• 제목/요약/키워드: radiofrequency

검색결과 383건 처리시간 0.026초

Radiofrequency catheter ablation of atrioventricular nodal reentry tachycardia in children and adolescents: a single center experience

  • Hyun, Myung Chul
    • Clinical and Experimental Pediatrics
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    • 제60권12호
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    • pp.390-394
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    • 2017
  • Purpose: Atrioventricular nodal reentry tachycardia (AVNRT) is less common in pediatric patients than in adult patients. Thus, data for pediatric AVNRT patients are insufficient. Hence, we aimed to analyze the patient characteristics, treatment, and any recurrences in pediatric AVNRT patients. Methods: We reviewed the records of 50 pediatric AVNRT patients who had undergone radiofrequency catheter ablation (RFCA) between January 1998 and December 2016 at a single regional center. The patients were aged ${\leq}18years$. Results: Among 190 pediatric patients who underwent RFCA for tachyarrhythmia, 50 (26.3%; mean age, $13.4{\pm}2.6years$) were diagnosed as having AVNRT by electrophysiological study. Twenty-five patients (25 of 50, 50%) were male. Twenty patients (20 of 50, 40%) used beta-blockers before RFCA. All patients had no structural heart disease except 1 patient with valvular aortic stenosis and coarctation of the aorta. RFCA was performed using the anatomic approach under fluoroscopic guidance. The most common successfully ablated region was the midseptal region (25 of 50, 50%). Slow pathway (SP) ablation and SP modulation were performed in 43 and 6 patients, respectively. Complication occurred in 1 patient with complete atrioventricular block. During follow-up, 6 patients had recurrence of supraventricular tachycardia, as confirmed by electrocardiography. Among them, 5 underwent successful ablation at the first procedure. In 1 patient, induction failed during the first procedure. Conclusion: RFCA is safe and effective in pediatric AVNRT patients. However, further research is needed for establishing the endpoints of ablation in pediatric AVNRT patients and for identifying risk factors by evaluating data on AVNRT recurrence after RFCA.

Reduction of opioid intake after cooled radiofrequency denervation for sacroiliac joint pain: a retrospective evaluation up to 1 year

  • Tinnirello, Andrea
    • The Korean Journal of Pain
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    • 제33권2호
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    • pp.183-191
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    • 2020
  • Background: Opioids can present intolerable adverse side-effects to patients who use these analgesics to mitigate chronic pain. In this retrospective analysis, cooled radiofrequency (CRF) denervation was evaluated to provide pain and disability relief and reduce opioid use in patients with sacroiliac joint (SIJ) derived low back pain (LBP). Methods: Twenty-seven patients with pain from SIJ refractory to conservative treatments, and taking opioids chronically (> 3 mo), were included. Numeric rating scale (NRS) and Oswestry disability index (ODI) scores were collected at 1, 6, and 12 months post-procedure. Opioid use between baseline and each follow-up visit was compared for the entire group and for those who experienced successful (pain reduction ≥ 50% of baseline value) or unsuccessful CRF denervation. Results: Severe initial mean pain (NRS score: 7.7 ± 1.0) and disability (ODI score: 50.1 ± 9.0), and median opioid use (morphine equivalent daily dose: 40 ± 37 mg) were significantly reduced up to 12 months post-intervention. CRF denervation was successful in 44.4% of the patients at 12 months. Regardless of procedure success, patients demonstrated similar opioid reductions and changes in opioid use at 12 months. Two patients (7.4%) experienced neuritis following CRF denervation. Conclusions: CRF denervation of the SIJ can safely elicit pain and disability relief, and reduce opioid use, regardless of intervention success. Future studies may support CRF denervation as a dependable therapy to alleviate opioid use in patients with SIJ-derived LBP and show that opioid use measurements can be a surrogate indicator of pain.

Selective Neurotomy of Sacral Lateral Branches for Pain of Sacroiliac Joint Dysfunction

  • Kim, Hyo-Joon;Shin, Dong-Gyu;Kim, Hyoung-Ihl;Shin, Dong-A
    • Journal of Korean Neurosurgical Society
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    • 제38권5호
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    • pp.338-343
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    • 2005
  • Objective : The sacroiliac joint complex is often related with functionally incapacitating pain in old aged people. The purpose of this study is to delineate the investigation strategies and to determine the long-term effect of radiofrequency [RF] neurotomies for pain arising from sacroiliac Joint dysfunction[SIJD]. Methods : Sixteen patients were diagnosed as having chronic pain from SIJD by comparative controlled blocks on L5 dorsal rami, sacroiliac Joints and deep interosseous ligaments. After confirming the positive response [more than 50% of pain relief], sensory stimulation was applied to detect the 'pathological' branches. Subsequently, RF neurotomies were performed on the selected nerve branches. Surgical outcome was graded as successful, moderate improvement, and failure after a 6month follow-up period. Results : Stimulation intensity was 0.45V to elicit pain response in the L5 dorsal rami and lateral sacral branches. The number of RF-lesioned nerve branches was 6per patient. The average number of lesions for each branch was 1.3. Most commonly selected branches were L5 dorsal ramus [88%] and S2-upper division [88%]. Ten patients [63%] reported a successful outcome according to the outcome criteria after 6months of follow-up, and five patients [31%] reported complete relief [100%]. Five patients [31%] showed moderate improvements. One patient reported failure. Conclusion : RF neurotomy of lateral sacral branches is an excellent treatment modality for the pain due to SIJD, provided that comparative controlled block shows a positive response.

