Atrial fibrillation kukanganisa rhythm yemwoyo, zvichiita kuti pave nemigumisiro yakakomba. Kana kutarisa kwepfungwa kwekutsvaira kwepenzi kunowanikwa munharaunda ye sinus kana mishonga yemuviri, iyo myocardium inopedzisira ichikanganiswa, nokukurumidza. Mwoyo unoyerera unosvika 300-600 U / min. Imwe zita rehutachiona ndechekushaya ropa. Inogona kukura sechiratidzo che ischemia, angina pectoris, kukanganiswa kwemwoyo uye dzimwe zvirwere.
Mafomu e-acrial fibrillation
Chirwere chinogona kupfuurira nenzira dzakasiyana. Mune pfungwa yakawanda, zvichienderana nemhando dzekushungurudzika, fibrillation uye yeputi flutter zvakasiyana. Muchiitiko chekutanga, mapoka ega ehutanda hwepurogiramu yemutsipa yemwoyo, kupisa kunoramba kuri pahuwandu hwe 500 paminiti. Kana chirwere chinonzi atrial fibrillation chikaonekwa, kuderedzwa kwavo kurongeka hakugoneki. Rhythm ruregerero rinoramba rakarurama ne flutter, asi chibvumirano cheatria chinokurumidza kukurumidza: kusvika ku 200-400 U / min, zvisingatongogadziriswi kufamba kwemyocardium. Pause diastolic yakafupika. Mhepo dzinobhururuka dziri kushanda kupfeka uye kuchema.
Nzira uye nguva yenguva yakagadziriswa ndiyo nheyo iyo chirwere ichi chakaparadzaniswa. Akagovera maitiro akadaro ehutano se:
- nguva dzose;
- kuramba;
- paroxysmal arrhythmia .
Constant atrial fibrillation
Kusavapo kwekudzorerwa kwechitendero che sinus kunoratidzwa nechimiro chenguva dzose yeutrial fibrillation. Kurwisana kunotora kwemakore, kuvapo kwechimiro ichi kunonzi kana nguva inopera kwevhiki 2-3 kana kupfuura. Kupindira kwezvechiremba kunotungamirirwa nekudzora rwiyo hakuiti kana kusina kuitika. Inofungidzirwa kuti inogona kuchengetedza arrhythmia. Iyo yakaguma yakakosha, iyo inogona kuwanikwa kuburikidza nerubatsiro rwerapi, iri kuderera mumoyo wezinga kusvika 60-75 U / min. Varwere vanorarama nehutano hwavo kwemakore akawanda uye vanonzwa zvakanaka.
Kuramba uchiita zveperiyumu fibrillation
Apo zviratidzo zvehutano zvinopfuurira kwemazuva anopfuura 7, dzinotaura nezvemhepo inoramba ichinyanya kuitika (AF). Nzira yaro inogona kudzoka zvakare, pane zvinorwadza zvakare. Kushandiswa kwepasire pakudengenyeka kwenyika kunowanzoitika, kuwanda kweropa kunopinda mumuviri kunoderera. Izvi hazvivhundusisi upenyu, kunze kwekunge zvichienda kune dzimwe zvirwere zvepfungwa. Dzimwe nguva nguva refu inoramba iine fyria inouraya yemwoyo, iyo inopedzisira inopfuura gore, inopesana, asi kusiyana nekuramba ichiedza, kuedza kunopesana nekambani yayo uye kutora kutonga kwe rhythm.
Paroxysmal atrial fibrillation
Chimiro chakareruka che AF, icho chinowanikwa icho chekuzvidzivirira pakarepo (pasina kushandiswa kwezvinodhaka) zvechivi rwiyo. Izvi zvinokonzerwa nekuguma kwemigumisiro yechikonzero chinokonzera, somuenzaniso, kuderera mumanzwiro, kuita basa kana kupera kwemamiriro ezvinhu anonetsa. Kurwiswa kwechirwere - kuputika kwehutachiona hwemagetsi - kunogona kudzokororwa. Hondo ye mwoyo inotorwa muzuva rokutanga (24-48 maawa), iyi ndiyo nguva yakakwana yekuipedza.
