• Title/Summary/Keyword: cardiac pacing

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Transcutaneous Cardiac Pacing in a Dog with Diltiazem Intoxication (딜티아젬 중독증 이환견에서 경피용 체외심박조절기의 적용 증례)

  • Lee, Seung-Keun;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.26 no.2
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    • pp.166-169
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    • 2009
  • An 11-year-old male Beagle, weighing 10.5 kg, was presented with sudden bradyarrhthmia and severe hypotension after incidental ingestion of diltiazem. The dog was treated with intravenous(IV) isotonic crystalloid solution, atropine, calcium gluconate, dobutamine, glucagon and gastric lavage under the aid of temporary transcutaneous cardiac pacing. With the short-term use of transcutaneous cardiac pacing and medical treatment, the heart rhythm and the condition of the patient were stabilized.

Optical Stimulation and Pacing of the Embryonic Chicken Heart via Thulium Laser Irradiation

  • Chung, Hong;Chung, Euiheon
    • Current Optics and Photonics
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    • v.3 no.1
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    • pp.1-7
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    • 2019
  • Optical stimulation provides a promising alternative to electrical stimulation to selectively modulate tissue. However, developing noninvasive techniques to directly stimulate excitable tissue without introducing genetic modifications and minimizing cellular stress remains an ongoing challenge. Infrared (IR) light has been used to achieve optical pacing for electrophysiological studies in embryonic quail and mammalian hearts. Here, we demonstrate optical stimulation and pacing of the embryonic chicken heart using a pulsed infrared thulium laser with a wavelength of 1927 nm. By recording stereomicroscope outputs and quantifying heart rates and movements through video processing, we found that heart rate increases instantly following irradiation with a large spot size and high radiant exposure. Targeting the atrium using a smaller spot size and lower radiant exposure achieved pacing, as the heart rate synchronized with the laser to 2 Hz. This study demonstrates the viability of using the 1927 nm thulium laser for cardiac stimulation and optical pacing, expanding the optical parameters and IR lasers that can be used to modulate cardiac dynamics.

Cardiac Resynchronization Therapy Using a Dual Chamber Pacemaker in Patients with Severe Left Ventricular Dysfunction and a Left Bundle Branch Block

  • Jung, Jae Jun;Kim, In Sook;Jeong, Jae-Han;Lee, Young Tak;Jeong, Dong Seop
    • Journal of Chest Surgery
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    • v.46 no.4
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    • pp.289-292
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    • 2013
  • Through the use of a dual chamber (DDD) pacemaker, we achieved a cardiac resynchronization effect in a 51-year-old female patient who was transferred to our hospital from another hospital for an operation for three-vessel coronary artery disease. Her electrocardiogram showed a left bundle branch block (LBBB) and a prolonged QRS interval of 166 milliseconds. Severe left ventricle (LV) dysfunction was diagnosed via echocardiography. Coronary artery bypass grafting (CABG) was then performed. In order to accelerate left atrial activation and reduce the conduction defect, DDD pacing using right atrial and left and right ventricular pacing wires was initiated postoperatively. The cardiac output was measured immediately, and one and twelve hours after arrival in the intensive care unit. The cardiac output changed from 2.8, 2.4, and 3.6 L/min without pacing to 3.5, 3.4, and 3.5 L/min on initiation of pacing. The biventricular synchronization using DDD pacing was turned off 18 hours after surgery. She was transferred to a general ward with a cardiac output of 3.9 L/min. In patients with coronary artery disease, severe LV dysfunction, and LBBB, cardiac resynchronization therapy can be achieved through DDD pacing after CABG.

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.

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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Automatic Determination of Pacing Threshold by Surface ECG Morphology (ECG 형태에 의한 자동화된 pacing 문턱 전압 결정에 관한 연구)

  • Kim, J.;Huh, W.
    • Journal of Biomedical Engineering Research
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    • v.22 no.3
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    • pp.269-273
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    • 2001
  • Proper determination of pacing threshold is important for patient safety and pacemaker longevity. In general, cardiac muscle contractions caused by pacing pulses are verified by observing the morphology of surface ECG displayed on a monitor. In this study, a method of automatic pacing threshold determination based on morphological difference between intrinsic and paced ECGs was developed. First, characteristics of intrinsic ECG and paced ECG were analyzed in time and frequency domain and a proper discrimination parameter was extracted. Then, the automatic capture verification method based on the parameter was developed and applied to 23 pacemaker patients. The selected parameter was the area of ventricular depolarization wave during 80ms after pacing stimulus. It was found that the method was reliable and effective in identifying paced ECG and, thereby, determing a proper pacing threshold.

