• The Korean Journal of Physiology and Pharmacology
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• v.20 no.5
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• pp.507-514
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• 2016

Although 3D-complex fractionated atrial electrogram (CFAE) mapping is useful in radiofrequency catheter ablation for persistent atrial fibrillation (AF), the directions and configuration of the bipolar electrodes may affect the electrogram. This study aimed to compare the spatial reproducibility of CFAE by changing the catheter orientations and electrode distance in an in -silico left atrium (LA). We conducted this study by importing the heart CT image of a patient with AF into a 3D-homogeneous human LA model. Electrogram morphology, CFAE-cycle lengths (CLs) were compared for 16 different orientations of a virtual bipolar conventional catheter (conv-cath: size 3.5 mm, inter-electrode distance 4.75 mm). Additionally, the spatial correlations of CFAE-CLs and the percentage of consistent sites with CFAE-CL<120 ms were analyzed. The results from the conv-cath were compared with that obtained using a mini catheter (mini-cath: size 1 mm, inter-electrode distance 2.5 mm). Depending on the catheter orientation, the electrogram morphology and CFAE-CLs varied (conv-cath: $11.5{\pm}0.7%$ variation, mini-cath: $7.1{\pm}1.2%$ variation), however the mini-cath produced less variation of CFAE-CL than conv-cath (p<0.001). There were moderate spatial correlations among CFAE-CL measured at 16 orientations (conv-cath: $r=0.3055{\pm}0.2194$ vs. mini-cath: $0.6074{\pm}0.0733$, p<0.001). Additionally, the ratio of consistent CFAE sites was higher for mini catheter than conventional one ($38.3{\pm}4.6%$ vs. $22.3{\pm}1.4%$, p<0.05). Electrograms and CFAE distribution are affected by catheter orientation and electrode configuration in the in-silico LA model. However, there was moderate spatial consistency of CFAE areas, and narrowly spaced bipolar catheters were less influenced by catheter direction than conventional catheters.

• Proceedings of the KOSOMBE Conference
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• v.1998 no.11
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• pp.119-120
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• 1998

In this study, the design of the single-chamber pacemaker tester is presented. It is important to test the functions of the pacemaker before it is implanted into the patient. A pacemaker tester, that is presented in this study, is able to examine pacemaker parameters such as sensing threshold and refractory period. We need to make artificial intracardiac electrogram in order to test the pacemaker parameters. We know from the previous practical examples that a triangle pulse is similar to the physiologic intracardiac electrogram. The tester generates the simplified electrograms and PC software examines the output pulses of the pacemaker which is VVIR mode in closed-loop simulation.

• Journal of Biomedical Engineering Research
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• v.16 no.1
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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.

• Journal of Biomedical Engineering Research
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• v.23 no.6
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• pp.477-484
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• 2002

A pacemaker autosense algorithm with dual thresholds. one for noise or tachyarrhythmia detection (noise threshold, NT) and the other for intrinsic beat detection (sensing threshold. ST), was developed to improve the sensing performance in single pass VDD electrograms. unipolar electrograms, or atrial fibrillation detection. When a deflection in an electrogram exceeds the NT (defined as 50% of 57), the autosense algorithm with dual thresholds checks if the deflection also exceeds the ST. If it does, the autosense algorithm calculates the signal to noise ratio (SNR) of the deflection to the highest deflection detected by NT but lower than ST during the last cardiac cycle. If the SNR 2, the autosense algorithm declares an intrinsic beat detection and calculates the next ST based on the three most recent intrinsic peaks. If the SNR $\geq$2, the autosense algorithm checks the number of deflections detected by NT during the last cardiac cycle in order to determine if it is a noise detection or tachyarrhythmia detection. Usually the autosense algorithm tries to set the 57 at 37.5% of the average of the three intrinsic beats, although it changes the percentage according to event classifications. The autosense algorithm was tested through computer simulation of atrial electrograms from 5 patients obtained during EP study, to simulate a worst sensing situation. The result showed that the ST levels for autosense algorithm tracked the electrogram amplitudes properly, providing more noise immunity whenever necessary. Also, the autosense algorithm with dual thresholds achieved sensing performance as good as the conventional fixed sensitivity method that was optimized retrospectively.

