• Title/Summary/Keyword: 서맥

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A Case of Bradycardia with Atrioventricular Block Treated with Korean Medicine (방실차단에 의한 서맥을 보이는 환자 한방 치험 1례)

  • Lee, Hyoung-min;Kim, Jeong-hwa;Lee, Sang-hwa;Jeong, Hye-seon;Yang, Seung-bo;Cho, Seung-yeon;Park, Seong-uk;Park, Jung-mi;Ko, Chang-nam
    • The Journal of Internal Korean Medicine
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    • v.39 no.4
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    • pp.839-845
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    • 2018
  • This is a case report of a 57-year-old patient diagnosed with bradycardia and atrioventricular (AV) block. The chief complaint of the patient was palpitation and dizziness. An electrocardiogram (ECG) showed a second degree AV block with 2:1 AV conduction. The patient was treated with Korean medicine, including herbal medicine, for 35 days. After 2 weeks of treatment, the heart rate increased from 33 to 56 and the follow-up electrocardiogram showed normal findings. The symptoms of palpitation and dizziness were also improved. The effect on heart rate, ECG, and symptoms lasted until the end of the treatment. This case report demonstrated that Korean medicine could be effective for treatment of symptomatic bradycardia with AV block.

Bradycardia after Dobutamine Administration in a Dog (Dobutamine 투여 후 발생한 개의 서맥 1례)

  • Jang, Min;Son, Won-Gyun;Hwang, Hyeshin;Jo, Sang-Min;Yi, Kang-Jae;Yoon, Junghee;Lee, Inhyung
    • Journal of Veterinary Clinics
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    • v.31 no.4
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    • pp.350-353
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    • 2014
  • A 13-year-old, castrated male, Shih Tzu dog with a history of acute ataxia was referred to veterinary medical teaching hospital and anesthetized for diagnostic magnetic resonance imaging of cervical intervertebral disk disease. After preanesthetic evaluation including physical examination, blood chemistry, radiography and ultrasound, the patient was premedicated with intravenous butorphanol (0.2 mg/kg). Anesthesia was induced by intravenous propofol (6 mg/kg) and maintained with isoflurane at 1.2 minimal alveolar concentrations. Because the mean arterial pressure (MAP) decreased from 70 to 58 mmHg at 70 minutes after induction, dobutamine was administered by constant rate infusion ($5{\mu}g/kg/min$) to treat hypotension. However MAP did not increase, and heart rate rapidly decreased from 100 to 55 beats per minute (bpm). To treat bradycardia, intravenous glycopyrrolate ($5{\mu}g/kg$) was administered, and heart rate increased to 165 bpm. After extubation of endotracheal tube, the patient showed normal recovery without any problems related to cardiovascular system. Unexpected dobutamine-induced bradycardia was considered as Bezold-Jarisch reflex. It is recommended that clinicians know and prepare the possibility of bradycardia during dobutamine therapy under general anesthesia.

Hypokalemia-induced Polyuria with Nocturia after Intravenous Methylprednisolone Pulse Therapy in a Henoch-Sch$\ddot{o}$nlein Purpura Nephritis Patient (Henoch-Sch$\ddot{o}$nlein Purpura 신염 환자에서 경정맥 고용량 스테로이드 충격요법 후 발생된 저칼륨혈증으로 인한 다뇨증과 야간뇨)

  • Kim, Geun-Jung;Lee, Jun-Ho
    • Childhood Kidney Diseases
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    • v.14 no.2
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    • pp.230-235
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    • 2010
  • Patients with moderate to severe degrees of Henoch-Sch$\ddot{o}$nlein purpura (HSP) nephritis receive high-dose intravenous methylprednisolone pulse therapy (IMPT). Although the regimen is generally safe and effective, various complications occasionally develop. administration of excessive corticosteroid can induce urinary potassium wasting leading to hypokalemia. Polyuria, one of the complications of hypokalemia, is related to both increased thirst and mild nephrogenic diabetes insipidus. And hypokalemia itself also impairs the maximal renal urinary concentration ability. Although polyuria or nocturia after IMPT is not common, it is correctable immediately by oral potassium supplementation. Therefore, during IMPT, careful history taking of nocturia as well as monitoring urine volume, serum and urine potassium level at regular follow-up are necessary because even mild hypokalemia can provoke urine concentrating ability defect. We experienced a case of 11 year-old boy with HSP nephritis who suffered from hypokalemia-induced polyuria with nocturia right after IMPT.

