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Abstract: Paroxysmal supraventricular tachycardia is a common type of supraventricular arrhythmia that may affect hemodynamic stability in severe cases. As in this patient, sudden onset of panic, dizziness and weakness were seen in our hospital. After examination, the diagnosis of paroxysmal supraventricular tachycardia was confirmed, and considering that traditional lifestyle changes and medication may not be effective, after perfecting cardiac electrophysiological examination with radiofrequency ablation, the patient’s condition was controlled and did not recur.
Basic information】Male, 60 years old
Disease Type】Supraventricular arrhythmia
Hospital】Shandong Provincial Third Hospital
Date of consultation】February 2022
Treatment plan] Cardiac electrophysiological examination + radiofrequency ablation
Treatment Period】4 days of hospitalization
Effectiveness】The condition was controlled, the symptoms disappeared, and the patient was discharged successfully.
I. Initial consultation
The patient came to the clinic because of sudden onset of panic with no obvious cause, dizziness and sweating 12 hours before admission, and he could not reach his pulse when he measured himself at home. The patient told me that he had a seizure more than 2 years ago, which occurred suddenly and terminated abruptly and lasted for half an hour. At that time, he only had a feeling of panic and felt that there was no big problem and he would be fine on his own, so he did not pay attention to this disease.
Second, the treatment process
The patient repeatedly had panic attacks, and the symptoms gradually worsened and the frequency of attacks increased. Based on the patient’s clinical symptoms and electrocardiogram, we noticed that “paroxysmal supraventricular tachycardia” is a disease with sudden onset and stop, which does not affect the patient’s daily life when it does not occur. For the root cause of the disease, we recommended cardiac electrophysiology and radiofrequency ablation. The patient and his family expressed a desire for pharmacological treatment only, and expressed some rejection of minimally invasive surgery. We talked to the patient and family about the pathogenesis, the difference between drug and surgical treatment, and the surgical approach, and they gradually removed their fear of minimally invasive surgery and accepted the minimally invasive surgical approach for the sake of resolutely resisting the “bomb” next to them from time to time. The intraoperative electrophysiological examination confirmed the dual atrioventricular node pathway, and after just 30 seconds of “discharge”, the disease was perfectly resolved.
III. Treatment results
The patient completed the whole procedure in a sober state, and after the operation, he even expressed that “it turns out that minimally invasive surgery is a few small eyes, I should have done it earlier, so I don’t have to be worried every day”. The patient did not have any episodes of supraventricular tachycardia after the surgery, and the symptoms of panic, dizziness and sweating disappeared. The patient himself and his family members were able to get rid of their anxiety and worries about episodes from time to time, and they were more cheerful and comfortable in their daily life, and they were no longer “cautious” every day.
IV. Notes
I felt happy for the patient when I saw that he was cured. Although paroxysmal supraventricular tachycardia usually does not have serious consequences, the symptoms during the attack usually cause fear in patients. With surgical treatment, the cure rate can reach 95%, and there is usually no need to continue taking medications for the disease, and there are no restrictions on daily activities. Some patients may still be worried about future seizures. After being discharged from the hospital and returning home, patients can resume their normal lives by going out more often and getting enough rest and sleep. Do not overwork and stay up late, and do not confine yourself to a small space, which is not conducive to mental recovery. You can enjoy beautiful works and watch relaxing entertainment programs, which are conducive to mood relaxation. If patients feel panic attacks, it is recommended to improve the electrocardiogram or ambulatory electrocardiogram in time to assess the cause of panic, and do not worry too much, which may usually be just premature beats or other causes, and just follow up in time.
V. Personal insight
Paroxysmal supraventricular tachycardia is one of the few diseases that can be cured clinically. The ECG at the onset of the disease is the key evidence to confirm the diagnosis of the disease, and cardiac electrophysiological examination + radiofrequency ablation can provide excellent treatment results. For patients, the elimination of disease limitations on daily life can be a great psychological boost. In our work, we should pay attention to the expression for minimally invasive surgery, fully explain the procedure and the way and the advantages of the procedure and the possible results, eliminate the patient’s fear and anxiety, and reduce the resistance of patients and their families.