• Title/Summary/Keyword: Cardiac arrhythmia

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Clinical Application of I-123 MIBG Cardiac Imaging (I-123 MIBG Cardiac SPECT의 임상적 적응증)

  • Kang, Do-Young
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.5
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    • pp.331-337
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    • 2004
  • Cardiac neurotransmission imaging allows in vivo assessment of presynaptic reuptake, neurotransmitter storage and postsynaptic receptors. Among the various neurotransmitter, I-123 MIBG is most available and relatively well-established. Metaiodobenzylguanidine (MIBG) is an analogue of the false neurotransmitter guanethidine. It is taken up to adrenergic neurons by uptake-1 mechanism as same as norepinephrine. As tagged with I-123, it can be used to image sympathetic function in various organs including heart with planar or SPECT techniques. I-123 MIBG imaging has a unique advantage to evaluate myocardial neuronal activity in which the heart has no significant structural abnormality or even no functional derangement measured with other conventional examination. In patients with cardiomyopathy and heart failure, this imaging has most sensitive technique to predict prognosis and treatment response of betablocker or ACE inhibitor. In diabetic patients, it allow very early detection of autonomic neuropathy. In patients with dangerous arrhythmia such as ventricular tachycardia or fibrillation, MIBG imaging may be only an abnormal result among various exams. In patients with ischemic heart disease, sympathetic derangement may be used as the method of risk stratification. In heart transplanted patients, sympathetic reinnervation is well evaluated. Adriamycin-induced cardiotoxicity is detected earlier than ventricular dysfunction with sympathetic dysfunction. Neurodegenerative disorder such as Parkinson's disease or dementia with Lewy bodies has also cardiac sympathetic dysfunction. Noninvasive assessment of cardiac sympathetic nerve activity with I-123 MIBG imaging nay be improve understanding of the pathophysiology of cardiac disease and make a contribution to predict survival and therapy efficacy.

Isolated Tricuspid Regurgitation: Initial Manifestation of Cardiac Amyloidosis

  • Yoon, Dong Woog;Park, Byung-Jo;Kim, In Sook;Jeong, Dong Seop
    • Journal of Chest Surgery
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    • v.48 no.6
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    • pp.422-425
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    • 2015
  • Amyloid deposits in the heart are not exceptional in systemic amyloidosis. The clinical manifestations of cardiac amyloidosis may include restrictive cardiomyopathy, characterized by progressive diastolic and eventually systolic biventricular dysfunction; arrhythmia; and conduction defects. To the best of our knowledge, no previous cases of isolated tricuspid regurgitation as the initial manifestation of cardiac amyloidosis have been reported. We describe a rare case of cardiac amyloidosis that initially presented with severe tricuspid regurgitation in a 42-year-old woman who was successfully treated with tricuspid valve replacement. Unusual surgical findings prompted additional evaluation that established a diagnosis of plasma cell myeloma.

Medullary Infarction Presenting as Sudden Cardiac Arrest: Report of Two Cases and Review of the Literature (급성 심정지로 나타난 연수경색)

  • Lee, Eung-joon;Choo, Il-yeon;Ha, Sue Young;Kwon, Hyung-min
    • Journal of the Korean neurological association
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    • v.36 no.4
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    • pp.310-313
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    • 2018
  • The causes of sudden death after medullary infarction involve arrhythmia, central respiratory failure, and dysautonomia. Sudden cardiac arrest in a medullary infarction is uncommon. Most of these cases experienced sudden cardiopulmonary arrest within 2 weeks from stroke onset as the extent of lesion increased. Here, we report two cases of medullary infarction presenting as sudden cardiac arrest. These cases indicate that medullary infarction could be one of the causes of sudden cardiac arrest.

P Wave Detection based on QRST Cancellation Zero-One Substitution

  • Cho, Ik-Sung
    • Journal of information and communication convergence engineering
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    • v.19 no.2
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    • pp.93-101
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    • 2021
  • Cardiac arrhythmias are common heart diseases and generally cause sudden cardiac death. Electrocardiogram (ECG) is an effective tool that can reveal the electrical activity of the heart and diagnose cardiac arrhythmias. We propose detection of P waves based on QRST cancellation zero-one substitution. After preprocessing, the QRST segment is determined by detecting the Q wave start point and T wave end point separately. The Q wave start point is detected by digital analyses of the QRS complex width, and the T wave end point is detected by computation of an indicator related to the area covered by the T wave curve. Then, we determine whether the sampled value of the signal is in the interval of the QRST segment and substitute zero or one for the value to cancel the QRST segment. Finally, the maximum amplitude is selected as the peak of the P wave in each RR interval of the residual signal. The average detection rate for the QT database was 97.67%.

