• Title/Summary/Keyword: 심방성 부정맥

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P Wave Detection Algorithm through Adaptive Threshold and QRS Peak Variability (적응형 문턱치와 QRS피크 변화에 따른 P파 검출 알고리즘)

  • Cho, Ik-sung;Kim, Joo-Man;Lee, Wan-Jik;Kwon, Hyeog-soong
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.20 no.8
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    • pp.1587-1595
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    • 2016
  • P wave is cardiac parameters that represent the electrical and physiological characteristics, it is very important to diagnose atrial arrhythmia. However, It is very difficult to detect because of the small size compared to R wave and the various morphology. Several methods for detecting P wave has been proposed, such as frequency analysis and non-linear approach. However, in the case of conduction abnormality such as AV block or atrial arrhythmia, detection accuracy is at the lower level. We propose P wave detection algorithm through adaptive threshold and QRS peak variability. For this purpose, we detected Q, R, S wave from noise-free ECG signal through the preprocessing method. And then we classified three pattern of P wave by peak variability and detected adaptive window and threshold. The performance of P wave detection is evaluated by using 48 record of MIT-BIH arrhythmia database. The achieved scores indicate the average detection rate of 92.60%.

A Study of the Atrial Arrhythmia Diagnosis Algorithm (심방성 부정맥 진단 알고리즘에 관한 연구)

  • 황선철
    • Journal of Biomedical Engineering Research
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    • v.10 no.1
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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.

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Fontan Conversion with Arrhythmia Surgery in a Jehovah′s Witnesses (여호와의 증인 환자의 폰탄전환술 및 부정맥수술)

  • Ryu, Jae-Wook;Kim, Woong-Han;Na, Chan-Young;Oh, Sam-Se;Kim, Soo-Cheol;Lim, Cheong;Baek, Man-Jong;Jong, Joon-Hyuk;Lee, Jae-Young;Park, Young-Kwan;Kim, Chong-Hwan
    • Journal of Chest Surgery
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    • v.35 no.1
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    • pp.48-51
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    • 2002
  • The conversion of failing Fontan circuit to total cavopulmonary connection(TCPC) is recommended as a therapeutic option in patients with late Fontan complications such as atrial arrhythmia, atrial enlargement, pulmonary venous obstruction, and ventricular dysfunction. Combined TCPC with extracardiac conduit and cryoablation of arrhythmia circuit is preferred for treatment of failing Fontan coulection with atrial lachyarrhythrnia. We report a case of conversion of atriopulmonary connection to extracardiac conduit Fontan and cryoablation of atrial arrhythmia circuit in a patient with tricuspid atresia, who also had ectopic atrial tachycardia, right atrial thrombi, pulmonary venous obstruction, and ventricular dysfunction. This patient and the parents were Jehovah's Witnesses; therefore, the patient underwent the procedure without blood transfusion.

Long term prognosis of patients who had a Fontan operation (폰탄 수술을 받은 환아들의 장기적 예후)

  • Kim, Hyun-Jung;Bae, Eun-Jung;Noh, Jung-Il;Choi, Jung-Yun;Yun, Yong-Su;Kim, Wong-Hwan;Lee, Jung-Yeul;Kim, Yong-Jin
    • Clinical and Experimental Pediatrics
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    • v.50 no.1
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    • pp.40-46
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    • 2007
  • Purpose : This study assessed the long term survival rate and long term complications of patients who had a modified Fontan operation for functionally univentricular cardiac anomaly. Methods : Between June 1986 and December 2000, 302 patients with a functional single ventricle underwent surgical interventions and were followed up until February 2006. The mean follow-up period was $8.3{\pm}5.3years$ (range 3.5-18 years). Their median age was 2.4 years at the Fontan operation. The survival rate, the incidence and the risk factor of late complications were evaluated retrospectively. Results : The verall survival rate was 91 percent at 5 years and 87 percent at 10 years. In multivariate analysis, early calendar year of operation and significant regurgitation were risk factors of death. The surviving patients showed NYHA functional class I in 82 percent, class II in 15 percent, and class III in 3 percent. Redo Fontan operations were necessary in 8.8 percent of patients at average $12.8{\pm}3.6years$ after initial Fontan operation. The most common cause of Fontan conversion was atrial arrhythmia. The incidence of thromboembolic events was 9.3% and these complications were associated with the occurrence of atrial tachyarrhythmia. Supraventricular tachycardia including atrial flutter or fibrillation were reported on the follow-up examination by 11.2 percent of survivors after $8.4{\pm}5.6years$. Atriopulmonary connection showed higher rates of late tachycardia than lateral tunnel operation. Conclusions : This study revealed that the recent survival rate of Fontan type operation was satisfactory, but the occurrence of late complications after a Fontan type operation increased with the longer survival. There is a need for strict follow up and early treatment of late complications in patients who had a Fontan operation.

