• Title/Summary/Keyword: Arrhythmias

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Neonatal arrhythmias: diagnosis, treatment, and clinical outcome

  • Ban, Ji-Eun
    • Clinical and Experimental Pediatrics
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    • v.60 no.11
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    • pp.344-352
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    • 2017
  • Arrhythmias in the neonatal period are not uncommon, and may occur in neonates with a normal heart or in those with structural heart disease. Neonatal arrhythmias are classified as either benign or nonbenign. Benign arrhythmias include sinus arrhythmia, premature atrial contraction, premature ventricular contraction, and junctional rhythm; these arrhythmias have no clinical significance and do not need therapy. Supraventricular tachycardia, ventricular tachycardia, atrioventricular conduction abnormalities, and genetic arrhythmia such as congenital long-QT syndrome are classified as nonbenign arrhythmias. Although most neonatal arrhythmias are asymptomatic and rarely life-threatening, the prognosis depends on the early recognition and proper management of the condition in some serious cases. Precise diagnosis with risk stratification of patients with nonbenign neonatal arrhythmia is needed to reduce morbidity and mortality. In this article, I review the current understanding of the common clinical presentation, etiology, natural history, and management of neonatal arrhythmias in the absence of an underlying congenital heart disease.

Benign Arrhythmias in Infants and Children (소아에서 치료가 필요 없는 부정맥)

  • Ko, Jae Kon
    • Clinical and Experimental Pediatrics
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    • v.48 no.1
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    • pp.1-5
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    • 2005
  • Pediatricians often encounter some electrocardiographic abnormalities in infants and children. However, treatment or referral to pediatric cardiologist is not indicated for all arrhythmias. Many of them are benign in nature. Benign arrhythmias can be defined as the arrhythmias that no serious problem currently exists and no treatment is needed. The prognosis of benign arrhythmias is so good that the condition will never be associated with future health problem. However, some of them are benign now, but have potential for variable degrees of change to a nonbenign condition and some form of follow-up is required. For the appropriate management of electrocardiographic abnormalities, not infrequently seen in infants and children, correct diagnosis of abnormal electrocardiogram and understanding of characteristics of arrhythmias are required.

The Effects of Acebutolol and Carbamazepine on the Ouabain-Induced Arrhythmias in Rabbits (가토의 ouabain 유발 부정맥에 미치는 acebuolol 및 carbamazepine의 영향)

  • Kim, Won-Joon;Ha, Jeoung-Hee
    • The Korean Journal of Pharmacology
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    • v.23 no.1
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    • pp.9-14
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    • 1987
  • The effects of acebutolol and carbamazepine on ouabain-induced arrhythmias were investigated in rabbits. Ouabain produced ventricular arrhythmias which persisted for 7-8 min at the mean dose of $69{\pm}1.3\;{\mu}g/kg$. Ouabain arrhythmias were converted to normal sinus rhythm by administration of acebutolol or carbamazepine singly but lower dosages increased the recovery time. And then, ouabain arrhythmias were effectively converted to normal sinus rhythm and prevented by combined administration of carbamazepine and acebutolol. Each of the combined doses was ineffective when given singly. From the above results, it may be concluded that carbamazepine and acebutolol inhibited the ouabain-induced arrhythmias depending on the level of dosage and showed synergistic interaction.

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General anesthesia using propofol infusion for implantation of an implantable cardioverter defibrillator in a pediatric patient with Andersen-Tawil syndrome: a case report

  • Seyeon Park;Wonjae Heo;Sang-Wook Shin;Hye-Jin Kim;Yeong Min Yoo;Hee Young Kim
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.23 no.1
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    • pp.45-51
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    • 2023
  • Andersen-Tawil syndrome (ATS) is a rare genetic disease characterized by a triad of episodic flaccid muscle weakness, ventricular arrhythmias, and physical anomalies. ATS patients have various cardiac arrhythmias that can cause sudden death. Implantation of an implantable cardioverter-defibrillator (ICD) is required when life-threatening cardiac arrhythmias do not respond to medical treatment. An 11-year-old girl underwent surgery for an ICD implantation. For general anesthesia in ATS patients, anesthesiologists should focus on the potentially difficult airway, serious cardiac arrhythmias, such as ventricular tachycardia (VT), and delayed recovery from neuromuscular blockade. We followed the difficult airway algorithm, avoided drugs that can precipitate QT prolongation and fatal cardiac arrhythmias, and tried to maintain normoxia, normocarbia, normothermia, normoglycemia, and pain control for prevention of sympathetic stimulation. We report the successful application of general anesthesia for ICD implantation in a pediatric patient with ATS and recurrent VT.

