I tan lɛk se yu at de bit sloslo? I kin bi bikɔs ɔf di Junctional Escape Rhythm (Junctional Escape Rhythm)!

Sɔntɛnde yu kin fil lɛk se yu at de bit smɔl smɔl, ɔ na wan strenj we? Imajin, yu de go du yu ɛvride rutin ɛn wantɛm wantɛm yu de fil bad bad wan , yu nɔ de blo fayn we yu klaym wan stej, ɛn yu fil lɛk se yu go fɔdɔm wit yu ed we de spin. Dis kayn tin nɔ kin jɔs apin, nɔto so? I kin bi smɔl chenj na yu at in signal sistɛm. Tide wi go tɔk bɔt wan pan dɛn kayn tin ya, we dɛn kɔl Junctional Escape Rhythm . Nɔ wɔri, wi go tɔk bɔt dis simpul wan.

Wetin na dis Junctional Escape Rhythm rili?

Fɔ tɔk am simpul wan, dɛn gi dis nem to di tru tin we mek yu at bigin fɔ bit smɔl smɔl pas usay i fɔ bit. Tink bɔt am lɛk smɔl mashin we de wok wit ilɛktrik sistem. I nid ‘ilɛktrik signal’ fɔ mek i bit fayn. dis signal kin stat na di tכp pat pan di at we dεn kכl di sinoatrial node (כ `SA node`). I tan lɛk di men kɔndɔkta na di fɔs steshɔn na tren. Na im de gi di kɔmand, ‘Okay, bit naw.’

Bɔt if sɔntin apin to dis `SA node`, i tan lɛk se di kɔndɔkta dɔn slip. Dɔn i nɔ kin ebul fɔ bigin at bit fayn fayn wan, ɔ ivin if i bit, i nɔ go strɔng.

So, wetin kin apin we dat apin? Di at nɔ jɔs de sidɔm de. sכmtεm dכn na di at, na di jכnkshכn usay di כp chεmba dεm (atria) εn di lכw chεmba dεm (vεntrikul) de mit, di atrioventrikular node (כ AV node) se, "Okay, a go tek ova," εn di at bigin fכ bit. I tan lɛk se if di kɔndɔkta na di fɔs steshɔn de slip, di kɔndɔkta na di nɛks steshɔn tek ova ɛn pul di tren. Dis nɔto in nɔmal wok, bɔt i de du am bikɔs i nɔ ebul fɔ stɔp fɔ wok.

כltu, di at bit we de apin dis we nכ de fast lεk di wan we de kכmכt frכm di `SA node`. pan tap we di nכmal at rεt fכ hεlty pכsin de bitwin 60 εn 100 bit pan minit, insay dis `Junctional Escape Rhythm` di rεt de bitwin 40 εn 60 bit pan minit . Dat min se, i slo smɔl.

Udat dɛn go mɔs afɛkt dis kayn tin?

Pan ɔl we dis sik kin afɛkt ɛnibɔdi, sɔm pipul dɛn kin gɛt bɔku prɔblɛm. fכ egzampl, stכdi dεn dכn sho se wan siknifikant nכmba pan pipul dεm we pas 65 ia wit at sik kin gεt sכm digri fכ SA node dysfunction. So, wit dis kayn prכblεm, di chans fכ divεlכp wan jכnkshכnal ritm de hכy.

Nɔr to dat nɔmɔ, dis sik kin afɛkt sɔm ɔda pipul dɛm bak:

• Atlet dɛm we de tren fayn fayn wan: Sɔntɛnde, dɛn kin si dis kayn ritm bikɔs dɛn at rit we dɛn de rɛst nɔ kin rit.
• Yɔŋ pikin dɛm: Sɔmtɛm pikin dɛm sɛf kin gɛt dis, bɔt i nɔr kin bɔrku.
• Pipul wae gɛt wan sik wae dɛn kɔl `Sick Sinus Syndrome`:insay dis kes bak, di SA node nכ de wok fayn, so כda pat dεm na di at gεt fכ kכntro di at bit.

