• 제목/요약/키워드: cardiac pacemaker

검색결과 75건 처리시간 0.023초

글루포시네이트 중독 후 심장독성의 다양한 임상경과를 보인 1례 (A case of various clinical aspects associated with cardiotoxicity after glufosinate poisoning)

  • 김선태
    • 대한임상독성학회지
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    • 제19권2호
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    • pp.133-138
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    • 2021
  • Glufosinate-containing herbicides is a non-selective herbicide commonly used worldwide. As the use of them increased gradually since paraquat was banned in 2012, the number of suicides by their ingestion is also increasing continuously. Complications of glufosinate-containing herbicide poisoning include various central nervous system (CNS) toxicities such as convulsions, loss of consciousness, memory impairment, and respiratory depression, which may be accompanied by hemodynamic changes such as bradycardia and hypotension. However, it is very rare that arrhythmias other than bradycardia occurred and Takotsubo cardiomyopathy was combined due to cardiotoxicity. A 71-year-old female patient was transferred to our hospital after ingesting 500 mL of glufosinate-containing herbicide and receiving 5 L of gastric lavage at a local hospital. A few hours later, she presented stuporous mentality, respiratory depression, and convulsions, and was accompanied by hypotension and bradycardia. On the second day of admission, electrocardiogram (ECG) showed bradycardia and QTc prolongation with hemodynamic Instability. Accordingly, we conducted the early treatment with continuous renal replacement therapy (CRRT) and the application of temporary cardiac pacemaker. An echocardiogram demonstrated decreased ejection fraction (EF) and Takotsubo cardiomyopathy on the third day of admission. Then, she was discharged safely with conservative treatment. At the follow-up after 1 year, Takotsubo cardiomyopathy, EF and QTc prolongation were recovered on echocardiogram and ECG. Because cardiac toxicity after glufosinate-containing herbicide poisoning may cause life-threatening consequences, caution is required while treating the patient. Therefore, if electrocardiogram changes are seen in the elderly with a large amount of glufosinate herbicide ingestion, additional cardiac function test through echocardiography should be concerned, and early treatment through CRRT or artificial cardiac pacing should be considered.

Left Atrial Strain Derived From Cardiac Magnetic Resonance Imaging Can Predict Outcomes of Patients With Acute Myocarditis

  • Jimin Lee;Ki Seok Choo;Yeon Joo Jeong;Geewon Lee;Minhee Hwang;Maria Roselle Abraham;Ji Won Lee
    • Korean Journal of Radiology
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    • 제24권6호
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    • pp.512-521
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    • 2023
  • Objective: There is increasing recognition that left atrial (LA) strain can be a prognostic marker of various cardiac diseases. However, its prognostic value in acute myocarditis remains unclear. Therefore, this study aimed to evaluate whether cardiovascular magnetic resonance (CMR)-derived parameters of LA strain can predict outcomes in patients with acute myocarditis. Materials and Methods: We retrospectively analyzed the data of 47 consecutive patients (44.2 ± 18.3 years; 29 males) with acute myocarditis who underwent CMR in 13.5 ± 9.7 days (range, 0-31 days) of symptom onset. Various parameters, including feature-tracked CMR-derived LA strain, were measured using CMR. The composite endpoints included cardiac death, heart transplantation, implantable cardioverter-defibrillator or pacemaker implantation, rehospitalization following a cardiac event, atrial fibrillation, or embolic stroke. The Cox regression analysis was performed to identify associations between the variables derived from CMR and the composite endpoints. Results: After a median follow-up of 37 months, 20 of the 47 (42.6%) patients experienced the composite events. In the multivariable Cox regression analysis, LA reservoir and conduit strains were independent predictors of the composite endpoints, with an adjusted hazard ratio per 1% increase of 0.90 (95% confidence interval [CI], 0.84-0.96; P = 0.002) and 0.91 (95% CI, 0.84-0.98; P = 0.013), respectively. Conclusion: LA reservoir and conduit strains derived from CMR are independent predictors of adverse clinical outcomes in patients with acute myocarditis.

가족성 동기능 장애 증후군 1례 (Familial Sick Sinus Syndrome)

  • 남인혜;천성희;길홍량
    • Clinical and Experimental Pediatrics
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    • 제46권2호
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    • pp.195-197
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    • 2003
  • 저자들은 비경화성 심근증을 동반한 두 자녀와 기질적 질환이 없이 발생한 동기능 장애 증후군 환자를 경험하였기에 문헌 고찰과 함께 가족성 동기능 장애 증후군 1례를 보고하는 바이다.

