1.1000 Cases of Multi-Staged Treadmill Exercise ECG Test: Is It Safe?.
Myun Ho KIM ; Nam Ho KIM ; Seon Joung KIM ; Suck Koo CHOI ; Won Sang YOO
Korean Circulation Journal 1986;16(4):503-508
We examined 984 objects for exercise stress test, using CASE I(computer assisted system for exercise). They exercised according to Bruce's protocol, Among them, the mal were 613 and the female were 371. (Male:Female;17:1) The 5th and 6th decades occupied 61% of total objects. The purpose of test was evaluation of chest pain in 84% of total cases. The most frequent end point of test was dyspnea(42%) and chest pain was observed in 13% of total cases. Most of all objects above 8-9 METS. Positive results of exercise stress tert were obtained in 23%. As complications, ventricular tachycardia occurred in 7 cases, supraventricular tachycardia; 8, high degree VPB's; 6, sudden cardiovascular collapse;15, The complication rate was 0.36% but morbidity and mortality were 0. All complicated cases recoved spontaneously only by rest.
Chest Pain
;
Electrocardiography*
;
Exercise Test
;
Female
;
Humans
;
Mortality
;
Tachycardia, Supraventricular
;
Tachycardia, Ventricular
2.Influence of left ventricular hypertrophy on ventricular arrhythmias in hypertensive patients.
Woo Hyung BAE ; Hyeon Gook LEE ; Yoong In PARK ; Yong Hyun PARK ; Hyun Myung OAH ; Jong Hoon LIM ; Byung Jae AN ; Seong Ho KIM ; Kook Jin CHUN ; Taek Jong HONG ; Yung Woo SHIN
Korean Journal of Medicine 1999;56(4):459-467
OBJECTIVES:Left ventricular hypertrophy(LVH) increases the risk of sudden death in hypertensive patients and this is known due to ventricular arrhythmias. Thus, author studied the relationship between LVH as a hypertensive target organ damage and ventricular arrhythmias. METHODS: 24-hour ambulatory electrocardiographic monitoring, measurement of microalbumin in 24-hour urine and fundoscopic examination were performed on 100 hypertensives (50 patients without LVH and 50 patients with LVH on EKG) who admitted Pusan National University Hospital. RESULTS: In patients with LVH, ventricular extrasystoles occurred more frequently than without LVH(p<0.05) and ventricular couplet and ventricular tachycardia were more common but statistically not different. Microalbuminuria and hypertensive retinopathy were more severe in patients with LVH than without LVH(p<0.05 and p<0.01, respectively). CONCLUSION: Of the ventricular arrhythmias, ventricular extrasystole but not ventricular couplet and ventricular tachycardia occurred more frequently in patients with LVH than without LVH. Thus, prospective study with long-term follow up should be done to establish the relationship between hypertensive LVH and cardiovascular mortality, especially sudden death. And, further study should be done to make the relationship between reduction in LVH with antihypertensive therapy and reduction in LVH-associated ventricular arrhythmias.
Arrhythmias, Cardiac*
;
Busan
;
Death, Sudden
;
Electrocardiography, Ambulatory
;
Humans
;
Hypertensive Retinopathy
;
Hypertrophy, Left Ventricular*
;
Mortality
;
Tachycardia, Ventricular
;
Ventricular Premature Complexes
3.Neonatal arrhythmias: diagnosis, treatment, and clinical outcome.
Korean Journal of Pediatrics 2017;60(11):344-352
Arrhythmias in the neonatal period are not uncommon, and may occur in neonates with a normal heart or in those with structural heart disease. Neonatal arrhythmias are classified as either benign or nonbenign. Benign arrhythmias include sinus arrhythmia, premature atrial contraction, premature ventricular contraction, and junctional rhythm; these arrhythmias have no clinical significance and do not need therapy. Supraventricular tachycardia, ventricular tachycardia, atrioventricular conduction abnormalities, and genetic arrhythmia such as congenital long-QT syndrome are classified as nonbenign arrhythmias. Although most neonatal arrhythmias are asymptomatic and rarely life-threatening, the prognosis depends on the early recognition and proper management of the condition in some serious cases. Precise diagnosis with risk stratification of patients with nonbenign neonatal arrhythmia is needed to reduce morbidity and mortality. In this article, I review the current understanding of the common clinical presentation, etiology, natural history, and management of neonatal arrhythmias in the absence of an underlying congenital heart disease.
