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Role of Transesophageal Pacing in Evaluation of Palpitation in Infants and Children (심계항진을 호소하는 소아에서 경식도 심전도 검사의 유용성)

  • Ryu, Su-Jeong;Ko, Jae Kon;Kim, Young Hwue;Park, In Sook
    • Clinical and Experimental Pediatrics
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    • v.46 no.1
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    • pp.51-55
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    • 2003
  • Purpose : We intended to find out the role of transesophageal atrial pacing in evaluation of infants and children with palpitation of unknown origin. Methods : We tried transesophageal atrial pacing study in 69 infants and children with palpitation, in whom tachycardia wasn't documented in electrocardiogram and reviewed retrospectively the records of transesophageal pacing and medical records of theses patients to find out the induction rate of tachycardia by transesophageal atrial pacing and the possible mechanism of tachycardia if induced. Results : In 70.1% infants and children with palpitation, tachycardia was induced, so we could conclude that tachycaridia was the cause of palpitation in these cases. In most cases, tachycardia was induced by rapid atrial pacing, and in 21% by using isoproterenol. Tachycardia induction rate was higher in <6-year-old children than ${\geq}6$-year-old children(P<0.05). In cases of the induced, we reviewed the mechanism of tachycardia. Of these induced tachycardias, 53.2% is atrioventricular reentry tachycardia, 34.0% were atrioventricular nodal reentry tachycardia, and 12.8% were idiopathic left ventricular tachycardia. Invasive electrophysiologic study was done to 10 patients of those induced. The results of electrophysiologic study and transesophageal pacing and recording were the same except for one patient. Conclusion : Transesophageal atrial pacing and recording is a less invasive, safe and useful method to find out the cause of palpitation and the mechanism of tachycardia in infants and children.

Signal-Averaged P Wave Analysis in Patients with Paroxysmal Atrial Fibrillation (발작성 심방세동 환자의 신호평균 P파 분석)

  • 김인영;이종연;이병채;이용희;이종민;김선일;김준수
    • Journal of Biomedical Engineering Research
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    • v.23 no.1
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    • pp.1-8
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    • 2002
  • Atrial fibrillation(AF). chronic or paroxysmal is the most frequent arrhythmia in human subjects Duration of P wave in signal-averaged electrocardiography(SAECG) reflects intra-atrial conduction time and therefore. could be used as an electrophysiological marker for atrial conduction chance at the earthy stave. So we apply the analysis method using SAECG to diagnose Paroxysmal atrial fibrillation(PAF) . Subjects Participated for the study consisted of two groups: a control group(n=34) of normal healthy volunteers and a group of AF Patients(n=38) with a documented history of PAF but no other history of cardiac disease. We evaluated the effect of several filtering and determination methods to find the starting and ending feints of the P wavy on its duration. To increase the measurement reliability of P wave duration. the automatic detection method was proposed. Also. to increase the detection rate for PAF risk, the decision threshold value was optimized using receiver operation characteristics(ROC) curve. Results showed that the highest statistical difference (p〈0.001) of the P wane duration between controls and subjects was obtained at the Processing condition, using absolute threshold vague(8.75 $\mu N$) , a least mean square(LMS) high pass filter and 30 Hz cutoff frequency. The most outstanding difference(sensitivity 88 % specificity 64.4 %) between controls and subjects was obtained at the decision threshold value of 112 ms.

Computed Tomography of the Left Atrium and Left Atrial Appendage: A Pictorial Essay on the Anatomy, Normal Variants, and Pathology (좌심방과 좌심방이의 전산화단층촬영 소견: 해부학, 정상변이 및 질환에 관한 임상화보 )

  • Minji Song; Sung Jin Kim;Hyun Jung Koo;Moon Young Kim;Jin Young Yoo
    • Journal of the Korean Society of Radiology
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    • v.81 no.2
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    • pp.272-289
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    • 2020
  • Current advances in CT techniques allow thorough evaluation of the beating heart. The strengths of cardiac CT relative to echocardiography and magnetic resonance imaging are its high availability in most institutions, rapid production of high-quality images, and outstanding delineation of the anatomy. For many normal variants and pathologic conditions, such as thrombi, masses, and congenital abnormalities of the left atrium, CT findings are sufficient to make a presumptive diagnosis. Assessments of the left atrium and left atrial appendage are particularly important for the management of atrial fibrillation, as various catheter-based procedures are aimed at the mechanical and electrical isolation of these structures. CT offers information crucial to a successful catheter-based procedure or surgery. Therefore, a comprehensive review of the geometry (shape, size, and relative position), along with various CT imaging features of pathologic states, should be provided in radiology reports to be of clinical value.

