Okufanele ukwazi mayelana nale fomu evamile ye-SVT
Abantu abathola ama-epidode okuzumayo we- tachycardia (amazinga wenhliziyo ephuthumayo), avame ukuba neyodwa yezinhlobonhlobo eziningi ze -tachycardia (SVT) ezingaphezulu. Igama elithi "SVT" lihlanganisa izinhlobo ezihlukahlukene ze- arrhythmias zenhliziyo ezivame ukuqala futhi zimise ngokuzumayo, okuhlala njalo kungesongela ukuphila, kodwa lokho kungaphazamisa kakhulu empilweni yakho.
I-Atrioventricular reentrant tachycardia (AVRT) yilona hlobo lwesibili oluvame kakhulu lwe-SVT, elibalinganiselwa ku-30% lwawo wonke ama-SVTs.
Kuyini i-AVRT?
I-AVRT uhlobo lwe- tachycardia ephindayo . Njengoba kunjalo nakuwo wonke ama-SVTs angenawo, abantu abane-AVRT bazalwa benokuxhumana okungavamile kagesi enhliziyweni. Ku-AVRT, uxhumano oluthe xaxa, oluvame ukubizwa ngokuthi "indlela yokufinyelela," luhlanganisa uxhumano kagesi phakathi kweyodwa ye-atria (amakamelo aphezulu enhliziyo), kanye neyodwa yezingqimba (amakamelo aphansi enhliziyo).
Ngokuvamile, ukuxhuma kuphela kogesi phakathi kwe-atria kanye ne-ventricles yiyona ndlela evamile yokuqhuba inhliziyo, equkethe i- AV node kanye nesikhwama Sakhe.
Ngakho-ke, kubantu abano-AVRT, indlela yokuthola izinto inikeza uxhumano lwesibili kagesi phakathi kwe-atria nama-ventricles. Lokhu kuxhumana kwesibili kusetha isifunda esingase sibe khona sokusungula i-tachycardia ephindaphindiwe.
I-AVRT isebenza kanjani?
Kumuntu onendlela yokufinyelela, isiqephu se-AVRT singabangela ukushaya kwenhliziyo ngaphambi kwesikhathi, noma ukuvinjelwa kwe-atrial ngaphambi kwesikhathi (PAC) noma ukuvinjelwa kwe-ventricular ngaphambi kwesikhathi (PVC) .
Le beat beat ngaphambi, uma kwenzeka ngesikhathi esifanele, kungabangela ukuqhubeka (noma reentrant) umfutho kagesi.
Lo mphumela uhamba phansi ohlelweni olujwayelekile lokuqhuba ama-ventricles, bese uhambela emuva indlela yokufinyelela ku-atria (okungukuthi, "ukubuyisela" i-atrial), bese uphenduka futhi uhlehle emuva ohlelweni olujwayelekile lokuqhuba, njalo njalo.
Ngakho-ke, isigqoko esisodwa ngaphambi kwesikhathi sakha i-tachycardia engazelelwe.
Izimpawu ze-AVRT zijwayelekile kwi-SVT. Ngokuvamile zibandakanya amaphupho , izinwele ezikhanyayo , kanye / noma isizungu . Iziqephu ngokuvamile zihlala emaminithini ambalwa kuya emahoreni amaningana.
I-AVRT ingayeka kanjani?
I-AVRT ingamiswa yi-PAC, i-PVC, noma nje ngokunciphisa ukuqhutshwa kagesi ngokusebenzisa i-AV node. Noma iyiphi yalezi zenzakalo zingaphazamisa ukuphindaphindiwe kabusha.
Iqiniso lokuthi ukunciphisa ukuqhutshwa kwe-AV node kungayeka i-AVRT inike umuntu ngalokhu kuhlela ithuba lokwenza luhambe. Leli thuba linenzuzo yokuthi i-AV node ihlinzekwa ngokucebile yi- vagus nererve . Ngakho-ke, abantu abane-AVRT bangakwazi ukuyeka isiqephu esiyinkimbinkimbi ngokuthatha isenzo sokwandisa ithoni lezinzwa zabo. Lokhu kungenziwa, ngokwesibonelo, ngokwenza umkhondo we- Valsalva , noma ngokugwinya ubuso bakho emanzini e-ice imizuzwana embalwa. (Ukuhamba kwe-Valsalva kuyashesha, okulula kakhulu, futhi okungajabulisi kunokuba ubhekene namanzi.)
I-AVRT ne-Wolff-Parkinson-White Syndrome
Kwamanye abantu abane-AVRT, indlela yokufinyelela iyakwazi ukwenza imishini kagesi kunoma yikuphi ukuqondisa (okungukuthi, kusukela ku-atrium kuya kwe-ventricle njengoba sekushiwo kakade, noma kusukela e-ventricle kuya ku-atrium). Kwabanye abantu, indlela yokufinyelela ingakwazi ukuqhuba ukufundwa kagesi kwesinye isiqondiso noma enye.
Lo umehluko uba obalulekile. Kubantu abaningi abane-AVRT, izimpendulo zingahamba ngaphesheya kwendlela yokufinyelela kusuka ku-ventricle kuze kufike ku-atrium.
Uma izimpendulo zikwazi ukuwela ngaphesheya - kusukela ku-atrium kuya kwi-ventricle - i- Wolff-Parkinson-White (WPW) syndrome kuthiwa ikhona.
I-WPW ihlotshaniswa nezinkinga zemitholampilo ezihamba ngaphesheya kwe "AVRT" nje, futhi ngokuvamile zidinga ukuphathwa kabi.
Ukwelapha i-AVRT
Uma ngabe i-WPW engekho futhi izimpawu ze-AVRT zingavamile futhi zimile kalula (zithi, ngokwenza u-Valsavla umshayeli), ngakho-ke akukho ukuphathwa okudingekayo ngaphandle kokufunda ukuthi benzeni uma isiqephu senzeke. Kodwa-ke, uma une-WPW, iziqephu ezivamile ze-SVT, izimpawu ezinzima ikakhulukazi ngesikhathi seziqephu, noma unenkinga yokuvimba iziqephu uma kwenzeka, khona-ke ukwelashwa okucacile kufanele kusetshenziswe.
I-antiarrhythmic therapy yezidakamizwa ivame ukuphumelela kancane ekuvimbeleni iziqephu ze-AVRT. Kodwa-ke, kubantu abaningi abane-AVRT, ukwelashwa kwe-ablation uyakwazi ukuqeda indlela yokufinyelela, futhi uvimbele ngokuphelele ezinye iziqephu. Ngezindlela zanamuhla, izindlela zokuphelisa ezithengisayo zingenziwa ngokuphumelelayo nangokuphepha kuningi lamacala.
Izwi elivela
I-Atrioventricular reentrant tachycardia (AVRT) iyinhlobo ehlukahlukene ye-SVT. Ngenkathi ivame ukuveza izimpawu ezibalulekile futhi ingabaphazamisa empilweni, i-AVRT namuhla iyaphathwa kakhulu.
> Imithombo:
> Brembilla-Perrot B, Pauriah M, Sellal JM, et al. Isigameko nokubaluleka kokubikezelwa kweTachycardia engavamile futhi engabonakali. I-Europace 2013; 15: 871.
> Chugh A, Morady F. Atrioventricular > Ama-Reentry > nama-Variants. Ku: I-Cardiac Electrophysiology kusuka ku-Cell kuya Ekubhedeni, Edition 5, > Zipes DP, Jalife J. (Eds), Saunders / Elsevier, Philadelphia 2009. p. 605-614.