Surgical Management for Chronic Atrial Fibrillation (만성 심방세동에 대한 외과적 치험 4례)

  • 강경훈;김철환;김병열
    • Journal of Chest Surgery
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    • v.31 no.1
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    • pp.59-65
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    • 1998
  • Atrial fibrillation is the most common of all cardiac arrhythmias. It is associated with significant morbidity and mortality and is frequently resistant to medical therapy. On the experimental and clinical study, the presence of macroreentrant circuits and the absence of either microreentrant circuits or evidence of atrial automaticity suggests that atrial fibrillation should be amenable to surgical ablation. The results of the maze III procedure are associated with a higher incidence of postoperative sinus rhythm, improved long-term sinus node function, fewer pacemaker requirements, less arrhythmia recurrence, and improved long-term atrial transport function. We had experienced 4 patients with chronic atrial fibrillation. For the first time, Hioki procedure had been performed in the first patient with ASD and atrial fibrillation, regular sinus rhythm showed on postoperative EKG, but junctional rhythm and bradycardia developed postoperative 3 years. The maze III procedure for the rest with mitral valvular disease and atrial fibrillation had been done, followed by regular sinus rhythm for 2 patients and atrial fibrillation for 1 patient, managed with amiodarone, on immediate postoperative state. Echocardiogram documented good contraction of right atrium and hardly contraction of left atrium for 2 patients with regular sinus rhythm postoperative 3 months.

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Extracorporeal Membrane Oxygenation in the Patient with Cardiopulmonary Resuscitation Failure after Open Heart Surgery. - A case report - (개심술 후 심폐소생술 실패환아에서의 체외막산소화 치험 1례)

  • 전희재;성시찬;우종수;이혜경
    • Journal of Chest Surgery
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    • v.32 no.1
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    • pp.53-57
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    • 1999
  • We describe a case of successful extracorporeal membrane oxygenation(ECMO) in a small infant with cardiopulmonary resuscitation(CPR) failure after an open heart surgery. A 35-day-old male infant weighing 4.4 kg who had congestive heart failure and pulmonary hypertension underwent patch closure of ventricular septal defect without any intraoperative event. Postoperative course was unremarkable in the intensive care uint for about 5 hours before the junctional ectopic tachycardia developed. Sudden cardiac decompensation with bradycardia occurred about 50 minutes after the development of junctional ectopic tachycardia. He was put on ECMO by arterial cannulation at the ascending aorta and by venous cannulation at the right atrial appendage after 4 hours' CPR. The hemodynamics were stable with enough urine output during ECMO. He was weaned from ECMO 38.5 hours after initiation. Delayed sternal closure was attempted. He was extubated on postoperative day 7 and discharged home on postoperative day 21 without any neurologic sequelae.

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A Study on Auti-extraction Methods of Heart Rate from ECG (ECG 심박수의 자동 추출법에 관한 연구)

  • Cho, Eun-Seuk;Cha, Sam;Lee, Sangsik;Lee, Ki Young
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.2 no.3
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    • pp.23-29
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    • 2009
  • The heart sends blood to the body with heart rate. When heart rate for men is from 60 to 80 per minute, he is generally normal. However, if heart rate is less than the normal heart rate, the symptom is called by bradycardia. Otherwise, the symptom is called by tachycardia. These symptoms make him even to death. Therefore, heartbeat rate has a very important role in a healthy life. In this study, we studied on auto-extracting methods of heart rates from ECG, and compared them with those measured by naked eyes. The first auto-extracting method employs the 2-order differential equations to extract heart rate. The second method uses the autocorrelation coefficients to detect heart rate. To verify its efficacy and validity in practical applications, these method has been applied to MIT/BIH database.