Thermal Property Measurement of Swine Atrium

  • ;김지연
    • 대한의용생체공학회:의공학회지
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    • 제29권5호
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    • pp.343-347
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    • 2008
  • Thermal conductivity, thermal diffusivity were measured in the atrium of a swine heart. Radiofrequency (RF) catheter ablation in an atrium has rapidly emerged at the treatment of symptomatic reentrant arrhythmia associated with accessory pathway or Atrioventricular (AV) node conduction. The thermal properties of an atrium are definitely necessary for these treatments because, in thermal treatments, conductivity and diffusivity are significant factors in the relationship between the applied RF power and the resulting atrium temperature rise. Thermal properties were measured using a self-heated thermistor probe. Thermistor probes were inserted into the tissue of interest and were used to supply heat within the tissue as well as to monitor the temperature rise in the tissue. The measurements were performed at temperatures of 25, 37, $50^{\circ}C$. Atrium thermal conductivity ranged from 5.17$\pm$0.12 mW/cm$^{\circ}C$ at $25^{\circ}C$ to 5.33$\pm$0.08 mW/cm$^{\circ}C$ at $37^{\circ}C$. Atrium thermal diffusivity ranged from 0.00132$\pm$0.00007$cm^2$/sec at $25^{\circ}C$ to 0.00138$\pm$0.00003 $cm^2$/sec at $50^{\circ}C$. This paper also present the thermal property comparison of both chambers of a heart (ventricle and atria).

Wolff-Parkinson-White 증후군의 외과적 치료 (Surgical Treatment of the Wolff-Parkinson-White Syndrome)

  • 박남희;이광숙
    • Journal of Chest Surgery
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    • 제29권12호
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    • pp.1373-1376
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    • 1996
  • 1993년 10월부터 1996년 2월까지 9명의 Wolfr-Parkinson-White증후군을 가진 환자에서 우회로의 외과적 절제술을 시행하였다. 수술적응례를 살펴보면 도자절제술이 실패한 경우가 6례, 우회로가 2개 있었던 경우와 도자절제술중 도자 말단부위가 부러졌던 경우가 1례씩 있었으며, 나머지 1례는 승모판막재치환술이 필요했던 경우이다. 수술사망은 없었으며 술후합병증은심낭삼출액과 창상감염이 각각 1례씩 있었다. 모든 환자에서 술후 심전도검사 및 전기생리검사를 통해 우회로가 완전 절제되었슴을 확인할 수 있었으며 추적 관찰기간중 인맥을 보인 환자는 없었다. 이상의 결과로 Wolfr-Parkinson-White증후군에서 우회로의 외과적 절제는 도자절제술이 실패한 경우, 우회로가 여러개 있는 경우, 그리고 동반된 심질환의 교정을 요하는 경우로 국한되며 수술적응례에서 외과적 절제술은 비교적 안전하고 효과적인 치료방법으로 사료된다.

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Comparing neuromodulation modalities involving the suprascapular nerve in chronic refractory shoulder pain: retrospective case series and literature review

  • Dey, Saugat
    • Clinics in Shoulder and Elbow
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    • 제24권1호
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    • pp.36-41
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    • 2021
  • Chronic shoulder pain not relieved by either conservative or surgical management is referred to as chronic refractory shoulder pain. This is a retrospective case series where chronic refractory shoulder pain patients were treated either with peripheral nerve stimulation (PNS) or with pulsed radiofrequency (p-RF) therapy to the suprascapular nerve. Both patients receiving PNS reported 100% pain relief for the first month. At the 3- and 6-month follow-ups, one patient continued to experience 100% relief while the other reported 90% relief. One patient undergoing p-RF experienced about 90% pain relief at both 1- and 3-month intervals and 0% relief at the 6-month interval. The other patient with p-RF experienced 33% relief at 1-month and 0% relief thereafter. No patient reported any complications. The results of previous randomized controlled trials evaluating the efficacy of p-RF administered to the suprascapular nerve were mixed, and there is a lack of published studies on PNS effects. Neuromodulation of the suprascapular nerve can be effective for chronic refractory shoulder pain patients. Larger scale randomized controlled trials comparing PNS and p-RF are needed to better understand their respective therapeutic capacity.

Human Fibroblast-derived Multi-peptide Factors and the Use of Energy-delivering Devices in Asian Patients

  • Suh, Sang Bum;Ahn, Keun Jae;Chung, Hye Jin;Suh, Ji Youn;Cho, Sung Bin
    • Medical Lasers
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    • 제9권1호
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    • pp.12-24
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    • 2020
  • Human fibroblast-derived multi-peptide factors (MPFs) have been used during treatments with energy-delivering modalities to enhance energy-induced tissue reactions. Human fibroblast-derived MPFs, which include a range of growth factors and chemoattractive factors, activate and recruit fibroblasts and endothelial cells, as well as promote extracellular matrix deposition, all of which are crucial to wound repair. Interestingly, fibroblasts from different species or anatomical sites exhibit distinct transcriptional properties with high heterogeneity. In addition, the patterns of MPF secretion can differ under a range of experimental conditions. Therefore, the use of allogeneic fibroblasts and proper cultivation thereof are necessary to obtain MPFs that can enhance the epithelial-mesenchymal interactions during wound repair. Moreover, energy-delivering devices should be selected according to evidence demonstrating their therapeutic efficacy and safety on a pathological skin condition and the major target skin layers. This paper reviewed the histologic patterns of post-treatment tissue reactions elicited by several energy sources, including non-ablative and ablative fractional lasers, intense focused ultrasound, non-invasive and invasive radiofrequency, picosecond-domain lasers, and argon and nitrogen plasma. The possible role of the immediate application of human fibroblast-derived MPFs during wound repair was proposed.