• 한국지능시스템학회논문지
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• 제23권4호
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• pp.292-297
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• 2013

본 논문에서는 불응기(Refractory Period)에 기반한 부정맥 심전도 신호의 특이 파형 검출 알고리즘을 제안한다. 부정맥 심전도 신호는 대부분 평균 10% 정도의 특이 파형을 갖는다. 따라서 장시간 심전도 신호를 관찰 및 분석해야 하는 의료진에게 심전도 신호 샘플의 90%이상이 축소된 특이 파형만을 제공함으로써 시간과 비용 측면에서 매우 큰 효과를 볼 수 있다. 제안 알고리즘은 R-파의 특징과 가변 불응기를 이용하여 R-peak를 검출한다. 검출된 R-peak에 대해 특이 파형에 포함되지 않은 R-peak들의 전위 및 첨도의 평균과 표준편차를 이용하여 특이 파형을 검출한다. 제안한 알고리즘을 MIT-BIH 부정맥 데이터베이스의 모든 레코드에 적용한 결과 평균 90% 이상의 압축률을 보였다.

• 한국임상수의학회지
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• 제18권4호
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• pp.402-410
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• 2001

This study was performed to investigate the hemodynamic changes which occur after occlusion of coronary artery and relation to reperfusion arrhythmias(RA) which occur when occlusion materials were removed form coronary artery in dogs. The occlusion of coronary artery was designed by temporary ligation of left circumflex branch of coronary artery during 30 minutes in 16 dogs. During occlusion of coronary artery, cardiac output(CO), mean aortic pressure (mAP), aortic systolic pressure(ASP), aortic diastolic pressure(ADP). left ventricular systolic pressure(LVSP), left ventricular maximum dp/dt (LV max. dp/dt) and left ventricular end-diastolic pressure (LVEDP) were measured. The occurrence of RA were observed for 5 minute after reperfusion by explained of ligation. As a results, cardiac arrest occurred in 4 dogs during occlusion of coronary artery, and RA was not observed in 5 dogs while it was seen in 5 dogs when explained ligation(reperfusion) after 30 minutes, the rest 2 dogs occurred temporary tachycardia. In hemodynamics changes, LVSP decreased by 10.9% and LV max. dp/dt by 5.4 % in comparison to control value which not ligated coronary artery, and LVEDP increased by 73.3%. The CO/min and mAP also decreased by 10.7% and by 11.3% expectedly. In the relationship to occurrence RA and hemodynamics changes, the LVSP and LV max. dp/dt at the time of occlusion in the RA group decreased by 11.9% and 0.8% in comarison to the control value while the decrease was 7.7% and 10% in the non-RA group. But the LVEDP in creased by 109.1% in the RA group while the decreased was 44.6% in the non-RA group. Referring CO/min, the drop was 8.8% in the RA occurrence group and 12.9% in the non-occurence group. These parameters of LVEDP, LV max. dp/dt, and CO were significant difference(p<0.05). The mAP also decreased by 11.9 in the RA group and by 9.8% in the non-RA group, but these defference were not the significant difference.

• 한국정보통신학회논문지
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• 제20권2호
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• pp.437-444
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• 2016

일반적인 부정맥 분류 방법의 경우 심방 박동 수와 관련한 PP간격, P모양의 다양성과 같은 조건을 이용하는데, 잡음으로 인해 정확한 P파의 검출이 어렵기 때문에 잡음의 영향을 비교적 적게 받는 R파를 이용하는 것이 유리하다. 따라서 본 연구에서는 R파 중심의 ECG(electrocardiography) 패턴 분석과 템플릿 문턱치를 도입하여 조기수축 부정맥 분류 방법을 제안한다. 이를 위해 형태 연산을 통한 전 처리 과정과 차감 동작 기법을 통해 R파를 검출하였다. 이후 RR 간격의 평균 가중치와 변화율을 이용하여 먼저 조기수축 파형의 패턴을 분류하고, R파의 진폭에 대한 템플릿 문턱값을 통해 조기심실수축과 조기심방수축을 분류하는 알고리즘을 개발하였다. 제안한 방법의 우수성을 입증하기 위해 조기 심방과 심실수축이 30개 이상 포함된 MIT-BIH 6개의 레코드를 대상으로 한 R파의 평균 검출율은 99.77%의 성능을 나타내었고, 조기심실수축과 심방수축 부정맥은 각각 94.91%와 95.76%의 평균 분류율을 나타내었다.