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A Wireless ECG monitoring System for Application in Life Emergency Event Detection and Analysis (긴급환자 상황인식 및 분석을 위한 무선 ECG모니터링 시스템)

  • Bhardwaj Sachin;Lee Dae-Seok;Chung Wan-Young
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2006.05a
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    • pp.421-425
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    • 2006
  • An ubiquitous healthcare system for the home care of elderly persons was designed and implemented using wireless sensor network technology. The wireless technology for home-care purpose gives new possibilities for monitoring of vital parameter with wearable biomedical sensors, and will give the patient the freedom to be mobile and still be under continuously monitoring and thereby to better quality of patient care. Emphasis is placed on recent advances in wireless ECG system for cardiac event monitoring with particular attention to arrhythmia detection in patient. This paper presents a diagnostic system for cardiac arrhythmias from ECG data, using wireless sensor technology. The system also provides an application for recording activities, events and potentially important medical symptoms. The hardware allows data to be transmitted wirelessly from on-body sensor to the base station and then to PC/PDA. Data is also transmitted to a back-end server for analysis using wireless internet connection. Experiments were conducted using the system for activity monitoring, exercise monitoring and medical screening tests and present preliminary data and results.

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The Efficacy of Needle-Acupuncture at Nei Guan (PC06) and Xin Shu (BL15) on Bradycardia in Dogs (내관(PC06) 및 심수(BL15)에 대한 자침이 개의 서맥에 미치는 효과)

  • Lee, Hyun-Hwa;Oh, Hyun-Wook;Han, Ji-Won;Jun, Hyung-Kyou;Kim, Duck-Hwan
    • Journal of Veterinary Clinics
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    • v.24 no.3
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    • pp.345-349
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    • 2007
  • The objective of this study was to investigate the efficacy of needle-acupuncture (needle-AP) at PC06 and BL15 on xylazine induced bradycardia in dogs. Total 12 dogs were divided into control (4 dogs), PC06 (4 dogs) and BL15 (4 dogs) groups, respectively. As for the treatments in each group, control group was injected with xylazine only. PC06 and BL15 groups were treated by needle-AP during 20 minutes at the same time of xylazine injection. The changes of heart rates, R-R intervals and respiratory rates were investigated on pre, 10, 20, 30, 40, 50 and 60 minutes after xylazine injection. The change of heart rates in experimental PC06 and BL15 groups revealed significant increase on 10 (p<0.05) and 20 minutes (p<0.05) after xylazine injection, compared with those of control group. In addition, heart rates in PC06 group showed increased value on 30 minutes (p<0.05) after xylazine injection, comparing with those of BL15 group. The changes of respiratory rates in experimental PC06 and BL15 groups revealed significant increase on 20 minutes (p<0.05) after xylazine injection, compared with those of control group, however, significance was not found between experimental groups. In conclusion, needle-AP at PC06 and BL15 were effective for improvement of xylazine induced canine bradycardia and needle-AP at PC06 was more effective than that at BL15.

Effect of Glycopyrrolate on Cardiovascular System in Dogs Sedated with Medetomidine-Midazolam Combination (개에서 Medetomidine과 Midazolam 병용 투여 시 Glycopyrrolate가 심맥관계에 미치는 영향)

