Awakening phenomenon

Introduction

Cause

Common in arrhythmia, sinus reentry tachycardia.

(1) The speed of auto-depolarization during diastole: the speed becomes larger, the time to reach the threshold is short, the frequency of pacing impulse is fast, and the self-discipline is increased; on the contrary, the auto-depolarization speed in diastolic period is slowed, and the time to reach 5 threshold is long. The frequency of excitement slows down and self-discipline decreases.

(2) Threshold potential: the threshold potential level decreases (ie, the negative membrane potential increases), the distance from the diastolic potential of the cell membrane is shortened, the time required for the automatic depolarization to reach the threshold potential is reduced, the frequency of excitation is increased, and the self-discipline is high; The potential level rises (the negative value of the membrane potential becomes smaller), the distance from the diastolic membrane potential increases, the time of the automatic depolarization is prolonged, the frequency of excitation decreases, and the self-discipline decreases.

(3) Maximum diastolic potential: the maximum diastolic potential becomes larger (the negative membrane potential decreases), the distance from the threshold potential is shortened, the time required for automatic depolarization is reduced, the frequency of excitation is increased, and the self-discipline is high; otherwise, self-discipline Low in sexuality. Among them, the speed of automatic depolarization during diastole is the most important.

an examination

Related inspection

Dynamic electrocardiogram (Holter monitoring)

The dynamic electrocardiogram shows a form in which the heart rate is gradually increasing. When sinus reentry tachycardia occurs, it is often accompanied by warm-up phenomenon, that is, in the first 3 to 5 cardiac cycles, the heart rate may be irregular, and gradually increase and stabilize. (1) An electrocardiogram examination during the onset can confirm the diagnosis of arrhythmia and perform a dynamic electrocardiogram if necessary. (2) Cardiac ultrasound and X-ray examination. (3). Exercise test. (4) Other tests, such as thyroid function, serum electrolytes, etc.

Differential diagnosis

Dynamic electrocardiography is more valuable for identifying tachycardia caused by different mechanisms, especially the tachycardia of the reentry mechanism and the non-reentry mechanism. The former manifests as a sudden onset of tachycardia episodes. The heart rate at the time of onset is relatively neat. The latter shows that the heart rate is not neat during the attack, and there may be warming and cooling, that is, the heart rate gradually increases when the attack occurs. Form (warm-up phenomenon), there is a tendency to gradually slow down before termination (cooling phenomenon).

The dynamic electrocardiogram shows a form in which the heart rate is gradually increasing. When sinus reentry tachycardia occurs, it is often accompanied by warm-up phenomenon, that is, in the first 3 to 5 cardiac cycles, the heart rate may be irregular, and gradually increase and stabilize.

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