This results in that when electrical signals pass through the scar area, they can only rely on these myocardial cells to support the electrical signal channel. Just like a ship passing through a waterway with very little water, the speed will inevitably become very slow. In terms of electrical conduction in the heart
It is called conduction block. Conduction block causes electrical signal confusion and causes cardiac arrhythmia.
Is it possible to ablate the ectopic pacing point of scar tissue and accurately call it an ectopic pacing area? Yes, it is.
Medical research has found that the electrical signal channel in scar tissue is as narrow as a strait. In medicine, it is called the isthmus. The isthmus goes around in the scar tissue and is like a maze. The medical word is called the reentry loop. It doesn't matter, the electrical signal will always be there.
There is an exit for those who run out.
Doctors can wait and wait to find the outlet to fuse it. This is because scars generally cause atrial tachycardia and ventricular tachycardia at this outlet. At this place, the electrical signal can go back and excite the scar, and on the other hand, it can be discharged to the ventricle and atrium, causing cardiac arrhythmia and atrial tachycardia.
Ventricular tachycardia.
Theoretically, if the doctor follows the method mentioned above, he should be able to successfully cure the arrhythmia caused by the scar. Why would the doctor think that the scar is more of a headache?
Here’s the problem. The reentry loop and outlet of scar tissue-related ventricular tachycardia are variable. This outlet changes. If you eliminate it, it will become another outlet next time. As you can imagine, Dr. Che said the wrong thing
It is a fallacy that it is impossible to find an ectopic pacing point accurately.
When scar tissue is ablated, the surgical recurrence rate is very scary. Nearly half of the patients will relapse after one year. The risk during the operation is very high as Xie said. When you can’t find the lesion, the disease will be stimulated and you will be attacked instantly.
Monster, your doctor is at a loss and doesn’t know how to save the patient, so the patient has no choice but to die. The mortality rate during such an operation is as high as one to three percent, and one to three people will die in a hundred people. It’s terrifying.
In order to avoid this high risk, doctors may take another approach.
"You can consider ICD implantation," Director Gao said.
ICD is a treatment device that integrates cardiac pacing and electrical cardioversion. Like a pacemaker, the electrodes are placed in the heart, and the small machine is buried in the patient's body. Once the patient develops a malignant arrhythmia, the machine automatically detects and automatically
Provide electrical cardioversion, if the heart rate is too low, and directly provide pacing. It sounds like this is a very good thing.
"Wouldn't electric defibrillation have no effect on him?" Dr. Che remembered what seemed to be written in the medical record.
Besides, ICD implantation also requires intraoperative stimulation to search for lesions and discharge electrodes, which can at most reduce the postoperative recurrence rate. The most fundamental problem is that ICD implantation does not cure the disease. Wei wants to be a surgeon and has this thing in his body.
You will definitely face discrimination when you go to work.
If the doctor has the ability to ablate and cure the patient, why bother with something that is not a cure?
By now, the discussion had become a dead end. Dr. Che found that he could only ask the young Dr. Xie again.
People blame the person who got lucky and succeeded, no matter how young or lucky you are.
Doctor Che asked: "Please tell me your specific approach and basis."
Here Xie Wanying needs to explain the source of her idea: "I used to think that I knew the heart very well through dissection. Until today, I found during the operation that the compensatory thickening of the myocardium is not completely orderly. Scars are difficult to treat because they are disordered."