Dzidza Zvakawanda Pamusoro Pemaitiro EEGG asina kunaka
Kana iwe wakamboudzwa nachiremba kuti une bundle branch block, zvinoreva kuti electrocardiogram yako (ECG) iri kuratidza nzira yakasiyana, isina kunaka. Muchikamu chino tichataura pamusoro pekuti bundle rebazi rinorevei, uye mibvunzo ipi yaungada kubvunza chiremba wako.
Iro Cardiac Electrical System System
Matavi ehomwe iyo chikamu chakakosha chemagetsi emagetsi , chirongwa chinotungamirira mwoyo rhythm uye chinogadzirisa kushambadzira chiito chemoyo.
Mwoyo unorova mukupikisa chiratidzo chenyu chemagetsi. Sezvo nhare yemagetsi inoparidzirwa mukati memwoyo, moyo wemishumbisi yemagetsi. Saka kuparidzirwa kwakarongeka, kwakanyatsogadziriswa kwemashoko emagetsi kwakakosha zvikuru kushanda zvakanaka kwemwoyo.
Chiratidzo chemagetsi chemwoyo chinotangira munharaunda ye sinus mumusoro wepamusoro weatrium, inopararira kune zvose maasria (zvichiita kuti atria irove), uye inopfuurira nenzira yeAV . Kusiya nhamba yeAV, kushandiswa kwemagetsi kunopinda mavhirikiriya kuburikidza neboka remaviri emweya anonzi His bundle. Kubva pahombodo Yake, kushandiswa kwemagetsi kunopinda mumatavi maviri ehomwe: iro rakanaka bundle bazi uye kuruboshwe bundle branch. Mashizha ezvakarurama uye ezasi kwechikwata anopa simba rekugadzira magetsi kumativi ekurudyi uye kuruboshwe, zvichienderana nekuita kuti varove. Apo matavi ehomwe ari kushanda zvakajairika, kodzero dzakasara uye dzakasara dzinobvumirana zvakabatana panguva imwe chete.
IEECG inoratidzirwa kuenzanisira kwekushandiswa kwemagetsi sezvainofamba nemwoyo. Chinyorwa cheQRS ndechokuti mapurisa evanhu vanodana imwe chikamu cheEECG, chikamu chinoratidza kushandiswa kwemagetsi sezvo iri kugoverwa ne bundle branch system mumhepo dzose dzevhirikiri.
Mumufananidzo uri pamusoro apa, Panel A inoratidza izvo zvinowanzoitwa QRS yakaoma zvinoratidzika pane ECG yakajairika.
(Kune avo vanofarira, chiyero ichi chinoratidza mutungamiri ini kubva kune 12-inotungamirira ECG.) Sezvo zvose zvinyorwa zvinowanzogamuchira magetsi masikati panguva imwe chete, iyo yakagadzikana QRS yakaoma yakanyanya kuderera (kazhinji pasi pe1.12 yechipiri munguva.) Kukurudzirwa kweiyo imwechete kwezvinhu zvose zviviri zvinotenderera kunobva pamusana pemagetsi kuenderera pasi ose maviri ezvo zvakanaka uye nechebo mashizha mashomanana paanenge akaenzana nehuwandu hwekukurumidza.
Bundle Branch Block: Tsanangudzo
Basa rematavi ehomwe nderokuparadzira kupararira kwemagetsi emagetsi emagetsi kumativi ose emhepo, kuitira kuti kana chibvumirano chekuvhara ropa (kurega ropa kubva mumoyo), vanozviita nenzira yakarongeka uye yakashanda. Bhuku rakanaka rebazi rinopa simba remagetsi kumhepo yakarurama, uye kuruboshwe bundle bazi rinopa mhirizhonga kuruboshwe rweseri.
Muchikwata chebazi, rimwe kana kuti maviri ezvikwata zviviri izvi hazvisisiri kutumira mafungiro emagetsi kazhinji. Izvi zvinowanzoitika semagumisiro ezvirwere kana kukuvadza kune rimwe rematavi emashamba, sezvingaitika kune myocardial infarction (kurwisa kwemwoyo) kana nekushaya mwoyo .
Zvisinei, bundle branch block inogonawo kuitika pasina chikonzero chakajeka muvanhu vane utano hwakakwana.
