effects on the peripheral release sites. Unitary properties of single sparks were not altered by FP. Exposure to higher FP often triggered longitudinal $Ca^{2+}$ wave. These results suggest that fluid pressure may directly alter excitability of atrial myocytes by activating $Ca^{2+}$-dependent ionic conductance in the peripheral membrane and by enhancing spontaneous activation of central myofilaments.

• Journal of Chest Surgery
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• 제28권4호
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• pp.335-339
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• 1995

Secundum atrial septal defect occupies about 10 to 15% of congenital heart diseases, and the surgical accomplishment is outstanding, so that the operative mortality is getting near to zero percent. But, the methods of correction, direct closure versus patch closure are still controversial and there is no absolute method about it. Some surgeons prefer direct closure technique for its simplicity and lesser thrombogenicity but others, afraid of arrhythmia and suture detachment after closure of large defect, prefer patch closure. Usually most surgeons use direct suture technique in small and moderate sized defects and patch closure in large defects. In our hospital, 156 cases of isolated secundum atrial septal defect were closed directly by double continuous over and over suture using 5-0 polypropylene[prolene , regardless their sizes and the amounts of shunt flow. There were no operative mortality and no serious complications such as heart block, suture detachment and embolism.

• Clinical and Experimental Pediatrics
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• 제60권11호
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• pp.344-352
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• 2017

Arrhythmias in the neonatal period are not uncommon, and may occur in neonates with a normal heart or in those with structural heart disease. Neonatal arrhythmias are classified as either benign or nonbenign. Benign arrhythmias include sinus arrhythmia, premature atrial contraction, premature ventricular contraction, and junctional rhythm; these arrhythmias have no clinical significance and do not need therapy. Supraventricular tachycardia, ventricular tachycardia, atrioventricular conduction abnormalities, and genetic arrhythmia such as congenital long-QT syndrome are classified as nonbenign arrhythmias. Although most neonatal arrhythmias are asymptomatic and rarely life-threatening, the prognosis depends on the early recognition and proper management of the condition in some serious cases. Precise diagnosis with risk stratification of patients with nonbenign neonatal arrhythmia is needed to reduce morbidity and mortality. In this article, I review the current understanding of the common clinical presentation, etiology, natural history, and management of neonatal arrhythmias in the absence of an underlying congenital heart disease.

• 대한전기학회:학술대회논문집
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• 대한전기학회 1988년도 전기.전자공학 학술대회 논문집
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• pp.746-749
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• 1988

This paper describes an arrhythmia detection algorithm using PP and PR Interval. In order to detect P-wave accurately, an improved 5-point derivative method is used. In this paper, the RR, PP and PR interval. and the number of P-waves per RR Interval are detected for arrhythmia detection. These parameters can be utilized to diagnose in the varied types of AV block, atrial fibrillation, and PVC.

• 대한간호
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• 제33권4호
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• pp.62-85
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• 1994

