• Korean Circulation Journal
• /
• v.52 no.9
• /
• pp.699-711
• /
• 2022

Background and Objectives: We investigated whether extra-pulmonary vein (PV) ablation targeting a high maximal slope of the action potential duration restitution curve (Smax) improves the rhythm outcome of persistent atrial fibrillation (PeAF) ablation. Methods: In this open-label, multi-center, randomized, and controlled trial, 178 PeAF patients were randomized with 1:1 ratio to computational modeling-guided virtual Smax ablation (V-Smax) or empirical ablation (E-ABL) groups. Smax maps were generated by computational modeling based on atrial substrate maps acquired during clinical procedures in sinus rhythm. Smax maps were generated during the clinical PV isolation (PVI). The V-Smax group underwent an additional extra-PV ablation after PVI targeting the virtual high Smax sites. Results: After a mean follow-up period of 12.3±5.2 months, the clinical recurrence rates (25.6% vs. 23.9% in the V-Smax and the E-ABL group, p=0.880) or recurrence appearing as atrial tachycardia (11.1% vs. 5.7%, p=0.169) did not differ between the 2 groups. The post-ablation cardioversion rate was higher in the V-Smax group than E-ABL group (14.4% vs. 5.7%, p=0.027). Among antiarrhythmic drug-free patients (n=129), the AF freedom rate was 78.7% in the V-Smax group and 80.9% in the E-ABL group (p=0.776). The total procedure time was longer in the V-Smax group (p=0.008), but no significant difference was found in the major complication rates (p=0.497) between the groups. Conclusions: Unlike a dominant frequency ablation, the computational modeling-guided V-Smax ablation did not improve the rhythm outcome of the PeAF ablation and had a longer procedure time.

• The Korean Journal of Nuclear Medicine
• /
• v.31 no.1
• /
• pp.73-82
• /
• 1997

Regional myocardial blood flow (rMBF) can be noninvasively quantified using N-13 ammonia and dynamic positron emission tomography (PET). The quantitative accuracy of the rMBF values, however, is affected by the distortion of myocardial PET images caused by finite PET image resolution and cardiac motion. Although different methods have been developed to correct the distortion typically classified as partial volume effect and spillover, the methods are too complex to employ in a routine clinical environment. We have developed a refined method incorporating a geometric model of the volume representation of a region-of-interest (ROI) into the two-compartment N-13 ammonia model. In the refined model, partial volume effect and spillover are conveniently corrected by an additional parameter in the mathematical model. To examine the accuracy of this approach, studies were performed in 9 coronary artery disease patients. Dynamic transaxial images (16 frames) were acquired with a GE $Advance^{TM}$ PET scanner simultaneous with intravenous injection of 20 mCi N-13 ammonia. rMBF was examined at rest and during pharmacologically (dipyridamole) induced coronary hyperemia. Three sectorial myocardium (septum, anterior wall and lateral wall) and blood pool time-activity curves were generated using dynamic images from manually drawn ROIs. The accuracy of rMBF values estimated by the refined method was examined by comparing to the values estimated using the conventional two-compartment model without partial volume effect correction rMBF values obtained by the refined method linearly correlated with rMBF values obtained by the conventional method (108 myocardial segments, correlation coefficient (r)=0.88). Additionally, underestimated rMBF values by the conventional method due to partial volume effect were corrected by theoretically predicted amount in the refined method (slope(m)=1.57). Spillover fraction estimated by the two methods agreed well (r=1.00, m=0.98). In conclusion, accurate rMBF values can be efficiently quantified by the refined method incorporating myocardium geometric information into the two-compartment model using N-13 ammonia and PET.

• Journal of the Korean Institute of Landscape Architecture
• /
• v.38 no.5
• /
• pp.80-92
• /
• 2010

The purpose of this study was to analyze drainage facilities in mountainous urban neigbborhood parks--Baebongsan Park and Ogeum Park--in Seoul. Based on an analysis of existing drainage facilities, the volume of storm water runoff (VSW), the runoff rate of open channels(ROC), and the detention capacity of open charmels(DCOC) by each drainage watershed, the coefficient of runoff rate(CROC) as evaluated to be relevant between VSW and ROC and the coefficient of the detention capacity of open channe1s(CDCOC) as evaluated with DCOC compared to VSW were estimated and analyzed by parks and by watersheds. The results are as follows: 1. The total drainage area of Baebongsan Park was 34.13ha including surface runoff area(15.05ha; 44.09%), open channel area(l4.60ha; 42.78%), and natural waterway area(4.48ha; 13.13%). The total drainage area of Ogeum Park was 20.39ha including open channel area (10.14ha; 49.73%), ridge-side gutter area(7.17ha; 35.16%), surface runoff area (2.52ha; 12.36%), and natural waterway area (0.56ha; 2.75%). In Baebongsan Park, the portion of surface runoff was comparatively higher while the portion of artificial drainage area was higber in Ogeum Park. 2. In Baebongsan Park drainage districts were largely divided: VSW was $7.28m^3/s$ in total(average $0.23m^3/s$). Comparatively, tbe VSW in Ogeum Park, including smaller drainage districts, was $4.37m^3/s$ in total(average $0.12m^3/s$). 3. The ROC of Baebmgsan Park was $11.58m^3/s$ in total(average $0.77m^3/s$) and the CROC was 5.26, while in Ogeum Park, the ROC was $15.40m^3/s$(average $0.34m^3/s$) and tbe CROC was 8.87 higher than that of Baebongsan Because the size and slope of the open channel in Baebongsan Park was higher, the average ROC was larger, while tbe CROC of Ogeum Park was higher than that of Baebongsan Park, for the VSW in Ogeum Park was comparatively lower. 4. The DCOC in Baebongsan Park was $554.54m^3$ and the average of CDCOC was 179.83. That of Ogeum Park was $717.74m^3$ and the average of the CDCOC was 339.69, meaning that the DCOC of Ogeum Park was so much higber that drainage facilities in Ogeum Park were built intensively. This study was focused m the capacity of the drainage facilities in mountainous urban neighborhood parks by using the CROC to evaluate relevance between VSW and ROC and the CDCOC to evaluate the DCOC as compared with VSW. The devised methodology and coefficient for evaluating drainage facilities in mountainous urban neighborhood parks may he universally applicable through additional study. Further study m sustainable urban drainage systems for retaining rainwater in a reservoir and for enhancing ecological value is required in the near future.