Chapter 909: Urging Marriage

Jin Miao quickly instructed the resident doctors to complete the electrocardiogram.

Taking advantage of this time, Lu Chen continued to ask the patient about his condition.

Then, the patient added some medical history.

About 6 months ago, the frequency of her palpitations gradually increased, and it was obvious when she continued to talk.

The palpitations were not related to coughing, sneezing, swallowing and other actions.

There were no symptoms such as headache, blurred vision, impaired consciousness, convulsions and foaming at the mouth.

The valsalva maneuver did not induce the above symptoms.

After asking about the medical history, the electrocardiogram results before and after the patient spoke appeared.

Lu Chen took over the three electrocardiograms.

After a careful comparison.

Sure enough, the patient really had "speaking-induced atrial tachycardia"!

After speaking, the heart rate increased significantly, showing atrial tachycardia.

After speaking stopped, the heart rate began to slow down in less than ten seconds.

This magical phenomenon was the first time for everyone except Lu Chen.

"It's really rare. No wonder doctors from other hospitals in Shanghai want to send patients to us!"

Back in the doctor's office, Jin Miao couldn't help but sigh.

The current diagnosis of the patient is clear, but for "speaking-induced atrial tachycardia", are its electrophysiological characteristics different from other types of atrial tachycardia?

What is its possible mechanism?

More importantly, based on the current guidelines, cardiac radiofrequency ablation surgery is still the main treatment for atrial tachycardia.

This kind of arrhythmia is the first time for most people to encounter it, and how to perform radiofrequency ablation surgery is one of the difficulties!

"Currently, there are less than ten cases of this kind reported internationally!" Gu Xinyue has already checked the relevant information online, "and the relevant surgical ablation information is blank, and it is generally not disclosed to outsiders."

Therefore, how to ablate, how to completely eliminate the origin of the arrhythmia as much as possible without damaging the myocardial tissue, has become extremely difficult.

Lu Chen suddenly asked, "Does anyone know which nerve controls speech?"

Gu Xinyue was stunned, knowing that Lu Chen was testing everyone. He thought for a moment and said, "Speech is controlled by the recurrent laryngeal nerve and the superior laryngeal nerve, both of which belong to the parasympathetic nerve. Cardiopulmonary activity is regulated by the sympathetic and parasympathetic nerve centers."

"Yeah, not bad." Lu Chen nodded slightly, "Old Gu, then tell me what might be the cause of speech-induced atrial tachycardia?"

Gu Xinyue was stunned, touched the back of his head, and said awkwardly, "No... I don't know."

Lu Chen looked at Gu Xinyue helplessly, "You mentioned the parasympathetic nerve, why don't you know the finishing touch?"

He had great expectations for Old Gu, hoping that he could be independent in the future.

Lu Chen said slowly: "When the central nervous system regulates speech through the parasympathetic nerves, the electrical signals of the parasympathetic nerves may also be transmitted to the atria."

"In the atria, the parasympathetic (vagus) nerves activate ikach, resulting in an increase in potassium conductance, which in turn hyperpolarizes the resting membrane potential, reduces the fourth phase of depolarization, and shortens the action potential duration. This may lead to reentry and triggering activities, prompting focal discharges in atrial tissue."

Lu Chen's few words explained the possible mechanism.

This made Jin Miao and Gu Xinyue start taking notes.

It seems to be a simple mechanism, but it is not easy to associate it with speech.

Lu Chen then said to the two: "Perfect preoperative preparations and arrange the surgery as soon as possible."

"Okay, got it!" Jin Miao nodded.

He and Gu Xinyue looked at each other.

Although the two were used to Lu Chen's magical operations, Lu Chen could still surprise them from time to time.

"Hey, Old Gu, how much more do you think the director has not revealed to us?" Jin Miao whispered, his eyes sparkling.

"Who knows?" Gu Xinyue lowered her voice, "We have to squeeze him dry!"

Jin Miao secretly gave a thumbs up, "I like it when he has ideals and pursuits!"

The two of them whispered secretly, and were discovered by Lu Chen.

"What are you two doing?"

Gu Xinyue quickly sat up straight and grinned, "Nothing."

Jin Miao also nodded repeatedly.

Lu Chen looked at the two helplessly, "Do a good job of preoperative preparation, and arrange the operation for the day after tomorrow."

"Got it!"

After leaving the doctor's office.

Lu Chen called his mother Luo Meizhen.

"Hey, Xiaochen, you are so busy, how come you have time to call me today?"

Lu Chen smiled, "Mom, are you introducing me to another job?"

"What did you say?" Luo Meizhen didn't react yet.

"It's that distant relative of our family." Lu Chen curled his lips, "A relative who has nothing to do with me at all came to Shanghai to find me."

"Oh, you're talking about this!" Luo Meizhen suddenly realized, "I just said casually that if I really want to go to a big hospital for treatment, I can go to Shanghai to find you."

Lu Chen held his forehead and sighed, "Mom, don't introduce these jobs to me next time. It's not good for me to open a back door for them. They didn't come to me at first this time."

"Okay." Luo Meizhen smiled, "Let's not talk about this. How is your marriage with Xu Wei going?"

Speaking of this, Lu Chen was a little overwhelmed.

No matter how difficult the operation was, he was not afraid.

But when it came to these things, he was really at a loss.

"Well, we are still discussing it, mom, don't worry."

Lu Chen said a few words and hung up the phone quickly.

Since he came to Shanghai, Xu Wei followed him to Shanghai.

She became a reporter again at a local TV station.

Lu Chen wanted her to switch to some easier industries, but she refused.

Lu Chen's influence in Shanghai was not bad, so he helped her find a good TV station.

Their relationship was stable, and they were both not young anymore.

Marriage was on the agenda.

Lu Chen realized that arranging various matters for marriage was much more difficult than performing an operation!

...

Two days later.

The preoperative preparations for the distant relatives had been completed.

The operation went on normally.

Lu Chen took Jin Miao and Gu Xinyue into the operating room.

Now, except for some difficult operations, Lu Chen would not do it himself.

With Jin Miao's current ability, he could handle most of the operations.

In Lu Chen's plan, Jin Miao, Gu Xinyue and Fan Zhiping would form the surgical team of Shanghai Fifth Hospital.

Ke Yue, Xu Shan and others would form a scientific research team.

"Today's operation is not difficult." Lu Chen said to Jin Miao and Gu Xinyue, "It's mainly the mapping of the origin point, which is more difficult. I will remind you during the operation later."

"Okay." Jin Miao and Gu Xinyue said in unison.

In general cardiac electrophysiological examinations, drugs may be used to induce arrhythmias.

But this patient is different. Just by letting her talk, atrial tachycardia can be induced, and then cardiac electrophysiological mapping can be performed.

The pentaray electrode mapping prompts that the earliest point is at the top of the left atrium posterior wall, which is 26ms earlier than the surface electrocardiogram.

The mapping begins!

"Pay attention to the origin point between the top of the left atrium and the left and right pulmonary veins." Lu Chen began to remind.

"Received. UU Reading www.uuｋanshu.net"

Under Lu Chen's guidance, Gu Xinyue and Jin Miao became more and more handy.

The origin point of atrial tachycardia was quickly found.

After the most difficult stage was passed, the remaining ablation was much simpler.

Under the joint operation of Gu Xinyue and Jin Miao, the operation was completed quickly.

At this time, Lu Chen's system panel also popped up a prompt.

"Congratulations, the system upgrade completion rate has increased!"

"Congratulations, I received a thank you from Gu Xinyue!"

"Congratulations, I received a thank you from Jin Miao!"

"..."

7017k

:,!