Pasinei nokuti munhu ane mwoyo wekuda anoda pacemaker anobva pane zvimwe zvinhu
"Heart block" idambudziko rinowanzokonzera mafungiro emagetsi emwoyo. Heart block-inonziwo atrioventricular block, kana AV block-ndeimwe yezvikonzero zviviri zvinoita kuti bradycardia (slow heart rate).
Overview
Muchivimbiso chemwoyo, mafungiro emagetsi emagetsi anokwana kana kuti akadzivirirwa zvachose sezvaanoedza kufamba kubva kumakamuri emagetsi emoyo kusvika kumakamuri emhepo.
Nemhaka yokuti mafungiro aya emagetsi anoita kuti mwoyo uzive apo inofanirwa kurova, kana mwoyo wekubata wakaoma zvakakwana kunogona kuderedza mwoyo wekuda kune ngozi zvishoma.
Kana iwe uine mwoyo wekuvhara, pano ndidzo huru dzinozoita kuti uone kana iwe uchida pacemaker:
- Kana mwoyo wako wakagadzikana wakakonzerwa nekuwedzera kwenguva pfupi mumutauro wevari, pacemaker inenge isina kumbodiwa.
- Kana uine dhigirii yekutanga mwoyo block, pacemaker haifaniri kunze kwekuti bhokisi iri kure.
- Kana iwe une yechipiri yechirwere chepfungwa chinenge chichiratidza zviratidzo kana kuti chinokanganisa, pacemaker inodiwa. Chikoro chechipiri chechigadziri chisina kukonzera zviratidzo uye chinowanzoitika hachirevi pacemaker.
- Kana iwe uine dhigirii yemoyo wechipiri, ipapo kunze kwekuda kwekuwedzera kwechirwere chema vagal tone, pacemaker inowanzodiwa nguva dzose.
Zvinokonzera
Muchidimbu zvikamu zve mwoyo block hazvisi nguva dzose zvine ngozi kana kuti zvisingaiti. Nyaya yemwoyo inodzivirira inowanzoonekwa muvanhu vaduku, vane hutano avo vanowedzera kuwedzera kwekutaura kwevaviri vavo.
Izvi zvakawedzera vagal tone zvinowanzoitika nekunyunyuta, kurutsira, kana kupindura kurwadziwa, kutya, kana kushungurudzika kamwe. Ichi chimiro chemwoyo chinokonzera hachisi kutyisa upenyu uye hachiratidze chero chinetso chinokonzerwa nemagetsi emhepo. Iyo inonyangarika pakarepo kana chiitiko chinokonzera chichigadzikana uye inenge isisambodi kuisa kuiswa kwe pacemaker.
Kune rumwe rutivi, bhokisi remwoyo rinogonawo kuitika nezvirwere zvakasiyana-siyana zvepfungwa, kunyanya chirwere cheyoronic, chirwere chemoyo , kana myocarditis . Kunewo mhuri yemhando ye moyo block.
Muzhinji, apo bhokisi remoyo rinokonzerwa nechirwere chemwoyo, rinoreva kuti kune chirwere chisingaperi chemagetsi emagetsi. Rudzi urwu rwemwoyo hunowanzowedzera kuwedzera pane nguva, saka vanogadzirisa zvinowanzodiwa.
Zviratidzo
Zvichienderana nechisimba chayo, mwoyo unogona kuita zviratidzo zvakasiyana-siyana, kubva pane zvachose kusvika kune chizivo , syncope (kurasikirwa kwekuziva), kana kunyange rufu. Mwoyo wemukati wakaoma zvakakwana kubudisa zviratidzo, kana izvo zvinotyisidzira kuti zvive zvakanyanya, zvinogona kubudirira kurapwa ne pacemaker . Saka kana iwe uine mwoyo wakavhara, nyaya huru iwe newachiremba wako ndeyekuona kana mwoyo wako bumbi rakakosha zvokuti unoda pacemaker.
Mwoyo wemukati usina kubudisa zviratidzo chero chipi zvacho hazvidi kuti pave pacemaker, kunze kwekuti iine yechitatu degree heart block kana distal moyo block. Kana bhokisi remoyo riri kubudisa zviratidzo-kunyanya uchezesi kana syncope-zvino kuchibata ne pacemaker kunowanzodiwa. Zvimwe ndeye apo mwoyo bhokisi rinozivikanwa kuti inopera-semuenzaniso, kana zvichiitika nokuda kwekuwedzera kwenguva pfupi mumutauro wevari.
Degree
Chiremera chemwoyo chinongororwa navanachiremba mune chimwe che "zvitatu" zvitatu. Chiremba wako anogona kugona kukosha kwepfungwa yako yebhokisi ne electrocardiogram (ECG) .
- Yokutanga digiti yepamusoro inoreva kuti mutsara wega wega wega wekupedzisira unouita kubva paAria kusvika kumavhiriki, asi kuitisa kwepfungwa kunonoka.
