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Abstract: The patient had recurrent episodes of panic and chest tightness for 3 years, which were characterized by sudden onset and stopping of episodes of variable duration with no specific trigger, and was diagnosed as atrioventricular node folding tachycardia after examination. The patient was advised to use catheter radiofrequency ablation for treatment to prevent recurrence of the disease. After treatment, the patient’s panic and chest tightness disappeared, and no further episodes of tachycardia occurred, so she can work and live normally.
Basic information】Female, 19 years old
Type of disease】Atrioventricular node regurgitation tachycardia
Hospital】The First Affiliated Hospital of Zhengzhou University
Date of Consultation】November 2020
Treatment plan】Catheter radiofrequency ablation
Treatment Period】5 days of inpatient treatment and 1 month of outpatient follow-up
Results】Patient can work and live normally after the operation, no more tachycardia, no panic, no chest tightness
I. Initial consultation
The patient was 19 years old and came to our hospital with recurrent panic attacks and chest tightness for more than 3 years. He complained of frequent episodes of panic attacks over the past 3 years, with a strong feeling of heartbeat, which often occurred suddenly and then disappeared suddenly. Recently, in February, due to the increase of study pressure, the attacks were more frequent and longer in duration.
II. Treatment history
Since there is a risk of recurrence for this patient with pharmacological treatment or electrical cardioversion, catheter radiofrequency ablation was considered as a minimally invasive and relatively safe treatment that can achieve a cure in most patients. We informed the patient and his family in detail about the above-mentioned morbidity characteristics and the available treatment options and their pros and cons. Considering the patient’s heavy study load, the disease seriously affected his life and study, and in order to avoid recurrence of the disease, we finally chose catheter radiofrequency ablation surgery, and the patient was discharged after 5 days of hospitalization.
III. Treatment effect
Catheter radiofrequency ablation has better effect and higher surgical safety, which is suitable for young patients with heavy study tasks. After the operation, the patient’s folding tachycardia has been significantly improved, and symptoms such as panic and chest tightness have been significantly relieved, and basically resumed normal life and study. One month later, the patient went to our hospital for re-examination of cardiac ultrasound and ECG, and the results were not significantly abnormal, no further episodes of tachycardia, no panic and chest tightness.
IV. Precautions
Catheter radiofrequency ablation is a minimally invasive surgical treatment with little trauma, and the patient can be discharged early after the procedure. We are glad to see that the patient’s condition has basically improved, and the tachycardia has not recurred. The patient did not need long-term medication after the operation and could live and study normally. The patient was instructed to pay attention to good living habits after surgery, avoid overworking, avoid staying up late, pay attention to the regularity of three meals, keep a relaxed mood, avoid giving himself too much psychological pressure due to study, and vent his bad emotions in time to help stabilize the disease and prevent its recurrence.
V. Personal insight
Atrioventricular nodal tachycardia is an arrhythmogenic disease and is the most common form of paroxysmal supraventricular tachycardia in clinical practice. The patient’s concurrent symptoms are strongly related to the underlying cardiac function, the rapidity and duration of the heart rate. If the episodes are infrequent, physical stimulation and drug diversion can be considered, although there is a risk of reoccurrence after diversion. If frequent episodes occur, minimally invasive radiofrequency ablation treatment is feasible. The procedure is less invasive, more effective, and does not require long-term oral medication and frequent hospital visits after surgery.