I can see health

Chapter 913
Jin Miao quickly ordered the resident physician under him to complete 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, she had progressively increased frequency of palpitations, evident when she continued to speak.

Palpitation symptoms have nothing to do with coughing, sneezing, swallowing, etc.

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

The Valsalva maneuver did not induce the above symptoms.

After asking about the medical history, the ECG results before and after the patient spoke appeared.

Lu Chen took three electrocardiograms.

Compare carefully.

Sure enough, the patient was really "talk-induced atrial tachycardia"!
After speaking, the heart rate increased significantly, showing atrial tachycardia.

Talking stopped, and within ten seconds, the heart rate began to slow down.

Except for Lu Chen, it was the first time for anyone else to encounter this miraculous 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 sighing.

The diagnosis of the current patient is clear, but for "speech-induced atrial tachycardia", are its electrophysiological characteristics different from other types of atrial tachycardia?

What is its possible mechanism?
More importantly, based on current guidelines, cardiac radiofrequency ablation remains the primary treatment for atrial tachycardia.

This kind of arrhythmia is usually encountered for the first time by most people. How to perform radiofrequency ablation surgery is the difficulty!
"Currently there are less than ten cases of this kind reported internationally!" Gu Xinyue has checked the relevant information on the Internet, "And the relevant information on surgery financing is blank, and generally it will not be released to outsiders."

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

Lu Chen suddenly said, "Who of you know what nerves control speech?"

Gu Xinyue was taken aback, 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 belong to the parasympathetic nerve. Cardiopulmonary activity is regulated by the sympathetic and parasympathetic nerve centers."

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

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

Lu Chen looked at Gu Xinyue helplessly, "You have already mentioned the parasympathetic nerve, how can you not do it like this?"

He has great expectations for Lao Gu, and hopes that he will be able to be alone in the future.

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

"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 reentrant and triggered activity, Promote focal discharge of atrial tissue."

In a few words, Lu Chen revealed the possible mechanism.

This made both Jin Miao and Gu Xinyue start to take notes.

It looks like a simple mechanism, but it is really not easy to associate it with speech.

Lu Chen then said to the two of them: "Perfect the preoperative preparations and arrange the operation 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 miraculous operations, Lu Chen could still surprise them from time to time.

"Hey, Lao Gu, how many things do you think the director hasn't revealed to us?" Jin Miao whispered, his eyes gleaming.

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

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

The two whispered secretly, but was discovered by Lu Chen.

"What are you two doing?"

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

Jin Miao nodded again and again.

Lu Chen looked at the two of them helplessly, "Make good preparations before the operation, the operation will be arranged the day after tomorrow."

"Roger that!"

Leave the doctor's office.

Lu Chen called his mother Luo Meizhen.

"Hey, Xiaochen, you are a busy person, why do you have time 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 curled his lips, "The relative who can't beat eight poles, come to find me."

"Oh, what are you talking about!" Luo Meizhen suddenly realized, "I just said something casually, if you really want to go to a big hospital for medical treatment, you can go to Shanghai to find you."

Lu Chen rubbed 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 for me to open the back door. They didn't come here this time to find me in the first place."

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

Speaking of this, Lu Chen felt a little overwhelmed.

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

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

"Well, we are still discussing, Mom, so don't worry."

After Lu Chen said a few words, he hung up the phone quickly.

Since he came to Shanghai, Xu Wei followed him to Shanghai.

In the local TV station, I became a reporter again.

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

Lu Chen's current influence in Shanghai is not bad, and he successfully helped her find a good TV station.

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

Marriage is on the agenda.

It was only then that Lu Chen discovered that arranging various matters of marriage is much more difficult than performing an operation!
……

Two days later.

The preoperative preparations for distant relatives have been perfected.

The operation proceeded normally.

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

Except for some difficult surgeries, Lu Chen would never do them himself.

With Jin Miao's current ability, it can solve most of the surgeries.

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

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, "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 examination, drugs may be used to induce arrhythmia.

But this patient is different. Just by letting her speak, she can induce atrial tachycardia, and then perform cardiac electrophysiological mapping.

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

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

"receive."

Under Lu Chen's teaching, Gu Xinyue and Jin Miao became more and more handy.

The origin of the room rate was quickly found out.

After passing the most difficult level, the rest of the ablation is much easier.

Under the joint operation of Gu Xinyue and Jin Miao, the operation was completed very 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 the thank you value from Gu Xinyue!"

"Congratulations, I received the thank you value from Jin Miao!"

"..."

(End of this chapter)