Atrioventricular dissociation

Introduction The separation of the atrioventricular compartment is: the patient separated from the atrioventricular compartment, there are two activation points, the atrial activation point controls the atrium, and the ventricular activation point controls the ventricle. Therefore, the room rate and the ventricular rate are often inconsistent. Usually speaking, the heart rate refers to the ventricular rate. Normal people are excited by the sinus node, first excited about the atrium, then excited down the ventricle, so the room rate and ventricular rate are the same as the separation of the atrioventricular compartment. Atrioventricular septal separation is common in third degree atrioventricular block (blocking atrioventricular septum), atrial fibrillation, ventricular tachycardia, and interfering atrioventricular separation.

Cause

There are mainly the following types of compartment separation:

1, ventricular tachycardia referred to as ventricular tachycardia, refers to the existence of abnormal electrical pathways in the ventricle, usually this pathway exists in myocardial infarction or myocardial lesions of the ventricular muscle, and some can occur in patients without structural heart disease (called "Idiopathic ventricular tachycardia"). When an electrical signal enters such a path, it can operate along the loop, and the ventricle contracts once with each loop operation, resulting in a fast heart rate. Ventricular tachycardia is a more serious arrhythmia, with a higher mortality rate, more common in patients with structural heart disease. Ventricular tachycardia usually does not terminate on its own, and sometimes ventricular tachycardia can even worsen to ventricular fibrillation and cardiac arrest, leading to death. Ventricular fibrillation, referred to as ventricular fibrillation, refers to the electrical activity of multiple parts of the ventricle, which is transmitted in a very rapid and irregular manner, causing the ventricle to stop effectively pumping blood and stop the blood circulation. If ventricular fibrillation cannot be terminated in time, the patient will die within a few minutes.

2, atrial fibrillation referred to as atrial fibrillation, is one of the most common clinical arrhythmias. The general prevalence rate in the general population is 0.4%, the adult prevalence rate is between 0.5% and 0.95%, and the prevalence rate under 60 years old is 1%. With the increase of age, atrial fibrillation has a tendency to increase gradually. Up to 10% of people over the age of 75. In atrial fibrillation, the direction of agitation conduction in the atrium is inconsistent, the frequency is fast and irregular, which causes the atrium to lose its effective contractile function. The atrial fibrillation frequency during atrial fibrillation is as high as 300-600 beats/min. Although the activation of the atrioventricular node can not reach all of the ventricles, the ventricular rate (heart rate) can still reach 100-160 beats/min, not only than Normal sinus rhythm is much faster, and the rhythm is absolutely not neat.

Causes of atrial fibrillation and associated factors hypertension, coronary heart disease, cardiac surgery, valvular disease, chronic lung disease, heart failure, cardiomyopathy, congenital heart disease, pulmonary embolism, hyperthyroidism, pericarditis, combined with other types of arrhythmias Others - may be related to alcohol, stress, electrolyte or metabolic imbalance, serious infections.

Atrial fibrillation palpitations, heartbeat, heartbeat disorder, or rapid heartbeat; physical fatigue or fatigue; dizziness, dizziness, or fainting. Chest discomfort, pain, oppression or discomfort, shortness of breath, difficulty breathing during mild physical activity or rest. Although some patients may not have any symptoms, the hazard (thromboembolic complications) still exists.

Atrial fibrillation

1. Thrombosis and embolism: Atrial fibrillation loses contractile function during atrial fibrillation, blood is easily stagnated in the atria and forms a blood clot. Thrombosis can accompany the blood to all parts of the body, leading to cerebral embolism (stroke, hemiplegia), limb arterial embolism (serious Even need amputation). In patients with atrial fibrillation who are less than 60 years old without other diseases, the annual incidence of stroke is about 1%, while in patients 60 to 75 years old, the annual incidence of stroke is 2%. If there are other risk factors for embolism, the annual incidence of stroke can reach 4%. Risk factors for stroke in patients with atrial fibrillation include previous history of embolism, hypertension, diabetes, coronary heart disease, heart failure, left atrial enlargement, and age over 65 years.

2. The heart rate is fast and the rhythm is not neat, which makes the patient feel guilty.

3. Loss of atrial contraction and long-term heart rate can lead to heart failure.

4. Increase mortality (twice as many as normal people).

3 "Interfering atrioventricular dislocation" generally refers to the separation of the atrioventricular compartment caused by disturbances in the sinus agitation and junctional zone near the border zone or in the border zone (see Interference). It is divided into two types: completeness and incompleteness. The ECG findings of interfering compartmental separation vary depending on the source of the agitation and the location of the disturbance. Interfering compartmental separation is often a secondary manifestation of other arrhythmias, rather than a primary disease, and most are a temporary phenomenon.

an examination

Related inspection

Electrocardiogram two-dimensional echocardiography

The clinical manifestations of ventricular tachycardia were not consistent.

1 Symptoms: There may be palpitation, chest tightness, chest pain, black Mongolian, syncope, and its clinical features are sudden onset, sudden disappearance after treatment or self-limiting, sudden palpitations, rapid heart rate, mental anxiety, fear, pre-existence Area discomfort, head or neck bloating and jumping.

2 Asymptomatic: People with non-sustained ventricular tachycardia are usually asymptomatic and are only found on physical examination or 24h ambulatory electrocardiography.

Differential diagnosis

Room separation is distinguished from arrhythmia.

Room separation: room rate and room rate are inconsistent.

Arrhythmia: The normal activation of the heart originates from the sinus node, which is transmitted along the conduction system and reaches the atria and ventricles in a certain time frame, causing the heart to contract and relax. If the sinoatrial node is abnormal or agonistically produced outside the sinus node, arrhythmia occurs when the conduction of the stimuli is slow, blocked, or transmitted through the abnormal passage. Thus, arrhythmia is the frequency and/or rhythm abnormality of the heart beat due to the origin and/or conduction impairment of cardiac activity. Arrhythmia is an important group of diseases in cardiovascular disease.

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