  • Han, Dae-Kyung;Shin, Beom-Jun;Lee, Jae-Yeon;Jee, Hyun-Chul;Park, Ji-Young;Kim, Myung-Cheol;Jeong, Seong-Mok
    • Journal of Veterinary Clinics
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    • v.26 no.4
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    • pp.317-323
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    • 2009
  • This study was performed to evaluate the effect of intravenous administration of glycopyrrolate on cardiovascular and respiratory system in dogs given intravenous medetomidine (20 ${\mu}g$/kg) and intramuscular midazolam (0.3 mg/kg) (MM). Prior to administration of MM, glycopyrrolate was administered intravenously at doses of 5 ${\mu}g$/kg (Gly-5), 10 ${\mu}g$/kg (Gly-10) or 20 ${\mu}g$/kg (Gly-20), respectively. For the control group saline was administered intravenously. In the cardiovascular system, HR, BP, RAP, PAWP, CI, SI, SVR, and PVR were measured. RR, $V_T$, $P_{ETCO2}$, and arterial blood gas analysis were measured for respiratory system. Although rapid and satisfied depth of sedation was obtained by MM, life-threatening bradycardia, the outstanding side-effect on cardiovascular system in dogs were observed. This combination also decreased CO and increased SVR, RAP, and PAWP significantly. The bradycardia could be prevented in all the glycopyrrolate treated groups, but tachycardia was observed in Gly-10 and Gly-20 groups. Significant increases in blood pressure were shown in glycopyrrolate treated groups. Also, tachycardia depends on dose of glycopyrrolate, compensating the CO. However, these were not fully reserved. In conclusion, MM combination could induce rapid and satisfied depth of sedation but was not the suitable method for the deep sedation of dogs with cardiovascular or circulatory problems.

Comparison of Electrocardiographic Time Intervals, Amplitudes and Vectors in 7 Different Athletic Groups (운동종목별(運動種目別) 선수(選手)의 심전도시간간격(心電圖時間間隔), 파고(波高) 및 벡터의 비교(比較))

  • Kwon, Ki-Young;Lee, Won-Jung;Hwang, Soo-Kwan;Choo, Young-Eun
    • The Korean Journal of Physiology
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    • v.19 no.1
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    • pp.61-72
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    • 1985
  • In order to compare the cardiac function of various groups of athletes, the resting electrocardiographic time intervals, amplitudes and vectors were analyzed in high school athletes of throwing(n=7), jumping(n=11), short track(n=8), long track(n=14), boxing(n=7), volleyball(n=8) and baseball(n=9), and nonathletic control students(n= 19). All athletic groups showed a significantly longer R-R interval(0.96-1.09 sec) than the controls (0.78 sec). Therefore, the heart rate was significantly slower in atheletes than in the control, but was not different among the different athletic groups. R-R interval is the sum of intervals of P-R, 0-T and T-P: P-R and Q-T intervals showed no difference among the control and athletic groups, but T-P interval in the jump, short track, long track and boxing groups was significantly higher than the control. R-B interval showed a significant correlation with T-P or Q-T intervals but no correlation with P-R or QRS complex. Comparing the amplitude of electrocardiographic waves, the athletic groups showed a lower trend in P wave than the controls. T wave in lead $V_5\;(Tv_5)$ was similar in the athletic and control groups. The long track group showed a significantly higher waves of $Rv_5$, $Sv_1$, and the sum of $Rv_5$ and $Sv_1$ than not only the controls but also the other athletic group. The angles of P, QRS, and T vector in the frontal and horizontal planes were not different among the control and all the athletic groups. Each athletic group stowed a lower trend in amplitude of P vector in the frontal plane, but in horizontal plane, throwing, jump, short track and baseball groups showed a significantly lower than the controls. The amplitude of QRS and T vector was similar in the athletic and control groups, but only the baseball group showed a significantly higher QRS vector in the frontal plane. In taken together, all the athletic groups showed a slower heart rate than the controls, mainly because of elongated T-P interval. Comparing the electrocardiographic waves and vector, the athletic groups showed lower amplitudes of P wave and P vector than the controls. Values of $Rv_5$ and $Sv_1$ strongly suggest that only the long distance runners among the various athletic groups developed a left ventricular hypertrophy.

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