• Title/Summary/Keyword: ARRHYTHMIA

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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.

Clinical Usefulness of Digital ECG Recorder in Dogs : 4 Cases (디지털 심전도기의 임상적 적용 예 : 4 증례)

  • Moon, Hyeong-Sun;Lee, Seung-Gon;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.24 no.2
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    • pp.218-224
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    • 2007
  • Digital electrocardiogram (ECG) recorders are rapidly replacing to conventional paper ECG recorders. Digital ECG recorders have several advantages over conventional type ECG recorders, including better capability for data storage, better portability and better applicability in clinical settings. In this study, we presented 4 case studies related to cardiac rhythm disturbances, which were diagnosed and managed using a digital ECG recorder.

Idiopathic Atrial Standstill in an Old English Sheepdog Cross Dog (Old English Sheepdog Cross Dog에서의 특발성 심방정지)

  • Suh, Sang-il;Choi, Ran;Hyun, Changbaig
    • Journal of Veterinary Clinics
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    • v.32 no.4
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    • pp.330-333
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    • 2015
  • An 1 year old intact male mixed dog (weighing 20 kg) was presented with primary complaints of abdominal distension and severe exercise intolerance. Electrocardiogram found profound bradycardia (46-79 beats/min) with atrial standstill. Laboratory studies found no particular abnormalities. Serum cortisol and T4 concentration were within normal range. Diagnostic imaging studies revealed generalized cardiomegaly, ascites, dilation in all cardiac chambers, absence of atrial contraction, absence of transmitral A-peak, mitral and tricuspid valve insufficiency and normal left ventricular systolic dimension. Based on diagnostic findings, the case was diagnosed as idiopathic atrial standstill. The dog was treated with conventional therapy for heart failure.

Case report : Administration of amiodarone for polymorphic ventricular tachycardia due to long QT syndrome during out-of-hospital advanced cardiac life support (병원 밖 전문 심장소생술에서 긴QT증후군에 의한 Polymorphic Ventricular Tachycardia에 아미오다론이 투여된 1예)

  • Kang, Min Seong;Kim, Ji-Won
    • The Korean Journal of Emergency Medical Services
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    • v.24 no.3
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    • pp.155-160
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    • 2020
  • Torsades de pointes refers to polymorphic ventricular tachycardia (PMVT), which is caused by the suppression of potassium channels owing to genetic and electrolytic abnormalities, resulting in the extension of the QT interval. Symptoms range from spontaneous circulation recovery to fainting and sudden death. Defibrillation, magnesium correction, and the use of lidocaine as an antiarrhythmic agent are recommended as treatments for persistent torsades de pointes. Currently, only amiodarone is available in the ambulance; however, torsades de pointes does not respond efficiently to amiodarone because it suppresses potassium channels and increases the refractory period of the myocardium. Lidocaine, in contrast, reduces the relative refractory period of the myocardium caused by suppressing sodium channels; thus, it inhibits the occurrence of and treats arrhythmia. In cases where PMVT did not respond to defibrillation, the administration of lidocaine showed no difference in survival and discharge rates compared to amiodarone. Thus, ambulances must be equipped with provisions to administer lidocaine.

Severe Case of Hypermagnesemia Caused by Ingesting Magnesium Containing Fertilizer (마그네슘 포함 비료 음독 후 발생한 중증의 고마그네슐혈증의 1례)

  • Lee, Ka-young;Yu, Jin-young;Cho, Nam-Jun;Park, Samel;Lee, Eun-young;Gil, Hyo-Wook
    • Journal of The Korean Society of Clinical Toxicology
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    • v.18 no.2
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    • pp.141-144
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    • 2020
  • Hypermagnesemia is a rare condition that is usually iatrogenic in patients with elderly or renal failure. Severe hypermagnesemia is uncommon in patients with a normal renal function. Symptoms due to hypermagnesemia can range from mild symptoms, such as nausea, to severe symptoms, such as cardiac and respiratory arrest. This paper describes a case of a 49-year-old woman who ingested a magnesium-containing fertilizer with normal renal function. Cardiac arrest occurred eight hours after poisoning. Electrocardiography changed from a narrow QRS to a wide QRS and then to a complete atrioventricular block. Her hemodynamic state was unstable. Continuous renal replacement therapy was performed to remove magnesium from the blood, with the subsequent resolution of arrhythmia and hemodynamic stabilization. This paper reviews the pathophysiologic effects of magnesium on the cardiovascular system, clinical manifestation, and treatment of hypermagnesemia.

Case Report: Cardiac tamponade in a patient with isolated posterior myocardial infarction presenting with syncope (실신으로 내원한 후벽 단독 심근경색 환자에서 발생한 심장눌림증 1례)

  • Kang, Min Seong;Oh, Seong Beom;Kim, Ji-Won
    • The Korean Journal of Emergency Medical Services
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    • v.25 no.1
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    • pp.235-241
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    • 2021
  • Cardiogenic syncope occurs due to arrhythmia (bradycardia and tachycardia) or decreased cardiac output, and if proper treatment is not provided, it can lead to acute sudden death. A detailed medical history and physical examinations are required to determine the cause of syncope, and clinical approaches, including 12-lead ECG, are important. The 12-lead ECG does not have a chest lead in the posterior wall of the left ventricle; therefore, ECG of the isolated posterior wall myocardial infarction caused by left circumflex artery occlusion is not observed with ST elevation. Therefore, the significantly higher appearance of ST depression and R waves than S waves from V1 to V3 of the chest lead must be interpreted meaningfully. Isolated posterior wall myocardial infarction is small in the area of myocardial necrosis, and tension is increased in the necrotic area due to the contraction of the normal myocardial muscle, which can cause ventricular wall rupture. Therefore, it is necessary to additionally check Beck's triad, such as jugular venous distension and decreased heart sound, in patients with low blood pressure with an isolated posterior wall myocardial infarction on 12-lead ECG in patients with syncope.

A Study on Finding Emergency Conditions for Automatic Authentication Applying Big Data Processing and AI Mechanism on Medical Information Platform

  • Ham, Gyu-Sung;Kang, Mingoo;Joo, Su-Chong
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.16 no.8
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    • pp.2772-2786
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    • 2022
  • We had researched an automatic authentication-supported medical information platform[6]. The proposed automatic authentication consists of user authentication and mobile terminal authentication, and the authentications are performed simultaneously in patients' emergency conditions. In this paper, we studied on finding emergency conditions for the automatic authentication by applying big data processing and AI mechanism on the extended medical information platform with an added edge computing system. We used big data processing, SVM, and 1-Dimension CNN of AI mechanism to find emergency conditions as authentication means considering patients' underlying diseases such as hypertension, diabetes mellitus, and arrhythmia. To quickly determine a patient's emergency conditions, we placed edge computing at the end of the platform. The medical information server derives patients' emergency conditions decision values using big data processing and AI mechanism and transmits the values to an edge node. If the edge node determines the patient emergency conditions, the edge node notifies the emergency conditions to the medical information server. The medical server transmits an emergency message to the patient's charge medical staff. The medical staff performs the automatic authentication using a mobile terminal. After the automatic authentication is completed, the medical staff can access the patient's upper medical information that was not seen in the normal condition.