• Title/Summary/Keyword: ARRHYTHMIA

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Cardiometabolic Effects of Obstructive Sleep Apnea and Treatment Effects of Oral Appliance: An Updated Review for Dentists

  • Kim, Hye-Kyoung;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.43 no.3
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    • pp.61-69
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    • 2018
  • Obstructive sleep apnea (OSA) is a relatively common, but greatly underdiagnosed sleep-related breathing disorder, characterized by recurrent collapse of the upper airway during sleep. OSA has been associated with a variety of cardiometabolic disease, such as hypertension, coronary artery disease, cardiac arrhythmia, cerebrovascular disease and metabolic dysfunction. Neurocognitive impairment, including excessive daytime sleepiness, increased risk of motor vehicle accidents, is also related to OSA. Sleep fragmentation and related arousals during sleep lead to intermittent hypoxia, sympathetic activation, oxidative stress, systemic inflammation and metabolic dysregulation which provide biological plausibility to this pathologic mechanism. Extensive studies demonstrated that OSA is a modifiable risk factor for the above mentioned diseases and oral appliances (OAs), although continuous positive air pressure (CPAP) is a first-line therapy of OSA, are not inferior to CPAP at least in mild OSA, and may be an alternative to CPAP in CPAP-intolerant subjects with OSA. The goal of this article is to provide a current knowledge of pathologic link between OSA and cardiovascular disease, focusing on intermittent hypoxia, sympathetic activation, oxidative stress and metabolic dysregulation. Then, previous epidemiologic studies will be reviewed to understand the causal relationship between OSA and cardiovascular disease. Finally, the effects of OAs will be updated via recent metaanalyses compared to CPAP.

Curvature Based ECG Signal Compression for Effective Communication on WPAN

  • Kim, Tae-Hun;Kim, Se-Yun;Kim, Jeong-Hong;Yun, Byoung-Ju;Park, Kil-Houm
    • Journal of Communications and Networks
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    • v.14 no.1
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    • pp.21-26
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    • 2012
  • As electrocardiogram (ECG) signals are generally sampled with a frequency of over 200 Hz, a method to compress diagnostic information without losing data is required to store and transmit them efficiently on a wireless personal area network (WPAN). In this paper, an ECG signal compression method for communications onWPAN, which uses feature points based on curvature, is proposed. The feature points of P, Q, R, S, and T waves, which are critical components of the ECG signal, have large curvature values compared to other vertexes. Thus, these vertexes were extracted with the proposed method, which uses local extrema of curvatures. Furthermore, in order to minimize reconstruction errors of the ECG signal, extra vertexes were added according to the iterative vertex selectionmethod. Through the experimental results on the ECG signals from Massachusetts Institute of Technology-Beth Israel hospital arrhythmia database, it was concluded that the vertexes selected by the proposed method preserved all feature points of the ECG signals. In addition, it was more efficient than the amplitude zone time epoch coding method.

Clinical characteristics and treatment plan for patients with snoring and obstructive sleep apnea (코골이와 수면무호흡증 환자의 임상적 특징과 치료계획)

  • Jung, Jae-Kwang;Kim, Ki-Rim;Byun, Jin-Seok;Choi, Jae-Kap
    • The Journal of the Korean dental association
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    • v.53 no.4
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    • pp.249-258
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    • 2015
  • Snoring and obstructive sleep apnea are the representative sleep disordered breathings, caused by the temporary and repetitive constriction or obstruction of upper airway during sleep. They present with excessively vibratory noise and repetitive cease of respiration. These disorders commonly result in sleep disturbance and the subsequent daytime sleepiness, chronic fatigue. Furthermore, they can cause the serious and extensive complications including increased risk of hypertension, cardiac arrhythmia, cardiovascular disease, cerebrovascular accident, neurocognitive disturbance, traffic and occupational accidents, type II diabetes, childhood growth interruption, awakening headache and finally, relatively increased mortality rate. Because appropriate therapeutic intervention is best way for patients to relieve their symptoms and prevent their possible complications, it is very important for dentists to recognize their own role and responsibility in diagnosis and treatment of these disorders. For this, the present article provides the understanding of the clinical features, possible complications, various treatment modalities, and suitable treatment strategies for snoring and obstructive sleep apnea.

The diagnosis of sleep related breathing disorders and polysomnography (수면호흡장애의 진단과 수면다원검사)

  • Park, Ji Woon
    • The Journal of the Korean dental association
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    • v.53 no.4
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    • pp.238-248
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    • 2015
  • Sleep related breathing disorders(SRBDs) are a group of diseases accompanied by difficulties in respiration and ventilation during sleep. Central sleep apnea, obstructive sleep apnea(OSA), sleep-related hypoventilation, and hypoxemia disorder are included in this disease entity. OSA is known to be the most common SRBDs and studies show its significant correlation with general health problems including hypertension, arrhythmia, diabetes, and metabolic syndrome. The diagnostic process of OSA is composed of physical examinations of the head and neck area and also the oral cavity. Radiologic studies including cephalography, CT, MRI, and fluoroscopy assist in identifying the site of obstruction. However, polysomnography(PSG) is still considered the gold standard for the diagnosis of OSA since it offers both qualitative and quantitative recording of the events during a whole night's sleep. The dentist who is trained in sleep medicine can easily identify patients with the risk of OSA starting from simple questions and screening questionnaires. Diagnosis is the first step to treatment and considering the high rate of under-diagnosis for OSA the dentist may play a substantial role in the diagnosis and treatment of OSA which will eventually lead to the well-being of the patient as a whole person. So the objective of this article is to assist dental professionals in gaining knowledge and insight of the diagnostic measures for OSA including PSG.