Wetin kin bi di sayn dɛm fɔ dis?

Bɔrku tɛm, yu nɔr kin gɛt ɛni sayn . Dɛn kin no am bay we dɛn de du ECG tɛst fɔ ɔda rizin. Bɔt if di sayn dɛn kin apin, dɛn kin gɛt:

• Fɔ fil taya bad bad wan (`Fatigue`): Fɔ fil lɛk se yu jɔs nɔ gɛt ɛnaji, so taya dat yu want fɔ slip ɔl di de.
• Fain ɔ sinkɔp: Dis kin apin if di at rit slo tumɔs, we kin mek di blɔd we de flɔ na di bren nɔ bɔku .
• Diziz ɔ layt ed: Dis kin apin we yu tinap ɔ we yu grap wantɛm wantɛm.
• Palpitations: I kin fil lɛk se yu at de bit insay yu chɛst, ɔ i kin tan lɛk se i de skip wan bit wantɛm wantɛm.
• Fɔ blo shɔt: Sɔm pipul dɛn kin gɛt shɔt briz we dɛn taya smɔl.

Wetin mek dis de apin? Wetin na di rizin dɛn?

Bɔku rizin dɛn de we mek yu SA node kin stɔp fɔ sɛn ilɛktrik signal ɔ wik. Dis na wetin de mek di Junctional Escape Rhythm. Lɛ wi luk di men rizin dɛn.

Sɔm mɛrɛsin ɛn tritmɛnt dɛn kin mek dis apin:

• Slip apnea: Dis na sik wae yu kin stɔp fɔ blo fɔ shɔt tɛm wae yu de slip. Dis kin afɛkt yu at.
• Radiation therapy: Radiation therapy, mɔ fɔ kansa na di chɛst eria, kin pwɛl di at in ilɛktrik sistɛm.
• At atak: At atak kin pwɛl di at mɔsul ɛn bak di SA node.
• Mayokarditis: Na inflamɛns na di at mɔsul we kin kam wit sɔntin lɛk vayral infɛkshɔn.
• inflameshn na di sak we de rawnd di at (pericarditis): Dis kin afɛkt di wok we di at de du bak.
• Trauma to yu chɛst: If dɛn bit yu shap shap na yu chɛst, lɛk we aksidɛnt apin.
• Laym sik: Dis sik we tik kin kam wit kin afɛkt di at bak.
• Hypothyroidism: Di tayroyd gland de wok fayn fayn wan.
• Sɔm ɔpreshɔn dɛn: Ɛspɛshali afta dɛn dɔn du ɔpreshɔn we gɛt fɔ du wit at.

Dis kin kam bak bikɔs ɔf sɔm mɛrɛsin dɛn:

sכm mεdikeshכn dεm de ridyus di aktiviti fכ di SA no, εn dis jכnkshכnal εspεk ritm kin apin bak.

• Lithium: Na mɛrɛsin we dɛn kin yuz fɔ mɛn pɔsin we gɛt maynd sik.
• Beta-blockers: Na wan kayn mɛrɛsin we dɛn kin yuz fɔ mɛn ay blɔd prɛshɔn ɛn at sik.
• Calcium channel blockers: Dɛn kin gi dɛn tin ya bak fɔ ay blɔd prɛshɔn ɛn at sik.
• Digoxin: Na drɔg we dɛn kin yuz fɔ trit at pwɛl ɛn sɔm at ritm dizayd.
• Opioids: Pawaful tin dɛn we de mek pɔsin fil pen.
• Adenosine: Na drɔg we dɛn kin yuz fɔ no ɛn trit di at ritm dizayd.
• Klɔnidin (fɔ ɛgzampul, Catapres® ɔ Kapvay®): Na mɛrɛsin we dɛn kin yuz fɔ mɛn ay blɔd prɛshɔn.

Aw yu kin no bɔt dis?

If yu gɛt di sayn dɛm we wi dɔn tɔk bɔt, ɔ if yu dɔktɔ sɔprayz dis, dɛn go chɛk yu.

