Male, 38 years old, underwent radiofrequency ablation for paroxysmal atrial fibrillation 2 years ago.
Figure 1 ECG analysis :
The basic heart rhythm is sinus rhythm .
R10 and R15 appear early and are supraventricular, with P' (red mark, hidden in T) in front of them. According to the characteristics of T malformation, P'R0.12s is considered, so it is premature atrial contraction.
R3-R6 is paroxysmal atrial tachycardia starting from atrial premature, and the atrioventricular conduction ratio is not 1:1.
Figure 2 ECG analysis:
The basic heart rhythm is sinus rhythm .
R3 is premature atrial contraction. The P' (red mark) that is missed after
R9 has a compensatory interval, indicating that atrial premature beat is not transmitted.
Figure 3 ECG analysis :
The basic heart rhythm is sinus rhythm .
R2, R3, R15, R16, R19, R20 are paired atrial premature beats.
R7-R13 is paroxysmal atrial tachycardia starting from atrial premature tachycardia, with an atrioventricular conduction ratio of 1:1.
Figure 4 ECG analysis :
The basic heart rhythm is sinus rhythm .
R3 and R14 are premature atrial contractions.
R7-R10 is paroxysmal atrial tachycardia starting from atrial premature, and the atrioventricular conduction ratio is not 1:1.
scatter plot expresses the regularity of adjacent RR intervals with the position of points. Drawing principle: Taking the adjacent RR periods as the horizontal (x-axis) and vertical (y-axis) coordinates, depict the RR interval scatter set (Rn-Rn-1) of the dynamic electrocardiogram in the plane rectangular coordinate system ,Rn+1-Rn). Since a Lorenz scatter point expresses the regularity of two adjacent RR intervals, involving three adjacent heart beats Rn-1, Rn, and Rn+1, the Lorenz scatter point is a three-beat and two-phase point.
purple is the sinus point set, blue is the sinus point set.
Related knowledge points:
1. Tachycardia caused by a moderate increase in the autonomic intensity of intraatrial ectopic pacemaking points is called autonomic atrial tachycardia.
Some scholars believe that autonomous atrial tachycardia only accounts for about 5% of supraventricular tachycardia. In fact, of all types of supraventricular tachycardia, autonomous atrial tachycardia is the most common. Generally, it is an occasional atrial tachycardia that lasts for a few seconds or tens of seconds and occurs during sleep at night. The patient may not have any reaction.
2. Electrocardiogram characteristics
. The frequency of atrial tachycardia is 100-250bpm.
. The P' wave morphology of tachycardia is usually different from the sinus P wave.
. Tachycardia occurs occasionally or repeatedly in short bursts, or it can be continuous.
. When tachycardia begins, the P'-P' interval gradually shortens. Before the tachycardia terminates, the cardiac cycle tends to gradually lengthen.
. Tachycardia may be accompanied by atrioventricular block or bundle branch block, but it does not affect the atrial cycle of tachycardia.
. Stimulating vagus nerve cannot terminate atrial tachycardia.
. Atrial tachycardia begins in late diastole and is the result of 4-phase automatic depolarization.
. If there is an inserted premature atrial beat, it will not stop the atrial tachycardia, but will make the atrial tachycardia become more frequent.
. Atrial tachycardia does not need to be induced by premature atrial contractions.
0. If the onset of atrial tachycardia can be recorded, usually appears in the form of premature atrial contractions or accelerated atrial escape beats . The compensatory interval when atrial tachycardia terminates is longer than a sinus cardiac cycle.
Most atrial tachycardia is short-term and sporadic, and a few show repeated short-term episodes. Atrial tachycardia persists for several months, and it is even rarer for several months or several years.
1. The atrial P'-P interval can be even or irregular.
Those with varying degrees of atrioventricular interference, hidden conduction, and atrioventricular block may have significant P'R interval prolongation or ventricular leakage, and atrioventricular conduction ratios of 2: 1, 3:1, 4: 1, or 3:2, 4:3.
When the atrial velocity is fast and the atrioventricular conduction is disproportionate, it needs to be differentiated from atrial flutter:
( Atrial velocity has a P wave frequency of 100~250/min and an F wave frequency of 250~350/min.)
