• Title/Summary/Keyword: Fibrillation

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A Clinical Analysis on the Restoration of Sinus Rhythm Following Mitral Valve Surgery (승모판 수술 후 동율동 회복에 관한 임상분석)

  • 백완기;심상석;김현태;조상록;진성훈
    • Journal of Chest Surgery
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    • v.32 no.4
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    • pp.347-352
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    • 1999
  • Background: The atrial fibrillation in patients with mitral valvular heart disease is frequently converted to sinus rhythm after the mitral valve surgery. This sinus restoration implies an important meaning in that it not only helps postoperative convalescence in patients with unstable hemodynamics but also reduces the rate of postoperative thromboembolism. Material and Method: We retrospectively analyzed 184 patients who received mitral valve surgery from June 1986 to December 1996 to investigate the trend of rhythm change following mitral valve surgery and thus to clarify the predisposing factors of postoperative sinus rhythm conversion and its maintenance. Result: The sinus rhythm was restored after the operation in 54 out of 139 patients with atrial fibrillation preoperatively(38.8%). However, the atrial fibrillation recurred in 41 patients at the time of discharge showing a recurrence rate of 75.9 percent. The mean duration of sinus rhythm in patients with eventual atrial fibrillation recurrence was 8.2${\pm}$5.9 days. Only 15 patients were in sinus rhythm at the time of late follow-up with the mean follow-up period of 84.4${\pm}$34.7 months. While the age, duration of symptoms, duration of atrial fibrillation, left atral size, and pulmonary artery pressure were thought to be the predisposing factors for sinus conversion after the operation, only the duration of atrial fibrillation and ejection fraction were considered risk factors for the recurrence of the atrial fibrillation following sinus conversion. Conclusion: This study suggests that the early operation is mandatory for the satisfactory result regarding postoperative rhythm. Moreover, additional operative measure in adjunct to the intervention of mitral valve should be considered for the maintenance of restored sinus rhythm as reflected by high postoperative recurrence rate of atrial fibrillation.

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Result of Cox Maze Procedure with Bipolar Radiofrequency Electrode and Cryoablator for Persistent Atrial Fibrillation - Compared with Cut-sew Technique - (양극고주파전극과 냉동프로브를 이용한 지속성 심방세동의 수술 결과 - 절개/봉합술식과 비교 -)

  • Lee, Mi-Kyung;Choi, Jong-Bum;Lee, Jung-Moon;Kim, Kyung-Hwa;Kim, Min-Ho
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.710-718
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    • 2009
  • Background: The Cox maze procedure has been used as a standard surgical treatment for atrial fibrillation for about 20 years. Recently, the creators have used a bipolar radiofrequency electrode (Cox maze IV procedure) instead of the incision and suture (cut-sew) technique to make atrial ablation lesions for persistent atrial fibrillation. We investigated clinical outcomes for the Cox maze procedure with a bipolar radiofrequency electrode and cryoablator in patients with persistent atrial fibrillation, and compared results with clinical outcomes of the cut-sew procedure. Material and Method: Between April 2005 and July 2007, 40 patients with persistent atrial fibrillation underwent Cox maze IV procedure with a bipolar radiofrequency electrode and cryoablator (bipolar radiofrequency group). Surgical outcomes were compared with those of 35 patients who had the cut-sew technique for the Cox maze III procedure. All patients had concomitant cardiac surgery. Postoperatively, the patients were followed up every 1 to 2 months. Result: At 6 months postoperatively, the conversion rate to regular sinus rhythm was not significantly different between the two groups: 95.0% for the bipolar radiofrequency ablation group; 97.1% for the cut-sew technique (p=1.0). At the end of the follow-up period, the conversion rate to regular sinus rhythm was also not significantly different (92.5% vs. 91.6%, p=1.0). In multivariate analysis using a Cox-regression model, the postoperative atrial dimension was an independent determinant of sinus conversion in the bipolar radiofrequency ablation group (hazard ratio 31, p=0.005). In the Cox-regression model for both groups, atrial fibrillation at 6 months postoperatively (hazard ratio 92.24, p=0.003) and the postoperative left atrial dimension (hazard ratio 16.05, p=0.019) were independent risk factors of continuance or recurrence of atrial fibrillation after Cox maze procedures. Aortic cross-clamp time and cardiopulmonary bypass time were significantly shorter in the radiofrequency group than in the cut-sew group. Conclusion: In the Cox maze procedure for patients with persistent atrial fibrillation, the use of bipolar radiofrequency ablation and a cryoablator is as good as the cut-sew technique for conversion to sinus rhythm. The postoperative left atrial dimension is an independent determinant of postoperative continuance and recurrence of atrial fibrillation.