The data were analyzed by using an S. P. S. S. computerized program for mean, standard deviation, percentage and paired t-test. The results of this study were as follows: 1. The increase in $PaO_2$ after hyperoxygenation and hyperinflation was highly statistically significant(p=0.041), and the increase in $PaO_2$ immediately after suctioning was not significant (p=0.752). The time of lowest $PaO_2$ was 30 seconds after the endotracheal suction. 2. The occurrance of cardiac arrhythmia after the endotracheal suction included sinus tachycardia, sinus arrhythmia, sinus bradycardia, premature atrial contraction (PAC), and premature ventricular contraction (PVC). The most frequent cardiac arrhythmia was sinus tachycardia (a subjects). Sinus arrhythmia was observed in 5 subjects and continued till 10 minutes after suctioning in two of these. Sinus bradycardia occurred in only 3 subjects and among them, 1 subjects shows sinus arrythmia till 10 minutes after suctioning along. PAC was observed in only one subject and continued till five minutes after suctining along with sinus arrhythmia. PVC was observed in three subjects: it lasted for only 30 seconds after suctioning in two subjects. but continued for 10 minutes after suctioning in the third. 6 subjects manifested two kinds of Cardiac arrhythmia Three of them showed sinus tachycardia with PVC, another 2 showed sinus bradycardia with sinus arrhythmia, and the other subject showed sinus arrhythmia with PAC. 3. The increases in heart rate during the endotracheal suction immediately after and at 30 seconds after suctioning were statistically significant (p=0.005). The increase in heart rate at one minute after suctioning was also significant (p=0.023). The increase in heart rate continued until 10 minutes after the endotracheal suction, but was not statistically significant In this study, endotracheal suctioning with hyperoxygenation and hyperinflation was effective in preventing a decrease in $PaO_2$ after suctioning, but not in preventing cardiac arrhythmias. Nurses should be aware of the complications of endotracheal suctioning and do effective hyperoxygenation and hyperinflation before and after suctioning. Further research is needed to develop a efficient endotracheal suction method which will minimize complications. This study needs to be replicated with different population of patients intubatted or having a tracheostomy, specifically, patients who cardiac or pulmonary desease. The data were analyzed by using an S. P. S. S. computerized program for mean, standard deviation, percentage and paired t-test. The results of this study were as follows: 1. The increase in $PaO_2$ after hyperoxygenation and hyperinflation was highly statistically significant(p=0.041), and the increase in $PaO_2$ immediately after suctioning was not significant (p=0.752). The time of lowest $PaO_2$ was 30 seconds after the endotracheal suction. 2. The occurrance of cardiac arrhythmia after the endotracheal suction included sinus tachycardia, sinus arrhythmia, sinus bradycardia, premature atrial contraction (PAC), and premature ventricular contraction (PVC). The most frequent cardiac arrhythmia was sinus tachycardia (a subjects). Sinus arrhythmia was observed in 5 subjects and continued till 10 minutes after suctioning in two of these. Sinus bradycardia occurred in only 3 subjects and among them, 1 subjects shows sinus arrythmia till 10 minutes after suctioning along. PAC was observed in only one subject and continued till five minutes after suctining along with sinus arrhythmia. PVC was observed in three subjects: it lasted for only 30 seconds after suctioning in two subjects. but continued for 10 minutes after suctioning in the third. 6 subjects manifested two kinds of Cardiac arrhythmia Three of them showed sinus tachycardia with PVC, another 2 showed sinus bradycardia with sinus arrhythmia, and the other subject showed sinus arrhythmia with PAC. 3. The increases in heart rate during the endotracheal suction immediately after and at 30 seconds after suctioning were statistically significant (p=0.005). The increase in heart rate at one minute after suctioning was also significant (p=0.023). The increase in heart rate continued until 10 minutes after the endotracheal suction, but was not statistically significant In this study, endotracheal suctioning with hyperoxygenation and hyperinflation was effective in preventing a decrease in $PaO_2$ after suctioning, but not in preventing cardiac arrhythmias. Nurses should be aware of the complications of endotracheal suctioning and do effective hyperoxygenation and hyperinflation before and after suctioning. Further research is needed to develop a efficient endotracheal suction method which will minimize complications. This study needs to be replicated with different population of patients intubatted or having a tracheostomy, specifically, patients who cardiac or pulmonary desease.

• Journal of Chest Surgery
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• 제31권1호
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• pp.59-65
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• 1998

심방세동은 심부정맥중 가장 흔한 질환이다. 이환율과 사망율에 있어서 심각한 문제를 일으킬 수 있으며 약물치료에 반응을 않하는 경우가 많다. 실험적 및 임상적 연구의 측면에서 볼 때, 거대회귀성 회로의 존재와 소회귀성 회로 혹은 심방의 자동성의 결핍을 근거로 심방세동에 대한 수술적 절제가 가능하다고 확신한다. maze III술식을 통해서 술후 동성 율동으로의 회복 빈도 증가, 장기적으로 볼 때 동방결절의 기능 향상, 인공심박동기의 사용 감소, 부정맥의 재발 감소, 심방의 전달 기능의 장기적 측면에서의 향상 등의 효과를 기대할 수 있다. 본원에서는 만성 심방세동을 가진 4명의 환자를 치험했다. 심방중격결손증 및 심방세동을 가진 환자에대해 Hioki술식을 시행했으며 술후 심전도상 정상 동방율동을 보였으나 술후 3년후에 접합부율동 및 서맥을 보였다. 승모판막질환 및 심방세동을 가진 나머지 3명의 환자에 대해서는 maze III술식을 시행했으며, 수술직후 2명의 환자에서는 규칙적인 동방율동을 보였으며, 1명의 환자에서는 심방세동을 보여서 amiodarone으로 조절하였다. 술후 3개월후 규칙적인 동방율동을 보이는 2명의 환자에 대해 심초음파를 실시한 결과 우심방의 수축은 양호하나 좌심방의 수축은 미미한 편이였다.

