• Title/Summary/Keyword: Pacemaker, artificial

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Endocarditis with Intracardiac Migration of Transvenous Permanent Pacing Lead - 1 Case Report - (영구 경정맥 심박조율도관의 심장내 이동과 동반된 심내막염 - 1례 보고 -)

  • Ku, Gwan-Woo;Kang, Shin-Kwang;Won, Tae-Hee;Kim, Si-Wook;Yu, Jae-Hyun;Na, Myung-Hoon;Lim, Seung-Pyung;Lee, Young
    • Journal of Chest Surgery
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    • v.35 no.11
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    • pp.831-834
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    • 2002
  • When any part of the pacemaker system is infected, all pacemaker hardware should be removed, because reinfection rates of 51% to 77% have been noted in patients whose infected pacemaker system has been only partially explanted. The removal of infected leads during cardiopulmonary bypass prevents mechanical injury as well as the spread of infection and vegetation. We report one case of endocarditis by staphylococcus aureus with infected transvenous pacing lead which was migrated into the heart from the left subclavian vein. We removed the migrated pacing lead and vegetation under cardiopulmonary bypass.

Implantation of a permanent pacemaker through the coronary sinus in a patient who underwent mechanical valve replacement for infective endocarditis with a complete atrioventricular block (완전방실차단을 동반한 감염성 심내막염 환자에서 판막치환술 후 관정맥동을 통해 좌심실을 조율하는 심박조율기 시술)

  • Jo, Kwan Hoon;Kim, Inho;Ann, Soe Hee;Oh, Yong Seog
    • Journal of Yeungnam Medical Science
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    • v.31 no.2
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    • pp.113-116
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    • 2014
  • A 52-year-old man was referred to our hospital due to fever and myalgia that occurred 2 weeks earlier. He showed a complete atrioventricular block on his electrocardiogram, and his vital signs were unstable. On his transthoracic echocardiograph, the 1.5 cm vegetation in the aortic valve with severe aortic regurgitation suggested infective endocarditis. His transesophageal enchocardiograph showed abscess in his mitral-aortic intervalvular fibrosa and vegetation was suspected on his anterior mitral valve leaflet. The patient underwent an emergent operation for valve replacement with temporary epicardial pacing. Intraoperatively, the septal leaflet of his tricuspid valve was injured during the debridement of the abscess pocket that was extended to the membranous septum. The aortic, mitral, and tricuspid mechanical valves were replaced with annular reconstruction without complications. After 14 days of intravenous antibiotics, we successfully changed the epicardial pacemaker into a transvenous DDD-type permanent pacemaker by placing a left ventricular lead via the coronary sinus and an atrial lead in the right atrium appendage. The patient was discharged in a tolerable state and was examined uneventfully in our hospital's outpatient clinic for 8 months.

Preparation and properties of crosslinked polyurethane containing phospholipid component for biomaterials (Phospholipid Component 를 함유한 가교된 Polyurethane Biomaterials의 제조와 물성)

  • Yoo, Hye-Jin;Kim, Han-Do
    • Proceedings of the Korean Fiber Society Conference
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    • 2003.10b
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    • pp.55-58
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    • 2003
  • Segmented polyurethanes have been widely used for various commercial and experimental blood-contacting and tissue-contacting applications such as vascular prostheses, blood pumps, heart valves, pacemaker lead wire insulation, catheters, artificial hearts, and cardiac assist devices due to their generally favorable physical and mechanical properties, as well as fairly good biocompatibility and antithrombogenicity characteristics. (omitted)

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A Case of Patient with Brady-arrhythmia Complaining Dizziness Treated with complex Korean Medicine treatments (어지럼증을 호소하는 서맥성 부정맥 환자의 한의복합치료 1례)

  • So-Min, Jung;Seong-Wook, Lee;Won-Jung, Ha;Ki-Ho, Cho;Sang-Kwan, Moon;Woo-Sang, Jung;Seungwon, Kwon;Han-Gyul, Lee
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.23 no.1
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    • pp.41-54
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    • 2022
  • Brady-arrhythmia is defined as an arrhythmia in which the heart rate slows to less than 60 beats per minute. Brady-arrhythmia reduces cardiac output and causes changes in blood flow. As a result, dizziness occurs because not only ischemia occurs in the central nervous system, but also blood flow in major organs decreases. The insertion of an artificial pacemaker is known as almost the only treatment alternative for patients with brady-arrhythmia with symptoms. This study reports a case of 85 year old male diagnosed with brady-arrhythmia complaining presyncope type of dizziness. The patient underwent complex Korean medicine treatments by herbal medicine, acupuncture and moxibustion. The daily average value of pulse rate, K-DHI score, NRS score and the patient's subjective expression of symptoms were used as evaluation tools. This study suggested a significant improvement in symptoms through complex Korean medicine treatments without the use of anti-arrhythmic drugs or insertion of an artificial pacemaker in the patient with brady-arrhythmia complaining dizziness.