이식용 심장박동기(Pacemaker) 및 심장 세동제거기 (AICD)를 위한 심장 탈분극파 검출지연 방지 알고리즘 (A Belay Prevention Algorithm of Cardiac Depolarization Wave Detection for Pacemakers or Automatic Implantable Cardioverter/Defibrillator (AICD))

  • 김정국;박충규;한상휘;조병서;허웅
    • 대한전자공학회:학술대회논문집
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    • 대한전자공학회 1999년도 하계종합학술대회 논문집
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    • pp.1063-1066
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    • 1999
  • The delay of cardiac depolarization wave detection in the conventional pacemakers or AICD (automatic implantable cardioverter/ defibrillator, or ICD) has been overlooked. However, it is known that the delay may cause hemodynamic problems and may prevent the proper operation of a new automatic feature, automatic capture verification, that is to be appeared in the near-future devices. In order to reduce the effects of the delay, a delay prevention algorithm was developed and tested by applying three human electrograms. The algorithm set the sensing threshold just above the measured noise level to reduce the detection delay. It is found that the low threshold was able to reduce the delay by 20msec(average) In most cases. The implementation results showed reliability and efficacy of the algorithm, and the algorithm could be applicable to the existing hardware and software of the conventional pacemakers and AICD without any significant modifications.

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이식형 심장 모니터링 장치 관련 감염의 위험요인 (Risk Factors for Cardiac Implantable Electronic Device-Related Infections)

  • 박진영;최혜란
    • Journal of Korean Biological Nursing Science
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    • 제23권4호
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    • pp.298-307
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    • 2021
  • Purpose: This study aimed to investigate the risk factors for cardiac implantable electronic device (CIED)-related infections within the first post-procedural year after CIED insertion. Methods: This study included 509 adult patients undergoing CIED implantation procedures between January 1, 2011 and December 31, 2015. The data were analyzed by t-test, chi-square test, Fisher's exact test, and logistic regression analysis using SPSS/WIN 23.0. Results: Fifteen infections and 494 non-infections were examined. The CIED-related infection rate was 2.9%; patients with 14 pocket infections and one bacteremia were included in the CIED-related infection. The risk factors of CIED-related infections were the estimated glomerular filtration rate (eGFR) of ≤ 45 mL/min/1.73 m2 (Odds ratio [OR]= 4.03, 95% confidence interval [CI],1.15-14.10) and taking a new oral anticoagulant (NOAC) (OR = 4.50, 95% CI 1.09-18.55). Conclusion: These results identified the CIED infection rate and risk factors of CIED-related infection. It is necessary to consider these risk factors before the CIED implantation procedure and to establish the relevant nursing interventions.

Towards Evolutionary Approach for Thermal Aware In Vivo Sensor Networks

  • Kamal, Rossi;Hong, Choong-Seon
    • 한국정보과학회:학술대회논문집
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    • 한국정보과학회 2012년도 한국컴퓨터종합학술대회논문집 Vol.39 No.1(D)
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    • pp.369-371
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    • 2012
  • Wireless sensor networks have taken immense interest in healthcare systems in recent years. One example of it is in an in vivo sensor that is deployed in critical and sensitive healthcare applications like artificial retina, cardiac pacemaker, drug delivery, blood pressure, internal heat calculation, glucosemonitoring etc. In vivo sensor nodes exhibit temperature that may be very dangerous for human tissues. However, existing in vivo thermal aware routing approaches suffer from hotspot creation, delay, and computational complexity. These limitations motivate us toward an in vivo virtual backbone, a small subset of nodes, connected to all other nodes and involved in routing of all nodes, -based solution. A virtual backbone is lightweight and its fault-tolerant version allows in vivo sensor nodes to disconnect hotspot paths and to use alternative paths. We have formulated the problem as m-connected k-dominating set problem with minimum temperature cost in in vivo sensor network. This is a combinatorial optimization problem and we have been motivated to use evolutionary approach to solve the problem.

Rastelli 씨 수술을 이용한 선천성 교정형 대동맥 전치증 (I.D.D.) ; 1예 보고 (Rastelli Operation In Congenitally Corrected Transposition Of Great Arteries (I.D.D.) -A Case Report-)

  • 조범구
    • Journal of Chest Surgery
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    • 제12권3호
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    • pp.215-224
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    • 1979
  • Corrected transposition of great arteries associated with dextrocardia [I.D.D.] is a very rare congenital cardiac malformation in which the atria and ventricles are in discordant relation, as are the ventricles and great arteries, but the aorta is to the right of the pulmonary artery. A 13 year old male patient who complained cyanosis and dyspnea on exertion for 8 years, was diagnosed as congenitally corrected transposition of great arteries associated with dextrocardia [I.D.D.], large ventricular septal defect, patent foramen ovale and pulmonary stenosis. He was operated on Nov. 22 1978. The ventricular septal defect was closed with Teflon felt and the pulmonary hypoplasia was corrected with Rastelli operation successfully. On 34th postoperative days, complete heart block was occurred and permanent epicardial pacemaker was implanted with good result.

