• Korean Journal of Oriental Medicine
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• v.13 no.3
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• pp.97-103
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• 2007

The object of this study is to evaluate confounding effect of sleeping behavior on heart rate variability (HRV) in healthy volunteers during a randomized clinical trial. From 6 healthy volunteer, we acquired circadian electrocardiography(ECG) with a Holter monitoring device(DigiTrak Plus, Philips). The compatible analytical program, Zymed, was used for calculation of RR intervals of 24h ECG signal. Then, we generated HRV signals and calculated 9 HRV parameters in time domain and frequency domain for every 30 minute with Matlab 6.x software. We also encoded participants' activities as follows; stable condition(1), sleeping behavior(2), eating behavior(3), and undefined condition(4). Using SPSS 12.0, we tested if there was any difference between HRV parameters of day-time and night-time and between those of a subject in stable condition and in sleeping behavior. As a result, one of the most important parameter-LF/HF ratio, which indicates the autonomic balance between sympathetic and parasympathetic nervous systems, as same the other parameters, showed large inter-individual variations in circadian profiles. And, the mean LF/HF ratio of each participant was different between in stable condition and in sleeping behavior (p<.05). Consequently, the effect of sleeping behavior must be considered when one or more of HRV parameters, especially LF/HF ratio, are used as assessment index in clinical studies.

• Journal of the Institute of Convergence Signal Processing
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• v.22 no.2
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• pp.45-50
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• 2021

With the recent development of IT technology, research and interest in various bio-signal measuring devices are increasing. But studies related to ECG(electrocardiogram), which is one of the most representative bio-signals, particularly arrhythmic signal detection, are incomplete. Since arrhythmia has various causes and has a poor prognosis after onset, preventive treatment through early diagnosis is best. However, the 24-hour Holter electrocardiogram, a tool for diagnosing arrhythmia, has disadvantages in the limitation of use time, difficulty in analyzing motion artifact due to daily life, and the user's real-time alarm function in danger. In this study, an ECG and pulse monitoring device capable of continuous measurement for a long time, a real-time monitoring app, and software for analysis were developed, and the trend of the measured values was confirmed. In future studies, research on derivation of quantitative results of ECG signal measurement analysis is required, and further research on the development of an arrhythmic signal detection algorithm based on this is required.

• Journal of Biomedical Engineering Research
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• v.20 no.1
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• pp.75-80
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• 1999

Since a Holter monitor records a patients' ECG when he is in motion, it can monitor complex heart disease effectively. But it can not handle a sudden heart disease because the diagnosis process will be done only after 24 hours. So in this study, a model of ambulatory monitoring system using wireless data communication network is proposed. And a mobile ECG equipment and a doctors' terminal are developed for the proposed system implementation. As a result, we can evaluate that the proposed ambulatory monitoring system is suitable for the management of ambulatory patients who may be at risk form sudden cardiac abnormalities.

• Journal of the Korean Society of Clothing and Textiles
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• v.34 no.1
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• pp.112-125
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• 2010

A Holter monitor is used for ECG monitoring of ambulatory daily life in hospital. However, the use of this apparatus causes skin allergies and discomfort in patients because of the attachment gel and tapes used to attach disposable electrodes to the skin. In this study, the development of tight-fitting clothing connected to a portable Holter monitor was proposed. In addition, the use of conductive fabrics as electrodes was proposed; this will enable the use of garments in u-health care for measuring ECG signals. The male subjects were university students in the ages of 20 to 24. Subjective wear sensations of the experimental garments were rated using seven Likert scales. A Likert type scale was used for the evaluation and a 7 point score indicates that it provided the best fit as a tight-fitting upper clothing. Clothing pressure was measured using an air-pack-type pressure sensor (model AMI 3037-2) at 4 locations (the conductive fabric electrode) As results, a male basic sloper for upper clothing was developed and that pattern was manipulated to the tight fit pattern by considering the reduction rate of the percentage stretch in the fabric. The developed tight-fitting garment was superior in terms of subjective sensation and 6t. The mean pressure of the garment with reduction rates of 40% in width and of 50% in length was 8.45gf/$cm^2$. A conductive fabric electrode was developed by considering the sewing method and the developed electrode was detected well. The ECG data were recorded for 13 hr 19 min 44 sec and the artifacts in the ECG signals were recorded for 9 hr 3 min 46 sec (total time: 22 hr 23 min 23 sec). The artifacts data were obtained during heavy activities.

