ventricular rest
Introduction
Introduction to ventricular quiescence Ventricular quiescence, also known as ventricular arrest, refers to the pacing of the atrioventricular junction and ventricular pacing. At this time, the atrium has contracted, the mechanical contraction of both ventricles is stopped, and the ventricular rest time is usually 2.7 s or more. Ventricular quiescent transients can cause palpitations, slightly longer can induce syncope or angina, and longer can cause A-S syndrome or sudden death. The endurance will eventually die. basic knowledge The proportion of the disease: the incidence of this disease in the middle-aged and elderly people over 50 years old is about 0.001%-0.002% Susceptible people: no specific population Mode of infection: non-infectious Complications: syncope, convulsions and convulsions, angina, A-S syndrome, sudden death
Cause
Ventricular stationary cause
Atrioventricular block (30%):
Ventricular quiescence can occur when atrioventricular block is associated with atrioventricular junction or ventricular pacing point failure or severe depression. The most important cause of ventricular systole is the most dangerous consequence of second-degree type II block, such as sudden onset of bundle branch block, often caused by sudden blockage of the contralateral bundle.
Increased vagal tone (20%):
In severe vomiting, carotid sinus allergy, etc., the blockage often occurs in the atrioventricular node, and such ventricular quiescence is often temporary and moderate.
Pathogenesis
1. Atrioventricular block with ventricular pacing or ventricular ventricular pacing point failure or severe depression, ventricular quiescence can occur, the most important cause of ventricular quiescence is the second degree II block Dangerous consequences, such as sudden onset of bundle branch block, are often caused by a sudden block of the contralateral bundle.
2. Third-degree atrioventricular block, escape rhythm in the atrioventricular junction, the mechanism of ventricular quiescence and A-S syndrome may occur when the sinus frequency is increased:
(1) There may be 4-phase conduction block in the atrioventricular junction: when the sinus frequency is increased, the atrioventricular conduction is improved, but due to occult conduction, it is still unable to enter the ventricle. This occult conduction can invade the pacing at the atrioventricular junction. Point, so that the depolarization can not be transmitted to the ventricle, because the faster frequency of sinus agitation in the junction area continuous concealed conduction, resulting in continuous inhibition of the pacemaker point in the atrioventricular junction area, so there is a long RR interval, resulting in A- The onset of the syndrome.
(2) The sinus agitation is deeper: the conduction can be concealed in the His bundle or the bundle branch, so that the lower pacing point is suppressed and the excitatory is not emitted, so there is no QRS wave in the long interval.
(3) Diffuse myocardial lesions: The negative value of the resting potential of the self-regulating cells of the His bundle, the bundle branch and the Pu's fiber or the drift of the threshold potential from the zero position makes the diastolic period automatically difficult to remove, and the self-discipline is reduced.
(4) The lower pacing point is in the "sleeping" state, and the starting is slower.
Prevention
Ventricular quiescence prevention
1. Appetite is appropriate, work and rest are moderate, and the mood is comfortable. Control emotion. Temper temper, unable to control themselves in the event of an emergency, is also easy to induce.
2. Actively treat the primary disease and correct electrolyte imbalance, and rationally use the drug.
3. Quit smoking. Smokers are twice as likely to suffer from heart disease as non-smokers. exercise more. A moderate exercise for 20 minutes a day can reduce the risk of heart disease by 30%, and the quickest effect is best.
4. People who eat fruits and vegetables often have a 30% lower risk of heart attack than those who eat less or never eat fruits and vegetables. With little or no fried foods.
Complication
Ventricular complication Complications, syncope, convulsions, convulsions, angina, sudden death
Such arrhythmia is one of the serious arrhythmias. The consequences of a long-term episode are like cardiac arrest. Common complications include syncope, convulsions, angina pectoris, A-S syndrome and sudden cardiac death.
Symptom
Ventricular quiescence symptoms common symptoms angina pectoris cerebral ischemia
Ventricular quiescent transients can cause palpitations, a longer one can induce syncope or angina pectoris, longer can cause A-S syndrome or sudden death, and lasting will eventually die.
According to the clinical manifestations, the characteristics of the signs and electrocardiogram can be clearly diagnosed.
Examine
Ventricular quiescent examination
An electrocardiogram can confirm the diagnosis.
Characteristics of ventricular static electrocardiogram: The ventricular quiescence can have the following three manifestations, and the diagnosis of ventricular quiescence can be made according to any one.
1. Sinus rhythm with complete atrioventricular block without any escape rhythm, that is, only a series of sinus P waves are seen without any junction or ventricular escape.
2. Atrial rhythm with complete atrioventricular block without any escape rhythm, that is, only a series of atrial waves (including atrial P' wave, F wave or f wave), without any junction area and ventricular QRS wave .
3. Sinus rhythm or not too fast atrial rhythm (including a slow atrial escape rhythm to accelerated atrial escape rhythm) with a high degree of atrioventricular block longer than 2.7s (approximately equivalent to ventricular No transition zone and ventricular QRS waves were seen in the long interval of the longest cardiac cycle of escape rhythm.
Diagnosis
Ventricular stationary diagnosis
Ventricular quiescence and cardiac arrest (or whole heart arrest) need to be identified, with the following differences.
1. Ventricular quiescence occurs on the basis of high or third degree atrioventricular block, and cardiac arrest occurs in the dying period of various fatal arrhythmias, various organic heart diseases and various diseases. Sexual or secondary cardiac arrest, ventricular quiescence, etc.
2. The ventricle is stationary on the electrocardiogram with atrial P wave (P wave, P' wave, F wave or f wave) without the atrioventricular junction area and ventricular QRS wave, and the cardiac arrest on the electrocardiogram is for more than 2.7s. (a straight line).
3. The ventricle is still atrial contraction without ventricular contraction, the cardiac arrest is in the atria, the ventricles are not contracted, but the common point of both ventricular stillness and cardiac arrest is that the ventricle has no electrical activity (no QRS waves), and no heart. The mechanical contraction of the chamber causes the end of the blood circulation, so the two are compared. They are the two most serious types of arrest. Some people advocate the collectively referred to as cardiac arrest.