• 한국임상수의학회지
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• 제32권4호
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• pp.330-333
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• 2015

1년령 intact male mixed dog(체중 20 kg)가 복부 팽창과 심각한 운동불내성을 주증으로 내원하였다. 심전도 검사에서 심방정지와 함께 두드러진 서맥(46-79회/분)이 관찰되었다. 실험실 검사상 특별한 이상 소견은 관찰되지 않았다. 혈청 cortisol과 T4농도는 정상 범위였다. 영상검사상 심장비대, 복수, 모든 심장 chamber의 확장, 심방정지, transmitral A-peak 소실, 이첨판과 삼첨판 역류, 정상 좌심실 수축기 직경이 관찰되었다. 검사결과에 근거하여 특발성 심방정지로 진단되었으며 심부전에 준한 일반적인 치료를 실시하였다.

• International Journal of Arrhythmia
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• 제19권3호
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• pp.186-234
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• 2018

Catheter and surgical ablation of atrial fibrillation (AF) have evolved from investigational procedures to their current role as effective treatment options for patients with AF. Surgical ablation of AF is available in most major hospitals throughout the world. Catheter ablation of AF is even more widely available, and is now the most commonly performed catheter ablation procedure. Management of patients with AF has traditionally consisted of three main components: (1) anticoagulation for stroke prevention; (2) rate control; and (3) rhythm control. With the emergence of large amounts of data, which have both defined and called attention to the interaction between modifiable risk factors and the development of AF and outcomes of AF management, we believe it is time to include risk factor modification as the fourth pillar of AF management. Catheter and surgical ablation of AF are highly complex procedures, therefore a decision to perform catheter or surgical AF ablation should only be made after a patient carefully considers the risks, benefits, and alternatives to the procedure.

• International Journal of Arrhythmia
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• 제19권3호
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• pp.235-284
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• 2018

In this part the writing group will cover strategies, techniques, and endpoints of atrial fibrillation (AF) ablation. Prior to all, electrical isolation of the pulmonary veins is recommended during all AF ablation procedures. In addition, techniques to be used for ablation of persistent and long-standing persistent AF, adjunctive ablation strategies, nonablative strategies to improve outcomes of AF ablation, and endpoints for ablation of paroxysmal, persistent, and long-standing persistent AF will be reviewed. Currently many technologies and tools are employed for AF ablation procedures. Radiofrequency energy, cryoablation, and other energy sources and tools are in various stages of development and/or clinical investigation. Finally, anticoagulation strategies pre-, during, and postcatheter ablation of AF and technical aspects of ablation to maximize safety are discussed in this section.

• 한국정보통신학회논문지
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• 제20권8호
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• pp.1587-1595
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• 2016

P파는 심장의 전기적, 생리적 특성을 나타내는 파라미터로써 심방성 부정맥 진단에 있어 매우 중요하다. 하지만 R파에 비해 신호의 크기가 작고 그 형태가 다양하여 검출에 많은 어려움이 있다. P 파를 검출하기 위한 기존 연구방법으로는 주파수 분석과 비선형 접근방법 등이 제안되어 왔지만 방실 차단과 같은 전도 이상이나 심방성 부정맥의 경우에는 검출 정확도가 낮아진다. 이는 심장 상태에 따라 다양한 모양의 P파의 패턴이 존재하기 때문이다. 본 연구에서는 QRS 피크 변화에 따른 P파의 패턴을 분류하고 적응형 문턱치를 이용하여 P파를 검출하는 방법을 제안한다. 이를 위해 전처리를 통해 잡음이 제거된 심전도 신호에서 Q, R, S를 검출한다. 이후 피크 변화에 따른 P파의 3가지 패턴을 분류하고 적응형 윈도우와 문턱치를 통해 P파를 검출하였다. 제안한 방법의 우수성을 입증하기 위해 MIT-BIH 부정맥 데이터베이스 48개의 레코드를 대상으로 한 P파의 평균 검출율은 92.60%의 성능을 나타내었다.