I Can See Health

Jin Miao quickly ordered his resident doctors to perfect the electrocardiogram.

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

Immediately, the patient added some medical history.

About 6 months ago, the frequency of her heart palpitations gradually increased, which was evident when she continued to speak.

Symptoms of palpitations have nothing to do with coughing, sneezing, swallowing, etc.

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

Performing the valsalva maneuver did not induce the above symptoms.

After taking the history, the results of the electrocardiogram before and after the patient spoke appeared.

Lu Chen received three electrocardiograms.

Compare carefully.

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

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

When talking stops, within ten seconds, the heart rate begins to slow down.

Except for Lu Chen, this was the first time for everyone to encounter this magical phenomenon.

"It's really rare. No wonder doctors from other hospitals in Shanghai want patients to come to us!"

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

The current patient's diagnosis is clear, but are the electrophysiological characteristics of "talking-induced atrial tachycardia" different from other types of atrial tachycardia?

What are its possible mechanisms?

More importantly, based on current guidelines, cardiac radiofrequency ablation remains the primary treatment for atrial tachycardia.

This kind of arrhythmia is the first time most people encounter it. How to perform radiofrequency ablation surgery is one of the difficulties!

"Currently, there are less than ten cases of this kind reported internationally!" Gu Xinyue has checked the relevant information online. "And the relevant information on surgical dissipation is blank and generally will not be released to outsiders."

Therefore, how to ablate and completely eliminate the origin of arrhythmia as much as possible without damaging the myocardial tissue has become extremely difficult.

Lu Chen suddenly said: "Does any of you know what nerves control speech?"

Gu Xinyue was stunned, knowing that Lu Chen was testing everyone. He thought for a while and then said: "Speech is controlled by the recurrent laryngeal nerve and superior laryngeal nerve, both of which are parasympathetic nerves. Cardiopulmonary activity is controlled by the sympathetic and parasympathetic nerve centers."

"Yeah, not bad." Lu Chen nodded slightly, "Lao Gu, can you tell me what might be the cause of atrial tachycardia caused by talking?"

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

Lu Chen looked at Gu Xinyue helplessly, "You mentioned parasympathetic nerves, why can't you do this at the last minute?"

He has great expectations for Lao Gu and hopes that he can take charge of his own business in the future.

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

"In the atria, parasympathetic (vagal) nerve activation of ikach leads to increased potassium conductance, which hyperpolarizes the resting membrane potential, reduces phase 4 depolarization, and shortens action potential duration. This may lead to reentry and triggered activity, Promotes focal discharge in atrial tissue.”

Lu Chen's few words revealed the possible mechanism.

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

It seems like a simple mechanism, but it’s really not easy to associate it with speaking.

Lu Chen then said to the two of them: "Perfect pre-operative 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 of them were used to Lu Chen's magical operations, Lu Chen could still surprise them from time to time.

"Hey, Lao Gu, how many things do you think the director has yet to show us?" Jin Miao whispered, his eyes gleaming.

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

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

The two of them were muttering secretly, but were discovered by Lu Chen.

"What are you two doing?"

Gu Xinyue quickly sat upright and grinned, "Nothing."

Jin Miao also nodded repeatedly.

Lu Chen glanced at the two of them helplessly, "Make good preparations before the operation. The operation will be scheduled for the day after tomorrow."

"receive!"

Leave the doctor's office.

Lu Chen called his mother Luo Meizhen.

"Hey, Xiaochen, you are such a busy person, why do you have time to call me today?"

Lu Chen smiled and said, "Mom, have you introduced me to another job?"

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

"That's the distant relative of our family." Lu Chen curled his lips, "The relative who can't even be beaten with a stick came to the devil to find me."

"Oh, you're talking about this!" Luo Meizhen suddenly realized, "I just said casually, if you really want to see a doctor in a big hospital, I can go to Shanghai to find you."

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

"Okay, okay." Luo Meizhen smiled, "Let's not talk about this anymore. How is your marriage with Xu Wei going?"

Speaking of this, Lu Chen felt a little overwhelmed.

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

But when talking about these things, he was really at a loss.

"Well, we're still discussing it, Mom, don't worry."

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

Since he came to the Magic City, Xu Wei followed him to the Magic City.

At the local TV station, I returned to being a reporter.

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

Lu Chen's current influence in Shanghai is quite good, and he successfully helped her find a good TV station.

The relationship is stable, and both of them are not too young.

Marriage was on the agenda.

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

…

Two days later.

Preoperative preparation for distant relatives is complete.

The operation proceeds normally.

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

Nowadays, except for some difficult surgeries, Lu Chen doesn't know how to do it himself.

With Jin Miao's current ability, he can solve most surgeries.

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

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

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

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

In general cardiac electrophysiological examinations, drugs may be used to induce arrhythmias.

But this patient is different. Just by asking her to talk, atrial tachycardia can be induced, and then cardiac electrophysiological mapping can be performed.

Pentaray electrode mapping showed 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 vein openings." Lu Chen began to remind.

"Received. UU Reading www.uukanshu.net"

Under Lu Chen's guidance, Gu Xinyue and Jin Miao became more and more proficient.

The origin of atrial tachycardia was quickly found.

Once the most difficult level is over, the rest of the ablation becomes much easier.

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

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

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

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

"Congratulations, I received a thank you from Jin Miao!"

"..."

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