• 대한한의학회지
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• 제40권3호
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• pp.99-111
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• 2019

Objectives: The purpose of this study was to assess the effects of moxibustion treatment for Cardiac arrhythmia through a systematic review. Methods: Electronic database including Cochrane library, Pubmed, China National Knowledge Infrastructure, Embase, DBpia, and Korean studies Information Service System were searched by combining the keywords such as "arrhythmias", "cardiac arrhythmias", "心律失常", "moxibustion" and "艾灸". Through the searching, 5 randomized controlled trials(RCTs) were included except animal testing and cellular experiment etc. The quality of each RCTs was assessed using the Cochrane risk of bias tool. Results: We included 5RCTs involving 468 participants. Two RCTs compared moxibustion versus conventional treatment, another RCT compared moxibustion plus acupuncture versus conventional treatment, another RCT compared moxibustion plus herbal medicine verus conventional treatment, the other RCT compared moxibustion plus herbal medicine and ointment versus conventional treatment. These studies were evaluated by the efficacy rate of treatments. Studies measured outcomes in efficacy, heart rate, electrocardiogram and symptoms. Each of 5 trials statistically showed a significant differences in efficacy rate. One study reported about side effects and another study reported about complications. The overall risk of bias was unclear in 5 studies. Conclusions: The evidence suggests that moxibustion treatment may help to reduce cardiac arrhythmia, however, it is limited, low-certainty and we cannot rule out benefits or risks with this treatment. High-quality studies that report adverse effects are needed.

• Journal of Chest Surgery
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• 제37권8호
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• pp.644-651
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• 2004

배경: 폰탄 술식 후 추적과정 동안 혈역학적 이상에 부정맥이 발생하는 경우 예후 및 사망률에 심각한 영향을 미칠 수 있다. 본 연구에서는 폰탄 술식 후 발생한 부정맥의 종류 및 빈도에 대하여 평가하고, 폰탄 술식과 관련하여 부정맥수술을 시행한 환자들에 대한 후향적 임상분석을 시행하였다. 대상 및 방법: 1986년 6월부터 2004년 3월까지 폰탄 수술을 받고 조기 생존한 275명의 환자를 대상으로 하였고, 폰탄 수술과 관련하여 부정맥수술을 한 환자는 46명이었다. 폰탄 수술 후 재수술 시 시행한 부정맥수술이 14예였으며, 재수술 당시 평균 연령은 16.8$\pm$7.1 (범위 4.5∼30.6)세였다. 부정맥은 심방 조동이 8예였으며, 심방세동이 2예였다. 부정맥수술은 냉동소작술에 의한 협부차단이 12예였고, 우측maze 술식이 2예였다. 첫 폰탄 수술 시 동반 술식으로 예방적 냉동소작술에 의한 협부 차단을 32예에서 시행하였다. 결과: 폰탄 술식 후 추적관찰 동안에 부정맥의 발생은 조기 생존한 275명 중 68명(24.7%)에서 발생하였다. 폰탄 수술과 관련하여 시행한 부정맥 수술 후 조기 및 만기 사망은 없었다. 폰탄 수술 후 재수술 시 시행한 부정맥수술 후 평균 26.5$\pm$29.1 (범위: 2∼73)개월 동안의 추적 관찰 기간 중 14명의 환자에서 정상동율동을 보이고 있다. 3예에서 일시적 심방 조동이 재발하여 항부정맥 약물 투여 후 정상 동율동을 보였으며, 7명은 영구형 심박조율기가 필요하였다. 환자의 증상은 수술 전 NYHA 기능분류 IV (2예), III (8예), II (4예)에서 수술 후 I (11예), II (3예)로 호전되었다. 첫 폰탄 수술 시 동반 술식으로 예방적 냉동소작슬을 시행한 환자에서는 평균 51.3$\pm$19.8 (범위: 4∼80)개월 동안의 추적 관찰 기간 중 28명(90.3%)의 환자에서 정상동율동을 보이고 있으며, 심실성기외수축과 접합부성 빈맥이 1예, 동기능장애가 1예, 방실전도차단이 1예로 3명에서 부정맥이 발생하였다. 결론: 폰탄 환자에 대한 적절한 부정맥수술로 동율동 유지를 통한 증상의 완화 및 기능적 분류의 호전을 볼 수 있어 임상 경과와 예후에 도움이 되었다.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제7권1호
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• pp.99-118
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• 2013

Electrocardiograms (ECGs) are widely used by clinicians to identify the functional status of the heart. Thus, there is considerable interest in automated systems for real-time monitoring of arrhythmia. However, intra- and inter-patient variability as well as the computational limits of real-time monitoring poses significant challenges for practical implementations. The former requires that the classification model be adjusted continuously, and the latter requires a reduction in the number and types of ECG features, and thus, the computational burden, necessary to classify different arrhythmias. We propose the use of adaptive learning to automatically train the classifier on up-to-date ECG data, and employ adaptive feature selection to define unique feature subsets pertinent to different types of arrhythmia. Experimental results show that this hybrid technique outperforms conventional approaches and is therefore a promising new intelligent diagnostic tool.