Estimation of Cardiac Pumping Performance according to the Ventricular Electrical Activation Time Distribution by Using Physiome Model (피지옴 모델을 이용한 심실의 전기활성시간 분포에 따른 심박출 성능평가)

  • Kim, Hyeong-Gyun;Lim, Ki Moo
    • Journal of Biomedical Engineering Research
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    • v.36 no.5
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    • pp.198-203
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    • 2015
  • The purpose of the study is to examine the effects of pacemaker location on cardiac pumping efficacy theoretically. We used a three-dimensional finite element cardiac electromechanical model of canine ventricles with models of the circulatory system. Electrical activation time for normal sinus rhythm and artificial pacing in apex, left ventricular free wall, and right ventricular free wall were obtained from electrophysiological model. We applied the electrical activation time maps to the mechanical contraction model and obtained cardiac mechanical responses such as myocardial contractile ATP consumption, stroke work, stroke volume, ejection fraction, and etc. Among three artificial pacing methods, left ventricle pacing showed best performance in ventricular pumping efficacy.

Towards Evolutionary Approach for Thermal Aware In Vivo Sensor Networks

  • Kamal, Rossi;Hong, Choong-Seon
    • Proceedings of the Korean Information Science Society Conference
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    • 2012.06d
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    • pp.369-371
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    • 2012
  • Wireless sensor networks have taken immense interest in healthcare systems in recent years. One example of it is in an in vivo sensor that is deployed in critical and sensitive healthcare applications like artificial retina, cardiac pacemaker, drug delivery, blood pressure, internal heat calculation, glucosemonitoring etc. In vivo sensor nodes exhibit temperature that may be very dangerous for human tissues. However, existing in vivo thermal aware routing approaches suffer from hotspot creation, delay, and computational complexity. These limitations motivate us toward an in vivo virtual backbone, a small subset of nodes, connected to all other nodes and involved in routing of all nodes, -based solution. A virtual backbone is lightweight and its fault-tolerant version allows in vivo sensor nodes to disconnect hotspot paths and to use alternative paths. We have formulated the problem as m-connected k-dominating set problem with minimum temperature cost in in vivo sensor network. This is a combinatorial optimization problem and we have been motivated to use evolutionary approach to solve the problem.

Anatomy and Physiology in Human Circadian Rhythms (인체 일주기리듬의 해부학 및 생리학)

  • Sohn, Chang-Ho
    • Sleep Medicine and Psychophysiology
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    • v.5 no.1
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    • pp.1-11
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    • 1998
  • Chronobiology is the area of medicine that is, how time-related event shape our daily biologic responses and apply to any aspect of medicine with regard to altering pathophysiology and treatment response. In mammals, there are several evidences that prove suprachiasmatic nuclei(SCN) is the major circadian pacemaker and the circadian rhythm influences so many biological aspects of an living organism such as rest-activity, thermoregulation, reproduction, and endocrine system. In case of human beings, there had been little information of circadian system. That may be due to the experimental, technical difficulties to study but also to the fact that human has the more complex environments that may alter the circadina rhythm like the artificial light, many socio-cultural aspects and so forth. However, several reports of these days indicate human's circadian system is composed of two or more circadian oscillators and SCN is the major circadian oscillator among them like the other mammals. Free-running circadinan period of mankind is about 24 hours rather than about 25 hours, and rest-activity rhythm is polymodal like other species. In addition to that, human may have capcities to change the circadian rhythm as the seasonal changes of daynight schedule. In this article, the author will summarize recent progress of anatomy and physiology of the circadian clock mechanism in humans.

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Cardiac Surgery for the Patient with VVI Unipolar Pacing System -One Case- (VVI 단극유도의 심박조율치를 가진 환자의 개심술 -1례 치험-)

  • 정해동;최종범;최형호
    • Journal of Chest Surgery
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    • v.31 no.4
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    • pp.398-401
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    • 1998
  • A 56-year-old female with a permanent unipolar pacing(VVI) system underwent elective coronary bypass surgery and mitral valve replacement. Because the unipolar sensing is subject to considerable nonmyocardial electrical noise, the pacing function may be disturbed by the use of electrocautery. Temporary atrial and ventricular bipolar epicardial leads and external generator were used for maintaining A-V sequential pacing during the use of electrocautery. Before aortic cross-clamp was released after cardiac operation, regular cardiac rhythm could spontaneously be resumed with an integrated cardioplegic strategy, avoiding the use of defibrillator

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Risk Factors for Cardiac Implantable Electronic Device-Related Infections (이식형 심장 모니터링 장치 관련 감염의 위험요인)