• Mɛdikal histri ɛn fɔ chɛk yu bɔdi: Fɔs, dɛn go aks yu bɔt di sik dɛn we yu gɛt, di mɛrɛsin dɛn we yu de tek, ɛn if ɛnibɔdi na yu famili gɛt at sik. Dɔn, dɛn go du wan jenɛral ɛgzam pan dɛn bɔdi.
• Ilɛktrokardiogram (dɛn kin kɔl am bak ECG ɔ EKG): Dis na di tɛst we impɔtant pas ɔl. I de rayt di ilɛktrik wok we di at de du. if jכnkshכnal εspεk ritm de, in kכntribyushכn patεn go de fכ si pan di ECG (fכ egzampl, P wev dεm we nכ de כ we dεn chenj, di hat rεt we de slo).
• Blɔd tɛst: Dɛn tin ya kin ɛp fɔ pul ɔda tin dɛn we kin mek yu gɛt prɔblɛm, lɛk we yu gɛt tayroyd prɔblɛm ɔ we di ilɛktrɔlayt nɔ balans.
• di at ultrasound (Echocardiogram): Dis kin luk tin dεm lεk aw di at strכkchכ, aw di valv dεm de wok, εn di trεnk we di at mכsul de kכntrikshכn.
• Holter monitor: Sɔntɛnde, if di sik nɔ de ɔltɛm, dɛn kin yuz divays lɛk dis fɔ rikodɔ di ECG fɔ 24 ɔ 48 awa.

Wetin na di tritmɛnt dɛm fɔ dis?

Tritmɛnt de dipen pan if yu gɛt ɔr nɔr gɛt dis sik ɛn wetin de kɔz de sik.

• If yu nɔr gɛt ɛni sayn: Bɔrku tɛm, if yu gɛt wɛl bɔdi ɛn nɔr gɛt ɛni sayn, yu nɔr nid spɛshal tritmɛnt. I go mɔs bi se yu dɔktɔ go jɔs wach yu.
• If sɔm sayn dɛn de:
• Fɔ trit di rizin we mek i gɛt dis sik: Fɔ ɛgzampul, if na mɛrɛsin mek di sik, di dɔktɔ kin stɔp di mɛrɛsin ɔ chenj to ɔda mɛrɛsin. If na kכndyushכn lεk ``slip apnea,'' i go nid fכ trit am.
• Mεdikeshכn: If di at rεt tu lכw εn simptom dεm de lεk diziz, dεn kin gi mεdikeshכn lεk atropine (e.g., Atreza® כ Sal-Tropine®) fכ sכm tεm fכ inkrεs di at rεt sכmtεm.
• Pesmɛka: If di sik nɔ de chenj, di at rit denja fɔ smɔl, ɔ di ɔndalayn kɔz nɔ de bɛtɛ pan ɔl we dɛn de trit am, dɛn kin nid fɔ yuz pesmɛka fɔ ɔltɛm .I kin fayn fɔ mek dɛn put pesmɛka insay. Dis na smɔl tin we dɛn kin du ɔpreshɔn pan ɔnda di skin na di chɛst. I de sɛn ilɛktrik signal to di at, we de ɛp fɔ mek di at rit nɔmal. I kin nid fɔ mek dɛn put dis insay as ali as midul ej.
• Kateta ablεshכn: Dis nכto kכmכn tritmεnt fכ jכnkshכnal εspεk ritm, bכt dεn kin tink bכt am insay sכm spεshal kes dεm (fכ egzampl, if i kכlכs wit כda ritm prכblεm dεm lεk AV nodal reentrant takycardia). Dis kin min fɔ mek smɔl smɔl say dɛn na di at we de mek ilɛktrik signal dɛn we nɔmal, ɛn stɔp dɛn.

Ɛni prɔblɛm de wit di tritmɛnt?

