Sinus conduction
Introduction
Introduction to sinus conduction Sinus ventricular conduction (sino-ventricular conduction) sinus rhythm; diffuse complete atrial block; high-potassium diffuse complete atrial block with high indoor block; potassium increase in muscle weakness, even formation. Increased blood potassium leads to muscle weakness and even sputum formation. Usually the lower limbs appear more, and later extend along the trunk to the upper limbs, and the respiratory muscles can be involved in very few cases. The cause of the disease is mainly hyperkalemia, and sinus conduction may occur due to hyperkalemia caused by various causes. Sinus conduction occurs when the blood potassium level is increased. Winkler reported that when the blood potassium level was increased to 5 to 7 mmol/L, the electrocardiogram showed that the T wave became sharp and the P wave disappeared. However, there may be individual differences in ECG changes that occur when blood potassium levels increase. basic knowledge The proportion of sickness: 0.004% - 0.005% Susceptible people: no special people Mode of infection: non-infectious Complications:
Cause
Sinus conduction cause
Causes:
Mainly due to hyperkalemia, hyperkalemia caused by various reasons may lead to sinus conduction, how high the potassium level will increase sinus conduction, it is not clear, Winkler reported that blood potassium rose to At 5 to 7 mmol/L, the electrocardiogram showed that the T wave became sharp and the P wave disappeared, but the changes in the electrocardiogram that appeared in the increase in blood potassium may have individual differences.
Pathogenesis:
It has been confirmed by animal experiments that atrial myofibers are most sensitive to the inhibitory effect of potassium. When the blood potassium is slightly elevated, it may inhibit the atrial muscle. The obvious hyperkalemia can make the atrial muscle excitatory and completely conductive. Loss, ventricular myocardium also has conduction disorders, and the autonomicity of the sinus node and the conduction system (such as the conduction between the internode and interventricular junctions in the atria) have not been inhibited, so the sinoatrial node can still excite, and Directly transfer the interventricular junction and the Xipu system and the ventricular muscle to produce sinus conduction rhythm. Because the diffuse atrial muscle can not conduct excitatory, it can not produce atrial depolarization wave, also known as atrial muscle. Electric paralysis, QRS wave during sinus conduction should be supraventricular, but due to hyperkalemia caused by varying degrees of high indoor conduction block, the QRS complex is wide and deformed, and there are towering and symmetrical T waves, when potassium If the increase continues, the conductivity of the internode and interventricular junctions can be completely inhibited and the conductivity completely disappeared. At this time, complete intra-trial interstitial bundles and diffuse atrial muscle block can occur, on the electrocardiogram. No P Or atrioventricular junctional or ventricular escape rhythm, such as atrioventricular junctions, atrioventricular bundle, Greek - conductive pumping system is also suppressed, the performance of the ECG cardiac arrest.
Therefore, the occurrence of sinus conduction is a critical illness and must be diagnosed and treated promptly.
When hyperkalemia is corrected, sinus conduction can disappear, atrial muscles recover excitability and conduction, and the disappearing sinus P wave is reproduced.
Prevention
Sinus conduction prevention
1. Treatment and prevention of primary disease caused by hyperkalemia is the key to prevent this disease. When clinically encountering a disease that may cause hyperkalemia, the patient's blood potassium concentration and electrocardiogram should be closely monitored during the treatment. Variety.
2. It is found that the increase of blood potassium should be actively and effectively treated to prevent serious consequences.
Complication
Sinus conduction complications Complications
If hyperkalemia is not rescued in time, complications such as fatal arrhythmia (ventricular escape rhythm, ventricular fibrillation), cardiac arrest and death may occur. Dizziness, syncope, coma, A-S syndrome, ECG showed T-wave sharpening, P-wave disappearance, increased blood potassium, frequent or persistent sinus block for elderly or advanced heart disease, no escape Heart rhythm. Have flustered, sleep more dreams, poor digestion and so on.
Symptom
Sinus conduction symptoms common symptoms tall and symmetrical T wave weakness muscle myasthenia
Increased blood potassium occurs in muscle weakness and even sputum formation. Usually the lower limbs appear more, and later extend along the trunk to the upper limbs, and the respiratory muscles can be involved in very few cases.
1. There is hyperkalemia in the clinic and the cause of hyperkalemia.
2. A series of wide and deformed QRS complexes with tall, symmetrical T waves.
Increased blood potassium leads to muscle weakness and even sputum formation. Usually the lower limbs appear more, and later extend along the trunk to the upper limbs, and the respiratory muscles can be involved in very few cases. The cause of the disease is mainly hyperkalemia, and sinus conduction may occur due to hyperkalemia caused by various causes. Sinus conduction occurs when the blood potassium level is increased. Winkler reported that when the blood potassium level was increased to 5 to 7 mmol/L, the electrocardiogram showed that the T wave became sharp and the P wave disappeared. However, there may be individual differences in ECG changes that occur when blood potassium levels increase.
Examine
Sinus conduction test
Serological examination: increased blood potassium, the degree of elevated blood potassium corresponds to changes in electrocardiogram.
Electrocardiogram examination: It has the following characteristics: P wave disappears, QRS wave is wide and deformed, T wave is high and symmetrical, resembles ventricular escape rhythm or accelerated ventricular escape rhythm, and can also resemble atrioventricular junction rhythm with indoor conduction disorder. If you can observe it carefully, the corresponding P wave, QRS wave, and T wave dynamic change occur with the increase of blood potassium. If the blood potassium continues to rise and the disease progresses, the QRS wave time limit can be extended, T wave It is reduced and rounded, gradually sinusoidal, and even evolves into slow ventricular fibrillation.
Diagnosis
Sinus conduction diagnosis
1. There is hyperkalemia in the clinic and the cause of hyperkalemia.
2. A series of wide and deformed QRS complexes with tall, symmetrical T waves.
Should be differentiated from complete sinus block, sinus arrest and atrioventricular junction rhythm with indoor conduction disorders.
