Wolff-Parkinson-White syndrome (WPW) chirwere chepfungwa chinokanganisa chinokanganisa magetsi emhepo. Vanhu vakaberekerwa neWPW kazhinji vane maitiro ekuchinja pane electrocardiogram yavo (ECG) , uye vanowanzokura sravricar tachycardia (SVT) , chimiro chechiratidzo, chichikurumidza chinonzi cardiac arrhythmia . Mukuwedzera, dzimwe nguva vanhu vane WPW vanogona kuva nedzimwewo, dzinowedzera mungozi dzemaridythmias.
Chii chinonzi WPW?
Vanhu vane WPW vanoberekwa vane hutano husina kujairika hwemagetsi hunobatanidza imwe yemaatria (makamuri okumusoro emoyo) neimwe yezvinyorwa (makamuri apasi emwoyo). Izvi zvisingaenzaniswi magetsi ekubatanidza anonzi inyanzvi nzira. Nzira dzinoshandiswa nadzo dzinoita mamiriro ezvinhu emwoyo umo maitiro asina kufara emwoyo anogona kuitika.
Chikonzero nei nzira dzekuwana nadzo dzakakosha
Nzira dzekuwana nadzo dzakakosha nokuti dzinopa hutano hunodiwa kuti hugadzire imwe rudzi rweSVT - SVT inozivikanwa seatrioventricular reciprocating tachycardia (AVRT) . AVRT chiratidzo chekudzokazve tachycardia .
Nzira yekufambisa inokonzera "kuwedzera" magetsi ekubatanidza pakati peatrium uye mhepo ine simba, uye nokuita izvozvo zvinopedzisa magetsi emagetsi. Iyi dunhu risina kujairika inobvumira AVRT kukura.
Ne "typical" AVRT, panguva yeSVT kushandiswa kwemagetsi kunofamba kubva paatrium kuenda kune ventricle uchishandisa nzira yakasununguka (kureva, iyo node yeVV ), uye inodzokera kuatrium (kureva kuti, "vanodzoka" neatrium) kuburikidza iyo nzira yekuwana nayo.
Izvo zvinokonzerwa nemagetsi zvinogona kutenderera dunhu rinopfuurira, zvichigadzira arrhythmia. Iyo inofamba inofamba inotarisa nzira yevashandi kubva kune ventricle kuenda kuatrium nokuti, neAVRT chaiyo, ndiyo chete nzira iyo nzira yekuwana nayo inokwanisa kuita magetsi.
Nei IWPW Yakasiyana Nezvakaitwa AVRT?
Musiyano pakati peAVRT uyu chaiwo uye AVRT yakaonekwa neWPW ndeyokuti, muWPW, iyo nzira yekuwana nayo inogona kukwanisa kuita magetsi mumagariro maviri kubva - kubva paatrium kusvika kumhepo yevhu uyewo kubva ku ventricle kusvika kuatrium.
Somugumisiro, panguva yekutengesa tachycardia muWPW, kushandiswa kwemagetsi kazhinji kunofamba pasi panzira yevashandi kusvika mumhepo, uye inodzokera kuAria kuburikidza neNode yeAV, uye inodzokera shure kunzira yevashandi kusvika kumhepo yakasimba-uye inoramba ichidzokorora dunhu. Ichi ndicho chinopesana nekufambisa kupfuura kune varwere vane AVRT chaiyo.
Chikonzero nei WPW yakakosha
Kukwanisa kwenzira yekuwana nayo muWPW kuitisa mafungiro emagetsi kubva kuAria kusvika kune mavhiriki anokosha kune zvikonzero zvitatu.
Chokutanga, panguva yechimiro chechigarire , simba remagetsi rinopararira paAria rinosvika kumhepo dzomukati mbiri kuburikidza neAV node uye kuburikidza nemugwagwa unowanikwa. Iyi "miviri" yekukurudzira kwemhepo inokonzera maitiro ekusiyanisa kune ECG - kunyanya, "slurring" yeQRS complex iyo inonzi "delta wave." Nokuziva kuvepo kwema delta wave paEECG, chiremba anogona kuita kuti kuongororwa kweWPW.
