• Journal of Chest Surgery
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• v.40 no.3 s.272
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• pp.220-224
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• 2007

Extracorporeal membrane oxygenation (ECMO) provides mechanical cardiopulmonary support and has been used for children with severe respiratory failure, intractable heart failure, sepsis, pulmonary hypertension, and as a bridge to heart transplantation. There have been few reports of the use of ECMO to provide cardiac support in children with low cardiac output as a result of arrhythmias. We report the case of a 15-year-old female with circulatory collapse due to refractory ventricular arrhythmia after one and a half repair in Ebstein's anomaly, who was successfully resuscitated using ECMO.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.16 no.9
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• pp.2021-2030
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• 2012

Premature ventricular contraction(PVC) is the most common disease among arrhythmia and it may cause serious situations such as ventricular fibrillation and ventricular tachycardia. Particularly, in the healthcare system that must continuously monitor patient's situation, it is necessary to process ECG (Electrocardiography) signal in realtime. In other words, the design of algorithm that exactly detects R wave using minimal computation and classifies PVC by analyzing the persons's physical condition and/or environment is needed. Thus, the patient adaptive pattern matching algorithm for the classification of PVC is presented in this paper. For this purpose, we detected R wave through the preprocessing method, adaptive threshold and window. Also, we applied pattern matching method to classify each patient's normal cardiac behavior through the Hash function. The performance of R wave detection and abnormal beat classification is evaluated by using MIT-BIH arrhythmia database. The achieved scores indicate the average of 99.33% in R wave detection and the rate of 0.32% in abnormal beat classification error.

• Journal of Institute of Control, Robotics and Systems
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• v.22 no.8
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• pp.585-589
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• 2016

Recently, the robotic assist system for cardiovascular intervention gets continuously growing interest. The robotic cardiovascular intervention systems are largely two folds, systems for cardiac ablation procedure assist and systems for vascular intervention assist. For the systems, the clinician controls the catheter inserted through blood vessel to the heart via a master console or master manipulator. Most of the current master manipulators have structure of joystick-like pivoting 2 degree of freedom (DOF) handle in the core, which is used in parallel with other sliding switches and input devices. It however is desirable to have customized and optimized design manipulator that can provide clinician with intuitive control of the catheter motion fully utilizing the advantage of the use of robotic structure. A 6 DOF kinematic mechanism that can capture the motion control intention of the clinician in translational 3 DOF and rotational 3 DOF is proposed in this paper. Also, a master-slave motion relationship specially designed for the cardiac catheter manipulation motion is proposed and implemented in an experimental prototype. Design revision for implementation of more efficient motion and experiment in combination with an experimental slave robot system for catheter manipulation are underway.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.18 no.7
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• pp.1531-1539
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• 2014

Premature ventricular contraction(PVC) is the most common disease among arrhythmia and it may cause serious situations such as ventricular fibrillation and ventricular tachycardia. Nevertheless personalized difference of ECG signal exist, performance degradation occurs because of carrying out diagnosis by general classification rule. In other words, the design of algorithm that exactly detects abnormal signal and classifies PVC by analyzing the persons's physical condition and/or environment and variable QRS pattern is needed. Thus, PVC classification by personalized abnormal signal detection and QRS pattern variability is presented in this paper. For this purpose, we detected R wave through the preprocessing method and subtractive operation method and selected abnormal signal sets. Also, we classified PVC in realtime through QS interval and R wave amplitude. The performance of abnormal beat detection and PVC classification is evaluated by using MIT-BIH arrhythmia database. The achieved scores indicate the average of 98.33% in abnormal beat classification error and 94.46% in PVC classification.

• Journal of the Korean Institute of Intelligent Systems
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• v.21 no.6
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• pp.730-736
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• 2011

In this paper, we designed the models for pattern classification which can reflect the latest trend in time series. It has been shown that fusion models based on statistical and AI methods are superior to traditional ones for the pattern classification model supporting decision making. Especially, the hit rates of pattern classification models combined with fuzzy theory are relatively increased. The statistical SVM models combined with fuzzy membership function, or the models combining neural network and FCM has shown good performance. BPN, PNN, FNN, FCM, SVM, FSVM, Decision Tree, Time Series Analysis, and Regression Analysis were used for pattern classification models in the experiments of this paper. The economical indices DB with time series properties of the financial market(Korea, KOSPI200 DB) and the electrocardiogram DB of arrhythmia patients in hospital emergencies(USA, MIT-BIH DB) were used for data base.