Apo kushandiswa kwemagetsi kunononoka kusvika kune iyo ventricle inobata, kucherechedza kunoratidzika semuenzaniso wakasiyana paEECG inonzi bundle branch block. Mhedzisiro huru yebazi rebazi ndiro iyo inokanganisa kuputika kwechinguvana kwemaviri emhepo. Izvozvo zvinokonzerwa nemhepo imwechete (iyo ine "yakachengetwa" bundle branch) inowanikwa zvishoma pashure pekugumburwa kweimwe, pane panguva imwe chete.
Cherechedza kuti kunyange zvazvo shoko rokuti bundle branch "block" rinoshandiswa, dare rinoshandiswa rebazi rinogona kana kuti haringatombo "kudzivirirwa." Muzviitiko zvakawanda, bhururo rebazi harina kudziviswa zvachose, asi pane kungoita kuti magetsi ave zvishoma nezvishoma kupfuura chikamu chinopesana nebazi.
Iko Bundle Rebazi Rinovhara Rinotarisa Kufanana neEECG
Vanhu vane bhomba rebazi rinowanzove nekodzero yebazi rebazi (RBBB) kana kuti yakasara bundle branch block (LBBB), zvichienderana neyese yematavi maviri ehomwe inobatwa. Pane mapeji B uye C mumufananidzo anoratidza maitiro ekuchinja anowanikwa muQRS yakaoma kana munhu asiya kana kuti bundle rebazi rebazi. Muzviitiko zvose, chirongwa cheQRS chinowedzera kupfuura chinowanzoitika, sezvo zvinotora nguva kuti chiratidzo chegetsi chiparidzwe zvakakwana kune zvose zviri zviviri. Chimiro che QRS chinoratidzira kuti bundle rebazi (kurudyi kana kuruboshwe) riri kuita kuti magetsi aite zvisina kufanira.
Dzimwe nguva, matavi maviri ehomwe anokanganisa, uye bundle bazi rekutevedzera iro paEECG harisi pachena zvakajeka sezviri kurudyi kana kuruboshwe bundle branch block. Munyaya iyi, bundle branch block inotumidzwa se "intraventricular conduction kunonoka."
Zviratidzo uye Matambudziko
Muzviitiko zvakawanda, bundle bazi rekuvhara harina kubudisa zviratidzo. Zvisinei, mumatambudziko mashoma ebazi masimba ekugadzirisa kwemagetsi kusvika kune zvimwe zvinyorwa zvinogona kunge zvakanyanyisa. Muzviitiko izvi, kushungurudzika kunogona kuvharirwa zvachose kusvika pamhepo, zvichiita kuti pave nemhepo yakakwana -iyo inogona kubudisa syncope kana kufa kamwe kamwe .
Dzimwe nguva kuvapo kwebato rebazi rinogona kuratidza kuvapo kwechinetso chepfungwa chepfungwa. Saka kana bhokisi rebazi richizivikanwa, vanachiremba vazhinji vanorayira kuongorora kwepfungwa dzisingabvumirwi (kakawanda, echocardiogram ).
Kuvhara Kwebazi Kuvharidzirwa Kwebazi
Kazhinji nguva, bundle bazi rekuti pacharo haritsvaki kurapwa. Zvisinei, pane dzimwe nguva vanhu vane chikamu chekupedzisira chebazi vanofanira kugamuchira pacemaker , kunyanya, iyo iyo inobvumirana nekubatanidzwa kwezvinyorwa zvavo .
Shoko Rinobva
Bundle branch block inowanikwa zvakajeka paEECG. Kunyange zvazvo vanhu vane bundle bazi rekugadziriswa vanofanira kugara vachiwana chirwere chepfungwa chisingaverengeki kutarisa chirwere chepfungwa chepfungwa, mumatambudziko mazhinji bazi rega pacharo harisi dambudziko guru.
> Kwakabva:
> Surawicz B, Childers R, Deal BJ, et al. AHA / ACCF / HRS Mazano ekusimudzirwa uye kushandurwa kweElectrocardiogram: Chikamu III: Kuvhiringidzika kwekutengesa: Scientific Statement kubva kuAmerican Heart Association Electrocardiography uye Arrhythmias Committee, Council on Clinical Cardiology; iyo American College of Cardiology Foundation; uye Heart Rhythm Society. Yakabvumirwa neInternational Society ye Computerized Electrocardiology. J Am Coll Cardiol 2009; 53: 976.