Iyini i-reentrant arrhythmia?
I- tachycardias engenawo emndenini yimizi ye- arrhythmias ye- cardiac esheshayo ebangelwa ukuxhumana okungavamile kagesi enhliziyweni. Lezi zixhumanisi ezingavamile zakha ama-circuits angase abe namandla kagesi, okungaphazamisa isigqi senhliziyo evamile.
Ngomculo wenhliziyo evamile (okubizwa ngokuthi isigqi sesisindo esivamile ), umfutho wegesi wegesi uvela esivumelwaneni se - sinus , futhi usakazeka ngokulinganayo emakamelweni ase-atrial yenhliziyo (okwenza ukuba i-atria ingene), bese uqhubekela phambili ukusabalalisa ngokufanayo ngaphesheya kwenhliziyo Amakamelo angenawo amandla (okwenza ukuba ama-ventricles asebenze).
Emasekhondini ambalwa emva kwalokho umfutho omusha kagesi ukhiqizwa nge-node yesusus, futhi ukulandelana konke kuphinda.
Kodwa-ke, uma isifunda esingaba khona kagesi sisenhliziyweni, i-reentrant arrhythmia iba khona. I-arrhythmia ephindaphinda iyenzeka uma enye yezimfutho zikagesi (noma isisindo esivamile se-sinus, noma umfutho ongavamile kagesi owenziwe yinkimbinkimbi ye-atrial yangaphambi kwesikhathi (PAC) noma i -complex ventricular complex (PVC) ), ungena kwesifunda ngaphansi kwesokudla nje izimo. Ukuzizwa okunjalo kungaba "ukuthunjwa" ngaphakathi kwesifunda, ngendlela yokuthi iqala ukuqala ukuzungeza isifunda, ngokuphindaphindiwe. Ngogqoko ngalunye oluzungeza isifunda, umfutho uveza inhlitiyo entsha yenhliziyo. Lesi simiso esisha, esingavamile sibizwa ngokuthi i-reentrant arrhythmia (ngoba umfutho wegesi "ungena kabusha" ngesifunda ngasinye ngebhethri ngalinye).
Njengoba kungekho-khefu phakathi kwezinyosi zenhliziyo phakathi ne-arrhythmia ephindaphindiwe (ngenxa yokuthi izimpukane zomsakazo ziqhubeka ngokuzungeza isifunda), ngokuvamile izinga lokushaya kwenhliziyo ngesikhathi sokuvuselela kabusha okusheshayo. (Okungukuthi, i-tachycardia ikhona.)
Izinhlobo zeReentrant Tachycardia
Kunezigaba ezimbili ezibanzi zama-tachycardias angenawo ama-tachycardia (ama-tachycardia angaphezulu) (SVT) ; kanye ne -tachycardia ye-ventricular (VT) kanye ne-fibrication ye-ventricular (VF) .
I-Reentrant Supraventricular Tachycardias
Ukuxhumana okungavamile kagesi okwenza ukuba i-SVT ihlale ikhona kusukela ekuzalweni - ngakho-ke lezi zi-arrhythmias zivame ukubonakala kubantu abanempilo, abasha. I-SVT engena kabusha ingabangela izimpawu eziphawulekayo, kodwa ngokuvamile ayingozi noma isongela ukuphila. Izinhlobo ezihlukahlukene ze-SVT ngokuvamile zibizwa ngokuthi zihambelana nesimo se-reentrant circuit esibaveza. Izinhlobo ezinkulu ze-SVT zifaka:
- I-Sinus node reentrant tachycardia (i-SNRT) , lapho isifunda esivela khona sihilela i-node yesusus.
- I-AV nodal reentrant tachycardia (AVNRT) , lapho isifunda esivela khona sihilela i- AV node .
- I-revenrant reachrant tachycardia, lapho i-reentrant isifunda ikhona ngaphakathi kwe-atria.
- I-Atrioventricular reentrant tachycardia (AVRT) , lapho isifunda esivela khona siqukethe ukuxhuma kagesi ("i-bypass tract") phakathi kwe-atria nama-ventricles. Kunezinhlobo eziningana ze-bypass-tract reentrant tachycardia, kodwa eyaziwa kakhulu yiWolff-Parkinson-White syndrome (WPW) .
- I-flutter ye-Atrial , okuyinto ekhethekile ye-rerialrant reachrant tachycardia lapho i-reentrant circuit isikhulu ngokukhethekile.
- I-fibrillation ye-atrial ngokuvamile ibhekwa njengeyodwa ekhethekile ye-atrial tachycardia lapho i-circuits ephindaphinda khona ingathuthuka.
I-fibrillation ye-atrial ihluke kwezinye izinhlobo ze-SVT ephindaphindiwe ngoba ngokuvamile akubangelwa ukungajwayelekile kokuzalwa komzimba kagesi, kodwa kunalokho kubangelwa ukuthuthukiswa kwezinkinga zenhliziyo ezingaphansi. I-fibrillation ye-atrial ngokuvamile ibonakala kubantu abadala njengoba kunezinye izinhlobo ze-SVT.
I-Reentrant Tricycardias ye-Ventricular
Ngokungafani ne-SVT, ukuxhumeka okwengeziwe kagesi okukhiqiza i-VT noma i-VF ngokuvamile akukhona kusukela ekuzalweni. Esikhundleni salokhu, lokhu kuxhumene kubangelwa ukuhlukumeza kwenhliziyo eyenzeka ngezinhlobo ezithile zesifo senhliziyo (ikakhulukazi isifo somzimba we-coronary - CAD - noma ukuhluleka kwenhliziyo ).
Lokhu kusho ukuthi abantu abajwayele ukuthuthukisa i-VT noma iVF bavame ukudala, futhi bavame ukuba nesifo senhliziyo esibucayi esibalulekile. Ngeshwa, ingozi yokuba ne-VT noma i-VF ivame kakhulu ku-CAD nokuhluleka kwenhliziyo, futhi yingakho abantu abaningi abanezimo bezwa ukufa okuphazamiseka kwenhliziyo.
Imithombo:
Antzelevich C. Izindlela eziyisisekelo zokuhlelwa kabusha kwe-arrhythmias. I-Opinion Yamanje Ngo-Cardiology 2001, 16: 1-7
Xhumanisa i-MS. Umkhuba wokwelapha. Ukuhlolwa nokuphathwa kokuqala kwe-tachycardia engaphezulu. N Engl J Med 2012; 367: 1438.