Efficacy of Cox Maze IV Procedure Using Argon-Based Cryoablation: A Comparative Study with $N_2O$-Based Cryoablation

  • Lee, Kyung-Hak;Min, Jooncheol;Kim, Kyung-Hwan;Hwang, Ho Young;Kim, Jun Sung
    • Journal of Chest Surgery
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    • v.47 no.4
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    • pp.367-372
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    • 2014
  • Background: We compared the mid-term results of the Cox maze IV procedure using argon-based cryoablation with a procedure using $N_2O$-based cryoablation. Methods: From May 2006 to June 2012, 138 patients (mean age, $58.2{\pm}11.0$ years) underwent the Cox maze IV procedure. Eighty-five patients underwent the maze procedure using an $N_2O$-based cryoprobe (group N), and 53 patients underwent the maze procedure using an argon-based cryoprobe (group A). Bipolar radiofrequency ablation was concomitantly used in 131 patients. The presence of atrial fibrillation immediately, 6 months, 1 year, and 2 years after surgery was compared. Results: Early mortality occurred in 6 patients (4.3%). There were no differences in early mortality or postoperative complications between the two groups. Nineteen of 115 patients (16.5%) remained in atrial fibrillation at postoperative 12 months (14 of 80 patients (17.5%) in group N and 5 of 35 patients (14.3%) in group A, p=0.669). There were no differences in the number of patients who remained in atrial fibrillation at any of the time periods except in the immediate postoperative period. A multivariable analysis revealed that the energy source of cryoablation was not associated with the presence of atrial fibrillation at 1 year (p=0.862) and that a fine F wave (<0.1 mV) was the only risk factor predicting the presence of atrial fibrillation at 1 year (p<0.001, odds ratio=20.287). Conclusion: The Cox maze IV procedure using an argon-based cryoprobe was safe and effective compared with the maze procedure using an $N_2O$-based cryoprobe in terms of operative outcomes and the restoration of sinus rhythm for up to 2 years after surgery.

Fibrillation in TLCP/Polyester Binary Blends

  • Kim, Jun-Young;Kim, Seong-Hun
    • Proceedings of the Korean Fiber Society Conference
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    • 2003.10a
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    • pp.101-101
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    • 2003
  • TLCP/Polyester binary blends were prepared by melt blending. Rheological, morphological, and thermal properties of of TLCP/polyester blends were investigated with viscosity ratio. Diameter of TLCP fibrils decreased with viscosity ratio. More and smaller TLCP fibrils were obtained at higher shear rate. Lower viscosity ratio was necessary for the fibrillation of TLCP in the binary blends.

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Seed-dependent Accelerated Fibrillation of ${\alpha}$-Synuclein Induced by Periodic Ultrasonication Treatment

  • Kim, Hyun-Jin;Chatani, Eri;Goto, Yuji;Paik, Seung-R.
    • Journal of Microbiology and Biotechnology
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    • v.17 no.12
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    • pp.2027-2032
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    • 2007
  • [ ${\alpha}$ ]-Synuclein is the major component of Lewy bodies and responsible for the amyloid deposits observed in Parkinson's disease. Ordered filamentous aggregate formation of the natively unfolded ${\alpha}$-synuclein was investigated in vitro with the periodic ultrasonication. The ultrasonication induced the fibrillation of ${\alpha}$-synuclein, as the random structure gradually converted into a ${\beta}$-sheet structure. The resulting fibrils obtained at the stationary phase appeared heterogeneous in their size distribution, with the average length and height of $0.28\;{\mu}m{\pm}0.21\;{\mu}m$ and $5.6\;nm{\pm}1.9\;nm$, respectively. After additional extensive ultrasonication in the absence of monomeric ${\alpha}$-synuclein, the equilibrium between the fibril formation and its breakdown shifted to the disintegration of the preexisting fibrils. The resulting fragments served as nucleation centers for the subsequent seed-dependent accelerated fibrillation under a quiescent incubation condition. This self-seeding amplification process depended on the seed formation and subsequent alterations in their properties by the ultrasonication to a state that accretes the monomeric soluble protein more effectively than their reassociation of the seeds back to the original fibrils. Since many neurodegenerative disorders have been considered to be propagated via the seed-dependent amyloidosis, this study would provide a novel aspect of the significance of the seed structure and its properties leading to the acce]erated amyloid formation.

Automatic Detection of Congestive Heart Failure and Atrial Fibrillation with Short RR Interval Time Series

  • Yoon, Kwon-Ha;Nam, Yunyoung;Thap, Tharoeun;Jeong, Changwon;Kim, Nam Ho;Ko, Joem Seok;Noh, Se-Eung;Lee, Jinseok
    • Journal of Electrical Engineering and Technology
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    • v.12 no.1
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    • pp.346-355
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    • 2017
  • Atrial fibrillation (AF) and Congestive heart failure (CHF) are increasingly widespread, costly, deadly diseases and are associated with significant morbidity and mortality. In this study, we analyzed three statistical methods for automatic detection of AF and CHF based on the randomness, variability and complexity of the heart beat interval, which is RRI time series. Specifically, we used short RRI time series with 16 beats and employed the normalized root mean square of successive RR differences (RMSSD), the sample entropy and the Shannon entropy. The detection performance was analyzed using four large well documented databases, namely the MIT-BIH Atrial fibrillation (n=23), the MIT-BIH Normal Sinus Rhythm (n=18), the BIDMC Congestive Heart Failure (n=13) and the Congestive Heart Failure RRI databases (n=25). Using thresholds by Receiver Operating Characteristic (ROC) curves, we found that the normalized RMSSD provided the highest accuracy. The overall sensitivity, specificity and accuracy for AF and CHF were 0.8649, 0.9331 and 0.9104, respectively. Regarding CHF detection, the detection rate of CHF (NYHA III-IV) was 0.9113 while CHF (NYHA I-II) was 0.7312, which shows that the detection rate of CHF with higher severity is higher than that of CHF with lower severity. For the clinical 24 hour data (n=42), the overall sensitivity, specificity and accuracy for AF and CHF were 0.8809, 0.9406 and 0.9108, respectively, using normalized RMSSD.

