• Journal of Chest Surgery
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• v.27 no.7
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• pp.631-633
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• 1994

Congenital bronchoesophageal fistula is a rare anomaly that can appear in adult uncommonly. Especially sick sinus syndrome with bronchoesophageal fistula is very uncommon.The patient was 53 years old male who admitted for chronic coughing recurrent lobar pneumonia on RLL since few years ago. And he had familial history of sick sinus syndrome.We confirmed the fistula by barium swallow examination and performed ligation of the fistula and pacemaker implantation.

• Clinical and Experimental Pediatrics
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• v.46 no.2
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• pp.195-197
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• 2003

Sick sinus syndrome(SSS) constitutes a spectrum of cardiac arrhythmia, including sinus bradycardia, sinus pause-arrest, sinoatrial block, slow escape rhythm, bradyarrhythmia and tachyarrhythmia. SSS is relatively uncommon in children but its exact incidence is unknown because diagnostic criteria are not uniform and most children with SSS, in general are asymptomatic. SSS may be primary(organic sinus node disease) or secondary(cardiac surgery comprises much of SSS in children and adolescents), but it can hardly be caused by familial relations as well. We reports an occurrence of familial sick sinus syndrome. Mother was diagnosed as SSS, which was presented by symptoms of dizziness and treated by permanent pacemaker(DDD). Also, two daughters revealed SSS with non-compacted cardiomyopathy on neonatal screening and fetal echocardiography respectively. We concluded that familial SSS may occur, so familial screening should be suggested.

• The Journal of Internal Korean Medicine
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• v.23 no.2
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• pp.274-279
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• 2002

The sick sinus syndrome refers to a combination of symptoms (dizziness, confusion, fatigue, syncope, and congestive heart failure) caused by sinus node dysfunction and marked sinus bradycardia, sinoarterial block, or sinus arrest. 'Abdominal pulsation' means a disagreeable symptom that is defined as sensation of beating at the abdomen. We experienced a 84 year-old female patient who had dizziness, fatigue, abdominal pulsation and frequent voiding. These symptoms were related to previous episodes and presumed sick sinus syndrome by symptoms, ECGs and 24 hrs of holter monitoring. In the point of Differentiation of Syndrome (辨證), this patient was diagnosed as 'Water retention(水氣)' and was administered with Yeonggyechulgam-tang(岺桂朮甘湯). After the treatment, abdominal pulsation (frequency) and dizziness (VAS) were improved. Futhermore, the interval of voiding was longer and each volume of urination increased.

• Journal of Veterinary Clinics
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• v.22 no.4
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• pp.396-400
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• 2005

A 13-year old, female Maltese dog was presented due to a five-month history of episodic syncope. A diagnosis of sick sinus syndrome (SSS) with mitral valve endocardiosis (MVE) was made based on history takings, physical and cardiac examination, complete blood count (CBC), serum chemistry profiles, radiography, electrocardiography (ECG), atropine response test, hormonal assay, and echocardiography. In this case, SSS was definitely diagnosed by evaluation of ECG recording following atropine administration. Clinical signs were improved with medical management of theophylline (THEOLAN, KunWha Pharm, Seoul, Korea, 20 mg/kg, PO, BID). After 10 more month survival, the dog, died of respiratory distress and shock during the operation of abdominal mass removal in local animal hospital. Unfortunately, we were not able to perform necropsy after death due to owner's decline. This case demonstrates that theophylline can be used in management oF dog with SSS.

• Journal of Veterinary Clinics
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• v.27 no.5
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• pp.569-572
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• 2010

A 4-year-old neutered female Pekingese dog (weighing 3.6 kg) was referred with the primary complaint of exercise intolerance with occasional syncope. Physical examination revealed irregularly irregular heart rhythm with persistent pulse deficits. The 12-lead surface ECG showed a marked sinus arrest with occasional junctional escape beats, indicating a sick sinus syndrome. Permanent transvenous cardiac pacing with a rate-responsive bipolar implantable pacemaker (VVIR type) was performed in the right ventricle. After pacemaker implantation, the clinical signs were remarkably improved. No further syncopal episodes have yet been occurred after implantation.