Arrhythmia, Sinus
;
Arrhythmias, Cardiac*
;
Atrial Premature Complexes
;
Diagnosis*
;
Heart
;
Heart Defects, Congenital
;
Heart Diseases
;
Humans
;
Infant, Newborn
;
Mortality
;
Natural History
;
Prognosis
;
Tachycardia, Supraventricular
;
Tachycardia, Ventricular
;
Ventricular Premature Complexes
4.The Complexity of Pediatric Multifocal Atrial Tachycardia and Its Prognostic Factors
Seung Min BAEK ; Hyun CHUNG ; Mi Kyoung SONG ; Eun Jung BAE ; Gi Beom KIM ; Chung Il NOH
Korean Circulation Journal 2018;48(2):148-158
BACKGROUND AND OBJECTIVES: Multifocal atrial tachycardia (MAT), in general, has a favorable outcome. However, there are insufficient data regarding MAT in a pediatric population. This study sought to determine the clinical course of MAT and identify potential prognostic factors. METHODS: The medical records of MAT patients from 1997–2015 were reviewed. The arrhythmia control rate and factors for unfavorable outcomes were assessed and compared to those in the literature. RESULTS: Of the 33 included patients (19 boys and 14 girls), 27 were infants less than 1 year of age. The median age at diagnosis was 1.7 months (range, 0 day to 14 years). Fourteen (42%) patients had structural heart disease. Eight (24%) patients had lung disease and 6 (18%) had a syndromic diagnosis belonging to RASopathy. Two patients developed polymorphic ventricular tachycardia, in whom genetic analysis confirmed the presence of the RyR2 mutation several years later. MAT was controlled in 26 patients (84%) within 3.9 months (median; range, 16 days–18.4 years) using an average of 2.4 medications. There were 3 cases of cardiopulmonary mortality. The arrhythmia control rate was higher in the infant group (85%) than in the non-infant group (67%), although this trend was not statistically significant. There was a significantly lower rate of unfavorable outcomes in the idiopathic infant group (n=11) than in the other groups (p=0.008). Considering the findings of previous studies, the mortality rate was significantly higher in patients with structural heart disease than in patients without (21% vs. 5%, p=0.01). CONCLUSIONS: MAT usually affects infants and has a favorable prognosis, particularly in the idiopathic infant group. However, in the presence of other comorbidities, MAT may have a variable clinical course.
Arrhythmias, Cardiac
;
Atrial Fibrillation
;
Atrial Flutter
;
Comorbidity
;
Diagnosis
;
Heart Diseases
;
Humans
;
Infant
;
Lung Diseases
;
Medical Records
;
Mortality
;
Prognosis
;
Ryanodine Receptor Calcium Release Channel
;
Tachycardia
;
Tachycardia, Supraventricular
;
Tachycardia, Ventricular
5.Surgical Treatment of Arrhythmias Associated with Congenital Heart Disease.
Ui Dong HWANG ; Yu Mi IM ; Jeong Jun PARK ; Dong Man SEO ; Jae Won LEE ; Tae Jin YUN
The Korean Journal of Thoracic and Cardiovascular Surgery 2007;40(12):811-816
BACKGROUND: We analyzed our experience of arrhythmia surgery in patients with congenital heart disease. MATERIAL AND METHOD: A retrospective review was performed on 43 consecutive patients with congenital heart disease, who underwent arrhythmia surgery between June 1998 and June 2006. RESULT: The median age at surgery was 52 years (4~75 years). The most frequent cardiac anomaly was an atrial septal defect (23/43, 53.5%). The types of arrhythmias were atrial flutter-fibrillation, intermittent non-sustainable ventricular tachycardia and others in 37, 2 and 4, respectively. Arrhythmia surgery consisted of a bi-atrial maze operation in 18 patients (modified cox maze III procedure in 5 patients, and a right side maze plus pulmonary vein cryo-isolation in 13), right side maze operation in 18 patients, cavo-tricuspid isthmus cryoablation for benign atrial flutter in 4 patients, right ventricular endocardial cryoablation in 2 patients and extranodal cryoablation for atrioventricular node re-entry tachycardia in 1 patient. The median follow-up was 23.8 months (1~95.2 months). There was no early mortality, and one late non-cardiac related death. The overall rates of restored sinus rhythm before discharge and 3~6 months after surgery were 79% and 81%, respectively (bi-atrial maze group: 72% and 83%, right-side maze group: 77%, 77%). CONCLUSION: Arrhythmias associated with congenital heart disease can be safely treated surgically with an excellent intermediate-term outcome.
