Atrial escape beat acceleration
Introduction
Introduction Accelerated atrial escaping rhythm (acceleratedatrialescaperhytym) is also known as nonparoxysmalatrial tachycardia (nonparoxysmalatrialtachycardia), accelerated atrial autonomic rhythm, accelerated atrial rhythm and so on.
Cause
Cause
Accelerated atrial escape rhythm is common in organic heart disease involving the atria, such as rheumatic heart disease, chronic pulmonary heart disease, pulmonary infection, emphysema, coronary heart disease, myocardial infarction, myocarditis, heart surgery, Digitalis poisoning and systemic infections. Individual cases can be seen in people without structural heart disease, rarely seen in normal people. Accelerated atrial escape rhythm suggests a certain damage to the atrial muscle. However, it generally has no significant effect on hemodynamics and is not easy to develop into atrial fibrillation.
Pathogenesis: Because the ectopic pacemaker in the atrium is affected by certain factors, its self-discipline is significantly increased. When its frequency exceeds the sinus rhythm and/or the autonomicity of the sinus node decreases, according to the self-discipline The law of control occurs with accelerated escape rhythm. The frequency is generally 60-140 beats/min and rarely exceeds 140 beats/min. Because its frequency is close to the frequency of sinus rhythm, the two are often prone to competition, and sometimes sinus rhythm. Sometimes the accelerated escape rhythm can form the atrioventricular septal atrial fusion wave. When the sinus frequency is equal to the frequency of the accelerated atrial escape rhythm, the atrium can be controlled by the sinus node to control the ventricle from the atrial ectopic beat point.
If this phenomenon occurs temporarily, it is called a temporary synchronization phenomenon. If it is persistent, it is called a permanent synchronization phenomenon. At the same time, the formation of the equivalent atrioventricular septum also exists in the accelerated atrioventricular transfer escape rhythm and accelerated ventricular escape rhythm. Accelerated atrial escape rhythm is an active heterotopic arrhythmia between escape rhythm and paroxysmal atrial tachycardia, which is pathological. The escape and escape rhythm are passive arrhythmias that are physiological protection mechanisms. The nature of the two is different.
Examine
an examination
Related inspection
ECG 64-slice spiral CT examination
Diagnosis can be confirmed based on medical history, symptoms, signs, and electrocardiogram findings.
Diagnosis
Differential diagnosis
Differential diagnosis of atrial escape rhythm acceleration:
1. Accidental atrial escape rhythm and atrial parallel heart rhythm tachycardia
In the case of atrial rhythm tachycardia, the external impulse cannot invade the ectopic pacemaker and re-regulate the rhythm. This is due to the protective afferent block around the ectopic pacemaker. In addition, the adjacent ectopic beat interval is a multiple of the atrial parallel heart rhythm tachycardia cycle, and the accelerated atrial escape rhythm has no protective afferent block around the ectopic pacemaker, which is easily foreign. Impulsive intrusion reorganizes its rhythm. Once the frequency of sinus rhythm exceeds the atrial frequency, the atrial rhythm reforming causes the atrial atrial pace to temporarily become an ineffective pacemaker with sinus rhythm. In addition, the two ectopic beats before and after sinus rhythm capture are not a multiple of the accelerated atrial escape rhythm cycle.
2. Accelerated right atrial escape rhythm and accelerated intersection area escape rhythm
Both of them showed retrograde P-wave mainly to identify P--R interval accelerated right atrial lower escape rhythm with PR interval >0.12 s, while accelerated transition zone escape rhythm P--R interval <0.12 s. If the accelerated transition zone escape rhythm with a degree of atrioventricular block, P--R interval can be greater than 0.12 s can not be identified.
