This results in the electrical signal passing through the scar area and can only rely on these few myocardial cells to support the electrical signal channel. It is like a boat passing through a waterway with little water, the speed will inevitably become very slow. In cardiac electrical conduction, this is called conduction block. Conduction block causes electrical signal confusion and cardiac arrhythmia.
Is it possible to ablate the ectopic pacemaker points (or more precisely, the ectopic pacemaker areas) in scar tissue? Yes, it is possible.
Medical research has found that the electrical signal channel in scar tissue is as narrow as a strait, which is named isthmus in medicine. The isthmus winds around in the scar tissue like a maze, and the medical term is called reentry loop. It doesn't matter, the electrical signal always has an exit to get out.
Doctors can wait and find the right outlet to fuse it. Because generally scars are the cause of atrial tachycardia and ventricular tachycardia, and this is the outlet where the electrical signal can be turned back to excite the scar, and then discharged to the ventricle and atrium to cause cardiac arrhythmia, atrial tachycardia and ventricular tachycardia.
Theoretically, if doctors follow the above method, they should be able to successfully cure the arrhythmia caused by scars. Why do doctors think scars are more troublesome?
Here is the problem. The reentrant loop and exit of scar tissue-related ventricular tachycardia and atrial tachycardia are variable. This exit changes all the time. If you eliminate it, it will become another exit next time. It can be imagined that Dr. Che's mistake in saying that he can find an ectopic pacemaker is a fallacy that cannot be realized.
The recurrence rate of scar tissue ablation is very scary. Nearly half of the patients will relapse after one year. The risk during the operation is as high as Xie said. When you can't find the lesion, the disease will be stimulated and you, the doctor, will not know how to save the patient in confusion, and the patient will die. The mortality rate during such an operation is as high as 1 to 3 percent, which means one to three deaths in a hundred people. Isn't it terrifying?
To avoid this high risk, doctors may take another approach.
"You can consider ICD implantation." Director Gao said.
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ICD is a treatment device that combines cardiac pacing and cardioversion. It is like a pacemaker, with electrodes placed in the heart. The small machine is buried in the patient's body. Once a patient has a malignant arrhythmia, the machine automatically detects it and automatically gives cardioversion. If the heart rate is too low, it directly gives pacing. It sounds like a very good thing.
"Doesn't electric defibrillation have little effect on him?" Doctor Che seemed to remember this being written in the medical record.
Besides, ICD implantation also requires stimulation during surgery to find the lesion and discharge the electrode, which can at most reduce the postoperative recurrence rate. The most fundamental problem is that ICD implantation is not a cure. Wei wants to be a surgeon, but he will definitely be discriminated against if he goes to work with this device in his body.
If the doctor has the ability to perform ablation to cure the disease, why bother with this incurable thing?
The discussion had reached a dead end, and Dr. Che realized that he could only ask the young Dr. Xie again.
People blame it on the person who succeeded by luck, no matter how young or lucky you are.
Dr. Che asked, "Tell me more about your specific approach and the basis for it."
Here Xie Wanying needs to explain the source of her thoughts: "I used to think I knew a lot about the heart after doing dissection. Until today, I found out during surgery that compensatory thickening of the myocardium is not completely orderly. Scars are difficult to deal with precisely because they are disordered."
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