Arrhythmias, Cardiac*
;
Atrial Fibrillation
;
Atrial Flutter
;
Atrioventricular Node
;
Cryosurgery
;
Follow-Up Studies
;
Heart Defects, Congenital*
;
Heart Septal Defects, Atrial
;
Humans
;
Mortality
;
Pulmonary Veins
;
Retrospective Studies
;
Tachycardia
;
Tachycardia, Ventricular
6.Effects of Antiplatelet Agents in the Prevention of Ventricular Tachyarrhythmias during Acute Myocardial Ischemia in the Rats.
Young Keun AHN ; Jeong Gwan CHO ; Woo Suk PARK ; Nam Ho KIM ; Youl BAE ; Joo Hyung PARK ; Myung Ho JEONG ; Jong Chun PARK ; Jung Chaee KANG
Korean Circulation Journal 1998;28(5):795-804
BACKGROUND: Aspirin, one of the antiplatelet agents, improves the survival rate after myocardial infarction. This beneficial effect is known to be obtained in part by the antiarrhythmic action of aspirin. It is not known whether other antiplatelet agents have such effects. This study was performed to compare the effects of aspirin, ticlopidine, and abciximab (platelet glycoprotein IIb/IIIa receptor antagonist) on the ischemia-induced arrhythmias with a rat model of cardiac regional ischemia. METHODS: Experiments were performed in 4 groups of rats. The 4 groups were as follows : control, n=10:aspirin-pretreated, 300 mg/kg po for 1 week:ticlopidine-pretreated, 200 mg/kg po for 1 wk:abciximab-pretreated, 2 mg/kg iv 10-20 minutes before experiment. The electrocardiogram and blood pressure were recorded during 20 minutes. The time to the onset of ST-segment elevation and ventricular tachyarrhythmias, frequency and incidence of ventricular tachyarrhythmias, and death rate were assessed during acute myocardial ischemia induced by ligation of proximal left anterior descending coronary artery in anesthetized rats. RESULTS: Platelet aggregations to ADP were significantly lower in aspirin (42.8%), ticlopidine (43.8%), and abciximab group (34.0%) than in control group (66.4%). The frequencies of sustained ventricular tachycardia (VT) were 6.8+/-3.6 in control, 3.6+/-3.8 aspirin, 4.7+/-3.7 ticlopidine, and 1.4+/-2.5 abciximab group. The frequency of sustained VT in the abciximab group was significantly lower than in control group. The incidences of ventricular arrhythmias for 20 min were 10/10 for VT and 8/10 for ventricular fibrillation (VF) in control group, 7/10 for VT and 3/10 for VF in aspirin group, 10/10 for VT and 3/10 for VF in ticlopidine group, and 5/10 for VT and 4/10 for VF in abciximab group. The incidences of cardiac death during 20 min were 8/10 in control group, 4/10 in aspirin group, 2/10 in ticlopidine group and 5/10 in abciximab group. The incidence of VT in the abciximab group was significantly lower than in control group, incidences of VF in the aspirin and ticlopidine groups were significantly lower than in control group, and death rate in ticlopidine group was significantly lower than in control group. CONCLUSION: The present study suggested that aspirin, ticlopidine, and abciximab could prevent ventricular tachycardia or ventricular fibrillation in a rat model of cardiac regional ischemia and their antiarrhythmic effects improve the survival rate.