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대혈관전위증 수술 3례 보 (Operation using valved conduit in TGA: report of 3 cases)

  • 유회성
    • Journal of Chest Surgery
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    • 제16권4호
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    • pp.452-457
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    • 1983
  • Transposition of great arteries is relatively common cyanotic heart disease excluding TOF and is divided to two groups: complete TGA and congenitally corrected TGA. We experienced operations in 3 cases of TGA, the 1st case was 12 year-old male: TGA[SDD] + VSD+PS and treated with Rastelli`s operation, but expired due to low cardiac output syndrome postoperatively. The 2nd case,13 year-old male was also TGA[SDD]+VSD+PS and treated with Rastelli`s operation with good operative result. The 3rd case was 18-year old male: congenitally corrected TGA[SLL]+VSD+ PA+ASD and operation was done according to the met. hod reported by Danielson et al in 1980. Post-operative AV block led to implantation of permanent epicardial pacemaker with good result.

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이식형 심장 박동 조율기를 위한 저전력 심전도 검출기와 아날로그-디지털 변환기 (Low-Power ECG Detector and ADC for Implantable Cardiac Pacemakers)

  • 민영재;김태근;김수원
    • 전기전자학회논문지
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    • 제13권1호
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    • pp.77-86
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    • 2009
  • 본 논문에서 이식형 심장 박동 조율기를 위한 심전도 검출기와 아날로그-디지털 변환기(ADC)를 설계한다. 제안한 웨이블렛 심전도 검출기는 웨이블렛 필터 뱅크 구조의 웨이블렛 변조기, 웨이블렛 합성된 심전도 신호의 가설 검정을 통한 QRS 신호 검출기와 0-교차점을 이용한 잡음 검출기로 구성된다. 저전력 소모의 동작을 유지하며 보다 높은 검출 정확도를 갖는 심전도 검출기의 구현을 위해, 다중스케일 곱의 알고리즘과 적응형의 임계값을 갖는 알고리즘을 사용하였다. 또한 심전도 검출기의 입력단에 위치하는 저전력 Successive Approximation Register ADC의 구현을 위해, 신호 변환의 주기 중, 매우 짧은 시간 동안에만 동작하는 비교기와 수동 소자로 구성되는 Sample&Hold를 사용하였다. 제안한 회로는 표준 CMOS $0.35{\mu}m$ 공정을 사용하여 집적 및 제작되었고, 99.32%의 높은 검출 정확도와 3V의 전원 전압에서 $19.02{\mu}W$의 매우 낮은 전력 소모를 갖는 것을 실험을 통해 확인하였다.

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심박수 적응형 심박 조율 알고리즘 설계 및 평가: 시뮬레이션 연구 (Design and Evaluation of Blending Algorithm for Rate Adaptive Pace: Simulation Study)

  • 명현석;이경중
    • 대한의용생체공학회:의공학회지
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    • 제40권1호
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    • pp.32-37
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    • 2019
  • In this study, we designed a blending algorithm for rate adaptive pacing for cardiac pacemaker. Generally, rate adaptive pacing (RAP) is applied to patients whose heart rate does not rise during exercise for chronotropic incompetence (CI) patient. It is very important to develop an algorithm for RAP that can be properly applied to CI patients. In order to design an RAP algorithm we used dual sensors. Firstly, we designed a bio-signal measurement system based on the dual sensors, which are accelerometer and respiratory system. Secondly, we conducted treadmill test for the simulation experiment while using 3-lead ECG as reference. Finally, we designed a blending algorithm based on activation state of the dual sensors. The proposed blending algorithm was subdivided into three sections based on the accelerometer signal, which are rapidly increased section (W1), hardly changed section (W2), and decreased section (W3). Each weight is set aside for each section. To evaluate this algorithm, ten healthy adult males were participated. The correlation and Root Mean Square Error between the proposed algorithm and the reference were compared, and shown to be r=0.88 and 2.82 bpm, respectively. These results show that the proposed blending algorithm of dual sensors enables proper tracking of the heart rate during exercise. Also, it shows the possibility that the proposed blending algorithm can be applied to improve quality of life of the chronotropic incompetence patient.