Jɔs lɛk ɛni ɔda tritmɛnt, sɔm prɔblɛm dɛn de we kin apin, mɔ we i kam pan fɔ put pɔsin we de mek pɔsin in peshɛnt in bɔdi:

• Infekshɔn na di say we dɛn de du di ɔpreshɔn.
• Blɔd we de klɔt.
• Skar tisu fכmeshכn rawnd di pesmεka.
• Di divays in waya dɛn de muf ɔ brok usay dɛn fɔ de.
• Lɔng damej (nɔ kin apin so ɔltɛm).

Bɔt bɔku tɛm, dɛn prɔblɛm ya kin bi smɔl smɔl prɔblɛm dɛn, ɛn dɔktɔ dɛn no aw fɔ mɛn dɛn. Pesmaker insertion na jɛnɛral wan rili sef prosidur.

Aw lɔng e kin tek fɔ wɛl afta dɛn dɔn trit am?

If yu gɛt pesmɛka, bɔku tɛm yu kin go bak to yu nɔmal tin dɛn insay sɔm dez. Bɔt , yu go nid fɔ wet wan ɔ tu wik bifo yu du ɛni ɔda tin, lɛk fɔ es wet ɔ fɔ drayv , i go dipen pan wetin yu dɔktɔ tɛl yu fɔ du. If dɛn trit yu wit mɛrɛsin, yu go fil fayn as yu sik bigin fɔ stɔp.

Wetin wi go du fɔ ridyus dis prɔblɛm?

wi nכ kin kכntro sכm pan di tin dεm we de mek di Junctional Escape Rhythm (e.g. jεnεtik kכndishכn dεm). Bɔt sɔm tin dɛn de we wi kin du fɔ ridyus di prɔblɛm we wi gɛt:

• Fɔ fala di we aw yu de liv yu layf: If yu it di rayt tin, yu de du ɛksɛsayz ɔltɛm , ɛn yu nɔ fɔ smok, dat go ɛp yu fɔ mek yu at gɛt wɛlbɔdi.
• Trit di sik dɛn we de ɔnda yu fayn fayn wan: If yu gɛt tin dɛn lɛk dayabitis, ay blɔd prɛshɔn, ɛn slip apnɛa, mek dɛn trit dɛn fayn fayn wan.
• Tin dɛn we yu fɔ tink bɔt fɔ tek mɛrɛsin: Tɔk to yu dɔktɔ bɔt di mɛrɛsin dɛn we yu de tek. If yu tink se na wan patikyula mɛrɛsin de mek yu gɛt di prɔblɛm, yu dɔktɔ go luk fɔ ɔda mɛrɛsin. Nɔ ɛva stɔp fɔ tek mɛrɛsin if yu nɔ gɛt dɔktɔ advays.

Wetin kin apin if jɔnshɔnal ɛspɛk ritm de? Wetin na di tumara bambay?

Di prɔgnosis fɔ pipul dɛm wae gɛt Junctional Escape Rhythm kin jɔs fayn, mɔr lɛk if dɛn nɔr gɛt ɛni sayn ɔr if dɛn kin kɔntrol dɛn sik wit tritmɛnt. If yu gɛt peshɛnt, yu kin liv nɔmal layf. Di tin we impɔtant pas ɔl na fɔ fala yu dɔktɔ in instrɔkshɔn ɛn go fɔ chɛk-ap ɔltɛm.

Aw a fɔ kia fɔ misɛf?

We yu gɛt Junctional Escape Rhythm, yu dɔktɔ go mɔs pe atɛnshɔn pan di ɔndalayn kɔndishɔn we de mek yu gɛt am. So, i kin dipen pan di sik ɔ di mɛrɛsin we de mek yu gɛt di prɔblɛm, yu go nid fɔ tek ɔda mɛrɛsin ɔ gɛt di tritmɛnt we yu dɔktɔ se.