Computational analysis of vortex breakup in arrhythmias (심장 부정맥 시 vortex breakup 현상에 대한 수치적 연구)

  • Shim, Eun-Bo;Kwon, Soon-Sung;Choi, Seung-Yoon
    • 한국전산유체공학회:학술대회논문집
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    • 2008.03b
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    • pp.496-497
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    • 2008
  • In this study, we present the computational analysis of cardiac arrhythmias that is the major cause of human sudden cardiac death. First, electric excitation and condution in one dimensional cardiac tissue model is solved and the results on condution block are represented. In two dimensional model, vortex daynamics in cardiac tissue is analyzed to delineate the breakup phenomenon inducing ventricular fibrillation. We also simulated a three dimenional heart model to see the vortex breakup and explained the mechanism in physiological aspect.

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EMD based Cardiac Arrhythmia Classification using Multi-class SVM (다중 클래스 SVM을 이용한 EMD 기반의 부정맥 신호 분류)

  • Lee, Geum-Boon;Cho, Beom-Joon
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.14 no.1
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    • pp.16-22
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    • 2010
  • Electrocardiogram(ECG) analysis and arrhythmia recognition are critical for diagnosis and treatment of ill patients. Cardiac arrhythmia is a condition in which heart beat may be irregular and presents a serious threat to the patient recovering from ventricular tachycardia (VT) and ventricular fibrillation (VF). Other arrhythmias like atrial premature contraction (APC), Premature ventricular contraction (PVC) and superventricular tachycardia (SVT) are important in diagnosing the heart diseases. This paper presented new method to classify various arrhythmias contrary to other techniques which are limited to only two or three arrhythmias. ECG is decomposed into Intrinsic Mode Functions (IMFs) by Empirical Mode Decomposition (EMD). Burg algorithm was performed on IMFs to obtain AR coefficients which can reduce the dimension of feature vector and utilized as Multi-class SVM inputs which is basically extended from binary SVM. We chose optimal parameters for SVM classifier, applied to arrhythmias classification and achieved the accuracies of detecting NSR, APC, PVC, SVT, VT and VP were 96.8% to 99.5%. The results showed that EMD was useful for the preprocessing and feature extraction and multi-class SVM for classification of cardiac arrhythmias, with high usefulness.

Postoperative Arrhythmias after Open Heart Surgery in Adults (성인에서의 개심술후 부정맥)

    • Journal of Chest Surgery
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    • v.31 no.11
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    • pp.1056-1062
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    • 1998
  • Background: We prospectively investigated types, incidences, and risk factors for arrhythmias after open heart surgery in adults. Materials and methods: From June 1994 to May 1995, we performed 302 cases of adult cardiac surgery at our department. This study group consisted of 150 men and 152 women, with a mean age of 43.9±28.0(range 16 to 75)years. We included all the patients irrespective of their operative types or disease entities. Results: The overall incidence of arrhythmias after open heart surgery in adults was 58.3%. The incidence of postoperative arrhythmias for redo-valvular heart surgery was 77.8%, and those for simple valvular procedure, coronary artery bypass surgery, aortic surgery, and congenital heart disease were 70.8%, 45.3%, 40.0%, and 29.5%, respectively. Eight out of twelve risk factors showed statistical significance for the development of postoperative arrhythmias. They were preoperative history of arrhythmias, antiarrhythmic drug medication, previous cardiac surgery, larger left ventricular end-diastolic, end-systolic dimension, left atrial dimension on preoperative echocardiogram, longer cardiopulmonary bypass time and aortic cross clamping time. Univariated analyses for age and types of cardioplegic solution did not show statistical significance. Conclusions: Prospective study on postoperative arrhythmias occurrence, treatment and prevention of is warrauted to draw more clear conclusion.

