I-flutter ye-atrial iyimigomo yezinhliziyo ezihlobene ngezindlela eziningi ekufayeleni i-atrial fibrillation . I-flutter ye-atrial ibhekene nemisuka kagesi ephuthumayo kakhulu evela e-atria, eholele esilinganisweni senhliziyo esivame ukuba yingxenye yesigamu se-atrial. E-flutter ye-atrial, isilinganiso se-atrial ngokuvamile sizungeze ama-beats angu-300 ngomzuzu, futhi isilinganiso se-ventricular sizungeze izinsimbi ezingu-150 ngomzuzu.
Ngenxa yokuthi lesi sigamthmia sivela e-atria, kubhekwa njengendlela ye -tachycardia engaphezulu .
Sibutsetelo
I-flutter ye-Atrial iyinhlobo ye- reentrant arrhythmia ; kwenzeka lapho umfutho wegesi uqala "ukuboshwa" esiteshini ngaphakathi kwenhliziyo, futhi uqala ukuzungeza nxazonke futhi uzungeze leso sifunda. Nge-flutter ye-atrial, i-reentrant isifunda esikhulu kakhulu esivame ukutholakala ngaphakathi kwe-atrium efanele, futhi ngokuvamile evame ukulandela indlela yokuziphatha.
Leli qiniso livame ukwenza i-atrial flutter ngokukhethekile ngokufanelekayo ukwelashwa kwe-ablation . Ngokudala ukuvinjelwa endaweni ethile ngaphakathi kwalowo mzila, indlela yokuvuselela ingaphazanyiswa, futhi umcibisholo we-atrial awukwazi ukuvela.
Izimpawu
Ukushaya kwenhliziyo okusheshayo okuvame ukukhiqizwa yi-flutter e-atrial ngokuvamile kuvame ukuholela ekugqibeleni , ukuzondwa , ukukhathala, kanye nokudabuka (ukuphefumula).
Njengama-arrhythmias amaningi aphindaphindiwe, iziqephu ze-flutter ye-atrial zivame ukuza futhi zihambe ngokuzumayo ngokungazelelwe.
Uma isiguli esinomkhuhlane we-atrial sine- artery disease , isifo senhliziyo esisheshayo singakwazi ukubeka ukucindezeleka okwanele kumisipha yomzimba ukudala i- angina . I-flutter ye-Atrial ingase idale nokungazelelwe kwezimpawu kubantu abanesifo senhliziyo .
Ukubheka
Ngenxa yokuthi izimpawu ezikhiqizayo zingenakubekezeleleka, ukuqhuma kwe-atrial kuzoba yi-arrhythmia ebalulekile ngisho noma konke okwenzayo kubangele ukuphazamiseka, isizungu no-dyspnea.
Kodwa inkinga enkulu ehlobene ne-flutter ye-atrial yilokho, njengoba kunjalo nge-fibrillation ye-atrial, lokhu ku-arrhythmia kuvame ukudala ukwakheka kwe-thrombus (ama-clots egazi) ku-atria. Lezi zindwangu zegazi zingakwazi ukugqamuka ( ukufaka embolize ) futhi zidale imivimbo . Ngakho abantu abane-flutter ye-atrial, njengalabo abane-fibrillation e-atrial, banengozi enkulu kakhulu yokushaywa yisifo.
Ngaphezu kwalokho, imfucuza ye-atrial ngokuvamile ivame ukuba "i-bridge arrhythmia" ekufubeni kwe-atrial. Okusho ukuthi abantu abanomkhuhlane we-atrial bazovame ukuqhubeka nokuthuthukisa i-fibrillation engapheli.
Izingozi Zezingozi
Ngesikhathi noma ubani engase athuthukise i-flutter ye-atrial, akuyona isimiso esivamile. Ngokuvamile kakhulu, isibonelo, kunokwakheka kwe-atrial fibrillation.
Abantu abazokwazi ukuthuthukisa imfucumfucu ye-atrial kukhona okufanayo futhi okungenzeka kakhulu ukuthuthukisa i-fibrillation ye-inrial. Lezi zibandakanya abantu abakhuluphele, noma abanesifo samaphaphu (kufaka phakathi i- pulmonary embolus ), i- apnea yokulala , isifo se-sinus syndrome , i- pericarditis , noma i- hyperthyroidism . I-flutter ye-Atrial iyabonakala kubantu abaye bahlinzwa ukuhlinzwa kwenhliziyo.
