Pakati pemitemo miviri yakawanda inoshandiswa pakurapa friction fibrillation , nzira inotarisira kudzorera nekuchengetedza mwoyo wakakwana rhythm (rhythm control approach) pachiso chayo inoita seinodiwa. Zvisinei, nokuti nzira iyi inogona kutakura ngozi yakawanda uye inowanzo isiri yakakwana. Hazvina kunaka kune munhu wose.
Rhythm-control approach inosanganisira matanho maviri akadai: kudzorera uye nekuchengeta moyo wakakwana.
Cardioversion: Kudzorera Normal Heart Rhythm
Kana iwe uri muchirwere chetrial, chiremba wako anogona kuedza kugadzirisa mwoyo wako wakagadzikana nekushandisa zvinodhaka zvinodhaka kana motokari yemhepo.
Mishonga yakasiyana-siyana inorwisa zvirwere inogona kugoverwa mukati mekuedza kuvhara friggriation yezvemagetsi uye kudzorera rwiyo rwechirwere. Izvi zvinosanganisira Tambocor (flecainide), Corvert (ibutilide), Rhythmol (propafenone), uye Tikosyn (dofetilide). Zvisinei, mishonga iyi ichabudirira kudzorera rwiyo rwemaitiro chete rwe50 kubva kuzana kusvika 60 muzana yenguva, uye kunogona kuva nemigumisiro.
Nyanzvi dzezvemapurisa dzinosarudza magetsi emhepo panzvimbo. Uine motokari yemagetsi, iwe uchaiswa muine chiedza, kubatwa kweanesthesia-induced for minutes. Chiremba achabata kusunungura magetsi muchifuva chako uchishandisa seti yepaddles. Iyi nzira haina njodzi, inokurumidza, yakachengeteka uye inogara ichishanda.
Icho chinetso chikuru che cardioversion hachisi kubva pamitemo yacho pachayo, asi pane chikonzero chekubudirira kwemoyo.
Kana tsvina itsva yeropa iripo muAria apo mwoyo unotanga kupfura kazhinji zvakare, mahwendefa anogona kusununguka uye anoita kuti arohwa . (Izvi zvinogona kuitika panguva chero ipi zvayo ne-atrial fibrillation asi zvishoma zvingangoerekana zvaitika kana mushure mokunge mwoyo wakagadzikana wakagadziriswa.) Chiitiko ichi hachiwanzoitika mushure mekushaya moyo, asi kana zvichiitika zvinogona kuva zvinoparadza.
Dambudziko rekuvhara mushure mehutachiona rinogona kuderedzwa kana kuporesa ne anticoagulant drug (blood thinner) kwemavhiki mashomanana vasati vaita cardioversion kana nekunyora kuti hakuna mazamu ari kuruboshwe rerium kuburikidza nekuita eescardiogram inonzi transesophageal vasati vasvika pamwoyo. Uyezve, kana zviri chokwadi kuti friggrillation yeAryria yave iripo kwemaawa masere anopfuura makumi maviri, iyo cardioversion inogona kuitwa nehukama hwakachengeteka.
Iyi danho rokutanga kusvika rhythm kudzora-kudzorera chimiro chemazuva emoyo-iri kubudirira kupfuura 98% yenguva.
Kuramba Usingawanzo Rhythm
Icho chinonyengera chekuita rhythm kudzora ndiko kuchengetedza moyo wakakwana rhythm kana yakadzorerwa zvakare. Kazhinji, nechikamu chekutanga chetrial fibrillation, vanachiremba vazhinji vanongodzorera rwiyo rwemazuva ose uye vanotumira musha wevarwere vasina chero humwe mwoyo rhythm therapy (kunze kwekurapwa, zvechokwadi, chero ipi zvayo inofungidzirwa inokonzera zvikonzero zvehutrial fibrillation). Vanhu vazhinji vacharamba vachiita rwiyo rwemazuva akawanda kana kunyange makore vasina antiarrhythmic drug therapy.
