• Title/Summary/Keyword: Atrial fibrillation(AF)

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Modern Treatment of Atrial Fibrillation

  • Kim, Kyung-Hwan
    • Journal of Chest Surgery
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    • v.47 no.6
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    • pp.499-503
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    • 2014
  • Atrial fibrillation (AF) is the most common type of arrhythmia and has a large global burden. In general, treatment of AF is based on medication and consists of rate and rhythm control together with anticoagulation. However, surgical treatment may be required in patients with AF combined with organic valvular heart diseases or who experience recurrence despite medication. In addition, surgical treatment plays a role in the treatment of lone AF. This article reviews the various surgical treatment options for AF.

Atrial Fibrillation Pattern Analysis based on Symbolization and Information Entropy (부호화와 정보 엔트로피에 기반한 심방세동 (Atrial Fibrillation: AF) 패턴 분석)

  • Cho, Ik-Sung;Kwon, Hyeog-Soong
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.16 no.5
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    • pp.1047-1054
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    • 2012
  • Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice, and its risk increases with age. Conventionally, the way of detecting AF was the time·frequency domain analysis of RR variability. However, the detection of ECG signal is difficult because of the low amplitude of the P wave and the corruption by the noise. Also, the time·frequency domain analysis of RR variability has disadvantage to get the details of irregular RR interval rhythm. In this study, we describe an atrial fibrillation pattern analysis based on symbolization and information entropy. We transformed RR interval data into symbolic sequence through differential partition, analyzed RR interval pattern, quantified the complexity through Shannon entropy and detected atrial fibrillation. The detection algorithm was tested using the threshold between 10ms and 100ms on two databases, namely the MIT-BIH Atrial Fibrillation Database.

Recent Advances in Surgery for Atrial Fibrillation (심방세동의 최신 외과적 치료)

  • Lee, Dong-Hyup;Jung, Tae-Eun
    • Journal of Yeungnam Medical Science
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    • v.22 no.1
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    • pp.13-26
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    • 2005
  • Atrial fibrillation (AF) is the most common cardiac rhythm disturbance, which carries significant cardiovascular morbidity and mortality. The medical treatment for AF is cumbersome and unsatisfactory, which has highlighted the need to develop alternative treatments for AF. The recent discovery that AF is often initiated by atrial ectopic beats has resulted in treatments designed to target the ectopic sources, particularly those within the pulmonary veins. Building on the pioneering work of Cox et al., a recent reported series demonstrated the feasibility of treating patients undergoing cardiac surgery for other structural heart diseases with limited, left-atrial ablation lesion sets using alternative energy sources. As less complex modifications of the Maze procedure have been developed, a number of energy sources have been introduced to create of electrically isolating lesions within the atria. These sources have been used both endocardially in arrest heart procedures as well as epicardially in a beating heart setting. This review summarizes the recent advances in surgery for AF that will aid in the development of an effective, minimally invasive surgical procedure to cure patients with AF.

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Detection of Atrial Fibrillation Using Markov Regime Switching Models of Heart Rate Intervals (심박간격의 마코프 국면전환 모형화를 통한 심방세동 탐지)

  • Jung, Yonghan;Kim, Heeyoung
    • Journal of Korean Institute of Industrial Engineers
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    • v.42 no.4
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    • pp.290-295
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    • 2016
  • This paper proposes a new method for the automatic detection of atrial fibrillation (AF), using Markov regime switching GARCH (1, 1) model. The proposed method is based on the observation that variability patterns of heart rate intervals during AF significantly differ from regular patterns. The proposed method captures the different patterns of heart rate intervals between two regimes : normal and AF states. We test the proposed method using Massachusetts Institute of Technology-Beth Israel Hospital (MIT-BIH) atrial fibrillation database, and demonstrate the effectiveness of the proposed method.

