• 제목/요약/키워드: Lethal Arrhythmia

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QT-interval prolongation due to medication found in the preoperative evaluation

  • Seto, Mika;Koga, Sayo;Kita, Ryosuke;Kikuta, Toshihiro
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제17권4호
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    • pp.323-327
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    • 2017
  • QT prolongation is an electrocardiographic change that can lead to lethal arrhythmia. Acquired QT prolongation is known to be caused by drugs and electrolyte abnormalities. We report three cases in which the prolonged QT interval was improved at the time of operation by briefly discontinuing the drugs suspected to have caused the QT prolongation observed on preoperative electrocardiography. The QTc of cases 1, 2, and 3 improved from 518 to 429 ms, 463 to 441 ms, and 473 to 443 ms on discontinuing the use of a gastrointestinal prokinetic agent, a proton pump inhibitor, and a molecular targeted drug, respectively. These cases were considered to have drug-induced QT prolongation. We reaffirmed that even drugs administered for conditions unrelated to cardiac diseases can have adverse side effect of QT prolongation. In conclusion, our cases indicate that dental surgeons should be aware of the dangerous and even potentially lethal side effects of QT prolongation. For safe oral and maxillofacial surgery, cooperation with medical departments in various fields is important.

마이크로 컴퓨터를 이용한 다중 채널 심장 전기도 시스템 개발 (Development of Multi-Channel Cardiac Mapping System Using Microcomputer)

  • 장병철;김원기;김남현;정성헌
    • 대한의용생체공학회:학술대회논문집
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    • 대한의용생체공학회 1991년도 춘계학술대회
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    • pp.94-97
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    • 1991
  • 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 16 channel computerized data analysis system using microcomputer for basic research of electrophysiology and electrical propagation. 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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태아 심초음파 검사로 진단 된 뒤 출생 후 Propafenone으로 치유된 신생아 심방조동 1례 (A Case of Neonatal Atrial Flutter Treated by Propafenone after Fetal Echocardiographic Diagnosis)

  • 이경화;하창우;김철호;송민섭;성문수
    • Clinical and Experimental Pediatrics
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    • 제45권7호
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    • pp.928-932
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    • 2002
  • 저자들은 재태 연령 $38^{+6}$주에 태아 심초음파 검사에 의해 태아 심방 조동이 발견되어 산모에게 digoxin을 투여하였으나 효과가 없어 제왕 절개술을 통해 분만한 후, digoxin, 전기적 심율동 전환에 의해서도 치료되지 않아 propafenone을 복용하여 정상 동율동으로 회복된 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

64채널 심장전기도 시스템 구현에 관한 연구 (64 channels computerized cardiac mapping system)

  • 장병철;김남현
    • 대한의용생체공학회:의공학회지
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    • 제16권1호
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    • pp.107-113
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    • 1995
  • 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 ${II}_{x}$) for basic research of electrophysiology and electrical propagation. The bipolar electrogram information is acquired from 64 cardiac sites simultaneously at a sampling rate of 1 ksampls/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 is 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 result of diagnosis and surgical treatment for cardiac arrhythmia.

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심장 섬유종 -1례 보고- (A Case Report of Cardiac Fibroma)

  • 장재한;김민호;조중구;김공수
    • Journal of Chest Surgery
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    • 제29권1호
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    • pp.99-102
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    • 1996
  • Cardiac fibroma is a rare benign tumor of the heart that occurs primarily in infants and children. Prognosis depends on size, extent and site of tumor. Cardiac fibroma may invade the conduction system, papillary muscle and outflw of inflow tract of ventricle. In these situations, its clinical course is very poor Although operative mortality is high, surgical resection is treatment of choice because lethal arrhythmia and sudden death can be developed by the fibroma. A cardiac fibroma was successfully resected from the left ventricular myocardium of a 8 years old male patient in the Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital.

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

  • 장병철;김남현;정성헌;라상원;조범구
    • 대한의용생체공학회:학술대회논문집
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    • 대한의용생체공학회 1994년도 추계학술대회
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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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Pre-clinical QT Risk Assessment in Pharmaceutical Companies - Issues of Current QT Risk Assessment -

  • Takasuna, Kiyoshi; Katsuyoshi, Chiba;Manabe, Sunao
    • Biomolecules & Therapeutics
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    • 제17권1호
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    • pp.1-11
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    • 2009
  • Since the Committee for Proprietary Medicinal Products (CPMP) of the European Union issued in 1997 a "points to consider" document for the assessment of the potential for QT interval prolongation by non-cardiovascular agents to predict drug-induced torsades de pointes (TdP), the QT liability has become the critical safety issue in the development of pharmaceuticals. As TdP is usually linked to delayed cardiac repolarization, international guideline (ICH S7B) has advocated the standard repolarization assays such as in vitro IKr (hERG current) and in vivo QT interval, or in vitro APD (as a follow up) as the best biomarkers for predicting the TdP risk. However, the recent increasing evidence suggests that the currently used above biomarkers and/or assays are not fully predictive for TdP, but also does not address potential new druginduced TdP due to the selective disruption of hERG protein trafficking to the cell membrane or VT and/or VF with QT shortening. There is, therefore, an urgent need for other surrogate markers or assays that can predict the proarrhythmic potential of drug candidate. In this review, we provide an ideal pre-clinical strategy to predict the potentials of QT liability and lethal arrhythmia of the drug candidates with recent issues in this field in mind, not at the expense of discarding therapeutically innovative drugs.