• Proceedings of the KOSOMBE Conference
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• v.1994 no.12
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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.

• Proceedings of the KIEE Conference
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• 2005.10b
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• pp.29-31
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• 2005

Detection methods for atrial tachycardia and fibrillation on the time axis have the advantages of light operational load and are easy to apply to various applications. Despite these advantages, arrhythmia detection algorithm on the time axis cannot stand much noise such as motion artifacts, moreover the peak detection algorithm has high complexity. In this paper, we use a spectrum analysis method for the detection of atrial tachycardia and fibrillation. By applying spectrum analysis and digital filtering on obtained electrogram signals, we can diagnose heart arrhythmia without using peak detection algorithm.

• The Transactions of the Korean Institute of Electrical Engineers D
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• v.55 no.3
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• pp.142-145
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• 2006

Detection methods for atrial tachycardia and atrial fibrillation on the time axis have the advantages of light operational load and are easy to apply to various applications. Despite these advantages, arrhythmia detection algorithm on the time axis cannot stand much noise such as motion artifacts, moreover the peak detection algorithm has high complexity. In this paper, we use a spectrum analysis method for the detection of atrial tachycardia and atrial fibrillation. By applying spectrum analysis and digital filtering on obtained electrogram signals, we can diagnose heart arrhythmia without using peak detection algorithm.

• The Korean Journal of Physiology
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• v.1 no.1
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• pp.67-72
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• 1967

Present paper is attempted to introduce the phenomenon of 'after contraction' in isolated cardiac-muscle. Papillary muscles were removed from cat right ventricle and were used as a preparation. The muscle strip was Placed in tissue bath which is kept in steady temperature of around $25^{\circ}C$ and was perfuced by Tyrode solution, saturated with 95% $O_2$ and 5% $CO_2.$ under the condition of high calcium (8.2-10.0 mM/l), low sodium (72.4-70.0 mM/l) perfusion with the administration of epinephrine (1-2 mg/l) into tile tissue bath normally triggered muscle contraction was followed by oscillatory, repetitive contractions - after contraction. The phenomenon of after contraction was augumented by decrease in tissue bath temperature and by increase in number of preceding beats and in driving rate. Authors were able to maintain the phenomenon in prominent and steady state giving proper experimental conditions such as fixed bath temperature (ranged from $22^{\circ}C\;to\;27^{\circ}C$), suitable driving rate (20 per minute in average) and perfusion of high calcium, loll sodium and 1-2 mg/l of epinephrine. In some preparations, the strength of after contraction (second contraction) reached up-to 80% of normally triggered contraction and five repetitive contractions were observed as largest number of after contractions. Intracellular action potential measured in the muscle which was beating regulary showing steady after contraction revealed no oscillating after potential in most parts of the muscle but in few cases oscillating changes of after potentials were detectable. In electrogram of the muscle preparation recorded by means of contact electrode prominent, oscillating after potentials were observable when the recorder was set at highest sensitivity. It still is not clear that whether after contraction is the phenomenon which corresponds to those changes in action potential, oscillating after potential, of the muscle preparation. Possible mechanism of the phenomenon of after contraction relating with after potential changes was proposed. Detailed results obtained from further studies on after contraction and concrete discussion on the phenomenon will be reported by authors.

• Journal of IKEEE
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• v.5 no.2 s.9
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• pp.182-189
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• 2001

Single-pass VDD pacemakers have been used as a result of simple implantation procedures and generally reliable atrial tracking that ensures an A-V sequence pacing. However, there is a controversy over their reliabilities of atrial tracking. As a new sensing method for reliable atrial tracking, a simple automatic pacemaker sensing algorithm was implemented and evaluated to validate its benefits in sensing depolarization waves of Single-pass VDD atrial electrograms. The automatic sensing algorithm had a predetermined sensing dynamic range and the sensitivity level was controlled as 50% of the average of two most recently sensed intrinsic amplitudes. The behavior of the automatic sensing algorithm in the Single-pass VDD atrial electrograms was analyzed and characterized. It was observed that the automatic sensing algorithm was more effective than a conventional fixed threshold method to accurately detect and track p-waves in Single-pass VDD electrograms.