Characterization of Premature Ventricular Contraction by K-Means Clustering Learning Algorithm with Mean-Reverting Heart Rate Variability Analysis (평균회귀 심박변이도의 K-평균 군집화 학습을 통한 심실조기수축 부정맥 신호의 특성분석)

  • Kim, Jeong-Hwan;Kim, Dong-Jun;Lee, Jeong-Whan;Kim, Kyeong-Seop
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.66 no.7
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    • pp.1072-1077
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    • 2017
  • Mean-reverting analysis refers to a way of estimating the underlining tendency after new data has evoked the variation in the equilibrium state. In this paper, we propose a new method to interpret the specular portraits of Premature Ventricular Contraction(PVC) arrhythmia by applying K-means unsupervised learning algorithm on electrocardiogram(ECG) data. Aiming at this purpose, we applied a mean-reverting model to analyse Heart Rate Variability(HRV) in terms of the modified poincare plot by considering PVC rhythm as the component of disrupting the homeostasis state. Based on our experimental tests on MIT-BIH ECG database, we can find the fact that the specular patterns portraited by K-means clustering on mean-reverting HRV data can be more clearly visible and the Euclidean metric can be used to identify the discrepancy between the normal sinus rhythm and PVC beats by the relative distance among cluster-centroids.

Congenital Heart Disease in the Adult - 122 Cases Analysis - (성인의 선천성 심질환;122례 분석)

  • 정신현
    • Journal of Chest Surgery
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    • v.25 no.7
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    • pp.769-776
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    • 1992
  • Total 632 cases of open heart surgery were performed in the department of thoracic and cardiovascular surgery, Pusan Paik Hospital, Inje University from october 1985 to december 1990. Among them, there were 503 cases of congenital heart disease and 129 cases of acquired heart disease. In the cases of 503 congenital heart disease surgically corrected, 122 cases over 15 years of age were reviewed and its results were summarized as follows ; l. In total 122 cases 65 were male and 52 female. 2. There were 54 patients under 20 years of age, 31 between 20 & 24 years, 20 between 25 & 29 and 17 over 30 years of age. The eldest was a 46-year-old female of atrial septal defect group. 3. There were 63 cases of VSD[51.7%], 38 of ASD[31.2%], 11 cases of TOF[9%] and so on. 4. In recovery cases, main post-operative complications were as follows; cardiac tamponade, arrhythmia, low cardiac output syndrome, pulmonary, edema pericarditis, mediastinitis, sepsis and DIC. 5. There were 3 cases of post-operative death in this series, so operative mortality rate was 2.5% compairing with 1.8% of pediatric cases below 15 years of age. 6. This reviewed series reveal that aggressive surgical approach in adult congenital heart disease can be justified with low operative mortality like as pediatric age group.

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Intrapericardial Implantation of an Implantable Cardioverter-Defibrillator in a Child

  • Seong, Yong-Won;Kim, Woong-Han;Yoo, Jae-Suk;Kim, Hye-Seon;Min, Byoung-Ju;Lee, Young-Ok
    • Journal of Chest Surgery
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    • v.44 no.1
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    • pp.61-63
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    • 2011
  • Implantable cardioverter defibrillator (ICD) can be a crucial therapeutic modality for pediatric patients with congenital heart disease, Brugada syndrome, long QT syndrome and cardiomyopathy. Because transvenous implantation of ICD is mostly unfeasible for pediatric patients due to anatomical and technical limitations, epicardial patch type or subcutaneous type ICD have been used. Implantation of these alternative ICDs, however, was reported to be frequently associated with significant complications. We report a case of successful intrapericardial implantation of a single coil-type ICD through the transverse sinus in a 27 month-old child weighing lesser than 10 kg, and it was inferred from this experience that this alternative technique may decrease complications and morbidities after ICD implantation in children.

Low Cardiac Output Syndrome Caused by a Coronary Artery Spasm following CABG (관상동맥 우회술 직후에 발생한 자가 혈관의 연축에 의한 저심박출)

  • Kim, Young-Hak;Chung, Yoon-Sang;Kang, Jeong-Ho;Chung, Won-Sang;Shinn, Sung-Ho;Kim, Hyuck
    • Journal of Chest Surgery
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    • v.40 no.9
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    • pp.633-636
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    • 2007
  • Coronary artery spasm immediately after the coronary artery bypass graft (CABG) surgery is rare but it can cause sudden and severe hypotension or a ventricular arrhythmia. We report a case of low cardiac output syndrome caused by a right coronary artery spasm following CABG that did not show any significant stenotic lesions on preoperative coronary angiography.

Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery in Adulthood: Challenges and Outcomes

  • Kothari, Jignesh;Lakhia, Ketav;Solanki, Parth;Parmar, Divyakant;Boraniya, Hiren;Patel, Sanjay
    • Journal of Chest Surgery
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    • v.49 no.5
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    • pp.383-386
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    • 2016
  • Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is an extremely rare, potentially fatal, congenital anomaly with a high mortality rate in the first year of life. It occurs rarely in adulthood and may appear with malignant ventricular arrhythmia or sudden death. We report a case of a 49-year-old woman with ALCAPA who presented with dyspnea on exertion. Management was coronary artery bypass grafting to the left anterior descending artery and obtuse marginal arteries, closure of the left main coronary artery ostium, and reestablishment of the dual coronary artery system.