Atrial Fibrillation ye Moyo - Zvinokonzera
Atrial fibrillation inokonzera mwoyo kushanda zvakanaka. Mushure mekudzoka kwezvikwereti zvinokwana (2-3), kusagadziriswa kweperiyumu inouraya inobuda. Atrial fibrillation inobatanidza nehutachiona hunokurudzira kukura kweArmhythmia, uye inogona kuitika kune vanhu vezera ripi zvaro: kusvika ku40% yematambudziko eparoxysmal uye kusvika ku25% evhuni. Kurwisa kushandiswa, sekutonga, zvirwere zvemitsipa yeropa nemutsipa wemwoyo:
- heart attack ;
- heart failure ;
- ischemia;
- hypertension ;
- atherosclerosis;
- heart defects ;
- rheumatic lesions.
Zvimwe zvinokonzera fyria inouraya inonziwo. Izvi zvinosanganisira kusina-cardiac pathologies iyo inokanganisa basa remuviri mukuru, uye zvimwe zvinokanganisa:
- zvirwere zvepapupa;
- endocrine zvinetso;
- chirwere cheshuga mellitus;
- overweight;
- doro kudhakwa;
- depression conditions;
- basa rakasimba mumuviri;
- kutora mamwe mishonga;
- kushaya potassium;
- dehydration.
Atrial fibrillation - zviratidzo
Zvichienderana nechimiro chechirwere, zvinhu zvehupenyu hwemyocardium uye hutano huzhinji, hutachiona hwehutano hunozviratidza nenzira dzakasiyana. Chirwere chemakiriniki chinopesana kubva pakuyerera kwekuyerera kusvika pakuonekwa kwakasimba kwechirwere. Zviratidzo zvingasaonekwe, somuenzaniso, ne paroxysmal arrhythmia. Asi kunyange zvakadaro, sekutonga, kuratidzwa kwekutanga kwechirwere kunooneka: kurwadziwa kune rumwe rutivi rworuboshwe rwechipfuva nekupererwa kwemweya, izvo zvisingadziri uye zororo. Zvingangodaro, zvose zvezviratidzo izvi zvinoratidza kuti paiva nefridhi yefridhi ye mwoyo, zviratidzo zvinoratidza.
Izvozvo zviratidzo zvikuru zvinonetsa kupikisa nemamwe mamiriro ezvinhu, kunyanya kana munhu akatarisana neizvi kamwe chete. Zvimwe zviratidzo zvekugumburwa:
- moyo palpitations;
- kuwedzera kutuka;
- kupera kwemakumbo;
- kunetseka;
- kuputika kwemitsipa;
- kudengenyeka;
- fainting ;
- kushaya simba mumuviri wose;
- kazhinji uye zvakanyanya kurination;
- kutyisa kutyisa, kunzwa kwekutya.
Kurwiswa kwefridhi yefridhi
Zviratidzo zvehutachiona hwehutachiona zvinogona kuitika zvisingaoneki, uye murwere anodzidza nezvehutano hwake mushure mekunge aongorora chiremba. Kurwiswa kunotanga kamwe nekudzokorora hupenyu hwose. Nguva uye nguva yakawanda yepopoxysms kune mumwe nomumwe, zviratidzo zvinonzwa nenzira dzakasiyana. Muzvinyorwa zviitiko, kune utera, kutinhira, chaotic palpitations, kutya. Nekuwedzera kwakasimba kwemaitiro emwoyo, pallor, chirungu, uye kupera kunogona kuitika.
Shingaira ne-atrial fibrillation
Imwe yenzira dzinoshandiswa neutrial fibrillation (chisinganzwisisiki kana kwete) inowanikwa ihwo hutano hwemhepo. Murwere ane urombo: iyo atrium haisi kushanda, mavhiriki haana nguva yakakwana yekuzadza izwi rinodiwa reropa. Nhamba yemwoyo inorova muchiyero haisi yakakwana nemhepo. Kana paine flutter yeAria, zviratidzo zvehutano hwakataurwa pamusoro apa zvinowedzerwa nehurumende dzisina kukwana-nokukurumidza.
Ndeipi ngozi yehutachiona hwemhuka?
Chero chero chirwere chemwoyo chinokonzerwa nezvinetso. Mune nyaya yeairrial fibrillation, zvinowanzoitika mungozi ndezvokuti thromboembolism uye mwoyo kusagadzikana. Mitral stenosis inokonzera kubudiswa kwekutengesa kweatrioventricular thrombus, zvichiita kuti mwoyo usungwe. 15% yeaschemic stroke inokonzerwa nekurhythmia. Zvinotyisidzira izvo upenyu hwehutachiona hunounza hupenyu hunosanganisira pulmonary edema, chirwere chemwoyo, cardiomyopathy (yakaderedzwa).