• The Transactions of The Korean Institute of Electrical Engineers
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• v.60 no.7
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• pp.1417-1426
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• 2011

Radiofrequency ablation through cardiac catheterization is one of minimally invasive intervention procedures used in drug resistant arrhythmia treatment. To facilitate more accurate and precise catheter navigation, systems for robotic cardiac catheter navigation have been developed and commercialized. The authors have been developing a novel robotic catheter navigation system. The system is a network-based master-slave configuration 3-DOF (Degree-Of-Freedom) robotic manipulator for operation with conventional cardiac ablation catheter. The catheter manipulation motion is composed of the translation (forward/backward) and the roll movements of the catheter and knob rotation for the catheter tip articulation. The master manipulator comprises an operator handle compartment for the knob and the roll movement input, and a base platform for the translation movement input. The slave manipulator implements a robotic catheter platform in which conventional cardiac catheter is mounted and the 3-DOF motions of the catheter are controlled. The system software that runs on a realtime OS based PC, implements the master-slave motion synchronization control in the robot system. The master-slave motion synchronization performance tested with step, sinusoidal and arbitrarily varying motion commands showed satisfactory results with acceptable level of steady state error. The developed system will be further improved through evaluation of safety and performance in in vitro and in vivo tests.

• The Journal of Korean Institute of Communications and Information Sciences
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• v.38B no.9
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• pp.728-735
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• 2013

In this paper, we present a method of transmitting ECG signals in real-time mobile environment to be possible to implement the ubiquitous healthcare system. Because of the excessive amount of data transmission of ECG signals, it is necessary to propose a limitation to the real-time transmission. We propose a real-time electrocardiographic monitoring system based on the proposal of unusual waveform detection algorithm which detects the R-wave distortions from the arrhythmia ECG signals having unusual waveform of about 10% on average. It is very effective in terms of time and cost for medical staffs to monitor and analyze ECG signals for a long period of time. Monitoring unusual waveform by gradually adjusting the threshold values of potential and kurtosis makes the amount of data transmitted decrease and significance level of waveform to be enhanced. The unusual waveform detection algorithm is implemented with ubiquitous environment inter-working device client. It is applicable to ubiquitous healthcare system capable of real-time monitoring the ECG signal. While ensuring the mobility, it allows for real-time continuous monitoring of ECG signals.

• Journal of Chest Surgery
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• v.44 no.1
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• pp.18-24
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• 2011

Background: We evaluated the efficacy of Cox-maze IV procedure using bipolar irrigated radiofrequency ablation and cryothermy in chronic atrial fibrillation associated with valvular heart disease. Material and Methods: From November 2005 to June 2009, ninety four patients have undergone valvular heart surgery with Cox-maze IV procedure. Preoperative duration of atrial fibrillation was $7.6{\pm}6.5$ years and follow-up duration was $22.7{\pm}12.3$ months. Results: There were two (2.1%) postoperative deaths not related to maze procedure. Two cerebrovascular accidents, five low cardiac output syndromes and two permanent pacemaker implantations have occurred after surgery. Preoperative ejection fraction on echocardiography was $55.3{\pm}8.1%$ and ejection fraction of postoperative six month was $54.7{\pm}6.5%$. Left atrial size of preoperative and postoperative were $61.5{\pm}11.6\;mm$ and $53.1{\pm}8.4\;mm$ at each. Freedom from atrial fibrillation rate at postoperative six-month was 80.7% and the cases of recurrence of atrial fibrillation after six months were three (3.3%). Risk factors for failure or recurrence of maze procedure were old age (p=.010) and preoperative moderate or severe tricuspid regurgitation (p=.033). Conclusion: The Cox-maze IV procedure using RFBP2 and cryothermy is quite safe and freedom from atrial fibrillation at postoperative 6 month was 82.5%. Risk factors for failure or recurrence of atrial fibrillation after Cox-maze IV were old age and preoperative over moderate tricuspid regurgitation.

