1.Regularity of prescriptions for sick sinus syndrome based on latent structure combined with association rules.
Jing-Jing WEI ; Rui YU ; Peng-le HAO ; Xing-Yuan LI ; Xin-Lu WANG ; Li-Jie QIAO ; Ming-Jun ZHU
China Journal of Chinese Materia Medica 2023;48(22):6225-6233
This study aims to mine the regularity of traditional Chinese medicine(TCM) prescriptions for sick sinus syndrome(SSS) and provide a reference for clinical syndrome differentiation and treatment. The relevant papers were retrieved from CNKI, Wanfang, VIP, and SinoMed with the time interval from inception to January 31, 2023. The relevant information from qualified papers was extracted to establish a library. Lantern 5.0 and Rstudio were used to analyze the latent structure and association rules of TCMs with the frequency ≥3%, which combined with frequency descriptions, were used to explore the rules of TCM prescriptions for SSS. A total of 192 TCM prescriptions were included, involving 115 TCMs with the cumulative frequency of 1 816. High-frequency TCMs include Aconiti Lateralis Radix Praeparata, Ginseng Radix et Rhizoma, Glycyrrhizae Radix et Rhizoma, Astragali Radix, and Salviae Miltiorrhizae Radix et Rhizoma. The high-frequency medicines mainly had the effects of tonifying, releasing exterior with pungent-warm, and activating blood and resolving stasis. The analysis of the latent structure model yielded 13 hidden variables, 26 hidden classes, 8 comprehensive cluster models, and 21 core prescriptions. Accordingly, the common syndromes of SSS were inferred as heart-Yang Qi deficiency, heart-spleen Yang deficiency, heart-kidney Yang deficiency, Yang deficiency and blood stasis, both Qi and Yin deficiency and blood stasis, and Yin and Yang deficiency. The analysis of association rules predicted 30 strong association rules, among which Ginseng Radix et Rhizoma-Aconiti Lateralis Radix Praeparata had the highest support. SSS is a syndrome with Yang deficiency and Qi deficiency as the root causes and cold, phlegm, and stasis as the manifestations. The clinical treatment of SSS should focus on warming Yang and replenishing Qi, which should be supplemented with the therapies of activating blood and resolving stasis, warming interior and dissipating cold, or regulating Qi movement for resolving phlegm according to the patients' syndromes.
Humans
;
Sick Sinus Syndrome/drug therapy*
;
Yang Deficiency/drug therapy*
;
Drugs, Chinese Herbal/pharmacology*
;
Medicine, Chinese Traditional
;
Prescriptions
;
Rhizome/chemistry*
;
Aconitum
;
Panax
3.Catheter Ablation is Effective for Recovery from Sinus Node Dysfunction in Patients with Atrial Fibrillation, But Close Monitoring is Still Needed
Korean Circulation Journal 2020;50(4):358-360
No abstract available.
Atrial Fibrillation
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Catheter Ablation
;
Catheters
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Humans
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Sick Sinus Syndrome
;
Sinoatrial Node
4.Permanent Pacemaker Implantations after Catheter Ablation in Patients with Atrial Fibrillation Associated with Underlying Sinus Node Dysfunction
Tae Hyun HWANG ; Hee Tae YU ; Tae Hoon KIM ; Jae Sun UHM ; Jong Youn KIM ; Boyoung JOUNG ; Moon Hyoung LEE ; Hui Nam PAK
Korean Circulation Journal 2020;50(4):346-357
BACKGROUND AND OBJECTIVES: The objective of this study was to evaluate the long-term clinical outcomes and the incidence of permanent pacemaker implantation after catheter ablation in patients with of atrial fibrillation (AF) and sinus node dysfunction (SND).METHODS: Among 3,068 total consecutive patients who underwent AF catheter ablation (AFCA), this study included 222 (9.5%; men 53.2%, 63.7±9.2 years of age, 81.5% paroxysmal AF) with underlying SND and a regular rhythm follow-up. We analyzed the rhythm outcomes, changes in the mean heart rate or heart rate variability, and permanent pacemaker implantation rate.RESULTS: During 47.5±28.8 months of follow-up, 25 (11.3%) patients received pacemaker implantations due to symptomatic SND. More than half (56.0%, 14/25) underwent a pacemaker implantation within 3 months of the AFCA, and the annual pacemaker implantation rate was 2.0% afterwards. Both the early (68.0% vs. 31.0%, p<0.001) and clinical AF recurrence (68.0% vs. 32.5%, p=0.001) rates and continuous antiarrhythmic drug use after 3 months (44.0% vs. 24.4%, p=0.036) were significantly higher in patients requiring pacemaker implantations than those that did not. An anterior linear ablation (odds ratio [OR], 9.37 [3.03–28.9]; p<0.001) and the E/Em (OR, 1.15 [1.02–1.28]; p=0.018) were independently associated with permanent pacemaker implantations after AFCA in patients with AF and SND.CONCLUSIONS: After AFCA in patients with AF and SND, 1 of 9 patients needed a pacemaker implantation and half needed implantations within 3 months. The AF recurrence rate was significantly higher in those who required pacemaker implantations after the AFCA.