• Fɔ fala di advays we dɔktɔ gi yu di rayt we.
• Tek yu mɛrɛsin di rayt tɛm.
• If yu gɛt pesmɛka, fala yu dɔktɔ in instrɔkshɔn bɔt am (e.g., fɔ de fa frɔm sɔm ilɛktronik divays dɛn).
• If chenj de pan di sayn dɛm (i dɔn bɔku, nyu sayn dɛm de apia), tɛl di dɔktɔ wantɛm wantɛm.

Ustɛm a fɔ go to dɔktɔ?

• If yu gɛt di sayn dɛm we wi bin dɔn tɔk bɔt (taya, diziz, layt ed, chɛst tayt).
• If yu gɛt pesmɛka, yu go nid fɔ go to yu dɔktɔ lɛk wan mɔnt afta di ɔpreshɔn. Afta dat, yu go nid fɔ go fɔ fala-ap apɔntinmɛnt wan ɔ tu tɛm insay di ia.
• If yu fil se yu pesmɛka nɔ de wok fayn (e.g., if ol simptom dɛn kam bak), ɔ if yu gɛt infɛkshɔn (rɛd, swel, pus) usay dɛn put yu pesmɛka, yu fɔ kɔntak yu dɔktɔ wantɛm wantɛm.

Us kwɛstyɔn dɛn yu fɔ aks di dɔktɔ?

Nɔ fɔgɛt fɔ aks dɛn kwɛstyɔn ya we yu go si di dɔktɔ:

• "A nid tritmɛnt fɔ dis `Junctional Escape Rhythm`?"
• "Wetin na di spesifik rizin fɔ mi `Junctional Escape Rhythm`?"
• "Us layf stayl chenj a nid fɔ mek?"
• "If di situeshɔn we mek dis apin bak, a go gɛt `Junctional Escape Rhythm` bak?"
• "If dɛn nid `pacemaker`, wetin na di gud ɛn bad tin dɛn?"
• "Us aktiviti a fɔ avɔyd?"

Na dis na sɔm pan di tin dɛn we wi dɔn tɔk bɔt (Take-Home Message):

Okay, so naw yu get gud andastan fo wetin wi bin de tok abaut we dem kol `Junctional Escape Rhythm`. wetin de apin insay dis na we di `SA node` we na di say we di at in at bit de stat, de fεl, di at de stat fכ bit frכm di `AV node`, כ jכnkshכn, we de na di lכw pat pan di at. dis kin mek di hat rit slo dכn sכmtεm (arawnd 40-60 bit dεm pan minit).

Sɔm pipul dɛn nɔ kin gɛt ɛni sayn, bɔt ɔda pipul dɛn kin taya, dɛn kin gɛt diziz, dɛn kin gɛt layt, ɛn dɛn kin tayt na dɛn chɛst. Sɔm mεdikal kכndyushכn dεm (e.g., slip apnea, at fεil) εn sכm mεdikeshכn dεm (e.g., beta-blכk) kin mek dis.

De tin wae impɔtant pas ɔl na dat, if yu gɛt dɛn kayn sik ya, nɔr ignore dɛm ɛn go to dɔktɔ fɔ no wetin de apin. Dɛn kin no dis wit wan simpul tɛst lɛk ECG.

Di tritmɛnt kin inklud mɛrɛsin, ɛn sɔmtɛm dɛn kin yuz pacemaker, i kin dipen pan di tin we mek i apin. If yu nɔr gɛt ɛni sayn, yu nɔr nid tritmɛnt. Bɔt if yu gɛt sɔm sayn dɛn, yu dɔktɔ go mɔs pe atɛnshɔn fɔ trit di rizin we mek yu gɛt dis sik. Tɔk to yu bɔt yu tritmɛnt opshɔn dɛm, ɛn aks kwɛstyɔn if ɛnitin nɔr klia. Afta dat, i impɔtant fɔ tek yu mɛrɛsin ɛn chɛk yu ɔltɛm. Dɔn yu kin gɛt wɛlbɔdi ɛn nɔ wɔri.

` Junctional Escape Rhythm, At Ritm, At bit, SA Node, AV Node, Pesmɛka, At Wɛlbɔdi