Fibrillation - menene wannan? paroxysmal atrial fibrillation

Shin ka taba samun lokacin da lokacin da zuciya fara doke gargada? Ko, a akasin haka, shi ragae saukar? Ana sa a ji na tsoro da tashin hankali, da ke sa mu yi tunani game da wani kari zuwa asibiti. Likitoci da definition ga kowane jihar, ciki har da wannan manufa. Fibrillation - shi ne wani nau'i na cardiac arrhythmias. A cardiology yi irin haka ba nadiri, don haka shi ne game da su za mu yi magana a yau.

Definition da kuma ruwan dare

Akwai kimiyya definition irin wannan hali na zuciya. Fibrillation - shi tachyarrhythmia, wanda aka hada tare da m lantarki hasken dake fitowa daga atrial aiki. Su mita iya isa ɗari bakwai lashe minti daya, da kuma a wani kudi hadewa rage zama ba zai yiwu ba.

Atrial fibrillation ne daya daga cikin mafi tartsatsi siffofin arrhythmias. Dogara da shi za a iya ƙaddara kawai da sakamakon electrocardiography. Akwai halayyar ãyõyi: babu sinus kari, bayyanar f-kalaman (atrial flutter). Gajartatattun mita dogara a kan kaddarorin da atrioventricular kumburi, da kuma na ayyuka na autonomic juyayi tsarin a hade tare da kwayoyi.

Masana sun yi da'awar da cutar zuwa kwayoyin raunuka na zuciya tsoka. M contractions daga cikin zuciya gubar zuwa Sistem matsaloli da kuma hadarin da ya faru na emboli. Wannan sabon abu da ake dangantawa da high mace-mace da cutar.

rarrabuwa

Akwai da wadannan siffofin atrial fibrillation:

1. Da farko wahayi. Irin wannan ganewar asali da aka yi, idan haƙuri ba a baya nemi taimakon likita domin atrial fibrillation.
2. Paroxysmal. Attack flutter yana ba fiye da mako guda (yawanci kwana biyu) da kuma gudanar da kansa.
3. M. Hare-hare ci gaba fiye da kwana bakwai.
4. Long m. A hari yana goma - watanni goma sha biyu, amma likitoci yanke shawarar mayar da kari.
5. Dindindin. Atrial fibrillation faruwa duk lokacin, amma da kari na maido a farkon matakai da aka ba da za'ayi, sa'an nan ya juya m.

A cewar mai tsanani daga atrial fibrillation cututtuka kasu kashi hudu azuzuwan:

1. Asymptomatic.
2. M rashin jin daɗi ba tare da karya aiki.
3. Mai tsanani bayyanar cututtuka da shafi rayuwa ta'aziyya.
4. Tawaya. A wannan yanayin, da mãsu haƙuri ba zai iya kula da kansa ga wani.

Dangane da mita na bugun jini likitoci rarrabe tachy, kuma normo bradisistolicheskuyu nau'i na cutar.

hadarin dalilai

zuciya fibrillation bayyana a cikin marasa lafiya da suke da predisposition zuwa gare shi. Ta iya wadda ta gabãta daga daban-daban cardiac matsaloli:

- hauhawar jini.
- zuciya rashin cin nasara.
- samu mitral bawul.
- nakasar malformations na daban-daban etiologies.

An muhimmiyar rawa aka buga da dilated cardiomyopathy, jijiyoyin zuciya jijiya cuta, kullum kumburi cututtuka na zuciya membranes, kazalika da siffofin maruran. Paroxysmal atrial fibrillation a mutane a ƙarƙashin da shekaru, shekara arba'in na iya faruwa a ware su daga sauran cututtuka.

Bugu da kari, akwai jerin pathologies, wanda daidai da shafi da ya faru na atrial fibrillation, amma su ba su da alaka da aikin na zuciya da jijiyoyin jini tsarin:

- kiba.
- ciwon sukari.
- kullum obstructive na huhu cuta.
- ƙara ayyukan da thyroid gland shine yake.

Idan haƙuri ne damuwa iyali tarihi, wato, tsakanin kusantar dangi, akwai mutane da atrial fibrillation, chances cewa cutar zai bayyana a cikin proband, ya karu da kashi talatin.

pathogenesis

Fibrillation - shi ne m twitching na tsokoki, a cikin wannan yanayin na zuciya. Organic cuta taimakawa wajen tsarin canje-canje a cikin ilimin halittàr jiki da zuciya da kuma sa wani take hakkin da madugu na lantarki hasken dake fitowa. Wannan shi ne saboda kara yawa na connective nama da kuma m fibrosis. Wannan tsari progresses, tabi dissociation jijiya zaruruwa haka fibrillation ta ci gaba.

Doctors la'akari da dama shiriritar game da yadda za a can paroxysmal nau'i na wannan cuta. Mafi na kowa ne ka'idar foci da mahara tãguwar ruwa. Wasu masana kimiyya fi son a hada duka biyu versions, tun ba shi yiwuwa a rarrabe ƙarshen tafin kafa dalili da cutar.