Adenosine Diphosphate
;
Animals
;
Arrhythmias, Cardiac
;
Aspirin
;
Blood Platelets
;
Blood Pressure
;
Coronary Vessels
;
Death
;
Electrocardiography
;
Glycoproteins
;
Incidence
;
Ischemia
;
Ligation
;
Models, Animal
;
Mortality
;
Myocardial Infarction
;
Myocardial Ischemia*
;
Platelet Aggregation Inhibitors*
;
Rats*
;
Survival Rate
;
Tachycardia*
;
Tachycardia, Ventricular
;
Ticlopidine
;
Ventricular Fibrillation
7.Effects of Antiplatelet Agents in the Prevention of Ventricular Tachyarrhythmias during Acute Myocardial Ischemia in the Rats.
Young Keun AHN ; Jeong Gwan CHO ; Woo Suk PARK ; Nam Ho KIM ; Youl BAE ; Joo Hyung PARK ; Myung Ho JEONG ; Jong Chun PARK ; Jung Chaee KANG
Korean Circulation Journal 1998;28(5):795-804
BACKGROUND: Aspirin, one of the antiplatelet agents, improves the survival rate after myocardial infarction. This beneficial effect is known to be obtained in part by the antiarrhythmic action of aspirin. It is not known whether other antiplatelet agents have such effects. This study was performed to compare the effects of aspirin, ticlopidine, and abciximab (platelet glycoprotein IIb/IIIa receptor antagonist) on the ischemia-induced arrhythmias with a rat model of cardiac regional ischemia. METHODS: Experiments were performed in 4 groups of rats. The 4 groups were as follows : control, n=10:aspirin-pretreated, 300 mg/kg po for 1 week:ticlopidine-pretreated, 200 mg/kg po for 1 wk:abciximab-pretreated, 2 mg/kg iv 10-20 minutes before experiment. The electrocardiogram and blood pressure were recorded during 20 minutes. The time to the onset of ST-segment elevation and ventricular tachyarrhythmias, frequency and incidence of ventricular tachyarrhythmias, and death rate were assessed during acute myocardial ischemia induced by ligation of proximal left anterior descending coronary artery in anesthetized rats. RESULTS: Platelet aggregations to ADP were significantly lower in aspirin (42.8%), ticlopidine (43.8%), and abciximab group (34.0%) than in control group (66.4%). The frequencies of sustained ventricular tachycardia (VT) were 6.8+/-3.6 in control, 3.6+/-3.8 aspirin, 4.7+/-3.7 ticlopidine, and 1.4+/-2.5 abciximab group. The frequency of sustained VT in the abciximab group was significantly lower than in control group. The incidences of ventricular arrhythmias for 20 min were 10/10 for VT and 8/10 for ventricular fibrillation (VF) in control group, 7/10 for VT and 3/10 for VF in aspirin group, 10/10 for VT and 3/10 for VF in ticlopidine group, and 5/10 for VT and 4/10 for VF in abciximab group. The incidences of cardiac death during 20 min were 8/10 in control group, 4/10 in aspirin group, 2/10 in ticlopidine group and 5/10 in abciximab group. The incidence of VT in the abciximab group was significantly lower than in control group, incidences of VF in the aspirin and ticlopidine groups were significantly lower than in control group, and death rate in ticlopidine group was significantly lower than in control group. CONCLUSION: The present study suggested that aspirin, ticlopidine, and abciximab could prevent ventricular tachycardia or ventricular fibrillation in a rat model of cardiac regional ischemia and their antiarrhythmic effects improve the survival rate.
Adenosine Diphosphate
;
Animals
;
Arrhythmias, Cardiac
;
Aspirin
;
Blood Platelets
;
Blood Pressure
;
Coronary Vessels
;
Death
;
Electrocardiography
;
Glycoproteins
;
Incidence
;
Ischemia
;
Ligation
;
Models, Animal
;
Mortality
;
Myocardial Infarction
;
Myocardial Ischemia*
;
Platelet Aggregation Inhibitors*
;
Rats*
;
Survival Rate
;
Tachycardia*
;
Tachycardia, Ventricular
;
Ticlopidine
;
Ventricular Fibrillation
8.The Influence of Admission Hypoglycemia on Clinical Outcomes in Acute Myocardial Infarction Patients with Diabetes Mellitus.
