• Title/Summary/Keyword: bradycardia

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Sinus Node Dysfunction after Orthotopic Dog Heart Transplantation (잡종견의 심장 이식후 발생한 부정맥의 관찰)

  • 박국양
    • Journal of Chest Surgery
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    • v.27 no.5
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    • pp.339-344
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    • 1994
  • Sinus node dysfunction is common after orthotopic heart transplantation.Electrophysiologic studies have documented a high incidence [46% to 50%] of impaired sinus node automaticity and sinoatrial conduction in the early posttransplantation period. Sinus node dysfunction persists in over 20 % of patients and leads to prolonged bradyarrythmias, including sinus or nodal bradycardia and sinus arrest.The purpose of this paper was to observe sinus node dysfunction after orthotopic heart transplantation. Ten cardiac recipient dogs were monitored continuously after orthotopic transplantations between unrelated adult mongrel dogs. Crystalloid cardioplegic solution [Choongwoi Cardioplegia

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Transcranial Doppler Ultrasonography Monitoring during Head-up Tilt Test in Patients with Recurrent Syncope and Presyncope (반복적인 실신 및 실신전환자의 기립경사 검사시 경두개 초음파 감시)

  • Cho, Soo-Jin;Lee, Kwang-Ho;Chung, Chin-Sang
    • Annals of Clinical Neurophysiology
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    • v.1 no.1
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    • pp.64-69
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    • 1999
  • Background : Syncope was defined as transient loss of consciousness and postural tone. The mechanisms of changes in cerebral hemodynamics during syncope have not been fully evaluated. Transcranial Doppler Ultrasonography can continuously monitor the changes in cerebral hemodynamics during head-up tilt (HUT). TCD could reveal the different patterns of changes in cerebral hemodynamics during syncope. Syncope without hypotension or bradycardia could be detected by TCD. We investigated the changes in cerebral blood flow velocity during HUT using TCD in 33 patients with a history of recurrent syncope or presyncope of unknown origin. Methods & Results : The positive responses were defined as presyncope or syncope with hypotension, bradycardia, or both. During HUT without isoproterenol infusion, there were a $86{\pm}23%$ drop in DV and a $41{\pm}34%$ drop in SV in 5 patients with positive reponses, and mean changes in those were less than 10% in patients with negative reponses (p=.00, p=.00). During HUT with isoproterenol infusion, TCD showed a $80{\pm}18%$ drop in diastolic velocity in 14 patients with positive reponses, and a $47{\pm}10%$ drop in that in patients with negative reponses (p=.00), however the change in systolic velocity did not differ. TCD showed three patterns during positive responses; loss of all flow, loss of end diastolic flow, and a decrease in diastolic velocity. Loss of consciousness occurred in the patients with loss of all flow or end-diastolic flow during positive reponses. Conclusions : TCD shows different patterns of changes in cerebral hemodynamics during HUT. TCD can be used to investigate the pathophysiology of neurocardiogenic syncope.

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Atrial pacemaker implantation through left subclavian vein puncture (쇄골하정맥을 이용한 J 형의 전극도자를 가진 심방 Pacemaker 이식치험 2예)

  • Lee, Du-Yeon;Hong, Seung-Rok;Lee, Ung-Gu
    • Journal of Chest Surgery
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    • v.16 no.2
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    • pp.190-198
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    • 1983
  • The management of cardiac arrhythmias by cardiac pacing has increased greatly since the treatment of complete heart block with an external transcutaneous pacemaker in 1952, followed by the use of myocardial wires connected to an external pulse generation, by external transvenous pacing, and then by transvenous pacing with implantable components in thoracic wall.By now, the three bases of modern cardiac pacing for bradyarrhythmias had been established [1] an implantable device [2] the transvenous approach [3] the ability of the pacemaker to sense cardiac activity and modify its own function accordingly. In transvenous implantation of a pacemaker, any one of four vessels at the root of the neck is suitable for passage of the electrode - cephalic vein, external jugular vein, internal jugular vein, costo-axillary branch of the axillary vein. The new technique of direct puncture of the subclavian vein, either percutaneously or after skin incision only has been made, is invaluable & is used routinely. We have experienced one 25 years old patient who had rheumatic mitral stenosis & minimum aortic regurgitation with sinus bradycardia associated with premature atrial tachycardia & another 54 years old female patient who was suffered from sick sinus syndrome with sinus bradycardia & sinus arrest. The 1st patient was taken open mitral commissurotomy & aortic valvuloplasty and then was taken atrlal pace-maker implantation through If subclavian puncture method in post-op 14 days, and the second patient was taken atrial pacemaker implantation through If subclavian puncture method. Their postop course was in uneventful & were discharged, without complication. Their condition have been good to now.

