• Korean Journal of Clinical Pharmacy
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• v.26 no.1
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• pp.84-95
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• 2016

Objective: Atrial fibrillation (AF) guidelines have been published in the USA and Europe. Recently, the USA and Europe have updated their guidelines, respectively. These new AF guidelines help in addressing key management issues in clinical situations. This study, therefore, systematically compared guidelines for rate and rhythm control pharmacotherapy of patients with AF between the USA (American College of Cardiology and American Heart Association, ACC/AHA) and Europe (European Society of Cardiology, ESC). Methods: This study investigated and compared American guidelines (2014) and European guidelines (2010 and 2012). Results: Generally, there are four meaningful differences between ACC/AHA and ESC guidelines. Important differences are treatment classification system, level of recommendation, drug list, and dosage. In addition, ACC/AHA described pharmacokinetic drug interactions for antiarrhythmic drugs. ESC emphasized ECG and atrioventricular nodal slowing as feature of antiarrhythmic drugs. Conclusion: This research addresses important use of anti-arrhythmic drugs and movement to accept recent recommendations in Korea. For the successful application of the guidelines, a role of pharmacists is crucial in clinical situation.

• Journal of Korea Technical Association of The Pulp and Paper Industry
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• v.34 no.5
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• pp.56-62
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• 2002

Alternative way of shaping fibers suitable for papermaking was introduced. Impact refining, which was done simply by hitting wet fibers with a metal weight vertically, was intended to keep the fibers from shortening and to cause mostly internal fibrillation. Virgin chemical pulp, its recycled one and OCC were used in the experiment. It was noticed from the experiment that impact refining on virgin chemical pulp kept the fiber length and increased bonding properties greatly. However, in the recycled fibers from the chemical pulp, fiber length and bonding properties were decreased. In OCC, which seems to contain fractions of semi-chemical pulp and mechanical pulp (GP), and which is recycled pulp from corrugated boxes, fiber length and bonding properties were decreased disastrously. We believe recycled cellulosic fibers (recycled chemical pulp and OCC in this case), which went through hornification, were less resistant to the mechanical impact than virgin chemical pulp. For virgin chemical pulp, impact refining allowed no significant fiber length shortening, high WRV, and high mechanical strength.

• Proceedings of the KIEE Conference
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• 2007.10a
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• pp.473-474
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• 2007

본 연구는 체내 이식형 Pacemaker를 연구하면서 심장 질환을 Therapy 해 주는 방법에 대해 저전력 및 성능향상에 중점을 두고 연구 및 실험을 하였다. 우선적으로 심장의 심박동을 연산량이 적은 Peak_detection에서 체크하여 전력소모를 줄이고 나오는 각 심실 및 심방의 Interval을 Disease_episode 에서 받는다. 여기서 5가지 심실 및 심방에 관한 질환들 (VF : Ventricular Fibrillation, VT : Ventricular Tachycardia, FVT : Fast Ventricular Tachycardia, FAT_AF : Fast Atrial Tachycardia/Atrial Fibrillation, AT_AF : Atrial Tachycardia AT_AF : Atrial Fibrillation)을 판별한 후 각 병증에 맞는 Therapy 값을 출력하게 하였다. 그 외에 남아있는 병증에 대해서도 Therapy가 저전력 및 성능향상 되도록 설계하였다. 기존에 적용되어 있는 Detection 기법에서는 각각의 병증에 대해서 각 Detection이 있어 VF와 VT 사이에 있는 FVT와 같은 병증을 치료할 때 FVT 같은 경우에는 VF와 VT사이에 있는 질병이기 때문에 FVT_VF 및 FVT_VT와 같이 각각의 Detection을 두어 전력 소모가 있었다. 심장에서는 여러 질병이 한번에 나을 수 없다는 것에 착안하여 (심박동 Interval에 의해 질병이 판단되므로) 다른 병증이지만 같은 진단 기준을 쓰는 Detection을 통합함으로써 하나의 모듈로 구성하여 Gate수를 줄이고 저전력을 구현하였다. 또한 병증을 판별하는 진단 기준 모듈 중 Onset_Criterion 재설계하여 좀더 성능 향상에 중점을 두었다.

• 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.

• Journal of Korean Academy of Nursing Administration
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• v.15 no.2
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• pp.203-215
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• 2009

Purpose: In order to improve resuscitation rate of CPR through providing qualitative nursing while performing CPR in hospital ward and to enhance quality of emergency nursing in the ward, the author embarked on the research as a way of developing ventricular fibrillation protocol about CPR. Method: Collected data were analyzed by using the SPSS/PC14.0 program while the routes of final protocol developed in this research are as follows. Result: Based on analysis results of literature study and CPR electronic hospital records, a total of 22 items and 53 specific contents were confirmed through the gathering of opinions from panels, and the allotment of roles and tasks with a standard of 2 nurses was designated. As the result of specialists' verification on validity, the final protocol composed of a total of 23 items and 45 specific contents was confirmed. At the result of the pertinency evaluation of confirmed protocol, it was evaluated as relatively pertinent with its average score 2.89-3.32. Conclusion: The protocol developed in this research is seen as to contribute to nurses participating in CPR to avoid the overlapping of tasks and to develop CPR through effective teamwork of medical teams by presenting clear roles and tasks.