• Neonatal Medicine
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• v.18 no.2
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• pp.395-398
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• 2011

Sick sinus syndrome (SSS) is a disorder characterized by sinus node dysfunction. Although the condition is most common in the elderly, it can occur in children including neonates and its recognition and treatment are important. The diagnosis of SSS is based on the presence of sinus bradycardia, sinus arrest or exit block, combinations of sinoatrial and atrioventricular nodal conduction disturbances, and atrial tachyarrhythmias documented in the Holter recordings. In most children with SSS, previous history of congenital heart malformation or cardiac surgery is noted. SSS is also seen in the children including neonates without heart disease or other contributing factors, however SSS is most often idiopathic. The treatment of SSS depends on the basic rhythm problem, but generally involves the placement of a cardiac pacemaker. We report a case of SSS in extremely low birth weight infant without congenital heart disease and suggest that the treatment system is necessary for preterm infants with SSS.

• Journal of Chest Surgery
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• v.27 no.7
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• pp.571-575
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• 1994

The hemodynamic effects of thyroid hormone are well established, and this hormone affects myocardial contractility, heart rate, and myocardial oxygen consumption. But the role of cardiopulmonary bypass on the thyroid function is not yet fully understood. We have studied twelve patients [male and female patients were equal in number] who were performed open heart surgery under cardiopulmonary bypass. The results are followed. 1] The serum level of T3 began to fall after cardiopulmonary bypass and sustained significantly till 24 hours after operation[p<0.05] 2] The concentrations of T4, Free T4, and TSH were slightly decreased after cardiopulmonary bypass but was maintained within normal range. 3] This above findings are similar to the "sick sinus syndrome" that is seen in severely ill patient. 4] We can propose that T3 would be effective in postoperative low cardiac output syndrome. syndrome.

• Journal of Chest Surgery
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• v.16 no.2
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• pp.190-198
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• 1983

The management of cardiac arrhythmias by cardiac pacing has increased greatly since the treatment of complete heart block with an external transcutaneous pacemaker in 1952, followed by the use of myocardial wires connected to an external pulse generation, by external transvenous pacing, and then by transvenous pacing with implantable components in thoracic wall.By now, the three bases of modern cardiac pacing for bradyarrhythmias had been established [1] an implantable device [2] the transvenous approach [3] the ability of the pacemaker to sense cardiac activity and modify its own function accordingly. In transvenous implantation of a pacemaker, any one of four vessels at the root of the neck is suitable for passage of the electrode - cephalic vein, external jugular vein, internal jugular vein, costo-axillary branch of the axillary vein. The new technique of direct puncture of the subclavian vein, either percutaneously or after skin incision only has been made, is invaluable & is used routinely. We have experienced one 25 years old patient who had rheumatic mitral stenosis & minimum aortic regurgitation with sinus bradycardia associated with premature atrial tachycardia & another 54 years old female patient who was suffered from sick sinus syndrome with sinus bradycardia & sinus arrest. The 1st patient was taken open mitral commissurotomy & aortic valvuloplasty and then was taken atrlal pace-maker implantation through If subclavian puncture method in post-op 14 days, and the second patient was taken atrial pacemaker implantation through If subclavian puncture method. Their postop course was in uneventful & were discharged, without complication. Their condition have been good to now.

• 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.

• Journal of Chest Surgery
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• v.17 no.3
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• pp.356-361
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• 1984

During the period from January 1982 to June 1984 we implanted permanent pacemakers in 18 patients who received open heart surgery at Yonsei University Hospital. 1.In 11 patients, open heart surgery was performed at Yonsei University Hospital and new surgical induced heart blocks were developed and implantations of permanent pacemaker were done. 2.Total 1035 open heart surgeries were done and implantations of pacemaker were performed in 11 cases. [1.06%]. After total correction of TOF [215 cases] implantations of pacemaker were done in 3 cases. [1.4%] Implantations of pacemaker were 0.37% after VSD repair, 0.78% after ASD repair, 5.9% after ECD repair, 0.48% after MVR and 2.0% after AVR. 3.Causes were complete A-V block, sick sinus syndrome and A-V dissociation. 4.Heart blocks were developed immediately after bypass stop in 8 patients. 5.Implantations of pacemaker were done at more than 2 weeks after open heart surgery. 6.Local anesthesia was done in adult and general anesthesia in infants. Locations of pulse generator were subxiphoid, subcostal & subclavian. Position of pulse generator was between subcutaneous fat layer and muscle layer. 7.Types of pulse generator were VVI, VDD and AAI. 8.The postoperative complications included infection, pacing failure, sensing failure and lead dislodgment.