A cewar wannan mahanga ta farko (mai da hankali) a cikin myocardium auku jam'i na foci na lantarki aiki, wanda ake dake kusa da manyan tasoshin da atrial mayar da bango. A tsawon lokaci, da suka shafi dukan yankin na atria. Sannan mahanga ta biyu postulates cewa fibrillation ne sakamakon m maras wata-wata da kuma manyan yawan kananan kalaman zumudi.

Alamun da Matsalolin

Paroxysmal atrial fibrillation iya zama asymptomatic idan hemodynamic disturbances cika isasshe. Yawanci, marasa lafiya koka a ji na m palpitations, ciwon kirji, ko rashin jin daɗi a cikin yankin.

Da wannan bango, m zuciya rashin cin nasara, wanda aka asibiti bayyana dizziness, aka rufe da mãgãgi da nakasa daga 'ya'yan numfashi. Wani lokaci, a lokacin da akwai wani hari a marasa lafiya ya karu mita na urination. Masana sun sanyã wannan da karuwa a yawan natriydiureticheskogo gina jiki.

Ma'ana, akwai iya zama bugun jini gaira, lokacin da yawan zuciya rate ya wuce yawan bugun jini tãguwar ruwa wanda propagate ga periphery. Idan wani asymptomatic nau'i na fibrillation na farko "kararrawa" na iya zama wani bugun jini.

Long gudãna atrial fibrillation wuya da zuciya rashin cin nasara, thrombosis na manyan da kananan tasoshin zuciya ko kwakwalwa.

bincikowa da

Atrial fibrillation - wani m tare da la'akari akan rage cardiomyocytes. Da farko, likita tattara tarihin cutar da rayuwa, zai sami fita da kwanan wata na farko hari, gaban hadarin dalilai, kazalika da koyi game da magunguna da cewa haƙuri daukan a wannan lokacin. Marasa lafiya ba koka, sai nuna wannan Pathology amfani instrumental hanyoyin. Wadannan sun hada da duban dan tayi, Holter ECG da kullum saka idanu. Fibrillation aka bayyana ta da wadannan siffofin musamman:

- rashi na P kalaman (babu sinus kari).
- bayyanar f-tãguwar ruwa na atrial fibrillation.
- unequal jinkiri tsakanin hakora R.

A wannan hanya za a iya gane cardiac comorbidities :. tsokar zuciya infarction, arrhythmia, da dai sauransu dan tayi jarrabawa aka yi don gano da kuma tabbatar da kwayoyin cututtukan zuciya, da kuma tsokar bango kauri ma'aunai, da girma daga cikin atria da ventricles. Bugu da kari, da allon da kyau a bayyane parietal thrombi da kuma ciyayi a kan bawuloli.

Bugu da kari, bayan da farko episode na atrial fibrillation likita ta zayyana wani gwajin for thyroid hormone matakan ware ta Hyperactivity.

anticoagulation

A wannan lokaci mai karatu yana da wani ra'ayin abin da kuma yadda akwai atrial fibrillation. Jiyya directed zuwa ta kawar, ko etiological dalilai, ko leveling bayyanar cututtuka.

Anticoagulants, watau jini thinning magani, an nuna don rigakafin da jini clots kuma saboda haka shanyewar jiki da kuma zuciya harin. A mafi kowa daga kwamfutar hannu tsari - shi ne "Warfarin" da "asfirin". A nada wannan kungiyar da kwayoyi likita ya wadãtu da haƙuri da propensity zuwa thrombosis, hadarin ischemia a nan gaba, kuma ko da haƙuri contraindications to irin wannan far.

Yana da muhimmanci a tuna cewa a cikin yin amfani da anticoagulants wajibi ne a kullum saka idanu da INR (kasa da kasa bisa al'ada rabo). Wannan damar isa lokaci zuwa dakatar da miyagun ƙwayoyi da kuma rage hadarin zub da jini.

kari iko

Fibrillation na zuciya a mafi yawan lokuta da yanayin ne reversible. Idan daga farkon harin ya dauki wani lokaci kadan, wani likita zai iya maido da sinus kari. Wannan za a iya yi tare da directional sallama lantarki halin yanzu ko antiarrhythmic kwayoyi.

Da farko, da zuciya rate an rage ko tashe zuwa ɗaya da ɗari lashe minti daya. Sa'an nan kuma ka bukatar ka yi la'akari da hadarin da thromboembolism, don haka makwanni uku kafin hanya, da kuma wata guda bayan da haƙuri sami anticoagulant far. Amma duk da wannan ne kawai dole a yayin da wani hari na atrial fibrillation yana fiye da kwana biyu ko duration ba za a iya kafa. Idan an san cewa tun farkon m contractions daga cikin zuciya a kasa da arba'in da takwas hours more, ko haƙuri ya m hemodynamic rashin zaman lafiya, da kudi saukarwa ne da za'ayi gaggawa, gudanar low kwayoyin nauyi heparin.