Case Report of Chengsim Yeunja-tang (CYT) for Atrial Fibrillation with cerebral-infarction. (청심연자탕으로 호전된 뇌경색을 동반한 심방세동 환자 치험 3례)

  • Kim, Jung-Chul;Oh, Sung-Won;Song, Chang-Hoon;Lee, Seul-hee;Jeong, Jong-Jin;Kim, Jong-Yun;Sun, Seung-Ho
    • The Journal of Internal Korean Medicine
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    • v.27 no.3
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    • pp.751-761
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    • 2006
  • Atrial fibrillation (AF) is a common arrhythmia that is a potent independent risk factor for stroke. The incidence of AF increases with age and most affected people have underlying cardiac disease. An aging society increases the incidence of AF patients. The case was designed to evaluate the improving effect of Chengsim Yeunja-tang (CYT) for atrial fibrillation (AF) with Cb-infarction patients. This patient was treated with CYT and had significant improvement in symptoms and change of EKG. -Heart rate decreased in patients with higher than normal heart rate -RV5+SV1 voltage decreased (LVH improved) -Arrhythmia remained steady. -Palpitation. chest discomfort, dyspnea, headache, dizziness diminished. Results suggest that CYT is an effective treatment for Taeumin AF patients.

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Amiodarone Versus Propafenone to Treat Atrial Fibrillation after Coronary Artery Bypass Grafting: A Randomized Double Blind Controlled Trial

  • Nemati, Mohammad Hassan;Astaneh, Behrooz
    • Journal of Chest Surgery
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    • v.49 no.3
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    • pp.177-184
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    • 2016
  • Background: Atrial fibrillation (AF) is one of the most common complications after cardiac surgery. Several therapeutic and preventive strategies have been introduced for postoperative AF, but the treatment and prophylaxis of AF remain controversial. We aimed to compare the efficacy of intravenous amiodarone and oral propafenone in the treatment of AF after coronary artery bypass grafting (CABG). Methods: This was a randomized controlled trial performed in two hospitals in Shiraz, Iran from 2009 to 2012. We included all patients who underwent elective CABG and developed AF postoperatively. The patients were randomly assigned to receive propafenone or amiodarone. The duration of AF, the success rate of the treatment, the need for cardioversion, the frequency of repeated AF, and the need for repeating the treatment were compared. Results: The duration of the first (p=0.361), second (p=0.832), and third (p=0.298) episodes of AF, the need for cardioversion (p=0.998), and the need to repeat the first and second doses of drugs (p=0.557, 0.699) were comparable between the study groups. Repeated AF was observed in 17 patients (30.9%) in the propafenone group and 23 patients (34.3%) in the amiodarone group (p=0.704). Conclusion: Oral propafenone and intravenous amiodarone are equally effective in the treatment and conversion of recent-onset AF after CABG.

Paradoxical Response of Giant Left Atrial Appendage Aneurysm after Catheter Ablation of Atrial Fibrillation

  • Chung, Jee Won;Shim, Jaemin;Shim, Wan Joo;Kim, Young-Hoon;Hwang, Sung Ho
    • Investigative Magnetic Resonance Imaging
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    • v.20 no.2
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    • pp.132-135
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    • 2016
  • We report the case of a 43-year-old male with both giant left atrial appendage (LAA) aneurysm and drug-refractory atrial fibrillation (AF). The patient was treated with percutaneous electrical isolation of cardiac arrhythmogenic substrate, and has been free of AF symptom over one year. Although the surgical resection of giant LAA aneurysm is mostly used to prevent systemic thromboembolism, we have performed follow-up of the giant LAA aneurysm using cardiac magnetic resonance (CMR) imaging and transesophageal echocardiography (TEE) after the successful catheter ablation of refractory AF. At one-year follow-up CMR, the giant LAA aneurysm showed remarkable enlargement as well as decreased contractility. Additionally, one-year follow-up TEE showed spontaneous echo contrast as an indicator of blood stasis in the giant LAA aneurysm. Those findings of giant LAA aneurysm suggest that the risk of thromboembolism may be high despite termination of AF.

