• Neonatal Medicine
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• 제16권2호
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• pp.239-243
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• 2009

다소성 심방 빈맥은 신생아에서 드물게 발생하며 진단하기에 어려워 심방 조동으로 오인되기도 한다. 치료가 어려우나 생후 1년 안에 자연적으로 사라지는 경우도 있다. 불규칙한 심방 빈맥을 가진 신생아에게 직접 제작한 경식도 전극을 이용한 심전도를 시행하여 다소성 심방 빈맥을 진단하였다. Propranolol은 치료에 효과적이지 않았으나 digoxin과 sotalol 투여 후 환자는 점차 동리듬으로 회복되었다. 신생아에서 경식도 전극을 이용하여 다소성 심방 빈맥을 진단하였던 1례를 보고한다.

• Journal of Trauma and Injury
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• 제21권2호
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• pp.85-90
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• 2008

Purpose: Supraventricular arrhythmia is a well-known complication of cardiothoracic surgery, and is common in patients wirth underlying cardiovascular disease. Also, it's treatment and prognosis are well known. However the incidence, the contributing factors, and the prognosis for supraventricular arrhythmias in noncardiothoracic surgical patients are less well known. This study was undertaken to investigate the incidence, the clinical presentation, the prognosis, and the factors comtributing to the prognosis for supraventricular arrhythmia in the surgical intensive care unit. Methods: We performed a retrospective study of 34 patients with newly developed or aggravated supraventricular arrhythmias in the surgical intensive care unit between March 2004 and February 2005. The incidence, the risk factors, and the prognosis of supraventricular arrhythmias were analyzed. Results: During a 12month period, the incidence of supraventricular arrhythmia was 1.79% (34/1896). Most patients had pre-existing cardiovascular disease and sepsis. The mortality rate was 29.4%, and the most common cause of death was multiple organ failure due to septic shock. The mean value of the APACHE II score was 20.9, and the surgical intensive care unit and the hospital lengths of stay were 9.9 days and 25.8 days, respectively. The APACHE II score measured when the arrhythmia developed was a significant factor in predicting mortality, Conclusion: Supraventricular arrhythmias result in increased mortality and increased length of stay in both the surgical intensive care unit and the hospital. The arrhythmia itself did not cause death, but a high APACHE II score incicated a poor prognosis. This may reflect the severity of the illness rather than an independent contributor to mortality.

• Journal of Chest Surgery
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• 제40권12호
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• pp.811-816
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• 2007

배경: 선천성 심 질환에 동반된 심실성 혹은 상심실성 부정맥은 심기형에 대한 수술에 병행하여 적극적인 수술적 치료를 하는 것이 바람직하다. 본 연구에서는 선천성 심 질환에 동반된 부정맥의 양상 및 부정맥 수술의 중기 성적을 알아보았다. 대상 및 방법: 1998년 6월부터 2006년 6월까지 선천성 심 질환 및 동반 부정맥에 대한 수술이 동시에 시행된 43명의 환자의 임상 자료를 후향적으로 분석하였다. 결과: 수술 시 환자의 연령은 4세에서 75세(중간 값: 52세)이었다. 가장 흔한 심 질환은 심방 중격 결손(23예)이었으며, 기타 엡스타인 기형(5예), 과거 심방-폐동맥 연결형 Fontan 수술을 받은 기능적 단심증(3예)의 순이었다. 부정맥의 유형으로는 심방 조동-세동이 37예로 가장 많았고, 간헐적이면서 지속적이지 않은 심실성 빈맥이 2예, 기타 여러 유형의 상심실성 부정맥이 4예이었다. 심방 조동-세동 및 일부 상심실성 부정맥에 대하여 양심방 maze 술식이 18건(변형 Cox maze III 술식: 5예, 우심방 maze와 폐정맥 냉동 분리술: 13예), 우심방 maze 술식이 18건 시행되었으며, 짧은 병력의 심방 조동 만을 가진 4명의 환자에서는 하대정맥-삼첨 판막 협부 냉동 절제 만이 시행되었다. 또한 심실성 빈맥을 가진 2명의 환자들은 우심실 유출로 냉동 절제술이 시행되었고, 엡스타인 기형에 동반된 방실 결절 회귀성 빈맥에 대해서는 결절 주변 냉동 절제가 시행되었다. 수술 사망 및 부정맥 수술로 인한 합병증은 없었다. 수술 후 추적기간은 1개월에서 95.2개월(중간 값: 23.8개월)이었으며, 추적 기간 중 1명의 환자가 수술 후 5개월째 전격성 간염으로 사망하였다. 전체 환자의 동율동 회복률은 수술 직후 및 수술 후 $3{\sim}6$개월에 각각 79% 및 81%이었다(양심방 maze 군: 72% 및 83%, 우심방 maze 군: 77%, 77%). 양심방 maze 술식 및 우심방 maze 술식을 받은 환자 군에서 각각 1명씩 동방 결절 기능 부전으로 인공 심박동기를 삽입하였다. 결론: 선천성 심기형에 동반된 부정맥에 대한 수술적 치료는 안전하게 이루어 질 수 있으며, 우수한 중기 성적을 보인다.