Eun Jung KIM ; Myung Ho JEONG ; In Seok JEONG ; Sang Gi OH ; Sang Hyung KIM ; Young Keun AHN ; Ju Han KIM ; Young Jo KIM ; Shung Chull CHAE ; Taek Jong HONG ; In Whan SEONG ; Jei Keon CHAE ; Chong Jin KIM ; Myeong Chan CHO ; Ki Bae SEUNG ; Hyo Soo KIM
Korean Journal of Medicine 2014;87(5):565-573
BACKGROUND/AIMS: There are controversies surrounding strict control of blood glucose levels in diabetic patients. Therefore, we evaluated the influence of hypoglycemia at admission on the clinical outcomes of patients with acute myocardial infarction (AMI). METHODS: We analyzed 5,249 diabetic patients who enrolled in the Korean Acute Myocardial Infarction Registry from November 2005 to March 2013. The patients were divided into three groups according to their blood glucose level at admission; Group I: hypoglycemia (< or = 70 mg/dL), Group II: normoglycemia (70-140 mg/dL) and Group III: hyperglycemia (> or = 140 mg/dL). We assessed in-hospital mortality and the major adverse cardiac events based on blood glucose levels at admission. RESULTS: The mean age was older in group I at 72.6 +/- 11.0 years compared to 71.3 +/- 10.7 in group II and 70.3 +/- 11.1 in group III (p < 0.006). A total of 344 patients died during hospitalization. In-hospital mortality was higher in group I at 12.9%, compared to 5.2% in group II and 6.8% in group III (p < 0.006). Multivariable logistic regression analysis determined that the independent predictors of 1-month mortality were age, Killip class III-IV, cerebrovascular disease, chronic renal failure, acute renal failure, cardiogenic shock, ventricular tachycardia, ejection fraction < 40% and hypoglycemia in admission. The mortality rate at 1 month was significantly higher in group I compared to group II (odds ratio [OR] 3.571; 95% confidence interval [CI] 1.465-8.705, p = 0.005) compared to group II and group III (OR 4.088; 95% CI 1.757-9.511, p = 0.001). CONCLUSIONS: Hypoglycemia on admission was an important predictor of in-hospital and one-month mortality in AMI patients with diabetes mellitus.
Acute Kidney Injury
;
Blood Glucose
;
Diabetes Mellitus*
;
Hospital Mortality
;
Hospitalization
;
Humans
;
Hyperglycemia
;
Hypoglycemia*
;
Logistic Models
;
Mortality
;
Myocardial Infarction*
;
Prognosis
;
Renal Insufficiency, Chronic
;
Shock, Cardiogenic
;
Tachycardia, Ventricular
9.The Influence of Admission Hypoglycemia on Clinical Outcomes in Acute Myocardial Infarction Patients with Diabetes Mellitus.