1. Banana cardioversion. Wannan shi ne wani wajen m hanya da bukatar nutsewa a cikin haƙuri na likita mafarki. A zamani defibrillators sallame synchronous da R-kalaman a kan ECG. Wannan zai kawar mai haɗari na ramin zuciya fibrillation. Fara yawanci tare da mutum ɗari da joules, kuma idan ya cancanta kowace m sallama an tashe shi zuwa hamsin Joules. Wannan biyu-lokaci model. Single-lokaci sallama nan da nan sanya ɗari biyu joules, a matakin qarshe a cikin hudu.
2. Drug cardioversion. Domin kwayoyi da cewa zai iya shafar zuciya kari, sun hada da "Procainamide", "Amiodarone", "Nibentan" da "Propafenone".

Don hana maimaita hare-hare na atrial fibrillation bayan cardioversion nada ta antiarrhythmic kwayoyi, wanda da mãsu haƙuri dole dauki watanni, ko ma shekaru.

bugun jini iko

Duk aka sani siffofin atrial fibrillation unsa take hakkin da zuciya rate. Saboda haka, likitoci sun yi zato far kawar da alama. Yana amfani da kwayoyi da cewa zai iya rage zuciya rate. Wadannan sun hada da:

- beta-blockers.
- alli tashar blockers.

Tare da ineffectiveness daga wadannan magunguna gudanar kungiyoyin "Amiodarone" ko "Dronedarone". Irin wannan far iya rage bayyanar cututtuka na arrhythmia, amma cire shi gaba daya shi ne, ba iya.

Idan magani ne m, likitoci wani lokacin koma ga catheter ablation. Domin ya kula sinus kari, duk m shafukan bukatar da za a magance. Tare da radiofrequency bincike cardiac likita kunama filin ware daga juna, da hana yaduwar lantarki tãguwar ruwa.

Akwai wani hanya a wanda hallaka ganglion tsakanin atrium da ventricle. Wannan halitta ta wucin gadi mai gangara zuciya block. Sa'an nan wannan haƙuri shukakkun wucin gadi introducer na kari, wadda iko da yawan balli. Da ingancin rayuwa da haƙuri inganta markedly, amma tsawon ransa ba ya canzawa.

Atrial fibrillation bayan cardiac tiyata

Paroxysm na atrial fibrillation kamar yadda zai yiwu bayan tiyata a kan zuciya. Wannan shi ne daya daga cikin mafi m rikitarwa ci karo da bayan irin wadannan ayyuka. A pathophysiology wannan yanayin ne daban-daban daga abin da samu a al'ada marasa lafiya da atrial fibrillation.

Bugu da kari da na al'ada hadarin dalilai, da mãsu haƙuri ne ionic dissociation, wato wani karu a potassium matakan, rage jini girma, inji rauni daga cikin zuciya tsoka, kuma busa na atria. Duk wannan tsokani da kunnawa da wata barã'aa cikin nau'i na najumla cascade tsarin halayen. Ya zo a saki mai kumburi shiga tsakani, ruri daga m juyayi tsarin, kazalika da tashin hankali hadawan abu da iskar shaka dauki. Duk wannan shi ne jawo factor for farkon atrial fibrillation.

Saboda haka, lura da post-gudanar da rikitarwa fara da gyara na duk na sama matsaloli. A saboda wannan dalili, beta-blockers, "Amiodarone", steroids da kuma wadanda ba steroidal anti-kumburi kwayoyi.

Forecast da shawarwari

A mutum na iya kauce wa irin wannan hatsari ganewar asali, kamar yadda "atrial fibrillation". Yabo da likitoci ne quite sauki da kuma m. Wajibi ne a kai da lafiya salon, rage cin abinci, kauce wa cutar hawan jini a sama da ɗaya da ɗari da arba'in. Wadannan uncomplicated ayyuka ba kawai ya hana abin da ya faru na atrial fibrillation, amma kuma taimakawa wajen hana sauran zuciya cututtuka.

Hakika, muna bayar da shawarar quitting shan taba da kuma rage barasa amfani. Domin karfafa receptacles, cardiologists tambaye su sami isasshen adadin abin da ake ci da muhimmanci m acid, ko dauki capsules da kifi mai.

Jiyya na kwayan da kwayar cututtuka ne su bi ta hanyar ba, ko kai da kanka ka subjectively ji mai kyau.

A hadarin bugun jini a cikin mutane tare da atrial fibrillation ƙaruwa zuwa da shekaru hamsin da biyar da cent, da tamanin - ashirin. Daya a shida ruwaito a bugun jini a duniya an lura a marasa lafiya tare da ganewar asali "atrial fibrillation".