Atrial fibrillation - kurapa
Apo chirwere chinonzi atrial fibrillation chinoratidzwa, kurapwa kunoitwa maererano nemarayira ezvokurapa anotarirwa kudzivirira kudengenyeka kwepfungwa, normalizing moyo yemhepo, kuchengetedza sinus rhythm, kudzivirira thromboembolism. Atrial fibrillation haiporese zvakakwana, asi inodzorwa, uye vanachiremba vanoedza kudzivirira murwere kubva pakudzokazve, kudzorera rwiyo rwemoyo. Usati wapora chirwere chinonzi atrial fibrillation, unoda kuwana chikonzero chehutachiona uye kubvisa vanokurudzira, uye kubvisa zviratidzo zvekuratidzwa kwechirwere.
Atrial fibrillation - kliniki mazano
Kana pane hutachiona hwehutachiona, ndinofanira kuitei? Mazano ehutano anotsanangurwa nehutano, iyo, zvichienderana nehutano hunopisa, hunosanganisira kubvunzurudzwa kwevadzidzisi vakadaro se:
- arrhythmologist;
- the neuropathologist;
- pulmonologist;
- endocrinologist;
- cardiosurgeon.
Vanorayirazve kurapwa. Zvinangwa zvechirongwa zvehutano: kuvandudza hupenyu hwemurwere, kuwedzera nguva yaro neichi kuongororwa, kuderedza nhamba yezvipatara. Zviratidzo zvinofanira kubviswa kana kudziviswa, mwoyo rhythm uye zvinyorwa zvinyorwa zvinotorwa pasi pesimba. NeA AF iwe unogona kurarama, asi vanachiremba vanofanira kuvandudza kufungidzira.
Kugadzirira kwe-friction fibrillation
Izvo zvinobvira uye nzira yekurapa friction friction ye mwoyo nemubatsiro wemishonga here? Conservative medical therapy inoshandiswa kubudirira (10-15%). Mumatambudziko mashoma zvikuru - ciliary paroxysmal arrhythmia - yakamira ne novocaineamide, cordarone, quinidine kana parapanorm. Mishonga inotorwa nechisimba kana mumuromo, asi rubatsiro runofanira kupiwa panguva iyo, uye muzinga wekumanikidzwa unogara uchiongororwa. Chirongwa chekurapa nemimwe mishonga inotevera:
- Kuita kuti mwoyo unonoke uye kuderedza zviratidzo zvisingafadzi, kugadzirira kweboka re beta-blocker rinoshandiswa: Carvedilol, Proprorol, Pindolol, Anaprilin, nevamwe.
- Kuvhiringidzika kwemwoyo inoshandiswa neCordanon, Quinidine, Allapinin.
- Glycosides inowedzera basa remyocardium (Digoxin, Korglikon, Celanid).
- Kuumbwa kwe thrombi kunodzivirirwa neWarfarin uye Pradax uye anticoagulants Enoxaparin, Heparin, Fondaparinux.
- Zvinodhaka zvinodurura ropa - dezagreganty - zvinomiririrwa nemishonga yakadai saAspirin Cardio, Cardiomagnolo , TromboAss, nezvimwewo.
Ablation of the heart with atrial fibrillation
Kana chirwere chinodhaka chisina kupa mhinduro, kupindira kwekuvhiya kunogona. Catheter ablation ndiyo nzira yezvehutano umo hutungamiri hwerhythmia hunoparadzwa nehutano hwepanyama. Iko kushanda hakusi kushungurudza zvikuru, sezvo hazvidi kuti kuvhura kwechifuva - kungofungidzirwa zviduku chete kunogadzirwa uye catheter inowanikwa iyo inopinda kune myocardium. Izvozvo zvinogona kuitika nenzira dzakasiyana-siyana: kuburikidza nekutsva, chemikemikari, masero, magetsi, simba reredhi-frequency mafungu (RFA) ne-atrial fibrillation.
Kune marudzi akadaro ekubhadhara (kuparadzwa) se:
- ultrasound;
- laser;
- radiofrequency (cauterization ye node atrioventricular ne electrode);
- crystestruction;
- electrodestruction.
