Patient: disease: paroxysmal atrial tachycardia inverse longitudinal translocation How to treat. For the past two weeks, I have been experiencing head and eye darkness and panic, and my blood pressure is 110:65. What else do I need to do to check whether I should be hospitalized? Chen Songwen, Department of Cardiology, Shanghai First People’s Hospital: first improve the dynamic ECG, cardiac ultrasound, thyroid function and other tests before further analysis. If necessary, hospitalization can be considered. Patient: Thank you, Dr. Chen. I will accept Dr. Chen’s suggestion to go to the hospital for three cuttings of ambulatory ECG, cardiac ultrasound and thyroid function. I will upload the findings and consult with you again. Chen Songwen, Department of Cardiology, Shanghai First People’s Hospital: Oh, you are welcome, we will analyze after your information is perfect. Patient: Dr. Chen: Hello! My examination report conclusion 1, dynamic electrocardiogram: 1, sinus arrhythmia; 2, frequent atrial premature beats with paired, joint rhythm, atrial tachycardia, intraventricular differential, anisotropic conduction, and atrial premature uninferior transmission. In addition: total supraventricular ectopic beats: 21001 (18.6%) atrial velocity: 2481 cardiac beats: paired atrial premature: 1608 most L N-N interval: 1.9 seconds At 10:45 pm: single atrial premature: duplex triplex rhythm: 267107 cardiac beats. Second, cardiac ultrasound report: 1, slightly large left atrium; 2, reduced left ventricular diastolic function; 3, small amount of mitral regurgitation, small amount of tricuspid regurgitation cardiac function EF (67%); sv (64 ml). Mitral valve E peak is smaller than A peak, r have A peak fall three, A Nd once δ glycosides. The above z-check was done at Longhua Hospital, and the cardiologist prescribed medications: 1, cardioplegia; 2, o enzyme Q10 capsule. Chen Songwen, Department of Cardiology, Shanghai First People’s Hospital: Please take pictures of the ambulatory electrocardiogram and heart ultrasound and upload them. Your data shows frequent atrial premature and atrial tachycardia, which is a fast heart rate problem, and at the same time there is a long RR interval, which is a slow problem, so we need to see the specific ECG data before deciding how to treat next. Do you have any previous hypertension or diabetes? Do you usually have chest tightness or panic attacks? Is the frequency high? When did the darkness in front of the eyes first appear? Are the episodes frequent? If you have dizziness, you can monitor your heart rate and pulse to see how it is. If necessary, see an outpatient. Patient: The dizziness and black eyes occurred infrequently in the last two weeks, when I felt some panic and a fast pulse and an irregular heart rate. He had no previous heart disease, blood pressure, or diabetes mellitus. This time, the blood test report is only one triglyceride 2.0. Chen Songwen, Department of Cardiology, Shanghai First People’s Hospital: I saw the information, but I regret that the long interval of 1.9s is not shown independently in the ECG. Therefore, it can only be estimated that this long interval is caused by the failure of atrial premature transmission. The ultrasound report is fine. In general, we can take cardioplegia to see if the symptoms can be relieved and adjust the medication if necessary. If atrial tachycardia is still frequent, radiofrequency ablation can be considered. The success rate of pure atrial tachycardia is relatively high, around 90%, but the key is to identify where it originates from in the heart. Therefore, you can first consider medication to adjust for a period of time to see. Generally, you can review the ECG after taking cardioplegia for 3-4 weeks. Patient: Thank you very much, Dr. Chen, for your warm concern and help. I accept your suggestion to treat for a period of time before deciding on further treatment options based on my condition.