Surgical Outcome of Tetralogy of Fallot in Adolt -Implication of Preoperative Cyanosis- (수술 전 청색증 정도에 따른 성인 활로씨 4징증의 임상 양상)

  • Kim Sang-hwa;Park Soon-Ik;Park Jung-Jun;Song Hyun;Lee Jae-Won;Seo Dong-Man;Song Meong-Gun;Song Jong-Min;Kang Duck-Hyun;Song Jae-Kwan;Jang Wan-Sook;Kim Young-Hwue;Yun Tae-Jin
    • Journal of Chest Surgery
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    • v.38 no.4 s.249
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    • pp.271-276
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    • 2005
  • We analysed differences in operative methods and postoperative outcome according to the severity of preoperative cyanosis in adult ToF (Tetralogy of Fallot) patients. Material and Method: From August 1989 to June 2001, thirty three adult patients, 18 females and 15 males, underwent total correction for ToF. Their age ranged from 15 years to 54 years (median: 34). Patients were divided into 2 groups by preoperative $SaO_2$ (arterial oxygen saturation): group I$(n=cyanotic,\;SaO_2\;\geq94\%)$ and group II $(acyanotic,\; SaO_2\geq95%)$. Preoperative median hemoglobin level was higher in group I compared to group II (17.5 g/dl vs 15 g/dl). Postoperative follow-up duration ranged from 1 to 94 months (670 patient-month, median: 14 months), and 63 two-dimensional echocardiographic examinations were done during this period. Result: There were no early or late mortality. With regard to RVOT (right ventricular outflow tract) reconstruction, trans-annular patch and RV-PA extracardiac conduit were used in 7 and 3 patients respectively, and all of them belonged to group I. In group I, cardiopulmonary bypass time, aortic cross-clamping time, ICU day, hospital day were significantly longer than in group II, and postoperative inotropic support was significantly greater than in group II. There was no ventricular arrhythmia in both groups, and one patient in group I suffered from atrial arrhythmia, which was resolved spontaneously after tricuspid and pulmonary valve replacement. During follow-up periods, functional class, residual RVOT stenosis and pulmonary regurgitation, tricuspid regurgitation, occurrence of ventricular and atrial arrhythmias were comparable between two groups. Conclusion: In adult ToF patients with severe preoperative cyanosis, more aggressive RVOT reconstruction and careful postoperative care are mandatory. However intermediate-term outcome of this group of patients is comparable to the patients with minimal or no preoperative cyanosis.

Detection of Rapid Atrial Arrhythmias in SQUID Magnetocardiography (스퀴드 심자도 장치를 이용한 심방성 부정맥의 측정)

  • Kim Kiwoong;Kwon Hyukchan;Kim Ki-Dam;Lee Yong-Ho;Kim Jin-Mok;Kim In-Seon;Lim Hyun-Kyoon;Park Yong-Ki;Kim Doo-Sang;Lim Seung-Pyung
    • Progress in Superconductivity
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    • v.7 no.1
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    • pp.28-35
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    • 2005
  • We propose a method to measure atrial arrhythmias (AA) such as atrial fibrillation (Afb) and atrial flutter (Afl) with a SQUID magnetocardiograph (MCG) system. To detect AA is one of challenging topics in MCG. As the AA generally have irregular rhythm and atrio-ventricular conduction, the MCG signal cannot be improved by QRS averaging; therefore a SQUID MCG system having a high SNR is required to measure informative atrial excitation with a single scan. In the case of Afb, diminished f waves are much smaller than normal P waves because the sources are usually located on the posterior wall of the heart. In this study, we utilize an MCG system measuring tangential field components, which is known to be more sensitive to a deeper current source. The average noise spectral density of the whole system in a magnetic shielded room was $10\;fT/{\surd}Hz(a)\;1\;Hz\;and\;5\;fT/{\surd}Hz\;(a)\;100\;Hz$. We measured the MCG signals of patients with chronic Afb and Afl. Before the AA measurement, the comparison between the measurements in supine and prone positions for P waves has been conducted and the experiment gave a result that the supine position is more suitable to measure the atrial excitation. Therefore, the AA was measured in subject's supine position. Clinical potential of AA measurement in MCG is to find an aspect of a reentry circuit and to localize the abnormal stimulation noninvasively. To give useful information about the abnormal excitation, we have developed a method, separative synthetic aperture magnetometry (sSAM). The basic idea of sSAM is to visualize current source distribution corresponding to the atrial excitation, which are separated from the ventricular excitation and the Gaussian sensor noises. By using sSAM, we localized the source of an Afl successfully.

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