Supraventricular tachycardia in a neonate with cardiac rhabdomyoma and tuberous sclerosis (상심실성 빈맥과 심장 종양으로 진단된 결절성 경화증 1예)

  • Bang, In Kug;Kim, Yeo Hyang;Kim, Chun Soo;Lee, Sang Lak;Kwon, Tae Chan
    • Clinical and Experimental Pediatrics
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    • v.51 no.7
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    • pp.766-770
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    • 2008
  • Primary tumors of the heart are uncommon among pediatric patients. Rhabdomyoma is the most frequent cardiac tumor in infants and children, which is commonly associated with tuberous sclerosis. Tuberous sclerosis is a neurocutaneous syndrome affecting the brain, heart, skin, and other organs. Cardiac rhadomyomas are reported in 50-64% of infants with tuberous sclerosis. Tuberous sclerosis involves multiple locations in the atrium, ventricle and septum, and may induce mechanical obstruction of the outflow tract and heart failure depending on the location, number, size, and degree of invasion of tumors. Arrhythmias may also develop in infants with cardiac rhadomyomas, but only a few of these patients require prolonged anti-arrhythmic therapy because arrhythmia often disappears with spontaneous regression of the tumors, and the ultimate prognosis may be decided by the cerebral manifestations.

A study on the development of 64 channels computerized cardiac mapping system (64채널 심장전기도 시스템 구현에 관한 연구)

  • Chang, Byung-Chul;Kim, Nam-Hyun;Jung, Sung-Hun;Ra, Sang-Weon;Cho, Bum-Koo
    • Proceedings of the KOSOMBE Conference
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    • v.1994 no.12
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    • pp.88-91
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    • 1994
  • It is well known that multipoint and computerized intraoperative mapping systems improve the results of surgery for Wolff-Parkinson-White syndrome and show tremendous potential for opening an entirely new era of surgical intervention for the more common and lethal types of supraventricular tachyarrhythmias such as atrial flutter and atrial fibrillation. In addition, the ability to map and ablate the sometimes fleeting automatic atrial tachycardia is greatly enhanced by computerized mapping systems. In this study, we have developed 64 channel computerized data analysis system using microcomputer (Macintosh IIx) for basic research of electrophysiology and electrical propagation. The bipolar electrogram information is acquired from 64 cardiac sites simultaneously at a sampling rate of 1ksamples/sec with continuous and total data storage of up to 30 seconds. When the reference electrogram is selected and reference point is picked up, delay time from the reference point in displayed on two dimensional diagram of the heart. System design permits easy expansion to almost 256 simultaneous sites, This system is expected to enable us to study pathophysiology of cardiac arrhythmia and to improve the results of diagnosis and surgical treatment for cardiac arrhythmia.

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Understanding of antiarrhtymic drugs

  • 현창백
    • Journal of the korean veterinary medical association
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    • v.40 no.2
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    • pp.145-156
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    • 2004
  • 심부정맥(Cardiac arrhythmia)이란 심장내 박동, 율동, 충동 발생 및 전도장애를 유도하는 질환을 말하며, 주로 심근경색이나 심장비대증 같은 심장의 해부학적 질환과 약물중독 및 전해질 불균형에 의해 발생한다. 부정맥은 정상적인 심근 활성을 차단하여 심장박출을 감소시키므로 때로 생명을 위협하기도 한다. 본 종설에서는 심장의 전도계에 관련된 정상생리와 부정맥의 병리적 발생기전 및 부정맥 치료제에 대한 분류 및 약리기전에 대해 기술하고자 한다.

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Arrhythmia Classification using Hybrid Combination Model of CNN-LSTM (합성곱-장단기 기억 신경망의 하이브리드 결합 모델을 이용한 부정맥 분류)

  • Cho, Ik-Sung;Kwon, Hyeog-Soong
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.26 no.1
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    • pp.76-84
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    • 2022
  • Arrhythmia is a condition in which the heart beats abnormally or irregularly, early detection is very important because it can cause dangerous situations such as fainting or sudden cardiac death. However, performance degradation occurs due to personalized differences in ECG signals. In this paper, we propose arrhythmia classification using hybrid combination model of CNN-LSTM. For this purpose, the R wave is detected from noise removed signal and a single bit segment was extracted. It consisted of eight convolutional layers to extract the features of the arrhythmia in detail, used them as the input of the LSTM. The weights were learned through deep learning and the model was evaluated by the verification data. The performance was compared in terms of the accuracy, precision, recall, F1 score through MIT-BIH arrhythmia database. The achieved scores indicate 92.3%, 90.98%, 92.20%, 90.72% in terms of the accuracy, precision, recall, F1 score, respectively.