- Chikoro chechipiri chechigarire chinoreva kuti mamwe emafungiro aya anogadziriswa kubudiriro kumhepo, asi vamwe haasi.
- Chechitatu chidimbu chinoreva kuti zvese zvinokanganisa zvakavharwa. Chechitatu chitoro chinonzi heart block chinonziwo "chizere chinokonzera mwoyo."
Mune munhu ane nhamba yechitatu yemoyo block, kupona kunoenderana nekuvapo kwemasero echechi pacemaker ari pasi pekuchengetedza nzvimbo.
Izvi zvinoreva, masero anokonzera mafungiro awo emagetsi anobvumira mwoyo kuramba uchirova.
Mwoyo rhythm yakabudiswa nemasero emagetsi aya anonzi pacemaker anonzi "rhythm ramba". Kakawanda, izvi zvinyorwa zvisiri izvo zvinozivikanwa zvisingatendwi uye zvisingatauriki. Dzimwe nguva kuvapo kwechirongwa chekupukunyuka kunoonekwa sechirwere chekukurumidzira.
Pakati pese, iyo yakakwirira dhigirii yemwoyo, kunyanya kudiwa kwepemaker. Pacemakers nguva dzose inodiwa nechechitatu digiti block, kazhinji nechipiri digiti block, asi inongowanzosvika neyokutanga dhigirii.
Nzvimbo
Munguva yemwoyo wose rhythm, mafungiro emagetsi emagetsi anofambidzana nepakati pemagetsi pakati peatria uye ivhiri (AV junction). Iko kusangana kweAV ine zvivako zviviri:
- Iyo node yeAV
- Iyo mhemberero (inofungidzirwa sechinhu chinokonzerwa ne "cable" yezvipembenene zvinotungamirira mafungiro emagetsi kubva kuNode yeVV kusvika kune mhepo yakasimba)
Mukugadzirisa kuoma kwemwoyo wezvigadziro, zvakakosha kuti uzive kuti uri muAV junction ibwe iri kuitika. Iko ndiko, iyo chivharo mukati memharavha yeAV kana kuti iri muBundle Yake (kana matavi emakumbo anomuka kubva muhomwe Yake)?
Muzviitiko zvakawanda, chiremba anokwanisa kusarudza nzvimbo yemwoyo kubata nekungoongorora ECG. Dzimwe nguva, kunyange zvakadaro, kudzidza kwe electrophysiology kunoda.
Nhengo yemwoyo inowanikwa mukati meAV node ("proximal" moyo block) inowanzova yakasimba uye kazhinji haifaniri kusingaperi pacemaker. Izvi ndezvokuti kana bhero iri kuitika mukati meAV node, mamwe masero emakemikiramu emakemikari muAV node kunze kwenzvimbo yebhokisi kazhinji inotora rwiyo rwemoyo. Izvi zvinonzi "junctional kutamba rhythm" zvinowanzove zvisinganyatsogadzikane uye hazviiti mungozi kuhupenyu.
Kune rumwe rutivi, ne "distal" moyo block, umo ibwe rinowanikwa mukati kana pasi pechikwata Chake, chero masero emagetsi emagetsi anokwanisa kungove ari mumatavi emakumbo kana mavhiriki. Izvozvo zvinokonzera mwoyo rhythm inonzi "ventricular kupukunyuka rhythm." Sezvo masero aya emagetsi anokonzerwa nemagetsi anozivikanwa asingavimbiki uye anowanzomira pakarepo, chimiro chekuzvidzivirira chinonzi chinonzi chimiro chinoonekwa sechimiro chakaipa.
Rutsigiro rwemwoyo inodzivirira runowedzera kuipa kupfuura nguva. Saka kunyange mumamiriro ezvinhu iye zvino ari kukonzera kutanga kana kuti yechipiri digiti bhokisi, distal moyo block inonzi yakangwara uye inogara ichida kurapwa ne pacemaker.
Shoko Rinobva
Kana iwe wakamboudzwa kuti une mwoyo ye block kana AV block, iwe nechiremba wako uchada kufunga nezvezvinhu izvi zvose kuitira kuti uone kana iwe unoda pacemaker. Nenzira yakanaka, kuunganidza ruzivo rwakakosha inowanzomira nekukurumidza uye inongoda nguva nenguva inoda kuvhara electrophysiology kudzidza.
> Kwakabva:
> Epstein AE, DiMarco JP, Ellenbogen KA, et al. ACC / AHA / HRS 2008 Nhungamiro yeChirongwa-Based Based Therapy yeCardiac Rhythm Kusakanganiswa: Bhuku reAmerican College of Cardiology / American Heart Association Basa reMakadzi Pamitungamiri Yedzidzo (Komiti Yokunyora Kudzokorora ACC / AHA / NASPE 2002 Nhungamiro Yekutsvaga Kwekugadzirisa yeCardiac Pacemakers uye Antiarrhythmia Devices): yakagadziriswa pamwe chete neAmerican Association for Thoracic Surgery uye Society of Thoracic Surgeons. Circulation 2008; 117: e350.