• Journal of Chest Surgery
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• 제46권2호
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• pp.98-103
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• 2013

Background: Atrial fibrillation (AF) is a common complication in elderly patients with atrial septal defect (ASD). The purpose of this study was to examine the efficacy of the maze procedure in these patients. Materials and Methods: Between February 2000 and May 2011, 46 patients underwent the maze procedure as a concomitant operation with ASD closure. Three patients who underwent a right-sided maze were excluded, and one patient was lost to follow-up. The mean follow-up duration was $3.2{\pm}2.5$ years. Electrocardiography was performed 1 month, 3 months, 6 months, and 1 year after surgery, and checked annually after that. Results: AF persisted in 4 patients after surgery. One year after surgery, among 38 patients, 55.3% remained in sinus rhythm without antiarrhythmic drugs. However, when including the patients who took antiarrhythmic drugs, 92.1% were in sinus rhythm. Freedom from AF recurrence at 3 months, 6 months, 1 year, 2 years, 3 years, and 5 years after surgery were $97.4{\pm}2.6$, $94.4{\pm}3.8$, $91.2{\pm}4.9$, $87.8{\pm}5.8$, $79.5{\pm}7.6$, and $68.2{\pm}12.4$, respectively. There was no early mortality after operation. Conclusion: Concomitant treatment with the maze procedure and ASD closure is safe and effective for restoring the sinus rhythm.

• Journal of Chest Surgery
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• 제33권9호
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• pp.752-755
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• 2000

Isolated congenital aneurysm of the left atrium with intact pericardium is a rate anomaly, which usually presents with arrhythmia, cerebral embolism or abnormalities on routine chest X-ray. Surgery is indicated in most cases to eliminate a potential source of systemic emboli and arrhythmias. A 42-year-old woman having cervical cancer, she was suspected of having a left atrial aneurysm on review of chest X-ray and confirmed by echocardiography and cardiac catheterization. Surgical resection of Left atrial aneurysm was achieved without complication using median sternotomy with cardiopulmonary bypass. The postoperative course was uneventful.

• 한국생물물리학회:학술대회논문집
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• 한국생물물리학회 2001년도 학술 발표회 진행표 및 논문초록
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• pp.58-58
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• 2001

Even though atrial fibrillation is the most prevalent arrhythmia, the mechanism of development is not yet clear. Recently, there has been several reports that the most frequent source of paroxysmal atrial fibrillation is located inside pulmonary vein. Recently we successfully isolated single cardiac myocytes which were inside of pulmonary vein and reported the spontaneous action potential was generated from these cells.(omitted)

• 한국초전도학회:학술대회논문집
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• 한국초전도학회 2005년도 High Temperature Superconductivity Vol.XV
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• pp.50-50
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• 2005

• Journal of Chest Surgery
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• 제28권4호
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• pp.355-359
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• 1995

A clinical analysis was performed on 48 cases with mitral stenosis who received open mitral commissurotomy from December 1983 to June 1991 at the Department of Thoracic & Cardiovascular Surgery, Chungnam National University Hospital. Fifteen patients were men and 33 were women. the mean age was 35.6 years with the range of 16 to 61 years. The distribution of preoperative NYHA Functional Classes was as follows; class II, 25 patients; class III, 20 patients; class IV, 3 patients. Three patients had cerebral emboli preoperatively, all of whom were in atrial fibrillation. The preoperative electrocardiographic studies revealed that 32 patients had sinus rhythms and 16 had atrial fibrillations. Twenty-six patients had open mitral commissurotomy alone and 22 patients had additional cardiac procedures. Intraoperatively, there were 6 cases of left atrial thrombosis. There was no perioperative death but early postoperative complications were found in 3 cases. The patients were followed up from 2 to 99 months[mean 33.7 months . There was one case of late unexplained sudden death. There was a case of late postoperative cerebral infarction, 5 cases of mitral restenosis and 3 cases of congestive heart failure and/or arrhythmia. Mitral valve replacements were required in 3 patients.But, it is evident that open mitral commissurotomy has many advantages beyond mitral valve replacement concerning the results of the mitral valve replacement underwent during the same period at the Department of Thoracic & Cardiovascular Surgery, Chungnam National University Hospital.

• Journal of Chest Surgery
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• 제22권1호
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• pp.95-105
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• 1989

The records of 248 patients over 16 years of age who had undergone a surgical correction of a congenital cardiovascular malformation during the period of 10 years from August, 1978 to July, 1988 were reviewed. During this period, the incidence of congenital cardiovascular malformation in adult was 18.2% of 1376 total heart disease operated on and 25.5% of 986 congenital heart defects. Among them, there were 200 patients in acyanotic group and 48 patients in cyanotic group. Male versus female ratio was 1:1.28. The oldest patient was 59 years old female who had atrial septal defect. The mean age was 24.4 years old. The distribution of the lesions showed a large preponderance of atrial septal defects [37.19o] followed in frequency by ventricular septal defects [918.1%], patent ductus arteriosus [17.3%], tetralogy of Fallot [16.1%], and a variety of other complex malformations[3.2%]. In the pediatric age group, relative frequency was different from that of this adult group, showing ventricular septal defects, tetralogy of Fallot, patent ductus arteriosus and atrial septal defects in order of incidence. The hospital mortality and late mortality were 6.0% and 1.7% respectively. The causes of hospital death were low cardiac output in 10 patients, arrhythmia in 2, air embolism in 1, sepsis in 1 and respiratory failure in l. Clinical improvement upto NYHA functional class I or II postoperatively has been achieved and sustained in all patients following repair except the patients of late death and receiving reoperation. This result confirms that congenital heart defects in the adults can be corrected with a good outcome and an aggressive operative approach seems justified.

• 대한의용생체공학회:의공학회지
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• 제10권1호
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• pp.17-24
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• 1989

This papaer presents a new algorithm for the P-wave detection in the ECG signal. Digital differentiation method (7-point derivative) is used for detecting P-waves exactly. This algorithm can detect various parameters of PR, PP, RR interval, which are important to diagnosis AV blocks and WPW syndrome. Especially, this algorithm can detect P-waves very efficiently not only in well-preprocessed waves but in pccr waves with noise and artifact. And it enables to develope more reliable automatic diagnosis algorithm.