Zvisinei, nekukurumidza kana kuti gare gare frilling frilling inogona kudzoka zvakare. Kana izvozvo zvikaitika "chigadziro" chikamu che rhythm control method inowedzera zvakaoma.
Kazhinji kacho, kana chimiro chinowanzogadziriswa chidzorerwa chiremba achakurudzira imwe yemishonga inorwisa maitiro ekubatsira kudzivisa kudzokorora kwehuwandu hwehutachiona. Zvinosuruvarisa, zvinodhaka zvinodhaka, kunze kwekuve pakati pemishonga inonyanyisa inoshandiswa mumishonga, inongoshanda zvakanyanyisa pakuchengeta friggrizing inouraya kudzoka. Nekudaro, kuzadzisa chinangwa chekuita rhythm kunowanzodikanwa "miedzo" yakawanda nemishonga iyi, kutarisa imwe iyo yose inoshandisa chimiro chakanaka uye inokwanisika.
Kunyangwe nedambudziko rekuedza-uye-kukanganisa, chirwere chinopesana nehutachiona chinogadzirisa kutonga kwakanaka kwehutachiona hwehutachiona pasina kukonzera kusagadzikana nemigumisiro inowanikwa chingangova hafu yenguva.
Iko rudzi rwekubudirira kwehuwandu nemishonga inopesana nemasikirwo zvinonzwisisika kusiya zvakawanda zvingadiwa. Nokuda kwechikonzero ichi, vanachiremba nevatsvakurudzi vave vachishanda kushanda kwemakore anopfuura gumi kuvaka nzira dzakachengeteka uye dzinoshanda kuti "kuporesa" inyanzvi yefridhi-kureva, kuchengetedza moyo wakakwana rhythm nekusingaperi-uchishandisa catheter-based ablation procedures . Kunyange zvazvo huwandu hwakafambira mberi hwakagadzirwa, chirongwa chekubatsira kwepriydrifrillation ichiri kushanda zvishoma uye chinoramba chiine ngozi yakawanda yezvinetso zvakakomba. Ablation inzira yakanaka kune vamwe varwere vane friction, asi haisi yevanhu vose.
Pakupedzisira, mune varwere vanobudirira kuita rhythm kudzora nemishonga kana kubvisa, uchapupu huri kure hunoratidza kuti dambudziko ravo rekurohwa rinoramba rakasimudzirwa. Saka, nyanzvi dzakawanda dzinokurudzira varwere ava kuti varambe vari pane zvisingaperi zveanticoagulation therapy pasinei nokuti vari muchirongwa chemazuva ose.
Summary
Kana rhythm-control inosvika pakurapa friction fibrillation yaiva yakachengeteka yakachengeteka uye inoshanda, saka inogona kushandiswa munenge munhu wese ane chirongwa ichi. Zvinosuruvarisa, asi rwiyo rwekutonga zvakajeka kuti ndiyo nzira yakanakisisa yevanhu vazhinji, inosiya zvakawanda zvingadiwa. Ichi ndicho chikonzero kushandiswa kwakasiyana- kutonga -kunoshandiswa panzvimbo yevarwere vakawanda. Uye ichi ndicho chikonzero iwe unoda kudzidza zvakawanda sezvaunokwanisa pamusoro pezvipi zvese zvisati zvaitika usati wafunga pamusoro pekurwara kwehutachiona hwehutano iwe.
Sources:
Fuster, V, Ryden, LE, Cannom, DS, et al. ACC / AHA / ESC 2006 Nhungamiro Yekutungamira Kwevarwere Nehutachiona hweArper A Report of the American College of Cardiology / American Heart Association Task Force pamusoro Pemitemo Yezvokuita uye neEuropean Society of Cardiology Komitungamiri Yekushandisa Mazano (Komiti Yokunyora kuongororazve Zvinyorwa zve2001 nokuda kwekutungamira kwevarwere nehutachiona hwepanyika). J Am Coll Cardiol 2006; 48: e149.