Atrial Fibrillation
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Catheter Ablation
;
Catheters
;
Follow-Up Studies
;
Heart Rate
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Humans
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Incidence
;
Male
;
Pacemaker, Artificial
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Recurrence
;
Sick Sinus Syndrome
;
Sinoatrial Node
5.Usefulness of an Implantable Loop Recorder in Diagnosing Unexplained Syncope and Predictors for Pacemaker Implantation
Sung Ho LEE ; Tae Hoon KIM ; Yong Seog OH ; Seil OH ; Jong Il CHOI ; Jin Bae KIM ; Jong Chun NAH ; Sung Il IM ; Ki Woon KANG ; Seongwook HAN ; June Soo KIM
Journal of Korean Medical Science 2020;35(2):11-
sinus node dysfunction in 24 patients (70.6%), supraventricular tachyarrhythmia in 4 (11.8%), ventricular arrhythmia in 4 (11.8%), and sudden atrioventricular block in 2 (5.9%). Overall, ILR detected significant arrhythmia in 99 patients (57.2%) irrespective of syncope. Among patients with clinically relevant arrhythmia detected by ILR, PM implantation was performed in 60 (34.7%), an intra-cardiac defibrillator in 5 (2.9%), and catheter ablation in 4 (2.3%). In a Cox regression analysis, history of paroxysmal atrial fibrillation (PAF) (hazard ratio [HR], 2.34; 95% confidence interval [CI], 1.33–4.12; P < 0.01) and any bundle branch block (BBB) (HR, 2.52; 95% CI, 1.09–5.85; P = 0.03) were significantly associated with PM implantation.CONCLUSION: ILR is useful for detecting syncope-correlated arrhythmia in patients with US. The risk of PM is high in US patients with a history of PAF and any BBB.]]>
Arrhythmias, Cardiac
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Atrial Fibrillation
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Atrioventricular Block
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Bundle-Branch Block
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Catheter Ablation
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Defibrillators
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Follow-Up Studies
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Humans
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Korea
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Male
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Observational Study
;
Retrospective Studies
;
Sick Sinus Syndrome
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Syncope
;
Tachycardia
6.Severe Sinus Bradycardia Requiring Cardiac Pacing in a Lupus Patient Who Was Successfully Treated Using Methylprednisolone Pulse Therapy
Jinhee LEE ; Hyo Suk AHN ; Chong Hyeon YOON
Korean Journal of Medicine 2019;94(2):225-229
Symptomatic sinus bradycardia in adults with systemic lupus erythematosus (SLE) is rare. Here, we report a case of severe sinus bradycardia requiring temporary cardiac pacing in a SLE patient successfully treated using methylprednisolone pulse therapy.
Adult
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Bradycardia
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Humans
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Lupus Erythematosus, Systemic
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Methylprednisolone
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Sick Sinus Syndrome
7.Study on Recipients' Experience of Adapting to Permanent Pacemakers
Journal of Korean Critical Care Nursing 2018;11(3):23-34
PURPOSE: This study develops a substantive theory on the recipients' experience of adapting to a permanent pacemaker.METHOD: The study used the grounded theory method developed by Strauss and Corbin (1998). The participants of the study were 13 adults who had received a permanent pacemaker during the previous year. The study addressed the research question “what is the experience of adaptation in people who had received permanent pacemakers?” From October 2016 to March 2017, data were collected from the participants through in-depth interviews.RESULTS: The core category indicating the essence of the adaptation experience was shown to be “accepting the pacemaker as part of my body and living in line with it.”CONCLUSION: In nursing practice, the results of this study will assist nurses in improving their communications with and developing guidelines or interventions for their clients who have received permanent pacemakers. In the field of nursing education, this study is expected to provide a framework to understand the experiences of future nurses and other healthcare workers working with permanent pacemaker recipients.
Adult
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Delivery of Health Care
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Education, Nursing
;
Grounded Theory
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Humans
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Methods
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Nursing
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Sick Sinus Syndrome
8.Clinical Outcomes after Anatomic Repair Including Hemi-Mustard Operation in Patients with Congenitally Corrected Transposition of the Great Arteries.
