I Can See Health

   Chapter 913

  Jin Miao soon instructed the resident physicians under his command to improve the electrocardiogram.

   Taking advantage of this time, Lu Chen continued to inquire about the patient's condition.

   Immediately, the patient added some medical history.

  About 6 months ago, her palpitations gradually increased in frequency, evident when she continued talking.

   Palpitations are not related to coughing, sneezing, swallowing, etc.

   No symptoms such as headache, blurred vision, disturbance of consciousness, convulsions and foaming at the mouth.

   Valsalva maneuvers did not induce the above symptoms.

   After taking the medical history, the electrocardiogram results before and after the patient's speech appeared.

  Lu Chen took three electrocardiograms.

   Compare carefully.

   Sure enough, the patient is really "talking-induced atrial tachycardia"!

   After speaking, the heart rate increased significantly, showing atrial tachycardia.

  Speaking stopped, and within ten seconds, the heart rate started to slow down.

   This kind of miraculous phenomenon, except Lu Chen, was the first time anyone else had encountered it.

   "It's really rare, no wonder doctors from other hospitals in Modu want patients to come to us!"

   Back at the doctor's office, Jin Miao couldn't help sighing.

   The diagnosis of the current patient has been clear, but for "talking-induced atrial tachycardia", are the electrophysiological characteristics of the heart different from other types of atrial tachycardia?

   What is the possible mechanism?

   More importantly, based on current guidelines, cardiac radiofrequency ablation is still the main treatment for atrial tachycardia.

  This kind of arrhythmia is the first time most people encounter, and how to perform radiofrequency ablation is one of the difficulties!

   "At present, there are less than ten cases reported internationally!" Gu Xinyue has checked the relevant information on the Internet. "And the relevant surgical consumption financing materials are all blank and generally will not be announced to outsiders."

   Therefore, how to ablate and how to completely eliminate the origin of arrhythmia without damaging the myocardial tissue becomes extremely difficult.

  Lu Chen suddenly said: "Who knows, what nerves govern speech?"

  Gu Xinyue was stunned for a moment, knowing that Lu Chen was testing everyone, he thought about it, and said, "Speaking is controlled by the recurrent laryngeal nerve and the superior laryngeal nerve, both of which belong to the parasympathetic nerves. Cardiopulmonary activity is regulated by the sympathetic and parasympathetic nerve centers."

   "Well, not bad." Lu Chen nodded slightly, "Old Gu, then tell me what might be the reason for the atrial speed induced by talking?"

  Gu Xinyue was startled, touched the back of his head, and said embarrassedly, "No...I don't know."

  Lu Chen glanced at Gu Xinyue helplessly, "You already mentioned the parasympathetic nerve, how come you can't get it right at the door?"

   He has great expectations for Lao Gu, and hopes that he can be on his own in the future.

  Lu Chen said slowly: "When the central nervous system regulates speech movements through the parasympathetic nerves, the electrical signals of the parasympathetic nerves may also be transmitted down to the atrium."

"In the atrium, parasympathetic (vagal) activation of IKACh results in an increase in potassium conductance, which hyperpolarizes the resting membrane potential, reduces phase 4 depolarization, and shortens the action potential duration. This may lead to reentry and trigger activity, Promoting focal discharge of atrial tissue."

   After a few words, Lu Chen explained the possible mechanism.

   This made Jin Miao and Gu Xinyue both start taking notes.

   seems to be a simple mechanism, but it is really not easy to associate with speech.

  Lu Chen then said to the two of them: "Perfect the preoperative preparations and arrange the surgery as soon as possible."

   "Okay, received!" Jin Miao nodded.

   He and Gu Xinyue looked at each other.

  Although the two were used to seeing Lu Chen's magical operations, Lu Chen could still surprise them from time to time.

   "Hey, Lao Gu, how many things did the Director have not shown us?" Jin Miao whispered, his eyes glowing.

   "Who knows?" Gu Xinyue lowered her voice, "We have to squeeze him dry!"

