Clinical Implications of Device-Detected Atrial Fibrillation in Cardiac Resynchronization Therapy

Minjae Yoon,Jaewon Oh,Kyeong-Hyeon Chun,Hee Tae Yu,Chan Joo Lee,Tae-Hoon Kim,Hui-Nam Pak,Moon-Hyoung Lee,Boyoung Joung,Seok-Min Kang 대한심장학회 2023 Korean Circulation Journal Vol.53 No.7

Background and Objectives: Atrial fibrillation (AF) is associated with decreased cardiac resynchronization therapy (CRT) benefits compared to sinus rhythm (SR). Effective biventricular (BiV) pacing is a determinant of CRT success, but AF can interfere with adequate BiV pacing and affect clinical outcomes. We investigated the effect of device-detected AF on clinical outcomes and optimal BiV pacing in patients with heart failure (HF) treated with CRT. Methods: We retrospectively analyzed 174 patients who underwent CRT implantation between 2012 and 2019 at a tertiary center. The optimal BiV pacing percentage was defined as ≥98%. Device-detected AF was defined as an atrial high-rate episode ≥180 beats per minute lasting more than 6 minutes during the follow-up period. We stratified the patients without preexisting AF at pre-implantation into device-detected AF and no-AF groups. Results: A total of 120 patients did not show preexisting AF at pre-implantation, and 54 had AF. Among these 120 patients, 19 (15.8%) showed device-detected AF during a median follow-up of 25.1 months. The proportion of optimal BiV pacing was significantly lower in the device-detected AF group than in the no-AF group (42.1% vs. 75.2%, p=0.009). The device-detected AF group had a higher incidence of HF hospitalization, cardiovascular death, and all-cause death than the no-AF group. The device-detected AF and previous AF groups showed no significant differences regarding the percentage of BiV pacing and clinical outcomes. Conclusions: For HF patients implanted with CRT, device-detected AF was associated with lower optimal BiV pacing and worse clinical outcomes than no-AF.

Dynamic Changes of CHA₂DS₂-VASc Score and the Risk of Ischaemic Stroke in Asian Patients with Atrial Fibrillation: A Nationwide Cohort Study

Yoon, Minjae,Yang, Pil-Sung,Jang, Eunsun,Yu, Hee Tae,Kim, Tae-Hoon,Uhm, Jae-Sun,Kim, Jong-Youn,Pak, Hui-Nam,Lee, Moon-Hyoung,Lip, Gregory Y. H. F K SCHATTAUER VERLAGSGESELLSCHAFT MBH 2018 Thrombosis and Haemostasis Vol.118 No.7

<P>Conclusion In AF patients, stroke risk as assessed by the CHA(2)DS(2)-VASc score is dynamic and changes over time. Rates of ischaemic stroke increased when patients accumulated risk factors, and were re-classified into higher CHA(2)DS(2)-VASc score categories. Stroke risk assessment is needed at every patient contact, as accumulation of risk factors with increasing CHA(2)DS(2)-VASc score translates to greater stroke risks over time.</P>

Statins and Clinical Outcomes in Patients With Low to Moderate Risk but With Non-obstructive Carotid Plaques: The SCOPE-CP Study

Minjae Yoon,Chan Joo Lee,Sungha Park,Sang-Hak Lee 대한심장학회 2022 Korean Circulation Journal Vol.52 No.12

Background and Objectives: Some individuals exhibit discrepancies between risk classifications assessed using clinical factors and those obtained by vascular imaging. We aimed to evaluate whether statins provide clinical outcome benefits in patients classified as having low to moderate cardiovascular risk but with carotid plaque. Methods: This was a retrospective propensity score matching study. A total of 12,158 consecutive patients undergoing carotid ultrasound between January 2012 to February 2020 were screened. Individuals with low to moderate cardiovascular risk who were not currently recommended for statin therapy but had carotid plaques were included. Among 1,611 enrolled individuals, 806 (statin group: 403, control group: 403) were analyzed. The primary outcomes were major adverse cardiovascular and cerebrovascular events (MACCEs: cardiovascular death, myocardial infarction, coronary revascularization, and ischemic stroke or transient ischemic attack) and all-cause mortality. Results: During the median follow-up of 6.0 years, the incidence of MACCEs did not differ between the groups (6.1 and 5.7/1,000 person-years in the control and statin groups, respectively; adjusted hazard ratio [HR], 0.95; p=0.90). The incidence of all-cause mortality did not differ (3.9 and 3.9/1,000 person-years, respectively; adjusted HR, 1.02; p=0.97). Kaplan-Meier curves revealed similar rates of MACCEs (log-rank p=0.72) and all-cause mortality (log-rank p=0.99) in the 2 groups. Age and smoking were independent predictors of MACCEs. Subgroups exhibited no differences in clinical outcomes with statin use. Conclusions: Benefit of statin therapy was likely to be limited in low to moderate risk patients with carotid plaques. These results could guide physicians in clinical decision-making regarding cardiovascular prevention.