Arrhythmia Classification using GAN-based Over-Sampling Method and Combination Model of CNN-BLSTM (GAN 오버샘플링 기법과 CNN-BLSTM 결합 모델을 이용한 부정맥 분류)

  • Cho, Ik-Sung;Kwon, Hyeog-Soong
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.26 no.10
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    • pp.1490-1499
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    • 2022
  • Arrhythmia is a condition in which the heart has an irregular rhythm or abnormal heart rate, early diagnosis and management is very important because it can cause stroke, cardiac arrest, or even death. In this paper, we propose arrhythmia classification using hybrid combination model of CNN-BLSTM. For this purpose, the QRS features are detected from noise removed signal through pre-processing and a single bit segment was extracted. In this case, the GAN oversampling technique is applied to solve the data imbalance problem. It consisted of CNN layers to extract the patterns of the arrhythmia precisely, used them as the input of the BLSTM. The weights were learned through deep learning and the learning model was evaluated by the validation data. To evaluate the performance of the proposed method, classification accuracy, precision, recall, and F1-score were compared by using the MIT-BIH arrhythmia database. The achieved scores indicate 99.30%, 98.70%, 97.50%, 98.06% in terms of the accuracy, precision, recall, F1 score, respectively.

Modified Fontan Operation: Physio-anatomic Causes of Low Cardiac Output and Persistent Pleural Effusion (Fontan 수술후 저심장박출증 및 지속성 흉막 삼출액이 발생되는 해부생리학적 원인)

  • Han, Jae-Jin;Seo, Gyeong-Pil
    • Journal of Chest Surgery
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    • v.23 no.2
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    • pp.213-221
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    • 1990
  • We have experienced 62 cases of modified Fontan operations in Seoul Nat’l University Hospital from Apr. 1986 to Jul. 1989, They were 38 males and 24 females, and their age was ranged from 16 months to 15.5 years of age. [mean age : 5.73$\pm$2.99 years] There were 16 operative deaths and 2 late deaths, therefore 29% of overall mortality. Their diagnoses were as follows; 28 single ventricle, 11 tricuspid atresia, 6 DORV with LV hypoplasia, 3 pulmonary atresia with hypoplastic RV, 3 TGA with hypoplastic RV, 3 cor\ulcornerGA with hypoplastic LV and PA, 6 AV canal defects with PA, and 2 others. Low cardiac output and pleural effusion were developed frequently, so we divide 40 patients into some groups to analyze the physiologic and anatomic causes of them. By the degree of the LCO, group A was no LCO[mean amount of inotropics used: 0-5 \ulcornerg/kg/min] with 17 cases, B mild LCO [5-10] with 11, C moderate to severe LCO but alive[>10] with 8, D severe LCO to death with 4 cases. For the pleural effusion, group 1 was to be removed the chest tube within 1 week with 8 cases, group II within 3 weeks with 21 cases, group III beyond 3 weeks with 12 cases. We considered their age, diagnosis, pulmonary artery size[PA index], pulmonary artery abnormality, palliative shunt, systemic ventricular type, pulmonary artery wedge pressure, as preoperative factors, and operative methods, and as postoperative factors, CVP, LAP, arrhythmia, thrombosis, atrioventricular valvular insufficiency, etc. In the view of LCO, pulmonary artery size and PCWP were statistically significant [P<0.05], and arrhythmia, A-V valve insufficiency were inclined to the group C and D Pleural effusion was influenced by the pulmonary artery size, pulmonary artery resistance, PCWP, and CVP significantly. [P<0.05] And arrhythmia, residual shunt, and A-V valvular insufficiency were inclined to group II and III, too. As a results, the followings are to be reminded as the important factors at the care of post-Fontan LCO, and persistent pleural effusion [1] pulmonary artery size, [2] pulmonary artery resistance, [3] PCWP, [4] CVP, [5] arrhythmia, [6] residual shunt, [7]A-V valvular insufficiency.

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