Pacemaker lead induced cardiac perforation presenting with pneumothorax

An 87-year-old male with old myocardial infarction was referred to the hospital due to left femur neck fracture and intermittent dizziness. Significant 2:1 atrioventricular block was demonstrated on initial electrocardiogram (Figure 1). Transthoracic echocardiography showed reduced left ventricular function (LVEF = 47%) with regional wall motion abnormality of right coronary artery (RCA) and left circumflex coronary artery (LCx) artery. Coronary angiography showed patent previous proximal RCA and distal LCx stents. Temporary pacemaker was inserted initially and the patient was planned for permanent pacemaker insertion after the surgery.

Simultaneous multiple coronary arteries thrombosis in patients with STEMI

Simultaneous thrombosis affecting more than one coronary artery has been reported to occur in about 4.8% of the cases at the time primary percutaneous coronary intervention （PCI）. Simultaneous multiple coronary arteries throm-bosis is uncommon and can lead to a fatal outcome. Careful attention should be given to identification of abnormal ECG and coronary angiography （CAG） results. The affected ves- sel should be opened timely and efficiently in an effort to save the myocardium and reduce serious complications such as congestive heart failure, ventricular arrhythmia, cardiogenic shock, or sudden cardiac death.

Coronary-Cameral Fistula appeared after coronary artery intervention

A 63-year-old male with old myocardial infarction was referred to cardiology department with cardiac arrest.Electrocardiogram revealed Q wave in the precordial leads demonstrating ischemia of anterior left ventricular wall.Mild pulmonary edema was documented on chest X-ray.Transthoracic echocardiography showed severely reduced left ventricular function (EF: 28%) with enlarged left atrium and ventricle.Coronary angiography was performed showing a total occlusion of the proximal portion of the left anterior descending artery (LAD)(Figure 1) with chronic total occlusion in the proximal portion of right coronary artery.Xience stent 2.75 × 23 mm (Abbott) was implanted in the proximal LAD lesion.Coronary angiography after percutaneous coronary intervention (PCI) revealed no definite coronary fistula (Figure 2).Two weeks later,follow-up coronary angiography demonstrated multiple coronary-left ventricular fistulas (Figure 3) which were absent in the previous angiography.

Induced atrial fibrillation during defibrillation test on implantation of subcutaneous implantable cardioverter defibrillator

The subcutaneous implantable cardioverter defibrillator(S-ICD)has become an alternative to the transvenous ICD in indicated patients.However,inappropriate shock or failed ventricular tachycardia/fibrillation conversion is the most alarming complication of S-ICD.Therefore,defibrillation test(DFT)is recommended for the S-ICD implantation.

Thyrotoxicosis induced cardiogenic shock rescued by extracorporeal membrane oxygenation

Cardiomyopahty is one of complications of thyrotoxicosis. About 6% of thyrotoxic patients develop heart failure, but less than 1% of the patients progress dilated cardiomyopathy with systolic left ventricular dysthnction.

Polymorphic ventricular tachycardia during phase Ⅱ cardiac rehabilitation in a patient with heart failure: a case report

A 67-year-old man with a history of a prior cardiac arrest with ventricular fibrillation(VF)due to myocardial infarction underwent phase I(inpatient)and II(outpatient)cardiac rehabilitation(CR)exercise training.On the 33th CR session,15 min after the start of exercise training,the patient had syncope with evidence of a polymorphic and wide QRS complex tachycardia on electrocardiogram(ECG)monitoring.The initiation of a polymorphic ventricular tachycardia was evidenced by the coupled premature ventricular complex observed in the ECG monitoring screen(Figure 1).

Ultra-thin light-weight laser-induced-graphene (LIG) diffractive optics

The realization of hybrid optics could be one of the best ways to fulfll the technological requirements of compact,light-weight,and multi-functional optical systems for modern industries.Planar diffractive lens(PDL)such as diffractive lenses,photonsieves,and metasurfaces can be patterned on ultra-thin flexible and stretchable substrates and be conformally attached on top of arbitrarily shaped surfaces.In this review,we introduce recent research works addressed to the design and manufacturing of ultra-thin graphene optics,which will open new markets in compact and light-weight optics for next-generation endoscopic brain imaging,space internet,real-time surface proflometry,and multi-functional mobile phones.To provide higher design flexibility,lower process complexity,and chemical-free process with reasonable investment cost,direct laser writing(DLW)of laser-induced-graphene(LIG)is actively being applied to the patterning of PDL.For realizing the best optical performances in DLW,photon-material interactions have been studied in detail with respect to different laser parameters;the resulting optical characteristics have been evaluated in terms of amplitude and phase.A series of exemplary laser-written 1D and 2D PDL structures have been actively demonstrated with different base materials,and then,the cases are being expanded to plasmonic and holographic structures.The combination of these ultra-thin and light-weight PDL with conventional bulk refractive or reflective optical elements could bring together the advantages of each optical element.By integrating these suggestions,we suggest a way to realize the hybrid PDL to be used in the future micro-electronics surface inspection,biomedical,outer space,and extended reality(XR)industries.

Wireless,multimodal sensors for continuous measurement of pressure,temperature,and hydration of patients in wheelchair

Individuals who are unable to walk independently spend most of the day in a wheelchair.This population is at high risk for developing pressure injuries caused by sitting.However,early diagnosis and prevention of these injuries still remain challenging.Herein,we introduce battery-free,wireless,multimodal sensors and a movable system for continuous measurement of pressure,temperature,and hydration at skin interfaces.The device design includes a crack-activated pressure sensor with nanoscale encapsulations for enhanced sensitivity,a temperature sensor for measuring skin temperature,and a galvanic skin response sensor for measuring skin hydration levels.The movable system enables power harvesting,and data communication to multiple wireless devices mounted at skin-cushion interfaces of wheelchair users over full body coverage.Experimental evaluations and numerical simulations of the devices,together with clinical trials for wheelchair patients,demonstrate the feasibility and stability of the sensor system for preventing pressure injuries caused by sitting.