Saddle Embolism Caused by Left Atrial Myxoma -A Case Report- (안장 색전증을 유발한 좌심방 점액종 -수술 치험 1례-)

  • 송정근
    • Journal of Chest Surgery
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    • v.28 no.3
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    • pp.316-319
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    • 1995
  • Systemic emboli occur in approximately one-third of patients with cardiac myxoma. Embolization is common because of the friability of the tumor and intracardiac location. Embolic episodes in young patients with normal sinus rhythm should arouse suspicions of cardiac myxoma in the absence of active endocarditis. We present one case of 17 years old girl having saddle embolism combined with left atrial myxoma. We planned staged operation. First, the emergency thromboembolectomy of aortic bifurcation was performed through bilateral transfemoral approach with use of Forgaty catheter. One week later, the extirpation of myxoma was successfully done with ECC.

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Left ventricular right atrial canal: report of 2 cases (좌심실우심방 단락치험 2)

  • 박국양
    • Journal of Chest Surgery
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    • v.17 no.2
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    • pp.184-188
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    • 1984
  • As OHS is prevalent on whole world, LV-RA shunts once thought as quite rare congenital heart disease are reported frequently. Two cases of LV-RA shunts were operated at N.M.C. in 1983: One of them combined VSD, the other membranous ventricular septal aneurysm protruding into right atrial chamber. In case 1, which was diagnosed correctly, right atriotomy was enough to close the defect under ECC, but in case 2, which was misdiagnosed as ASD preoperatively, atriotomy was added to ventriculotomy. The LV-RA defects were closed by U-shaped direct suture with Teflon felt pledget. Postoperative course was uneventful in both of them.

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Surgical Treatment of Giant LA Myxoma (거대 좌심방 점액종 수술치험)

  • 송기호
    • Journal of Chest Surgery
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    • v.25 no.9
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    • pp.930-935
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    • 1992
  • Cardiac myxoma is the most common benign tumor of the heart, accounting for about half of primary cardiac tumors. It has clinical importance because the excision of the intracardiac myxoma is curative and long term survival is excellant, Their average size is about 5~6cm in diameter in most reported cases. We have experienced a giant atrial myxoma, arised from the interatrial septum of the left atrial side, and resected under the cardiopulmonary bypass.

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Left Atrial Myxoma (좌심방 점액종 1례 보고)

  • 오세웅
    • Journal of Chest Surgery
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    • v.20 no.4
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    • pp.809-814
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    • 1987
  • Myxoma is a benign growth constituting nearly 50% of all primary cardiac tumors. It is important because in can be abolished by surgical therapy and is usually fatal if unrecognized and untreated. Primary cardiac tumors are uncommon in all age group. In contrast, tumors metastatic to the heart are significantly more common. The diagnosis is made by echocardiography and cardiac angiography. Recently a wider use of echocardiogram as the screening test of valve lesions can be expected to increase the number of myxomas found preoperatively. We report the two cases of left atrial myxomas which were removed successfully by surgery in the thoracic and cardiovascular surgery department, Marryknoll Hospital.

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Surgical Treatment of Incomplete Endocardial Cushion Defect: 2 Cases Report (심장내막상결손증의 외과적 치료: 2예 보고)

  • 송요준
    • Journal of Chest Surgery
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    • v.7 no.1
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    • pp.101-108
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    • 1974
  • Repair of incomplete endocardial cushion defect was accomplished in two cases in September 1973 in this department. In each case a low atrial septal defect and a cleft of mitral septal cusp were found. Interrupted suture repair on the cleft mitral cusp and closure of the atrial septal defect with dacron patch were done successfully. Rigg-Kyvsgaard bubble oxygynator and Sigma motor were utilized for extracorporeal circulation. Follow up study, six months after discharge, revealed satisfactory results.

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Adrenotropic Receptor in the Frog Atria (개구리 심방(心房)의 Adrenotropic Receptor)

  • Cho, Soon-Im
    • The Korean Journal of Pharmacology
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    • v.5 no.1
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    • pp.35-38
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    • 1969
  • 1.On isolated atrial preparation of frog, effects of sympathomimetic amines were investigated. 2. Isoproterenol, epinephrine, norepinephrine, and phenylephrine produced positive chronotropic and inotropic effects. The relative potencies for the effects of these agents were: isoproterenol > epinephrine> norepinephrine> phenylephrine. Methoxamine had no effects or depressed the atria. 3. Pronethalol antagonized the positive effects of these adrenergic agents competitively. 4. Regitine did not affect the effects of these agents. 5. These data indicate that the adrenergic agents activate the atrial tissue of the frog via stimulation of adrenergic beta-receptor.

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