1. Definition:
Paroxysmal supraventricular tachycardia broadly includes atrioventricular node reentrant tachycardia, atrial tachycardia reentrant tachycardia, atrial tachycardia, junction tachycardia, atrial flutter, atrial fibrillation, etc. The narrow sense refers specifically to the first two tachycardias. What we generally refer to as paroxysmal supraventricular tachycardia refers specifically to atrioventricular nodal reentrant tachycardia and atrioventricular reentrant tachycardia. In the following we refer to paroxysmal supraventricular tachycardia as supraventricular tachycardia.
2. Clinical characteristics
Patients with supraventricular tachycardia often present with sudden panic, consciously fast heartbeat, sudden sensation of heartbeat, counting heart rate or heart rate and finding that the heartbeat can be between 100-250 beats / min, and the duration of symptoms varies, some patients It can last a few days, some patients last only a few minutes, and most patients last from a few minutes to a few hours.
Experienced patients can hold their breath hard and vomit in the throat can relieve the panic. There are also some patients whose panic cannot be terminated by themselves and need to be pushed to the hospital to relieve the symptoms. The patient's relief of the panic is just a sudden, so the symptoms appear to occur suddenly and suddenly terminate. This is also a characteristic clinical manifestation of supraventricular tachycardia.
3. Can patients with paroxysmal supraventricular tachycardia have dark shadows or syncope?
The heart rate of patients with supraventricular tachycardia is usually around 150-200 beats / min, and it may be slower or faster. Most patients with supraventricular tachycardia are hemodynamically stable and will not be life-threatening. A very small number of patients may have dark shadows and syncope, which is more common in patients with frailty, organic heart disease, or other dangerous conditions.
4. What is the reason for paroxysmal supraventricular tachycardia?
Simply put, there is one more circuit in the heart of patients with supraventricular tachycardia than normal. This circuit makes an excitement that was originally transmitted from the atrium to the ventricle, and then returns from the ventricle to the atrium through this circuit, so that the original one heartbeat becomes Twice, even many times, it becomes tachycardia.
There are two cases of this loop. For paroxysmal atrioventricular reentrant tachycardia, there is an extra bundle of muscles with fast conduction function between the atria and the ventricles. This muscle bundle connects the atria and the ventricles. The conduction of this muscle bundle can also be represented by the conduction of the atrial-muscle bundle-ventricular, at this time the electrocardiogram appears as a pre-excitation pattern, which is what we usually call the pre-excitation syndrome. For paroxysmal atrioventricular node reentrant tachycardia, there is an extra path in the atrioventricular node. This extra path and the normal path of the atrioventricular node constitute a reentrant loop, which causes tachycardia to occur.
5. How to confirm the room speed
If you feel panic, you must go to the hospital to get an electrocardiogram. We can confirm whether it is supraventricular tachycardia by electrocardiogram. Experienced doctors can also determine which type of supraventricular tachycardia is by comparing normal and panic ECG. Therefore, it is important for patients with supraventricular tachycardia to have an electrocardiogram.
6. How to cure room speed
When the supraventricular attack occurs, it can be terminated by pushing the medicine to the hospital. To cure the supraventricular tachycardia only by radiofrequency ablation.
At present, the rapid progress of radiofrequency ablation treatment rooms is very large, and it can achieve a success rate of 95% or more.
In our wards, the radiofrequency ablation treatment room is on the fast track, and it has entered a three-dimensional era. Traditionally, the upper speed of the treatment room needs to be carried out under X-ray fluoroscopy. The patient and the doctor have certain X-ray contact. In our ward, supraventricular ablation is performed under the guidance of three-dimensional navigation instruments, and supraventricular treatment can be completed with zero-X-ray or very low-dose radiation. The X-ray contact between the patient and the doctor has improved the success rate than the traditional method.
Fuwai Hospital is the largest ablation center in the world. It has thousands of cases of radiofrequency ablation of various arrhythmias every year and has rich experience. Patients with supraventricular tachycardia usually have an operation time of less than an hour. During the operation, the patient is awake and can easily chat with the doctor. Go to the ground six to twelve hours after surgery. He is usually discharged home the next day after surgery. Can return to normal life quickly. In terms of costs, if strictly in accordance with national regulations, it is generally around 2-3 million yuan.