Atrial fibrillation - operation
Mune zvimwe zviitiko, hazvibviri kubvisa arrhythmia pasina kushanda. Kutsigira kukodzera kwepfungwa yemwoyo kunobatsira pacemaker - chigadziri chinogadzirisa chinokodzera pasi peganda revarwere chakakomberedza collarbone. Nenzira yechipfuva, electrode yakabatana nayo uye inopinda mukati memwoyo. Chigadzirwa chacho chinokonzera mafungiro anoita kuti mwoyo musumbu uite chibvumirano panguva yakakodzera, friction fibrillation uye ventricular fibrillation inodzivirira.
Imwe nzira yekuvhiya inoshandiswa mukuongororwa kwehutachiona hwehutachiona ndiyo "labyrinth" operation. Basa rayo nderokubvisa kusabatana mumoyo, kumanikidzira nzvimbo dzepanyika kuti dzipere muhurongwa hwakarongeka. Chiratidzo chemagetsi chinopararira nenzira yakaratidzwa - iyo inonzi "labyrinth", iyo inoumbwa nekuumbwa kwezvitsva pamwoyo medu. Zvikwangwani zvinogadzirwa kwete chete neecalpel, asiwo ne-ablation yakarondedzerwa pamusoro apa: RFA (moxibustion) uye kuchemedza (kufisa).
Atrial fibrillation - kurapwa nemishonga yevanhu
Pasinei nekuoma kwechirwere chepfungwa, kugadziridza kwacho kunobvira nekubatsirwa nemishonga yakasiyana-siyana - pamwe chete nemishonga inodhaka kana zvakasiyana, somuenzaniso, sezviyero zvekudzivirira. Kana paiva nefriday fibrillation, mishonga yevanhu inoshandiswa nekuchenjerera, pasi pekutarisirwa kwechiremba. Mushonga ndewekubatsira.
Nzira dzinobudirira dzinobva pane zvakanaka zveimwe mbeu. Muchirapa chemishonga, iwe unofanirwa kubhadhara zvinodhaka zvinogona kunonoka kuvhara uye kudzivirira zviratidzo zvegurmemia. Yakakurumbira uye inobudirira:
- Hawthorn mishonga yakanaka yemusha yekubvisa magadziro emagetsi. Kubviswa kwemuti uyu kunogona kusanganiswa ne valerian kana motherwort.
- Kuvharirwa kwembeu yemadhiri inoshandiswa zvinobudirira izvo zvinoderedza kuoma kwehutachiona.
- Kugadziriswa kwezvikoroti zveKalina zvinowanzosimudzira kukwirira kweropa, zvakanaka kunobata midziyo. Dzimwe nguva tora nouchi.
- Yarrow (mumweya tincture yemashizha) akadhakwa kaviri pazuva mupasipuni, achideredza ngozi yeropa.
Atrial fibrillation - kufungidzira kwehupenyu
Zvirwere zvepachiviri, izvo zvakakomberedzwa ne arrhythmia, kuwedzera mukana wekuuraya nekupfuura kupfuura 1.5 nguva. Nokudaro, varwere vane chirwere ichi vanofarira mubvunzo: vangani vanorarama nehutano hwehutachiona hwehutachiona? Izvi zvinotsamira pazvinhu zvakadai sezvikonzero zvinokonzerwa nehutachiona, zvinowanika uye zvinokonzerwa nezvinetso, mamiriro eyoyo myocardium uye mhepo inobhururuka. Inonyanya kuipa yeyrhythmias - inotungamirira mukukurumidza kukura kwemoyo kusakundikana. Zvinokonzerwa nekuparara kwakanyanya kwemyocardial, somuenzaniso, kurwisa kwemwoyo. Matambudziko akafanana anokonzerwa nechirwere chemwoyo, asi huporofita huri pachena.
Chero zviratidzo zvinoratidza kusakanganiswa mumoyo hazvifaniri kuregererwa. NeA AF, mutsara mukuru unotanga kudengenyeka, kurumidza kukurumidza, kusina nguva. Kutya hakugoni kudarika nguva, asi inofanira kumira. Atrial fibrillation ndiyo chirwere chinowanzoitika mu 2% yevanhu vose. Asi chirwere chakakomba chinogona kuongororwa uye kubatwa. Mishonga yemazuva ano inopa maitiro anobudirira uye matsva mukurwisa kurwisana.