Muzvizhinji, kune zvikonzero zviviri chiremba wako angada kukuisa pamishonga yemukati wemaridymia . Chokutanga, chirongwa chinogona kunge chichikuita kuti uve nezviratidzo, zvakadai seplpitations kana kuchena , uye kurapa kungave kwakakosha kubvisa zviratidzo izvozvo. Kana, chechipiri, chirongwa chegrimmia chinogona kukuvadza kana kutyisidzira kuita saizvozvo. Vakawanda arrhythmias havasi kuita zvinhu zviviri izvi uye havadi kurapwa zvakanyatsorongedzerwa pachirongwa chega.
Kana uine chirmiti chinoda kurapwa, kune zvikamu zvitatu zvakakura zvemishonga zvingave zvinobatsira, zvichienderana nerudzi rweurhythmia yaunayo. Boka rokutanga rinosanganisira antiarrhythmic zvinodhaka-zvinodhaka zvakanyatsorongedzerwa kubvisa kusagadzikana kwemoyo. Chechipiri inoumbwa nemishonga inobata iyo node yeAV , iyo inonyanya kushandiswa kwepamusoro- soro tachycardias (SVT). Boka rechitatu rinoumbwa nemishonga yakasiyana-siyana yakaratidzwa kuderedza dambudziko rekufa kamwe-kamwe kubva pamaridythmias.
Antiarrhythmic Drugs
Antiarrhythmic zvinodhaka mishonga inoshandura magetsi emagetsi emwoyo, uye nokuita kudaro, shandura nzira iyo chiratidzo chemagetsi chinopararira mukati memwoyo. Sezvo tachycardias (arrhythmias inokonzera kukurumidza kwepfungwa yemwoyo) inowanzobatana nezvisina kukodzera mumagetsi emagetsi, zvinodhaka zvinoshandura chiratidzo chemagetsi emwoyo zvinowanzovandudza iyo arrhythmias.
Antiarrhythmic mishonga inowanzobudirira, kana kuti zvishoma nezvishoma inoshanda, mukurapa marudzi akawanda e tachycardias.
Zvinosuruvarisa, mishonga inopesana neboka seboka rinowanzokonzera huwandu hwakawanda hwehutsanana hworudzi rumwe kana rumwe, uye sechigumisiro, zvinogona kuva zvakaoma kutora. Chirwere chimwe nechimwe chinopesana nemishonga chinokonzerwa nehuwandu hwehutsinye, uye zvisati zvarondedzera chero ipi zvayo yemishonga iyi, zvinokosha kuti chiremba wako anotsanangura zvakanyatsonaka zvinetso zvinogona kuitika nemishonga yakasarudzwa.
Zvisinei, kune rimwe dambudziko rakaipa iro rinowanzoonekwa nezvose zvinodhaka remishonga: Dzimwe nguva madhiragi aya anoita kuti urongwa huve hwakaipa pane huri nani.
Ichi chinonzi antiarrhythmic zvinodhaka-chinonzi "proarrhythmia" -chinoshanduka kuva chizvarwa chezvinhu zvinodhaka chinoshandura chiratidzo chemagetsi emwoyo. Zvinyorwa zvishoma, kana iwe uchiita chero chinhu chipi zvacho kuti uchinje nzira iyo magetsi emagetsi anopararira mukati memwoyo, zvinoita kuti kuchinja kuchaita kuti tachycardia iwedzere, kana yakaipa.
Inowanzoshandiswa zvinodhaka zvinosanganisira amiodarone (Cordarone, Pacerone), sotalol (Betapace), propafenone (Rhythmol), uye dronedarone (Multaq).
Amiodarone ndiyo inonyanya kushandiswa nehutachiona hwehutachiona uye hainawo huwandu hwekuita proarrhymia kupfuura mamwe madhiragi. Zvinosuruvarisa, mamwe mhando dzezvinonyadzisa zvakaonekwa neamidodarone dzinogona kunge dzakanyanyisa kunaka, uye ichi chinodhaka chinofanira kungoshandiswa chete (kufanana nemishonga inopesana nemasikirwo) pazvinenge zvichidikanwa.
Chinonyanya kukosha ndechekuti vanachiremba vari-uye vanofanirwa kunge vasingadi kuisa zvinorwarisa zvinodhaka. Iyi mishonga inofanirwa kushandiswa chete apo arhythmia iri kubudisa zviratidzo zvakanyanya kana kuti iri kutyisidzira utano hwemwoyo.
AV Nodal Kudzivisa Zvinodhaka
Mishonga inonzi AV nodal inogadzirisa zvinodhaka- beta blockers , calcium channel blockers , uye digoxin-basa nekuderedza mhepo yemagetsi yemhepo sezvo ichipfuura nepakati peAV node panzira iyo kubva kuAria kusvika kumavhiriki.
Izvi zvinokonzera kuvhudzira kweAV kukudzivirira mishonga inobatsira mukurapa SVT. Mamwe maitiro eSVT (kunyanya, AV nodal reentrant tachycardia uye tachycardias inokonzerwa nepepass maturakiti), inoda kuti node yeV AV iite motokari yemagetsi zvakanaka, uye kana iyo node yeAV inogona kuitwa kuti iite zviratidzo zvegetsi zvishoma zvishoma, SVT iri nyore inoguma.
Nokuda kweSVT inozivikanwa seAricrial fibrillation , maAV nodal-blocking drugs haagadziri arrhythmia, asi anononoka kutara kwemwoyo kubatsira kubvisa zviratidzo. Kutaura zvazviri, kudzora mwoyo yevhiringi neAV nodal zvinodzivirira zvinodhaka kazhinji ndiyo nzira yakanakisisa yekugadzirisa zvirwere zvepriyria .
Zvinodhaka Zvinoderedza Dambudziko Rokufa Nenguva Isipi
Mishonga mashomanana inofungidzirwa kuti inoderedza njodzi yekufa kamwe kamwe, zvichida nekuderedza dambudziko re ventricular tachycardia kana ventricular fibrillation , the arrhythmias inoita kuti mwoyo usungwe .
Kutsvakurudza kunoratidza kuti beta blockers zvichida kuderedza dambudziko rekufa kamwe kamwe nekudzivisa kuitika kweAdrenaline pamutsipa wemwoyo, nokudaro kuderedza mikana yekuita zvirongwa zvinouraya. Vose varwere vakaponeswa nehutano hwemwoyo kana avo vane mwoyo yekukundikana vanofanira kutora beta blockers.
Zvishoma zvishoma zviri nyore kutsanangura ndezvokuderedza kufa kamwe kamwe kunorondedzerwa nevarwere vanotora maitiro, kana kuti vanodya avo oga-3 fatty acids, asi izvi zvinoratidzika sezviri kubatsira.
> Sources:
> Grant AO. Cardiac Ion Channels. Circ Arrythm Electrophysiol 2009; 2: 185.
> Sicilian Gambit. Nzira Itsva Yekutsvaga kweAnirrhythmic Zvinodhaka Zvakatorwa pamabasa avo paArrhythmogenic Mechanisms. Task Force yeChirongwa Chekushanda paArrhythmias yeEuropean Society of Cardiology. Kurwisana 1991; 84: 1831.