  Jin Miao secretly gave a thumbs up, "I like to have ideals and pursuits!"

   The two whispered secretly, but Lu Chen discovered them.

   "What are you two doing?"

  Gu Xinyue quickly sat up straight and grinned, "It's nothing."

  Jin Miao also nodded.

  Lu Chen glanced at the two of them helplessly, "Prepare well before the operation, the operation will be arranged the day after tomorrow."

"receive!"

   Leave the doctor's office.

  Lu Chen called his mother Luo Meizhen.

   "Hey, Xiaochen, you are so busy, why are you free to call me today?"

  Lu Chen smiled, "Mom, did you introduce me to work again?"

   "What did you say?" Luo Meizhen hadn't reacted yet.

   "It's that distant relative of our family." Lu Chen pouted, "The relative who can't be beaten by eight poles, came to the devil to find me."

   "Oh, you said this!" Luo Meizhen suddenly realized, "I just said casually, if you really want to go to a big hospital, you can go to the magic capital to find you."

  Lu Chen sighed lightly on his forehead, "Mom, don't introduce me to these jobs next time. It's not good for me to open the back door for them, and it's not good for me to open the back door. They didn't come looking for me at first."

   "Okay." Luo Meizhen smiled, "Stop talking about this, how's your marriage with Xu Wei going?"

   Speaking of this, Lu Chen's head was a little big.

   No matter how difficult the operation is, he is not afraid.

   But when it comes to these things, he is really at a loss.

   "That, it's still negotiating, Mom, don't worry."

  Lu Chen said a few words and hung up the phone quickly.

   Since he came to the magic capital, Xu Wei has followed him to the magic capital.

   At the local TV station, he became a reporter again.

  Lu Chen wanted her to switch to some easy jobs, but she also refused.

   is still in Lu Chen's current influence in the magic capital, and successfully helped her find a good TV station.

  The relationship is stable, and the two are not too young.

  Marriage is on the agenda.

   Only then did Lu Chen realize that arranging various matters for marriage is much more difficult than performing an operation!

  …

   Two days later.

  Preoperative preparation for distant relatives has been perfected.

   The surgery was performed normally.

  Lu Chen took Jin Miao and Gu Xinyue into the operating room together.

   Now, apart from some difficult operations, Lu Chen would never do it himself.

   With Jinmiao's current ability, most operations can be solved.

   In Lu Chen's plan, Jin Miao, Gu Xinyue and Fan Zhiping will form the surgical team of the Fifth Hospital of the Magic Capital.

   Ke Yue, Xu Shan and others formed a scientific research team.

   "Today's operation is actually not difficult." Lu Chen said to Jin Miao and Gu Xinyue, "It's mainly the mapping of the origin point, which is more difficult. I'll remind you later during the operation."

   "Okay." Jin Miao and Gu Xinyue said in unison.

   In general cardiac electrophysiological examination, drug-induced arrhythmia may be used.

   But this patient is different. Atrial tachycardia can be induced by letting her speak, and then cardiac electrophysiological mapping can be performed.

  PentaRay electrode mapping indicated that the earliest point was at the top of the posterior wall of the left atrium, 26ms earlier than the surface ECG.

   Mapping begins!

   "Pay attention to the origin point between the top of the left atrium and the left and right pulmonary veins." Lu Chen began to remind.

"receive."

   Under the guidance of Lu Chen, Gu Xinyue and Jin Miao became more and more handy.

  The origin of room speed was quickly found out.

  The hardest level is over, and the rest of the ablation is much easier.

   Under the joint operation of Gu Xinyue and Jin Miao, the operation was completed quickly.

   At this time, a prompt popped up on Lu Chen's system panel.

   "Congratulations, the completion of the system upgrade has increased!"

   "Congratulations, I received a thank you from Gu Xinyue!"

   "Congratulations, I received a thank you from Jinmiao!"

  “…”

   (end of this chapter)