Dynamic stroke risk scores of atrial fibrillation

Yoon, Minjae,Joung, Boyoung AME Publishing Company 2018 Journal of thoracic disease Vol.10 No.3

한국사회의 공정성 인식과 행복: 세대 간 차별적 관계를 중심으로

윤민재(MinJae Yoon),임정재(JeongJae Lim) 충남대학교 사회과학연구소 2023 사회과학연구 Vol.34 No.3

주행성능 향상 고강성 엔진마운트 개발

윤민재(Minjae Yoon) 한국자동차공학회 2020 한국자동차공학회 학술대회 및 전시회 Vol.2020 No.11

Engine mount has been widely used to control movement of powertrain and reduce vibration from engine. However, the characteristics of NVH(noise, vibration, harshness) and R&H(riding, handling) of engine mount are trade off relation in vehicle performance. Through the development of high stiffness engine mount, the performance of NVH and R&H was optimized.

한국의 산업화 시대 의료정책 특징과 국가통계

윤민재 ( Minjae Yoon ) 사단법인 아시아문화학술원 2021 인문사회 21 Vol.12 No.2

본 연구는 한국의 산업화 과정을 의료보험 및 인구센서스, 가족계획사업을 통해 분석하는데 목적을 둔다. 먼저 이 연구는 의료 정책들과 관련된 통계조직과 법 등을 분석하였다. 세부적으로는 보건, 출산, 양육 등 인구문제뿐만 아니라 의료보험에 적극적으로 개입한 내용을 역사적 자료를 통해 분석하였다. 분석 결과 산업화를 위해 국가는 개인과 인구에 대한 세밀한 분석을 필요했다는 점을 알 수 있다. 인구센서스를 통해 몸과 신체, 정신과 관련된 개인들의 정보가 체계적으로 수집, 분석되었다. 중요한 것은 의료정책이 이 모든 것의 기초였다는 점이다. 이 분석결과를 통해 산업화 과정은 의료보험 도입을 중심으로 한 보건, 인구 등의 영역과 밀접하게 연관되어 있음을 알 수 있었다. 이 연구는 한국사회의 산업화 과정을 의료보험 및 보건, 통계 영역이 어떻게 연관되어 있는가를 보았다. 이 연구를 통해 한국의 의료 및 보건분야의 연구지평과 시야를 넓힐 수 있을 것이다. This study is to demonstrate the industrialization process of Korea through health insurance, population census, and family planning projects. It also includes analyzation on statistical organization and laws related to these policies. Specifically not only the population problem such as health, childbirth and childcare is analyzed but the active involvement in health insurance is also examined through historical data. The result indicated that the state needed a detailed analysis of individuals and populations for industrialization. Information of individuals related to the health was systematically collected and analyzed through the population census. The health insurance policy was the basis of all this. Industrialization process was closely related to areas such as health care and population centered on the introduction of health insurance. This research investigated how health insurance, health and statistical areas are connected to the industrialization process in Korean society. It will help extend the horizons of research on Korea's medical and health sectors.

한국의 의문사 현황과 해결 방안 : 과거사 청산을 위한 정치사회학적 해법 모색

윤민재(Yoon, Minjae) 조선대학교 민주평화연구원 2020 민주평화연구 Vol.3 No.1

The Liquidation of the past related to state violence is a matter of a comprehensive and multi-layered structure that is closely related to whole life. Therefore, liquidation of the past should not be limited at the political level. The method should be expanded to the fundamental reflection on institutions, social order and culture. We should induce perpetrators to disclose the truth and establish an official organization that righteously judges the confession. Furthermore, the process of embracing fault of perpetrators and regaining the honor of the victim is the process of establishing a future community. The research goes with the state violence and suspicious deaths, the acitivities of Presidential Truth Commission on Suspicious Deaths and its result, and three ways to find solutions for them―systematic one, truth telling, remembrance war. This aspect is a step toward tolerance, forgiveness, reconciliation, and even truth beyond legal truth.

