Chii chinodzokorora arrhythmia?
Kudzorera tachycardias ndeyemhuri yemaridymia inokurumidza kuora mwoyo inokonzerwa nekubatana kwemagetsi kusina kuchena mumoyo. Izvi zvisingaenzaniswi zvakagadzirwa zvinogona kugadzirisa magetsi emakwikwi, izvo zvingavhiringidza hupenyu hwemwoyo.
Nechirevo chepfungwa chemazuva ose (iyo inonzi " sinus rhythm" ), moyo wemagetsi wemhepo unotangira musungo we sinus , uye unopararira pamwe chete pamakamuri emagetsi emoyo (zvichiita kuti atria iite chibvumirano), uye zvino inofamba kupararira pamwe chete pamwoyo dzimba dze ventricular (zvichiita kuti mhepo inobhururuka ishande).
Maminitsi mashomanana gare gare mutsva wekugadzirisa magetsi unoumbwa node ye sinus, uye zvese zvinotevera zvinodzokorora.
Zvisinei, kana chinangwa chemagetsi chiripo mumoyo, reitrant arrhythmia inogona kuitika. A reitrant arrhythmia inosvika kana imwe yemafungiro emagetsi emwoyo (zvichida nhengo dzemazuva ose dzisina simba, kana kusagadzikana kwemasimba emagetsi anokonzerwa nehutano husati hwasvika pari (PAC) kana kuti dutu rinotanga kupera (PVC) ), rinopinda pasi pasi pekodzero mamiriro ezvinhu. Kufungidzira kwakadai kunogona "kutorwa" mukati memutunhu, nenzira iyo inotanga kutanga kutenderera dunhu, kakawanda. Nebhokisi rimwe nerimwe rakakomberedza dunhu, kushingaira kunobereka mwoyo itsva kurohwa. Ichi chirevo chitsva, chisinganzwisisi chinonzi reentrant arrhythmia (nokuti simba remagetsi "rinopinda zvakare" mudunhu nejasi rimwe nerimwe).
Sezvo pasina pause pakati pemwoyo inorwa panguva yekudzoka kwemagirthmia (nokuti mhepo inoputira inoramba ichikomberedza dunhu), kazhinji moyo wepakati panguva yekudzoka kwegermythmia inokurumidza. (Ndiko, tachycardia iripo.)
Marudzi eReentrant Tachycardia
Iko kune mapoka maviri akawandisa ezvezvezve tachycardias - supraventricular tachycardia (SVT) ; uye ventricular tachycardia (VT) uye ventricular fibrillation (VF) .
Reentrant Supraventricular Tachycardias
Izvo zvisingaenzaniswi magetsi ekubatana anokonzera SVT kakawanda aripo kubva pakuberekwa - saka aya arhythmias anowanzoonekwa muhutano, vaduku. Kudzorera SVT kunogona kukonzera zviratidzo zvikuru, asi hazviwanzovi nengozi kana kutyisa upenyu. Mhando dzakasiyana-siyana dzeSVT dzinowanzozivikanwa maererano nehutano hwechirongwa chekare chinowedzera. Mhando huru dzeSVT dzinosanganisira:
- Sinus node reentrant tachycardia (SNRT) , iyo inowanzoita dunhu rinosanganisira node ye sinus.
- AV nodal reentrant tachycardia (AVNRT) , iyo inowanikwazve yeruwa inosanganisira iyo nhamba yeAV .
- Atrial reentrant reach tachycardia, umo iyo inowanzoita dunhu iri mukati meatria.
- Atrioventricular reentrant reachant tachycardia (AVRT) , iyo iyo inotenderera inotenderera ine magetsi ekubatanidza (a "bypass tract") pakati peatria uye mabhiriki. Kune mhando dzakasiyana-siyana dzechirongwa chekare chinonzi reach tachycardia, asi chinonyanya kuzivikanwa ndeye Wolff-Parkinson-White syndrome (WPW) .
- Atrial flutter , iyo inonyanya kushandiswa neatrial reentrant tachycardia iyo inowanzoita dunhu rakakura zvikuru.
- Atrial fibrillation inowanzoonekwa sechinhu chakasiyana chekare chinonzi atrial tachycardia umo maitiro akawanda emitambo inogona kuwedzera.
Atrial fibrillation yakasiyana nedzimwe mhando dzeSVT inodzokorora zvakare kuti kazhinji hazviiti nekuda kwekusagadzikana kwepamweya kwemhepo yemagetsi, asi zvinowanzokonzerwa nekuvandudzwa kwematambudziko emwoyo. Atrial fibrillation saka inowanzowonekwa kune vakwegura kupfuura dzimwe mhando dzeSVT.
Reentrant Ventricular Tachycardias
Kusiyana neSVT, humwe hutano hwemagetsi hunobereka VT kana VF huzhinji huripo kubva pakuberekwa. Pane kudaro, kubatana uku kunokonzerwa nokusuruvara kwepfungwa yemwoyo inowanikwa nemamwe marudzi ezvirwere zvepfungwa (zvikurukuru coronary artery matenda - CAD - kana mwoyo kusakwanisa ).
Izvi zvinoreva kuti vanhu vanowanzogadzira VT kana VF vanowanzove vakwegura, uye vanowanzova nehutano hwepfungwa yepfungwa. Zvinosuruvarisa, njodzi yekuva neVV kana yeVF inowanikwa muCAD uye mwoyo kusakundikana, uye ndicho chikonzero nei vanhu vakawanda vane mamiriro aya akawana kufa kamwe kamwe kwemoyo.
Sources:
Antzelevich C. Zvidzidzo zvekutanga zvekudzokazve arrhythmias. Nhasi Maonero muCardiology 2001, 16: 1-7
Link MS. Clinical practice. Kuongorora nekutanga kurapwa kwepamusoro-soro tachycardia. N Engl J Med 2012; 367: 1438.