• Journal of Physiology & Pathology in Korean Medicine
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• v.29 no.1
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• pp.1-10
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• 2015

This article is a study on palpitation of which disease cause, disease mechanism and formulas were analyzed with reference to annotations on "Shanghanlun" and "Jinkuiyaolue". And the scope of modern diseases related with palpitation was drawn by research on clinical papers. The source books are "Zhujieshanghanlun" and "Jinkuiyaoluefanglun" and the clinical papers are searched in China Academic Journals(CAJ) of China National Knowledge Infrastructure(CNKI). 13 clauses in "Shanghanlun" and 9 clauses in "Jinkuiyaolue" and 12 formulas are related with palpitation. Disease mechanisms of palpitation were classified as yang deficiency, yin deficiency, qi deficiency, blood deficiency, retained fluid, cold, etc and these days, qi stagnation, phlegm turbidity, blood stasis and fire heat are also considered as disease mechanisms. Modern diseases related with palpitation are arrhythmia(extrasystole, atrial fibrillation, bradycardia, tachycardia, sick sinus syndrome, atrioventricular block), vascular diseases(arterial occlusion, phlebothrombosis, Buerger's disease, coronary artery disease, vasculitis), blood pressure disorder(hypertension, hypotension) and heart diseases such as heart failure, angina pectoris, myocardial infarction, myocarditis, cardiomyopathy, pericardial effusion. And diseases related with psychological change(cardiac neurosis, anxiety neurosis, neurosis, depression, hyperthyroidism, hypothyroidism), pyrexia, anemia, drug intoxication, etc are also related with palpitation. Zhen Wu Tang showing an efficacy in dilating blood vessels and strengthening cardiac function, Wuling Powder with diuretic effect and Fried Glycyrrhizae Decoction acting on the ${\beta}$ receptor are applied to heart failure in different ways. Fried Glycyrrhizae Decoction(308 cases), Zhen Wu Tang(154), Wuling Powder(54), Xiao Chaihu Tang(34), Sini San(20) are reported to have been clinically applied to cardiovascular diseases and Zhen Wu Tang and Wuling Powder mainly applied to heart failure, Fried Glycyrrhizae Decoction, Lizhong Wan, Sini San and Zhen Wu Tang chiefly applied to arrhythmia related diseases. This study focuses on the general research and consideration on clinical applications and is a preliminary study to understand relations between Korean Medicine's symptoms and categories of modern diseases.

• International Journal of Arrhythmia
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• 제18권2호
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• pp.66-76
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• 2017

Background and Objectives: Although an anterior linear ablation is an effective lesion set in radiofrequency catheter ablation (RFCA) for longstanding persistent atrial fibrillation (L-PeAF), its durability for bidirectional block (BDB) is only about 60% at repeat procedure. We hypothesized that changes in electrocardiogram (ECG) may predict an anterior line block state and the clinical outcome of L-PeAF ablation. Subjects and Methods: We studied 304 L-PeAF patients (77% male, $60{\pm}10yrs$), who consistently underwent RFCA Dallas lesion set (circumferential pulmonary vein isolation, posterior box lesion, and anterior line) protocol with subsequent comparison of pre-procedural and post-procedural P wave axes, and one year follow-up (n=205) sinus rhythm (SR) ECGs. Results: 1. P wave axis shifted inferiorly at immediate post-procedure (p<0.001), and was independently correlated with BDB of anterior line (${\ss}=10.4$, 95% confidence interval [CI] 2.79-17.94, p=0.008). 2. The degree of post-procedural inferior shift of P wave axis did not reflect clinical recurrence within one-year (n=205, p=0.923), potentially due to conduction recovery of an anterior line. However, among 160 patients without clinical recurrence within one-year, P wave axis at one-year ECG was independently associated with very late recurrence of AF after one-year (n=160, hazard ratio [HR] 0.98; 95% CI 0.97-0.99, p=0.001), during $45.6{\pm}16.7$ months of follow-up. 3. Among 22 patients who underwent repeat procedures, P wave axis shift was more significant in patients with maintained BDB of an anterior line than in those without (p=0.015). Conclusion: An inferior shift of P wave axis reflects the achievement and the maintenance of an anterior line BDB, and is associated with better long-term clinical outcome after catheter ablation for L-PeAF based on Dallas lesion set.