한국사회의 경쟁과 자기계발, 그리고 자아테크놀로지: 청년세대 문제에 대한 연구

윤민재 ( Minjae Yoon ) 사단법인 아시아문화학술원 2020 인문사회 21 Vol.11 No.2

현대사회의 경쟁은 더욱 강화되고 있다. 청년세대는 경쟁질서를 내면화하여 일상생활, 학교, 취업과 노동, 결혼과 연애 등 모든 영역에서 경쟁에 승리하기 위한 계획을 세우고 있다. 이러한 배경 하에서 본 연구는 청년세대가 경쟁을 일상적 차원에서 어떠한 방식으로 내면화하여 자신의 삶을 어떻게 관리하고 계획하는가를 보았다. 이 연구는 자아테크놀로지와 경쟁사회에 대한 이론적 분석과 청년세대에 대한 인터뷰연구를 동원하였다. 연구결과 청년들은 경쟁과 관련된 자아테크놀로지를 구축하여 삶의 전체를 합리적으로 계획하였다. 이 연구는 청년세대의 자아테크놀로지 구축과정과 그 특징 분석을 통해 일상적 차원에서 나타나는 청년세대의 문제점과 그 해결방향을 모색하였다는 점에서 의의가 있다. Generation inequality and generational conflict are being magnified as social problems. Neoliberalism is intensifying competition across society. Therefore by internalizing the competition order, the younger generation is planning to win competition in all areas including daily life, school, employment and labor, marriage and love. They are autonomous, self-selective. They rationally plan their entire life by building their own technology of the self. As the interviewers revealed, excessive competition is causing depression, anxiety and dissatisfaction. In conclusion, by empirically demonstrating the process of younger generation building up self-technology and hearing from them are to find solutions.

민주화과정에서의 군의문사와 군대폭력

윤민재(Yoon MinJae) 비판사회학회 2014 경제와 사회 Vol.- No.104

군의문사는 국가폭력과 국가관리의 문제이다. 군의문사는 개별 군인들 간의 문제나 혹은 피해자나 사망자 자신의 문제로 국한될 수 없다. 일반적인 의문사와 마찬가지로 군의문사 문제도 국가책임의 문제로 보아야 하며, 이 문제의 진실규명이 단순히 개인의 죽음에 대한 의혹해결만으로 귀결되어서는 안 된다. 군의문사의 발생 이면에는 군폭력과 군인인권 문제가 관련되어 있다. 군의문사와 군인인권문제의 발생은 군조직의 구조적 문제이나 국가폭력의 문제이다. 따라서 군의문사를 비롯한 군인인권 침해문제는 민주주의의 공고화, 정의의 확립차원에서 다루어져야 한다. 군인권침해 사건은 물리적, 신체적, 제도적 폭력에 의해 발생한 사건이 대부분이다. 이 폭력은 군 개인들 간의 폭력에 의해 나타나기도 하지만 이를 군내부에서 조직적으로 은폐하거나 왜곡한 경우에는 국가폭력의 문제로 발전한다. 군조직이 군의 지휘와 감독을 잘못함으로써 인명적 피해를 입힌 경우도 국가관리의 소홀, 국가책임의 문제로 해석될 수도 있다. 군의 문사, 군인인권침해 문제의 해결방식의 모색은 군조직과 국가기구에만 맡겨둘 수 없고 시민사회가 함께 고민하고 토론하는 숙의과정을 거치는 과정에서 찾아야할 것이다. The issue of suspicious deaths in the military is related to the state violence and the governance. This issue cannot be limited to individual member of military or the victim himself. The issue of suspicious deaths in the military should also be seen as the responsibility of the state just as the general suspicious deaths. So, this issue should not simply end after the resolution of the suspicion of the death. The hidden side of the suspicious deaths in military is related to the violence of military and the human rights of soldiers. The suspicious deaths in military and the issue of human rights of soldiers are generally seen as the problem of the military organization, but they are also the problem of the state violence. Therefore, the human rights violation issues in the military including the suspicious deaths should be dealt as the problem of the consolidation of democracy and the establishment of justice. The violations of human rights in military are mostly occurred by physical and institutional violence. This violence occurs between the individual soldiers but if the military conceals or distorts the fact of the violence systematically, it then becomes the state violence. Casualtyresulted case as the failure of military organization in directing and supervising also can be seen as negligence of the state management and the responsibility problem of the state. Finding resolution for the issues of suspicious deaths and the violation of human rights can not be left with the military organization and the state organization themselves. The problem should get resolved with civil society in the process of consideration and discussion.