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Supraventricular Arrhythmias in the Surgical Intensive Care Unit (외과계 중환자실에서 발생한 상심실성 부정맥)

  • Yang, Song-Soo;Hong, Suk-Kyung
    • Journal of Trauma and Injury
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    • v.21 no.2
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    • pp.85-90
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    • 2008
  • Purpose: Supraventricular arrhythmia is a well-known complication of cardiothoracic surgery, and is common in patients wirth underlying cardiovascular disease. Also, it's treatment and prognosis are well known. However the incidence, the contributing factors, and the prognosis for supraventricular arrhythmias in noncardiothoracic surgical patients are less well known. This study was undertaken to investigate the incidence, the clinical presentation, the prognosis, and the factors comtributing to the prognosis for supraventricular arrhythmia in the surgical intensive care unit. Methods: We performed a retrospective study of 34 patients with newly developed or aggravated supraventricular arrhythmias in the surgical intensive care unit between March 2004 and February 2005. The incidence, the risk factors, and the prognosis of supraventricular arrhythmias were analyzed. Results: During a 12month period, the incidence of supraventricular arrhythmia was 1.79% (34/1896). Most patients had pre-existing cardiovascular disease and sepsis. The mortality rate was 29.4%, and the most common cause of death was multiple organ failure due to septic shock. The mean value of the APACHE II score was 20.9, and the surgical intensive care unit and the hospital lengths of stay were 9.9 days and 25.8 days, respectively. The APACHE II score measured when the arrhythmia developed was a significant factor in predicting mortality, Conclusion: Supraventricular arrhythmias result in increased mortality and increased length of stay in both the surgical intensive care unit and the hospital. The arrhythmia itself did not cause death, but a high APACHE II score incicated a poor prognosis. This may reflect the severity of the illness rather than an independent contributor to mortality.

A Study on Real Time Automatic Diagnosis of Arrhythmias (실시간 부정맥 자동진단에 관한 연구)

  • Shin, Ho-Yong;Shin, Kun-Soo;Lee, Byung-Chae;Lee, Myoung-Ho
    • Proceedings of the KIEE Conference
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    • 1987.07b
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    • pp.1276-1279
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    • 1987
  • Cardiac arrhythmias are associated with electrical Instability and, hence, with abnormal mechanical activity of the heart in many cases, arrhythmias can be treated with drugs or electric shock to control and/or stop them. Hence fast arrhythmia detection is very important. In this paper RR interval, QRS width, and morphology are used for diagnosis and QRS complex is detected by hardware system. hence diagnosing time is shorten. Moreover doctors or nurses who have little knowledge of computer manipulation can get the Information of Patient's ECG by showing characteristics of abnormal waveform and by mapping graphs of RR interval .vs. QRS width and RR interval .vs. morphology on screen.

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Torsade de Pointes Associated with Hypomagnesemia after Open Heart Surgery - A Report of 2 Cases - (개심술후 저마그네슘증에 동반된 Torsade de Pointes;치험 2례 보고)

  • 노환규
    • Journal of Chest Surgery
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    • v.25 no.2
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    • pp.188-193
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    • 1992
  • Life-threatening cardiac arrhythmia is a frequent complication of open heart surgery. There are many causes of postoperative cardiac arrhythmias. Electrolyte imbalance such as hypokalemia and acidemia are major causes of ventricular arrhythmias. Infrequently, however, antiarrhythmic agents and /or hypomagnesemia induce[s] a ventricular arrhythmia such as "torsade de pointes" by increasing the repolarization time of myocardium, Recently, we have experienced two cases of "Torsade de pointes" associated with hyp-omagnesemia after replacement of mitral valve and one of whom after use of procainamide. Intravenous infusion of magnesium immediately and successfully abolished the torsade de pointes in both cases.intes in both cases.

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