• Journal of Chest Surgery
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• v.57 no.1
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• pp.1-24
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• 2024

• Korean Journal of Clinical Pharmacy
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• v.23 no.2
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• pp.151-157
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• 2013

Purpose: Warfarin is the most widely used anticoagulant drug for preventing cardiovascular diseases after ischemic stroke and thromboembolism related to atrial fibrillation, artificial heart valves, deep vein thrombosis, and pulmonary embolism. Warfarin is commonly used in combination with other drugs such as diuretics in order to treat the comorbidity. Although several warfarin-diuretics interactions have been reported, the results are conflicting. Therefore, the initial aim of this study was to identify the effects of diuretics on the warfarin response in patients with atrial fibrillation. Methods: One hundred forty six patients with atrial fibrillation who were on anticoagulation therapy with warfarin and maintained INR levels of 2-3 for three consecutive times were followed up, retrospectively. Stable warfarin doses and INR per stable warfarin dose were compared according to age, gender, comorbidity, and concurrent medication. The stable warfarin dose was defined as the maintenance dose of warfarin of the measured patient whose INR was within the target INR range more than 3 times consecutively. Results: The differences of stable warfarin doses in patients with ($3.22{\pm}1.21$ mg/day) and without ($3.58{\pm}1.14$ mg/day) diuretics were marginally significant (P=0.069). On the other hand, stable warfarin doses were $2.97{\pm}1.10$ mg/day in patients with thiazide (n=36) and $3.58{\pm}1.14$ mg/day in patients without diuretics (n=82), which was statistically significant (p=0.009). INR values per stable warfarin dose in patients with diuretics and thiazide were $0.84{\pm}0.31$ and $0.90{\pm}0.34$, respectively, which were statistically different from those without diuretics ($0.72{\pm}0.21$, P=0.010 and P=0.006, respectively). Age, gender, and concurrent use of thiazide diuretics were found to have significant influence on the warfarin response from multivariate analysis. Conclusion: Our study showed that the concurrent use of thiazide diuretics could increase the response of warfarin in patient with atrial fibrillation. Therefore, clinicians should be aware that warfarin dose needs to be adjusted when it is used with thiazide diuretics concomitantly.

• Journal of Chest Surgery
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• v.31 no.7
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• pp.668-673
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• 1998

During the past several years, the maze operation has become the most effective method of treatment for chronic atrial fibrillation. When the maze procedure is done concomittantly with other cardiac operations, surgeons, in their initial experiences, may be concerned about the additional operative risks and uncertainty of the results. We performed the Cox-maze III procedure in six cases of chronic atrial fibrillation associated with mitral, mitral & aortic, or coronary arterial disease. Maze III procedure was done with open mitral commissurotomy(3 cases), mitral valve replacement(1 case), aortic and mitral valve replacement(1 case), and two-vessel coronary bypass graft(1 case). In spite of rather prolonged aortic cross clamp time, cardiac recovery was uneventful in all cases. No cases required reexploration for postoperative bleeding. All patients showed regular sinus rhythms immediate or between 2 and 20 days postoperateratively. Transient postoperative supraventricular arrhythmarias were easily controlled by various antiarrhythmic agents. In follow up evaluations, all cases showed regular sinus rhythm on ECG and the right and left atrial transport function was confirmed by Doppler echocardiography in all except one. Though our experience was limited in case number, the Cox-maze III procedure was effective in controlling the chronic atrial fibrillation without serious additional operative risks.

• Journal of Chest Surgery
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• v.32 no.3
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• pp.255-261
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• 1999

Background: Atrial fibrillation is one of the most prevalent of all arrhythmias and in up to 79% of the patients with mitral valve disease. This study examined whether the atrial fibrillation that occur in patients with mitral valve operation could be eliminated by a concommitant maze operation without cryoablation. Material and Method: From May 1997 to April 1998, 14 patients with atrial fibrillation associated with mitral valve disease underwent Maze III operation without cryoablation. Preoperatively there were 6 men and 8 women with an average age of 46.2${\pm}$10.7 years. Eleven patients had mitral stenosis, and three had mitral insufficiency. The associated heart diseases were aortic valve disease in 4, tricuspid valve regurgitation in 1 and ASD in 2. Using transthoracic echocardiography, the mean left atrial diameters was 54.7${\pm}$5.3 mm and thrombi were found in the left atrium of 2 patients. Postoperatively the ratio between the peak speed of the early filling wave and that of the atrial contraction wave (A/E ratio) was determined from transmitral flow measurement. Operations were mitral valve replacement in 13 including 4 aortic valve replacements, 1 DeVega annuloplasty and 2 ASD closures. Maze III operation was performed in 1 patient. Result: Five patients (38%) had recurred atrial fibrillation, which was reversed with flecainide or amiodarone at the average time of postoperative 38.8${\pm}$23.5 days. Postoperative complications were postoperative transient junctional rhythm in 6, transient atrial fibrillation in 5, reoperation for bleeding in 3, postpericardiotomy syndrome(1), unilateral vocal cord palsy(1), postoperative psychosis(1), and myocardial infarction(1). Postoperatively A/E ratio was 0.43${\pm}$0.22 and A wave found in 9(64%) patients. 3 to 14 months postoperatively (average follow- up, 8.1 months), all of patients had normal sinus rhythm and 9(64%) patients had left atrial contraction and 11(79%) patients were not on a regimen of antiarrhythmic medication. Conclusion: We conclude that Maze III operation without cryoablation is an effective surgical treatment in atrial fibrillation associated with the mitral valve disease.

• Proceedings of the KTCVS Conference
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• 2004.06a
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• pp.162-163
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• 2004