  • Park, Jin Yeong;Choi, Hye-Ran
    • Journal of Korean Biological Nursing Science
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    • v.23 no.4
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    • pp.298-307
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    • 2021
  • Purpose: This study aimed to investigate the risk factors for cardiac implantable electronic device (CIED)-related infections within the first post-procedural year after CIED insertion. Methods: This study included 509 adult patients undergoing CIED implantation procedures between January 1, 2011 and December 31, 2015. The data were analyzed by t-test, chi-square test, Fisher's exact test, and logistic regression analysis using SPSS/WIN 23.0. Results: Fifteen infections and 494 non-infections were examined. The CIED-related infection rate was 2.9%; patients with 14 pocket infections and one bacteremia were included in the CIED-related infection. The risk factors of CIED-related infections were the estimated glomerular filtration rate (eGFR) of ≤ 45 mL/min/1.73 m2 (Odds ratio [OR]= 4.03, 95% confidence interval [CI],1.15-14.10) and taking a new oral anticoagulant (NOAC) (OR = 4.50, 95% CI 1.09-18.55). Conclusion: These results identified the CIED infection rate and risk factors of CIED-related infection. It is necessary to consider these risk factors before the CIED implantation procedure and to establish the relevant nursing interventions.

Surgical Repair of Single Ventricle (Type III C solitus) (단심실 -III C Solitus 형의 수술치험-)

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    • Journal of Chest Surgery
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    • v.12 no.3
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    • pp.281-288
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    • 1979
  • For years, physicians and anatomists have been interested in the heart that has one functioning ventricle. Various terms have been suggested for this entity including single ventricle, common ventricle, double-inlet left ventricle, cor biatriatum triloculare, and primitive ventricle. In this report, the term "single ventricle" is utilized as suggested by Van Praagh, and is defined as that congenital cardiac anomaly in which a common or separate atrioventricular valves open into a ventricular chamber from which both great arterial trunks emerge. An outlet chamber, or infundibulum, may or may not be present and give rise to the origin of either of the great arteries. This definition excludes the entity of mitral and tricuspid atresia. An 11 year old cyanotic boy was admitted chief complaints of exertional dyspnea and frequent upper respiratory infection since 2 weeks after birth. He was diagnosed as inoperable cyanotic congenital heart disease, and remained without any corrective treatment up to his age of 11 year when he suffered from aggravation of symptoms and signs of congestive heart failure for 2 months before this admission. On 22nd of May 1979, he was admitted for total corrective operation under the impression of tricuspid atresia suggested by a pediatrician. Physical check revealed deep cyanosis with finger and toe clubbing, and grade V systolic ejection murmur with single second heart sound was audible at the left 3rd intercostal space. Development was moderate in height [135 cm] and weight[28Kg]. Routine lab findings were normal except increased hemoglobin [21.1gm%], hematocrit [64 %], and left axis deviation with left ventricular hypertrophy on EKG. Cardiac catheterization and angiography revealed 1-transposition of aorta, pulmonic valvular stenosis, double inlet of a single ventricle with d-loop, and normal atriovisceral relationship [Type III C solitus according to the classification of Van Praagh]. At operation, longitudinal incision at the outflow tract of right ventricle in between the right coronary artery and its branch [LAD from RCA] revealed high far anterior aortic valve which had fibrous continuity with mitral annulus, and pulmonic valve was stenotic up to 4 mm in diameter positioned posterolaterally to the aorta. Ventricular septum was totally defective, and one markedly hypertrophied moderator band originated from crista supraventricularis was connected down to the imaginary septum of the ventricular cavity as a pseudoseptum of the ventricle. Size of the defect was 3X3 cm2 in total. Patch closure of the defect with a Teflon felt of 3.5 x 4 cm2 was done with interrupted multiple sutures after cut off of the moderator band, which was resutured to the artificial septum after reconstruction of the ventricular septum. Pulmonic valvotomy was done from 4 mm to 11 mm in diameter thru another pulmonary arteriotomy incision, and right ventriculotomy wound was closed reconstructing the right ventricular outflow tract with pericardial autograft of 3 x 4 cm2. Atrial septal defect of 2 cm in diameter was closed with 3-0 Erdeck suture, and atrial wall was sutured also when rectal temperature reached from 24`C to 35.5`C. Complete A-V block was managed with temporary external pacemaker with a pacing rate of 110/min. thru myocardial wire, and arterial blood pressure of 80/50 mmHg was maintained with Isuprel or Dopamine dripping under the CVP of 25-cm saline. Consciousness was recovered one hour after the operation when his blood pressure reached 100 /70 mmHg, but vital signs were not stable, and bleeding from the pericardial drainage and complete anuria were persisted until his heart could not capture the pacemaker impulse, and patient died of low output syndrome 320 min after the operation.

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