• Journal of Chest Surgery
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• v.32 no.10
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• pp.903-909
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• 1999

Background: The current study was undertaken to investigate the results of a modification in the conventional Maze III Procedure devised by the authors. The aim of the technical modification was in improving the left atrial contractility. Material and Method: Between July 1997 and December 1998, 34 patients with chronic atrial fibrillation for more than 1 year duration underwent a modified Maze III procedure. The assessment of the left atrial function was made by various echocardiographic measurements and SA nodal recovery was evaluated by HRV Holter monitoring. Result: All 34 patients were in sinus rhythm. On echocardiography, right atrial contraction was detected in 32 patients(94.1%) and left atrial contraction in 33 patients(97.1%). The echocardiographic A wave at 1, 6, and 12 months or more were 50.5$\pm$31.5, 62.1$\pm$25.1, 66$\pm$20.6 cm/sec, respectively, and the E wave measurements at the same time points were 152$\pm$31.1, 134.4$\pm$35.2, 133$\pm$27.5 cm/sec. The corresponding A/E ratios were 0.32$\pm$0.13, 0.48$\pm$0.18, 0.5$\pm$0.15, showing a rising trend. Treadmill evaluation at 6 months showed a mean 82% increase in heart rate after excising, and the SDNN and SDANN upon HRV Holter at 1 and 3 months postoperatively were 65.3$\pm$28.1/87.8$\pm$27.2 ms, and 60.0$\pm$24.1/83.4$\pm$25.7 ms, respectively, showing a predoinant autonomic recovery in the parasympathetic system(PSDNN = 0.01, PSDANN =0.015). Conclusion: The results of our data suggest that the current modification in the conventional Maze III Procedure was efective in enhancing the postoperative left atrial contractility.

• The Journal of the Korean life insurance medical association
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• v.27 no.1
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• pp.18-20
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• 2008

I have taught various case audit underwriting methods to underwriters for many years. Underwriting requires specialized medical knowledge and experience of comprehensive individual risk analysis. Decisions in individualized underwriting depend on the insurance company's management philosophy and vision, marketing strategies, culture, product line etc. They also depend on the information acquired through proposal forms, inspection reports, laboratory results and disclosures. Underwriters match this acquired information to each insurance product, search appropriate medical resources, assess the probabilities of future claims, and decide what, if any, further medical information should be gathered. Sources include doctors' reports, medical records, biopsies, blood and urine tests, CT, MRI, Holter monitoring, sonography etc. Insurance medical directors help and teach underwriters to analyze individual medical risks and make effective.

• Tuberculosis and Respiratory Diseases
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• v.46 no.5
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• pp.645-653
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• 1999