Persistent Atrial Fibrillation Related to a Congenital Pericardial Defect and Left Atrial Appendage Herniation

  • Lee, Heemoon;Jeong, Dong Seop;Kim, In Sook;Park, Byung Jo
    • Journal of Chest Surgery
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    • v.48 no.6
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    • pp.429-431
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    • 2015
  • Congenital pericardial defects (CPDs) are infrequent anomalies that are usually asymptomatic and are discovered incidentally during unrelated interventions. Here we report the case of a CPD with herniation of an enlarged left atrial appendage identified during total thoracoscopic ablation (TTA) for persistent atrial fibrillation (AF). The persistent AF was successfully treated with a hybrid procedure, in which TTA was followed by an electrophysiological study.

Relationships between Symptom Experience and Quality of Life in Patients with Atrial Fibrillation (심방세동 환자의 증상경험 및 삶의 질간의 관계)

  • Baek, Kyung-Hwa;Son, Youn-Jung
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.15 no.4
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    • pp.485-494
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    • 2008
  • Purpose: In this study, relationships between symptom experience and quality of life in a cross-sectional sample of patients with Atrial Fibrillation (AF) were investigated. Methods: This descriptive study involved a convenience sample of AF patients from S university hospital, C city. One hundred and two AF patients completed psychometric validated measures of AF related symptoms and quality of life. Descriptive statistics and Pearson correlation coefficients with SPSS WIN 14.0 were used for data analysis. Results: Of 16 atrial arrhythmia-related symptoms, the patients reported 'tiredness' as the most frequent and 'shortness of breath' as the most severe. The level of overall quality of life for patients with AF was 53.92. There were significant differences in symptom frequency according to religion, New York Heart Association (NYHA) classification and left ventricular ejection fraction ; symptom severity according to monthly income and stroke ; quality of life according to age, job, alcohol intake, NYHA class and stroke. Quality of life for these patients was positively correlated with symptom frequency and symptom severity. Conclusions: This study demonstrated that patients with more frequent and severe symptoms perceive poorer quality of life than patients with less frequent and less severe symptoms. Symptom experience should be assessed early to improve quality of life for patients.

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Inducibility of human atrial fibrillation in an in silico model reflecting local acetylcholine distribution and concentration

  • Hwang, Minki;Lee, Hyun-Seung;Pak, Hui-Nam;Shim, Eun Bo
    • The Korean Journal of Physiology and Pharmacology
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    • v.20 no.1
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    • pp.111-117
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    • 2016
  • Vagal nerve activity has been known to play a crucial role in the induction and maintenance of atrial fibrillation (AF). However, it is unclear how the distribution and concentration of local acetylcholine (ACh) promotes AF. In this study, we investigated the effect of the spatial distribution and concentration of ACh on fibrillation patterns in an in silico human atrial model. A human atrial action potential model with an ACh-dependent $K^+$ current ($I_{KAch}$) was used to examine the effect of vagal activation. A simulation of cardiac wave dynamics was performed in a realistic 3D model of the atrium. A model of the ganglionated plexus (GP) and nerve was developed based on the "octopus hypothesis". The pattern of cardiac wave dynamics was examined by applying vagal activation to the GP areas or randomly. AF inducibility in the octopus hypothesis-based GP and nerve model was tested. The effect of the ACh concentration level was also examined. In the single cell simulation, an increase in the ACh concentration shortened $APD_{90}$ and increased the maximal slope of the restitution curve. In the 3D simulation, a random distribution of vagal activation promoted wavebreaks while ACh secretion limited to the GP areas did not induce a noticeable change in wave dynamics. The octopus hypothesis-based model of the GP and nerve exhibited AF inducibility at higher ACh concentrations. In conclusion, a 3D in silico model of the GP and parasympathetic nerve based on the octopus model exhibited higher AF inducibility with higher ACh concentrations.