Detecting Ventricular Tachycardia/Fibrillation Using Neural Network with Weighted Fuzzy Membership Functions and Wavelet Transforms (가중 퍼지소속함수 기반 신경망과 웨이블릿 변환을 이용한 심실 빈맥/세동 검출)

  • Shin, Dong-Kun;Zhang, Zhen-Xing;Lee, Sang-Hong;Lim, Joon-S.;Lee, Jung-Hyun
    • The Journal of the Korea Contents Association
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    • v.9 no.7
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    • pp.19-26
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    • 2009
  • This paper presents an approach to classify normal and ventricular tachycardia/fibrillation(VT/VF) from the Creighton University Ventricular Tachyarrhythmia Database(CUDB) using the neural network with weighted fuzzy membership functions(NEWFM) and wavelet transforms. In the first step, wavelet transforms are used to obtain the detail coefficients at levels 3 and 4. In the second step, all of detail coefficients d3 and d4 are classified into four intervals, respectively, and then the standard deviations of the specific intervals are used as eight numbers of input features of NEWFM. NEWFM classifies normal and VT/VF beats using eight numbers of input features, and then the accuracy rate is 90.1%.

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.

Physical Property and Virtual Sewing Image of Lyocell treated with Epichlorohydrine for the fibrillation control

  • Park, Ji-Yang;Jeon, Dong-Won;Kim, Sin-Hee
    • Journal of Fashion Business
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    • v.12 no.6
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    • pp.46-60
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    • 2008
  • Lyocell is a regenerated cellulosic fiber manufactured by an environmentally friendly process. The major advantages of lyocell are the excellent drape forming property, the genuine bulkiness, smooth surface, and high dry/wet tenacities. However, one drawback of lyocell is its fibrillation property, which would degrade its aesthetic quality and lower the consumer satisfaction. In our previous studies, lyocell was treated with epichlorohydrin, a non-formalin based crosslinker, to reduce its fibrillation tendency. To investigate the changes of physical properties upon ECH-treatment, the hand characteristics of ECH-treated fabric were observed using KES-FB system and the 3D-virtual sewing image of the fabrics were obtained using 3D CAD simulation system in this study. Since epichlorohydrin(ECH) treatment was conducted in the alkaline medium, the weight reduction was observed in all treated lyocell. The treated lyocell became light, smooth and flexible in spite of ECH crosslinker application. LT and RT in tensile property upon the ECH treatment did not change significantly, however, EMT and WT in the tensile property increased. The significant decrease in bending rigidity was resulted in all ECH-treated lyocell, which is the result of the weight loss upon the alkali condition of ECH treatment. The bending rigidity increased again in the ECH 30% treated lyocell, however, the B value is still lower than the original. Therefore, the ECH-treated lyocell would be more stretchable and softer than the original. Shear rigidity was also decreased in all ECH-treated lyocell, which would result in more drape and body fitting when it is made as a garment. The ECH-treated fabric showed the softer smoother surface according to SMD value from KES evaluation. The virtual 3D sewing image of the ECH-treated lyocell did not show a significant change from that of the original except ECH 30% treated lyocell. ECH 30% treated lyocell showed a stiffer and more puckered image than the original.

Effect of Different Delignification Degrees of Korean White Pine Wood on Fibrillation Efficiency and Tensile Properties of Nanopaper (잣나무의 탈리그닌 정도가 습식 해섬처리 효율 및 나노종이 인장 특성에 미치는 영향)

  • Park, Chan-Woo;Lee, Seo-Ho;Han, Song-Yi;Kim, Bo-Yeon;Jang, Jae-Hyuk;Kim, Nam-Hun;Lee, Seung-Hwan
    • Journal of the Korean Wood Science and Technology
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    • v.43 no.1
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    • pp.17-24
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    • 2015
  • In this study, the effect of delignification degree of Korean white pine wood on fibrillation efficiency by wet disk-milling (WDM) and the properties of thus-obtained microfibrillated cellulose (MFC) were investigated. The effect on the tensile properties of nanopaper was also investigated. The delignification degree was adjusted by repeating 'Wise' method using sodium chlorite and acetic acid. The increase in delignification degree improved fibrillation efficiency, showing the smaller nanofiber dimension at the shorter WDM time. The filtration time of MFC water suspension was increased by the increase of WDM cycles. Tensile strength and elastic modulus of the nanopaper were increased by increasing delignification degree and disk-milling cycles.