Man Shik SHIM ; Tae Gook JUN ; Ji Hyuk YANG ; Pyo Won PARK ; Yang Hyun CHO ; Seok KANG ; June HUH ; Jin Young SONG
Korean Circulation Journal 2017;47(2):201-208
BACKGROUND AND OBJECTIVES: The aims of this study were to determine the early and late outcomes of anatomic repair of congenitally corrected transposition of the great arteries (ccTGA) and to evaluate effectiveness of the hemi-Mustard procedure. SUBJECTS AND METHODS: We conducted a retrospective, single-center study of patients who underwent anatomic repair for ccTGA between July 1996 and December 2013. Sixteen patients were included in the study. The median age at the time of the operation was 3.5 years (range: 0.5-29.7), and the median body weight was 13.3 kg (range: 5.8-54). The median follow-up duration was 7.7 years (range: 0.2-17.4). RESULTS: Atrial switch was achieved using the Mustard procedure in 12 patients (hemi-Mustard procedure in 11) or the Senning procedure in four patients. The ventriculoarterial procedure was performed using the Rastelli procedure in 11 patients and arterial switch in five patients. Six patients underwent tricuspid valvuloplasty. The survival rate was 93.8±6.1%. The rate of freedom from reoperation at 5 years was 92.3±7.4% in the Rastelli group. All patients except one were New York Heart Association class I. All patients except one had mild tricuspid regurgitation. CONCLUSION: Anatomic repair can be performed with a low risk of in-hospital mortality. The hemi-Mustard strategy for selected patients is one solution for reducing early mortality and morbidity, and long-term complications such as venous pathway stenosis or sinus node dysfunction.
Arterial Switch Operation
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Arteries*
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Body Weight
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Constriction, Pathologic
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Follow-Up Studies
;
Freedom
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Heart
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Heart Defects, Congenital
;
Hospital Mortality
;
Humans
;
Mortality
;
Reoperation
;
Retrospective Studies
;
Sick Sinus Syndrome
;
Survival Rate
;
Tricuspid Valve Insufficiency
9.Focal Atrial Tachycardia Arising from the Inferior Vena Cava.
Yeong Min LIM ; Jae Sun UHM ; Hui Nam PAK
Yonsei Medical Journal 2017;58(4):884-887
The inferior vena cava (IVC) is a rare site of focal atrial tachycardia (AT). Here, we report a 20-year-old woman who underwent catheter ablation for anti-arrhythmic drug-resistant AT originating from the IVC. She had undergone open-heart surgery for patch closure of an atrial septal defect 17 years previously and permanent pacemaker implantation for sinus node dysfunction 6 years previously. The AT focus was at the anterolateral aspect of the IVC-right atrial junction, and it was successfully ablated under three-dimensional electroanatomical-mapping guidance. We suspect that the mechanism of this tachycardia was associated with previous IVC cannulation for open-heart surgery.
Catheter Ablation
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Catheterization
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Female
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Heart Septal Defects, Atrial
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Humans
;
Sick Sinus Syndrome
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Tachycardia*
;
Vena Cava, Inferior*
;
Young Adult
10.The Absence of Atrial Contraction as a Predictor of Permanent Pacemaker Implantation after Maze Procedure with Cryoablation.
Chang Seok JEON ; Man shik SHIM ; Seung Jung PARK ; Dong Seop JEONG ; Kyoung Min PARK ; Young Keun ON ; June Soo KIM ; Pyo Won PARK
The Korean Journal of Thoracic and Cardiovascular Surgery 2017;50(3):163-170
BACKGROUND: The absence of atrial contraction (AC) after the maze procedure has been reported to cause subsequent annular dilatation and to increase the risk of embolic stroke. We hypothesized that the lack of AC could increase the risk of permanent pacemaker (PPM) implantation in patients undergoing the maze procedure. METHODS: In 376 consecutive patients who had undergone a cryo-maze procedure and combined valve operation, recovery of AC was assessed at baseline and at immediate (≤2 weeks), early (≤1 year, 4.6±3.8 months), and late (>1 year, 3.5±1.1 years) postoperative stages. RESULTS: With a median follow-up of 53 months, 10 patients underwent PPM implantation. Seven PPM implants were for sinus node dysfunction (pauses of 9.6±2.4 seconds), one was for marked sinus bradycardia, and two were for advanced/complete atrioventricular block. The median (interquartile range) time to PPM implantation was 13.8 (0.5–68.2) months. Our time-varying covariate Cox models showed that the absence of AC was a risk factor for PPM implantation (hazard ratio, 11.92; 95% confidence interval, 2.52 to 56.45; p=0.002). CONCLUSION: The absence of AC may be associated with a subsequent risk of PPM implantation.
Atrial Fibrillation
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Atrioventricular Block
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Bradycardia
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Cryosurgery*
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Dilatation
;
Follow-Up Studies
;
Humans
;
Proportional Hazards Models
;
Risk Factors
;
Sick Sinus Syndrome
;
Stroke

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