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Postoperative Arrhythmia after Open Heart Surgery - Cause, Incidence and It`s Management - (개심수술후 심장부정맥에 대한 임상적 연구: 원인,빈도 및 치료)

  • 장병철
    • Journal of Chest Surgery
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    • v.24 no.9
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    • pp.843-852
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    • 1991
  • We prospectively studied postoperative cardiac arrhythmia after open heart surgery to analyze the types and incidence of cardiac arrhythmia and to predict preoperative risk factors. And also we evaluated the effectiveness of atrial and ventricular epicardial electrodes which were placed during operation Between March 1990 and August 1990, We had operated on in 211 patients and we studied 201 consecutive patients excluding 10 patients. The study group included 99 males and 102 female patients, ages 1 month to 75 years[Mean$\pm$SD=28.0$\pm$21.7 years]. Postoperatively, all patients were regularly seen by the cardiac surgeon and cardiologist, They had continuous electrocardiographic monitoring for the first 3 days, initially in the intensive care unit and were checked routine electrocardiography on the postoperative 7 days, The postoperative cardiac arrhythmia were analyzed and possible associations of this arrhythmia with various pre, intra, and postoperative factors were studied by univariate and multivariate discriminant analysis, The overall incidence of postoperative cardiac arrhythmia except relative sinus bradycardia was 36.8%;[74/201], The incidence of postoperative cardiac arrhythmia in acyanotic congenital heart disease: 19.4%, cyanotic congenital heart disease: 20.8%, cardiac arrhythmia surgery: 33.3%, acquired valvular heart disease: 60.9% and coronary artery occlusive disease: 38.9%. Both univariate and multivariate studies indicated the pre operative symptom duration[p = 0013], the duration of medication[p=0.003], presence of preoperative arrhythmia[p<0.001] and pre-operative left atrial dimension in echocardiography to be the factor promoting postoperative cardiac arrhythmia. Multivariate discriminant analysis showed that the presence of preoperative cardiac arrhythmia, bypass time and the duration of preoperative symptom duration conveyed considerable risk factor on post-operative arrhythmia. The atrial wire electrodes were used diagnostically in 36 and were used therapeutically in 89 among 201 patients. Atrial pacing were used to treat relative sinus bradycardia, accelerated junctional tachycardia or premature atrial or ventricular contractions in 51 patients. Atrioventricular sequential pacing were used in 16 patients and ventricular pacing were used in 20 patients. Hemodynamics were evaluated in 2 patients of relative sinus bradycardia before and after atrial pacing. The atrial pacing increased the amount of cardiac output to 15% more. Because of their great utility in the diagnosis and treatment of arrhythmias, we conclude that routine placement of atrial and ventricular electrodes at the time of operation is indicated regardless of the nature of the open-heart procedure.

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Acute Hemodynamic Effects of CJ-10513, an Angiotensin IIReceptor Antahonest, in Dog Treated with High Friquency Ventricular Pacing (안지오텐신 ll 수용체 길항약 CJ-10513이 고민도 심실 pacing 천에서의 혈행동태에 미치는 영향)

  • Kim, Young-Hoon;Jeong, Seong-Mok;Shin, Jae-Kyu;Choi, Jae-Mook;Jeong, Seong-Hak;Bae, Hoon;Lee, Gun-Ho;Kim, Je-Hak;An, Yang-Soo
    • Biomolecules & Therapeutics
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    • v.6 no.2
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    • pp.199-203
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    • 1998
  • Acute hemodynamic effects of CJ-18513, a non-peptide angiotensin IIreceptor antagonist, were examined in mongrel dogs treated with high frequency ventricular pacing for one week. Rapid ventricular pacing reduced mean blood pressure (mBP), Lvdp/dt and cardiac output (CO), and increased the left ventricular end-diastolic pressure (LVEDP) and pulmonary capillary wedge pressure (PCWP). Continuous infusion of CJ-10513 at doses of 10 and 20$\mu$g/kg/min, respectively, for 30 minutes reduced mBP, LVEDP and myocardial oxygen consumption rate (MVO,) and shifted the cardiac function curve (CO-LVEDP ourve) to the left in this dog model. In conclusion, CJ-10513 decreased the preload and afterload and increased the cardiac function in dogs with pacing-induced heart failure.

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Iatrogenic Spark Burn Injury to the Chest From a Transcutaneous Pacing Patch (경피적 심장 충격 장치의 사용으로 발생한 의인성 전기 화상의 증례 보고)

  • Choi, Jong Yun;Cha, Won Jin;Jung, Ee Room;Seo, Bommie Florence;Jung, Sung-No
    • Journal of the Korean Burn Society
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    • v.24 no.2
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    • pp.50-52
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    • 2021
  • Iatrogenic electrical burns that occur from the use of a defibrillator, a paddle-type cardiac shock device, have been reported in various forms. Electrical burns are usually conducted directly through the skin and are more damaging than scald burns or contact burns. A transcutaneous cardiac pacing device is a patch-type cardiac shock device that automatically delivers a shock when an abnormal heart rhythm is detected. We introduce a unique case of iatrogenic electrical burns caused by the transcutaneous pacing patch of a cardiac shock device. Electrical energy was converted into a spark due to foreign bodies deposited around the patch, resulting in damage to the peripheral area of the skin.

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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