Chechipiri, panguva yeAVRT yakaonekwa neWPW, mafungiro emagetsi anokonzera mavhirikiri chete kuburikidza nemugwagwa unowanikwa (panzvimbo yekufamba nenzira yakasarudzwa, yeAV nodal path). Somugumisiro, QRS yakaoma panguva ye tachycardia inotora chimiro chisina kujairika, iyo inofadza ye ventricular tachycardia (VT) pane SVT.
Kunyora iyo AVRT inokonzerwa neWPW yeVV inogona kuunza kuvhiringidzika kukuru uye alarm inenge isingakoshi pane zvevashandi vezvechiremba, uye inogona kutungamirira kurapa isina kukodzera.
Chechitatu, kana murwere ane WPW achifanira kukura neutrium fibrillation - arhythmia iyo iyo inria inokonzera mafungiro emagetsi panguva yakakurumidza zvikuru - izvo zvinoda kufamba zvinogona kufamba pasi nenzira yevashandi uye zvinokurudzira mhepo yepamhepo pane imwe nguva yakakurumidza, zvichiita kuti mwoyo unokurumidza kuora uchirova. (Kazhinji, iyo nhengo yeVV inodzivirira mhepo yakasimba kubva pakukurudzirwa nokukurumidza munguva yehutachiona.) Saka mune varwere vane WPW, zvirwere zvepanyama zvinogona kuva dambudziko rinotyisa.
Zviratidzo NeWPW
Zviratidzo zveSVT zvinokonzerwa neWPW zvakafanana neyese SVT. Dzinosanganisira mapapita , hutema , uye chizivo . Zvikamu zvinowanzotora kubva kumaminitsi mashomanana kusvika maawa akawanda.
Kana chirwere chinonzi atrial fibrillation chichiitika, zvisinei, kukurumidza kwemoyo wemwoyo kunogona kutungamirira mukurasikirwa kwekuziva, kana kunyange kusungwa kwemwoyo .
Kurapa WPW
Izvozve zvekare inharaunda iyo inobereka SVT muWPW inosanganisira iyo node yeAV, chimiro chinowanikwa zvakakwana neve vagus nerve . Saka varwere vane WPW vanogona kumira zvikamu zvavo zveSVT nekutora matanho ekuwedzera izwi revari vagar nerve yavo, yakadai sevashandi veValsalva , kana kunyorera chiso chavo mumvura yechando kwemaminitsi mashomanana. Kune vamwe vanhu vane zvikamu zvishoma zvishoma zveSVT, kurapwa uku kunogona kukwana.
Kushandisa antiarrhythmic madhiragi kudzivirira kudzika maitiro echirongwa muWPW kunongoshanda chete, uye nzira iyi haina kushandiswa kakawanda nhasi.
Zvisinei, iyo nzira yekuwana nayo muWPW inowanzo (inopfuura 95% yenguva) inobviswa zvachose nechirwere chekubatsira , iyo iyo nzira yekuwana nayo inonyatsorongedzwa uye yakanyatsorongedzwa. Ablation therapy inenge nguva dzose yakanakisisa kusarudzwa mune mumwe munhu ane WPW uyo ane arhythmias.
Uyezve, nokuti kutanga kweutrial fibrillation muWPW kunogona kutungamirira kune ngozi zvinokurumidza mwoyo mahara, uye nokuti inrial fibrillation inowanzoshamisika (uye inowanzova yakajairika kune vanhu vane WPW kupfuura munharaunda yakawanda), nyanzvi dzakawanda dzinokurudzira chero munhu ane WPW zvakasimba funga nezvekurapwa kwepabonde.
> Sources:
> Patiatric uye Congenital Electrophysiology Society (PACES), Heart Rhythm Society (HRS), American College of Cardiology Foundation (ACCF), uye al. PACES / HRS Expert Consensus Statement pamusoro pekutungamirirwa kwekusagadzikana kwechidiki Muduku ne Wolff-Parkinson-White (WPW, Ventricular Preexcitation) Electrocardiographic Mutevedzeri: Kuvandudzwa Mukubatana Pakati Pecheche uye Congenital Electrophysiology Society (PACES) uye Heart Rhythm Society (HRS) ). Ichitenderwa nehurumende dzinodzora dzePACES, HRS, American College of Cardiology Foundation (ACCF), American Heart Association (AHA), American Academy of Pediatrics (AAP), uye Canadian Heart Rhythm Society (CHRS). Heart Rhythm 2012; 9: 1006.