Eun Jung KIM ; Myung Ho JEONG ; In Seok JEONG ; Sang Gi OH ; Sang Hyung KIM ; Young Keun AHN ; Ju Han KIM ; Young Jo KIM ; Shung Chull CHAE ; Taek Jong HONG ; In Whan SEONG ; Jei Keon CHAE ; Chong Jin KIM ; Myeong Chan CHO ; Ki Bae SEUNG ; Hyo Soo KIM
Korean Journal of Medicine 2014;87(5):565-573
BACKGROUND/AIMS: There are controversies surrounding strict control of blood glucose levels in diabetic patients. Therefore, we evaluated the influence of hypoglycemia at admission on the clinical outcomes of patients with acute myocardial infarction (AMI). METHODS: We analyzed 5,249 diabetic patients who enrolled in the Korean Acute Myocardial Infarction Registry from November 2005 to March 2013. The patients were divided into three groups according to their blood glucose level at admission; Group I: hypoglycemia (< or = 70 mg/dL), Group II: normoglycemia (70-140 mg/dL) and Group III: hyperglycemia (> or = 140 mg/dL). We assessed in-hospital mortality and the major adverse cardiac events based on blood glucose levels at admission. RESULTS: The mean age was older in group I at 72.6 +/- 11.0 years compared to 71.3 +/- 10.7 in group II and 70.3 +/- 11.1 in group III (p < 0.006). A total of 344 patients died during hospitalization. In-hospital mortality was higher in group I at 12.9%, compared to 5.2% in group II and 6.8% in group III (p < 0.006). Multivariable logistic regression analysis determined that the independent predictors of 1-month mortality were age, Killip class III-IV, cerebrovascular disease, chronic renal failure, acute renal failure, cardiogenic shock, ventricular tachycardia, ejection fraction < 40% and hypoglycemia in admission. The mortality rate at 1 month was significantly higher in group I compared to group II (odds ratio [OR] 3.571; 95% confidence interval [CI] 1.465-8.705, p = 0.005) compared to group II and group III (OR 4.088; 95% CI 1.757-9.511, p = 0.001). CONCLUSIONS: Hypoglycemia on admission was an important predictor of in-hospital and one-month mortality in AMI patients with diabetes mellitus.
Acute Kidney Injury
;
Blood Glucose
;
Diabetes Mellitus*
;
Hospital Mortality
;
Hospitalization
;
Humans
;
Hyperglycemia
;
Hypoglycemia*
;
Logistic Models
;
Mortality
;
Myocardial Infarction*
;
Prognosis
;
Renal Insufficiency, Chronic
;
Shock, Cardiogenic
;
Tachycardia, Ventricular
10.Emergent Use of Intraaortic Balloon Pump in Patients with Ischemic Heart.
Dae Gyun PARK ; Dong Jin OH ; Kyung Soon HONG ; Young Cheoul DOO ; Kyoo Rok HAN ; Kyu Hyung RYU ; Chong Yun RIM ; Kwang Hack LEE ; Yung LEE ; Hyun Keun CHEE ; Weon Yong LEE ; Eung Joong KIM
Korean Circulation Journal 2000;30(10):1213-1219
BACKGROUND AND OBJECTIVES: The purpose of this study is to examine clinical characteristics and outcome in patients with cardiogenic shock or ongoing cardiogenic shock by acute coronary syndrome who underwent intraaortic balloon pump(IABP) support, and to identify factors predictive of in-hospital mortality. MATERIALS AND METHODS: Thirty-two consecutive patients with IABP support from 1994 to 1997 were analyzed retrospectively. RESULTS: The causes for insertion of IABP are cardiogenic shock(31%), unstable hemodynamics during angiography or angioplasty(31%), ventricular tachycardia(15%), mechanical complications(15%), and ongoing chest pain(6%). The overall survival rate was 47%. Revascularization procedures were done in 23 cases(72%) in whom inhospital survival rate was 52%. The mortality rate was significantly higher in patients with cardiogenic shock(80%) and mechanical complications(100%) including ventricular septal defect and acute mitral regurgitation, but lower with intractable ventricular tachycardia. Differences between survivors and nonsurvivors were not significant in regard to clinical characteristics, extent of coronary artery disease, time to IABP, time to coronary artery bypass graft, and clamping time, but only duration of IABP is longer in nonsurvivors. CONCLUSIONS: Emergent uses of IABP in patients with intractable ventricular tachycardia may be effective in maintaining hemodynamics before revascularization procedures, but patients with pump failure by cardiogenic shock or mechanical complications have higher mortality rates.
Acute Coronary Syndrome
;
Angiography
;
Constriction
;
Coronary Artery Bypass
;
Coronary Artery Disease
;
Heart Septal Defects, Ventricular
;
Heart*
;
Hemodynamics
;
Hospital Mortality
;
Humans
;
Mitral Valve Insufficiency
;
Mortality
;
Retrospective Studies
;
Shock, Cardiogenic
;
Survival Rate
;
Survivors
;
Tachycardia, Ventricular
;
Thorax
;
Transplants