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Bezold-Jarish Reflex during Shoulder Arthroscopy (in the Sitting Position) under Interscalene Block (사각근간 차단을 이용한 어깨 관절경수술에서 좌위에 따른 Bezold-parish 반사)

  • Lee, Doo-Ik;Won, Shi-Gwon;Kim, Dong-Woo;Kim, Dong-Ok;Choi, Young-Kyoo;Shin, Kwang-Il
    • The Korean Journal of Pain
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    • v.10 no.2
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    • pp.166-169
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    • 1997
  • Background: We have noted a high incidence of vasovagal episodes associated with use of interscalene block(ISB) for shoulder arthroscopy in the sitting position. The purpose of this retrospective study is to alert the possibility of potentially dangerous vasovagal events, describe the characteristics of this problem, and propose therapeutic devices. Methods: Results 62 patients who underwent shoulder arthroscopy in the sitting position with ISB were retrospectively analyzed. Group 1, 10 patients experienced vasovagal events characterized by sudden hypotension and bradycardia. Remaining 52 patients, Group 2, did not experience these symptoms. All patient charts were reviewed for age, sex, side of surgery, premedication, preoperative fluid and intraoperative medications. Perioperative hemodynamic changes were also compared between the two groups. Results: Vasovagal events experienced in 16% of patients(10/62) and occurred $39{\pm}18$ min after sitting position and $22{\pm}18$ min after start of operation. Number of patients who receiving anticholinergics for premedication were significantly lower in Group 1 than Group 2(2/10 vs. 28/52, p<0.05). Conclusions: Bezold-parish reflex is a potential mechanism for sudden hypotension and bradycardia which can occur during shoulder arthroscopy in sitting position. Therefore anticholinergic pretreatment and meticulous monitoring during operation are recommended to prevent B-J reflex.

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The Effects of Zingiberis rhizoma on Hypothyroidism Rat induced by PTU (건동(乾童)이 PTU로 유발된 Rat의 갑상선 기능저하증에 미치는 영향)

  • Kang, Ki-Hoon;Lee, Byung-Cheol;Ahn, Se-Young;Doo, Ho-Kyung;Ahn, Young-Min
    • The Journal of Internal Korean Medicine
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    • v.27 no.3
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    • pp.677-687
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    • 2006
  • Objective : Hypothyroidism is a common disease of the endocrinal system. characterized by fatigue, cold intolerance, bradycardia, and so on. Clinically, Levothyroxine(L-T4) has been usually used for replacement therapy, but it often has side effects. so many hypothyroidism patients wants oriental medical therapy. Zingiberis rhizoma, traditionally has been used in treatment of coldness, fatigue, and bradycardia. In this study. I investigated the therapeutic effects of Zingiberis rhizoma on PTU induced hypothyroidism in rats. Methods : I used two-month-old rats administered PTU and induced with hypothyroidism. After 2 weeks. Zingiberis rhizoma and thyroxine were daily administered, respectively. Body weights was measured every weeks. After 4 weeks, blood samples were taken and analyzed biochemically and T4 and TSH were measured by ELISA kits. Results : In comparison with normal groups, control groups showed hypothyroidism with low T4 and high TSH level. In Zingibris rhizoma administration groups were observed T4 level elevation, this elevation was dependent on the dose of Zingibris rhizoma. Between experimental groups and control groups, there was no difference in TSH level, statistically. Changes of biochemistry were not observed in any experimental groups. Conclusions : These findings suggest that Zingiberis rhizoma makes thyroid cells producing thyroid hormones. There is also a non-toxic effect on the cardiovascular system, liver and kidney function. So, Zingiberis rhizoma should be an effective agents for treating hypothyroidism.

