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Abstract: The patient in this article is a young woman who often has symptoms of panic without a cause, and is accompanied by sweating, weakness, and frequent urination, and often feels that the whole person is trembling. Each attack showed the characteristics of sudden onset and sudden stop, and the duration was very short. Many times the symptoms were relieved when she arrived at the hospital. The diagnosis of atrioventricular nodal tachycardia was made clearly through cardiac electrophysiological examination, and after minimally invasive cardiac radiofrequency ablation, the discomfort disappeared without further attacks, and the effect was obvious.
Basic information】Female, 31 years old
Type of disease】Atrioventricular node regurgitation tachycardia
Hospital】The 988th Hospital of the PLA Joint Security Force
Date of consultation】December 2021
Treatment plan] Cardiac radiofrequency ablation
Treatment Period】4 days of inpatient treatment, 1 month of outpatient review
Effectiveness】No recurrence of symptoms, the disease has been cured
I. Initial consultation
Over the past 3 years, Ms. Xu has been suffering from panic attacks without any cause, accompanied by sweating, dizziness, weakness, frequent urination, etc. She often feels that her whole body is trembling during the attacks. Each attack is characterized by sudden onset and sudden termination, and the duration of each attack varies, often lasting up to tens of minutes and rarely exceeding 2 hours. In most cases, the symptoms disappeared before arriving at the hospital in a hurry. A number of tests were done and there were no obvious abnormalities, so the patient was diagnosed with cardiac neurosis and prescribed some nerve regulating drugs, but the patient said that the symptoms still came on from time to time, adding to the patient’s worries and causing considerable trouble in life and work, so he came to the hospital again this time. After an active and detailed consultation, the initial consideration was paroxysmal supraventricular tachycardia. However, since paroxysmal supraventricular tachycardia contains common types of disease, including atrioventricular node folding tachycardia and atrioventricular folding tachycardia, the patient was admitted to the hospital for further clarification of the diagnosis.
II. Treatment history
After hospitalization, the patient’s electrocardiogram, chest X-ray, as well as cardiac ultrasound and laboratory results could not clearly distinguish between the 2 diseases mentioned above. Therefore, the patient was recommended to undergo further cardiac electrophysiological examination, which is a minimally invasive test that is not too painful and is safe. The diagnosis of atrioventricular node regurgitation tachycardia was clearly established by this test, and a minimally invasive cardiac radiofrequency ablation was performed by placing an ablation electrode catheter to a specific location in the heart, so that a radical cure could be achieved.
III. Treatment results
After 4 days of treatment, the patient indicated that his symptoms had improved significantly, and he had no other discomfort and good examination results, and was subsequently discharged. One month after the operation, the electrocardiogram, chest X-ray and cardiac ultrasound did not reveal any abnormal changes, and the patient said that he did not have any more panic attacks, sweating, weakness and body tremors in his daily life and work, and he was no longer worried about the recurrence of the disease and the feeling of despair, dying and fear when the disease recurred, indicating that this interventional technique did not leave any after-effects on the body.
IV. Precautions
We are happy that the patient’s AV node regurgitation tachycardia was successfully improved. Because AV nodal tachycardia is an abnormal electrical conduction pathway of the heart, it often occurs in patients without organic heart disease and is often triggered by stress, electrolyte disturbances, or other types of arrhythmias. Therefore, after discharge from the hospital, it is important to avoid mental stress, diarrhea, nausea, staying up all night with insomnia and drinking stimulating drinks in daily life. In addition, although the cardiac radiofrequency ablation is not very traumatic, try to pay attention to rest and avoid overexertion. If there are any uncomfortable symptoms, such as heartburn, dizziness, weakness, etc., seek medical attention as soon as possible.
V. Personal insight
In the clinical work, this kind of panic patients are very common, but most people think it is normal to have panic symptoms. If the symptoms of panic are accompanied by dizziness, weakness, sweating, frequent urination, etc., and the symptoms are sudden and abrupt, we should pay attention to them and think of atrioventricular node tachycardia. In most cases, this disease is a benign process that does not lead to malignant events, so there is no need to be overly concerned. The same patient went to the hospital and underwent minimally invasive cardiac radiofrequency ablation after a clear diagnosis and achieved a good treatment result.