• Industrial Engineering and Management Systems
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• 제12권4호
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• pp.380-388
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• 2013

Large variation in electrocardiogram (ECG) waveforms continues to present challenges in defining R-wave locations in ECG signals. This research presents a procedure to extract the R-wave locations by forward-backward (FB) algorithm and classify the arrhythmic beat conditions by using RR intervals. The FB algorithm shows forward and backward searching rules from QRS onset and eliminates lower-amplitude signals near the baseline using a statistical process control concept. The proposed algorithm was trained the optimal parameters by using MIT-BIH arrhythmia database (MITDB), and it was verified by actual Holter ECG signals from a local hospital. The signals are classified into normal (N) and three arrhythmia beat types including premature ventricular contraction (PVC), ventricular flutter/fibrillation (VF), and second-degree heart block (BII) beat. This work produces 98.54% accuracy in the detection of R-wave location; 98.68% for N beats; 91.17% for PVC beats; and 87.2% for VF beats in the collected Holter ECG signals, and the results are better than what are reported in literature.

• 대한한방내과학회지
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• 제30권3호
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• pp.604-611
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• 2009

Objectives : The aim of this study was to investigate the relationship between headache and gastric dysmotility in patients with functional dyspepsia by using electrogastrogram and bowel sounds analysis. Methods : 127 patients(male 40, female 87) with functional dyspepsia were enrolled. By using inquiry and the questionnaire, we examined whether each patient had headache and abdominal pain. All patients were divided into 4 groups according to the above symptoms. Gastric motility was measured during the fasting-postprandial state by using electrogastrogram and bowel sounds analysis. Results : 33 patients complained of headache. There was a significant difference between headache patients and non-headache patients in gastric arrhythmia of the fasting state. Moreover, in headache patients without abdominal pain, postprandial improvement of gastric arrhythmia was poorer than the other groups. So, headache patients without abnormal pain had more severe gastric myoelectrical rhythm disorder than headache patients with abdominal pain. Conclusion : Headache could be one of symptoms induced by gastric dysmotility in patients with functional dyspepsia. Especially, headache in functional dyspepsia was related to gastric arrhythmia.

• 대한의용생체공학회:의공학회지
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• 제30권4호
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• pp.294-305
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• 2009

The bio signals essentially have different characteristics in each person. And the main purpose of automatic diagnosis algorithm based on bio signals focuses on discriminating differences of abnormal state from personal differences. In this paper, we propose automatic ECG diagnosis algorithm which discriminates normal heart beats from premature ventricular contraction using optimization of wavelet parameterization to solve that problem. The proposed algorithm optimizes wavelet parameter to let energy of signal be concentrated on specific scale band. We can reduce the personal differences and consequently highlight the differences coming from arrhythmia via this process. The proposed algorithm using ELM as a classifier show high discrimination performance between normal beat and PVC. From the experimental results on MIT-BIH arrhythmia database the performances of the proposed algorithm are 98.1% in accuracy, 93.0% in sensitivity, 96.4% in positive predictivity, and 0.8% in false positive rate. This results are similar or higher then results of existing researches in spite of small human intervention.

• 한국의사학회지
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• 제26권2호
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• pp.63-74
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• 2013

Objective : In Donguibogam(東醫寶鑑), like a slow pulse with irregular intervals(結脈), an abrupt pulse(促脈) and a slow and weak pulse with regular intervals(代脈), an uneven pulse is written as a kind of arrhythmia. Such a recognition differs from the present one. In this study, I try to seize the meaning and deliberate whether those expressions are appropriate. Method : 1. Collect and compare the materials of the above four pulses among documentary records of feeling the pulse for diagnosis. 2. Grasp the aspect and trend of changes. 3. Reason whether records in Donguibogam(東醫寶鑑) are proper or not. Result & Conclusions : Donguibogam(東醫寶鑑) written "like a slow pulse with irregular intervals(結脈), an abrupt pulse(促脈) and a slow and weak pulse with regular intervals(代脈), an uneven pulse is written as a kind of arrhythmia". It is not 'an uneven pulse' is written about irregularity of pulse, but 'an uneven pulse' is written about irregularity of the sense able to be felt on the fingertip.