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Comparison of dexmedetomidine alone with dexmedetomidine and fentanyl during awake fiberoptic intubation in patients with difficult airway: a randomized clinical trial

  • Acharya, Ranjita;Sriramka, Bhavna;Koushik, Priyangshu
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.22 no.5
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    • pp.349-356
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    • 2022
  • Background: Awake fiberoptic intubation (AFOI) is the procedure of choice for securing the airway in patients with a difficult airway when undergoing surgeries under general anesthesia. An ideal drug would not only provide conscious sedation but also maintain spontaneous ventilation, smooth intubation conditions, and stable hemodynamics. We compared the effects of dexmedetomidine alone and dexmedetomidine in combination with fentanyl at a dose lower than the standard dose for achieving conscious sedation during AFOI in difficult airway patients undergoing oral cancer and dental surgeries. Methods: We included 68 adult patients undergoing AFOI. The patients were randomized in two groups, wherein Group D received intravenous dexmedetomidine 1 ㎍/kg and Group DF received dexmedetomidine 0.5 ㎍/kg and fentanyl 1 ㎍/kg. The outcomes measured were airway obstruction score, intubation scores, fiberoptic intubation comfort score, sedation score, and hemodynamic variables. Results: Low-dose dexmedetomidine with fentanyl showed similar results as those with the standard dose of dexmedetomidine in terms of airway obstruction, vocal cord movement, degree of cough, degree of limb movements, and intubation comfort. However, the sedation achieved and incidence of hypotension and bradycardia were higher in Group D than in Group DF. Conclusions: A low dose of dexmedetomidine-fentanyl provides satisfactory intubation conditions as those with a standard dose of dexmedetomidine in AFOI, thereby avoiding bradycardia, hypotension, and sedation.

A Study of ECG Based Cardiac Diseases Diagnoses (심전도 신호를 이용한 심장 질환 진단에 관한 연구)

  • Kim, Hyun-Dong;Yoon, Jae-Bok;Kim, Hyun-Dong;Kim, Tae-Seon
    • Proceedings of the KIEE Conference
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    • 2004.11c
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    • pp.328-330
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    • 2004
  • In this paper, ECG based cardiac disease diagnosis models are developed. Conventionally, ECG monitoring equipments can only measure and store ECG signals and they always require medical doctor's diagnosis actions which are not desirable for continuous ambulatory monitoring and diagnosis healthcare systems. In this paper, two kinds of neural based self cardiac disease diagnosis engines are developed and tested for four kinds of diseases, sinus bradycardia, sinus tachycardia, left bundle branch block and right bundle branch block. For diagnosis engines, error backpropagation neural network (BP) and probabilistic neural network (PNN) were applied. Five signal features including heart rate, QRS interval, PR interval, QT interval, and T wave types were selected for diagnosis characteristics. To show the validity of proposed diagnosis engine, MIT-BIH database were used to test. Test results showed that BP based diagnosis engine has 71% of diagnosis accuracy which is superior to accuracy of PNN based diagnosis engine. However, PNN based diagnosis engine showed superior diagnosis accuracy for complex-disease diagnoses than BP based diagnosis engine.

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Feature Extraction of ECG Signal for Heart Diseases Diagnoses (심장질환진단을 위한 ECG파형의 특징추출)

  • Kim, Hyun-Dong;Min, Chul-Hong;Kim, Tae-Seon
    • Proceedings of the KIEE Conference
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    • 2004.11c
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    • pp.325-327
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    • 2004
  • ECG limb lead II signal widely used to diagnosis heart diseases and it is essential to detect ECG events (onsets, offsets and peaks of the QRS complex P wave and T wave) and extract them from ECG signal for heart diseases diagnoses. However, it is very difficult to develop standardized feature extraction formulas since ECG signals are varying on patients and disease types. In this paper, simple feature extraction method from normal and abnormal types of ECG signals is proposed. As a signal features, heart rate, PR interval, QRS interval, QT interval, interval between S wave and baseline, and T wave types are extracted. To show the validity of proposed method, Right Bundle Branch Block (RBBB), Left Bundle Branch Block (LBBB), Sinus Bradycardia, and Sinus Tachycardia data from MIT-BIH arrhythmia database are used for feature extraction and the extraction results showed higher extraction capability compare to conventional formula based extraction method.

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Rhododendron Poisoning in Sheep and Goats (면양과 산양의 철쭉중독 발생)

  • Eo, Kyung-Yeon;Kwon, Oh-Deog
    • Journal of Veterinary Clinics
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    • v.26 no.4
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    • pp.344-347
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    • 2009
  • Four sheep and five Korean native goats became intoxicated after eating Rhododendron schlippenbachii clippings that a ranchman threw into the animal barn. The clinical signs included loss of appetite, lethargy, nausea, salivation, vomiting, dyspnea, staggering gait, and bradycardia. The animals were treated with atropine and carbo-pulbit. One goat died 8 hours later, and a field postmortem revealed a considerable quantity of rhododendron leaves in the rumen. The other sheep and goats recovered within 3 days after treatment.