Introduction : Although myocardial ischemia tends to occur more frequently than can he documented in ventilated patients, it has not been well studied on the factors related to the occurrence of the ischemia. Methods : To investigate the related factors to ischemia development, a prospective study was done in 95 cases with consecutive 73 patients who had received mechanical ventilation(MV) in MICU. In addition to 24 h holter monitoring, echocardiogram, electrolytes, cardiac enzymes, hemodynamic, and gas exchange measurements were done within 24 h after initiation of MV in 69 cases. The measurements were repeated at weaning period in 26 cases. The ischemia was defined by the ST segment changes; up-sloping depression more than 1.5 mm or down-sloping or horizontal depression more than 1.0 mm from isoelectric baseline for 80 ms following J point. Results : Twelve patients(12.6% in 95 cases) developed ischemia in total. The incidence of ischemia development showed an increased tendency in the initial 24 hr after MV (15.9%) and in patients with left-sided heart failure found by echocardiogram (18.2%) compared with that of the weaning period (3.8%) and patients without heart failure (10.9%) (P=0.12, P=0.09, in each). There were no differences in APACHE III score, baseline ECG findings, electrolytes abnormalities, use of inotropics or bronchodilators, presence of sepsis or shock, mode of ventilation, and survival rate according to the development of ischemia. Maximal heart rates and mean arterial pressure also were not different between patients with ($137.2{\pm}30.9/min$, $82.5{\pm}15.9$ mm Hg) and without ischemia ($l29.5{\pm}29.7/min$, $83.8{\pm}17.6$ mm Hg). Conclusion : Although the incidence of myocardial ischemia was 12.6% in total, there were no clinically predictable factors to the development of ischemia during mechanical ventilation.

• Journal of Chest Surgery
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• v.47 no.4
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• pp.358-366
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• 2014

Background: To improve sinus rhythm conversion, the Cox maze III procedure with narrow mazes (width: ${\leq}3.0cm$) was performed in combination with left atrial volume reduction. Methods: From October 2007 to April 2013, 87 patients with atrial fibrillation (paroxysmal in 3, persistent in 14, and permanent in 70) underwent the Cox maze procedure concomitant with another cardiac procedure. They were followed-up with serial electrocardiographic and echocardiographic studies. We used 24-hour Holter monitoring tests to evaluate postoperatively symptomatic patients. Results: At the mean follow-up time of 36.4 months, 81 patients (94.2%) had sinus rhythm and two were on anti-arrhythmic medication (one on a beta-blocker and the other on amiodarone). Five patients (5.8%) with postoperative recurrent and persistent atrial fibrillation never experienced sinus rhythm conversion; however, they did not require any medication for rate control. On postoperative echocardiography, the left atrial A waves were more frequently observed after concomitant mitral valve repair than after concomitant mitral valve replacement (82.4% vs. 40.4%, respectively; p<0.001). Conclusion: For the Cox maze procedure, narrow mazes and atrial volume reduction resulted in excellent sinus rhythm conversion without the preventive use of anti-arrhythmic drugs, and they did not affect the presence of the left atrial A waves on echocardiography.

• Journal of Yeungnam Medical Science
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• v.11 no.1
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• pp.181-185
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• 1994

Pacemaker malfunctions are secondary to alterations of the preset pacing rate, irregular pacing failure of sensing, failure of cardiac capture or depolarization, and various combinations of these events. A 76 years old male patient was admitted due to pacemaker malfunction. 2 years ago, he was diagnosed as complete atrioventricular block. And then bipolar permanent pacemaker was implanted. Since then syncopal attack developed repetitivly. 12 lead ECG and 24 hour holter moniter monitoring, revealed pacing and sensing failure, thus we converted bipolar system into unipolar system. Since then syncopal attack did not developed again.

• Clinical and Experimental Pediatrics
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• v.59 no.sup1
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• pp.129-132
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• 2016

Ictal tachycardia and bradycardia are common arrhythmias; however, ictal sinus pause and asystole are rare. Ictal arrhythmia is mostly reported in adults with temporal lobe epilepsy. Recently, ictal arrhythmia was recognized as a major warning sign of sudden unexpected death in epilepsy. We present an interesting case of a child with ictal sinus pause and asystole. A 27-month-old girl was hospitalized due to 5 episodes of convulsions during the past 2 days. Results of routine electroencephalography (EEG) were normal, but she experienced brief generalized tonic seizure for 3 days. During video-monitored EEG and echocardiography (ECG), she showed multiple myoclonic seizures simultaneously or independently, as well as frequent sinus pauses. After treatment with valproic acid, myoclonus and generalized tonic seizures were well controlled and only 2 sinus pauses were seen on 24-hour Holter ECG monitoring. Sinus dysfunction should be recognized on EEG, and it can sometimes be treated successfully with only antiepileptic medication.