• Title/Summary/Keyword: Electrophysiology

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Pearls and Pitfalls of Pulsed Field Ablation

  • Stefan Hartl;Nico Reinsch;Anna Futing;Kars Neven
    • Korean Circulation Journal
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    • v.53 no.5
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    • pp.273-293
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    • 2023
  • Pulsed field ablation (PFA) was recently rediscovered as an emerging treatment modality for the ablation of cardiac arrhythmias. Ultra-short high voltage pulses are leading to irreversible electroporation of cardiac cells subsequently resulting in cell death. Current literature of PFA for pulmonary vein isolation (PVI) consistently reported excellent acute and long-term efficacy along with a very low adverse event rate. The undeniable benefit of the novel ablation technique is that cardiac cells are more susceptible to electrical fields whereas surrounding structures such as the pulmonary veins, the phrenic nerve or the esophagus are not, or if at all, minimally affected, which results in a favorable safety profile that is expected to be superior to the current standard of care without compromising efficacy. Nevertheless, the exact mechanisms of electroporation are not yet entirely understood on a cellular basis and pulsed electrical field protocols of different manufactures are not comparable among one another and require their own validation for each indication. Importantly, randomized controlled trials and comparative data to current standard of care modalities, such as radiofrequency- or cryoballoon ablation, are still missing. This review focuses on the "pearls" and "pitfalls" of PFA, a technology that has the potential to become the future leading energy source for PVI and beyond.

The Effect of Differences in Age and Sex on Vestibular Evoked Myogenic Potentials (연령과 성별의 차이가 전정 유발근전위에 미치는 영향)

  • Moon, Sung-Sik;Kim, Kyoung-Mi;Kim, Young-Ji;Kim, Young-Hwal
    • Korean Journal of Clinical Laboratory Science
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    • v.39 no.2
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    • pp.136-140
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    • 2007
  • The aim of this study was to examine the effect of differences in age and sex on vestibular evoked myogenic potentials (VEMP), particularly in normal participants. Briefly, the VEMP is a response elicited by loud clicks or tone bursts recorded from the tonically contracted sternocleidomastoid muscle. A total of 72 participants were divided into 6 groups according to their age and sex (20~30/F, 20~30/M, 40~50/F, 40~50/M, ${\geq}60/F$, ${\geq}60/M$). We got the data of latency, amplitude, and asymmetry index of the amplitude(ASI) from them. As a result of this study, there are variations in VEMP amplitudes and ASI depending on the muscle tension and the intensity of stimuli. In contrast, the latency of the response is usually less varied and does not differ significantly.

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Effects on Hyperalgesia of Electroacupuncture (전침자극이 통각과민에 미치는 효과)

  • Choi, Sug-Ju;Seo, Sam-Ki;Yoon, Se-Won;Lim, Sang-Wan;Choi, Eun-Young
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.5 no.1
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    • pp.73-83
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    • 2007
  • This study aims to examine the effects on nociceptive neuron excitability by application of electroacupuncture in rat with inflammation. It used 20 rats for experiment, divided them into control group, electroacupuncture group (EA group), caused hyperalgesia by injecting ${\lambda}$-carrageenan into hindpaw and conducted treatment three times for experimental period. Change of NFR(reaction time, RMS) showed no significant differences among EA group showed significant differences compared to control group from 48 hours. This study showed that EA group had an effect on nociceptive neurone excitability. Therefore, it is considered that electroacupuncture for pain control will be very desirable.

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Effects on Knee Joint Pain by Phonophoresis of Piroxicam Gel (피록시캄 겔의 음파영동이 슬관절 통증에 미치는 효과)

  • Choi, Sug-Ju;Yoon, Se-Won
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.1 no.2
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    • pp.31-38
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    • 2003
  • This study was to compared the effectiveness of piroxicam gel phonophoresis with conventional ultrasound therapy in knee osteoarthritis. Eighteen patients with a means age of $55.7{\pm}5$ years were randomly assigned to phonophoresis or ultrasound groups. Continuous ultrasonic waves of 1 MHz frequency and $1\;W/cm^2\;SATA_i$ were applied for 5 minutes to the target knee joint. This study indicated their pain level by marking on a visual analog scale(VAS) at the start of treatment and at the end of 3day. Osteoarthritis VAS scores, pain on rest state, non weight bearing range of motion, 20 meters walking, and walking step by the patients were evaluated before and after therapy. Both therapeutic modalities were found to be effective and generally well tolerated after 3 therapy sessions. But piroxicam phonophoresis was not superior to conventional ultrasound in patients with knee osteoarthritis.

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The Change of Pressure Pain Threshold of Myofascial Trigger Points by Transcutaneous Electrical Nerve Stimulation (경피신경전기자극에 의한 근-근막 발통점의 압통각 역치의 변화)

  • Lee, Jeong-Woo;Han, Dong-Wook
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.1 no.2
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    • pp.69-76
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    • 2003
  • The purpose of this study was to determine the effect of transcutaneous electrical nerve stimulation(TENS) on the alteration of pressure pain threshold of myofascial trigger points. We used fifty nine patients with upper trapezius mayofascial pain syndrome. Participants classified according to each group in conventional TENS(high rate, low intensity) and acupuncture like TENS(low rate, high intensity). The test was measured continuously pre test, post-test by algometer. The following results were obtained; 1. Pressure pain threshold were significantly increased in all groups(p<.001). 2. In comparison between groups, pressure pain threshold were not significantly differenced. These results lead us to the conclusion that each method by TENS were significantly increased pressure pain threshold of upper trapezius trigger points. Therefore, a further direction of this study will be to provide more evidence that TENS method have an effect on pressure pain threshold of myofascial trigger points.

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Functional Electrical Stimulation : A Review of Clinical Application (기능적 전기자극의 임상 적용에 관한 고찰)

  • Cho, Mi-Suk;Lee, In-Hak;Kim, In-Sup
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.4 no.1
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    • pp.39-47
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    • 2006
  • Functional Electrical Stimulation(FES) cause paralysed muscles to contract in some clinical circumstances. Generally, FES has been thought of as a valuable tool in activating any skeletal muscle paralysed as a result of upper motor neuron damage. But, the function of cardiac and smooth muscle is also affected by upper motor neuron damage. Today, various applications of FES are investigated, including conditioning cardiovascular exercise, caugh and breathing assistant, improving bowel and bladder control, hand grasp, standing and walking etc. This review will focus on the literature reporting application of FES to control respiratory capabilities and internal organ function as well as increase muscular strength, hand grasp, standing and walking in patients with upper motor diseases.

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