Ukuxilongwa
Ukuqaphela ukuqhuma kwezilwane zasemgwaqweni kuyaqondana kahle. Ivele idinga ukuthatha i-arrhythmia ku- ECG , futhi ifuna lokho okubizwa ngokuthi "amagagasi e-flutter." Amagagasi e-Flutter ayimpawu ezivela ku-ECG ezimele umfutho wegesi ojikelezayo nxazonke futhi ezungeze isifunda se-reentrant esifundazweni.
Ukwelapha
Ngaphandle kokukodwa okuphawulekayo, ukwelashwa kwe-flutter ye-atrial kufana nokufana ne-fibrillation ye-atrial. Lokhu okunye okuwukuthi, uma kuqhathaniswa ne-fibrillation ye-atrial, ukusebenzisa i-ablation therapy ukuze kuqedwe ukuqhuma kwe-atrial kulula ukuyifeza.
Iziqephu eziqhamukayo
Ezigulini ezinesichungechunge esiyinkimbinkimbi, i-flutter ye-atrial ingamiswa ngokushelela kalula nge- cardioversion kagesi, noma ngokuphatha kabi izidakamizwa ezithintekayo (ngokuvamile, ibutilide noma i-dofilide).
Uma izimpawu zinzima ngesikhathi sesiqephu esiyinkimbinkimbi, ukunciphisa izinga lokushaya kwenhliziyo kungadingeka ngenkathi kwenziwa amalungiselelo okuphefumula. Lokhu kungavame ukufezwa masinyane ngokuhlinzeka ngamanani amancane we- calcium blockers diltiazem noma i-verapamil, noma i- beta blocker esmolol esebenza ngokusheshayo. Lezi zidakamizwa kumele zisetshenziswe ngokucophelela, noma kunjalo, kuziguli ezinesifo senhliziyo.
Ukwelashwa Kwesikhathi Eside
Uma kwenzeka isiqephu esiyinkimbinkimbi, isinyathelo esilandelayo ukuzama ukucindezela ezinye iziqephu ze-flutter ye-atrial. Kulokhu kubalulekile ukubheka, nokuphatha, noma yisiphi isizathu esibangela ukuguqulwa, njenge-hyperthyroidism, i-apnea yokulala noma ukukhuluphala. Ngokuvamile i-Hyperthyroidism ilawulwa ngokwanele ezinsukwini ezimbalwa, futhi ukuphefumula ukuphefumula nakho kuvame ukwelashwa ngaphakathi ngesikhathi esifanele. Nakuba ukukhuluphala kuyimbangela eguquguqukayo ye-flutter ye-atrial, ngendlela engokoqobo ngokuvamile ayiguquki ngokwanele noma ngokushesha ukuze kuzuze ukwelashwa kwalesi sigamu - ngakho-ke ezinye izindlela zokuzilawula kufanele zisebenzise.
Uma kungabikho imbangela eguquguqukayo etholakala, kutholakala ukuthi ukwelashwa okungajwayelekile okungavamile. Ukwelashwa okungapheliyo kwe-flutter ye-atrial ngokuvamile kubandakanya ukucindezela i-arrhythmia ngezidakamizwa, noma ukusebenzisa i-ablation therapy.
Izidakamizwa zokulwa ne-antiarrhythm zinezinga eliphansi lokuphumelela nge-flutter ye-atrial - kuphela 20% kuya ku-30% yeziguli eziphathwe izidakamizwa zilawulwa ngempumelelo ngemva konyaka wokwelashwa. Ngenxa yalesi sizathu, futhi ngenxa yezidakamizwa eziningi ezivame ukwelashwa kwezidakamizwa, i-ablation therapy iyindlela yokwelashwa okukhethwa yi-flutter ye-atrial.
Ngenhlanhla, njengoba kuphawuliwe ekuqaleni, ukuchithwa kwe-flutter yase-atrial ngokuvamile kuyinkqubo eqondile, ngokuphumelela kakhulu kwempumelelo - okungaphezu kuka-90%. Eziningi zeziguli ezine-arrhythmia, i-ablation kufanele icatshangwe ngokuqinile.
Njengoba ukuhlukunyezwa kwemisebenzi kusebenza kahle, ukusebenzisa "isu lokulawula isilinganiso" (ngokuvamile elisetshenziselwa ukucubungula i-atrial) akudingeki ukuthi kudingeke ukuba kusetshenziswe umthamo we-atrial flutter. Isu lokulawulwa kwezinga lisho ukuvumela ukuhlelwa kwe-arrhythmia ukuba kwenzeke, nokulawula isilinganiso senhliziyo esiphumele, ukunciphisa izimpawu.
Ukulawula izinga lokushaya kwenhliziyo ku-flutter ye-atrial kunzima nakakhulu kunalokhu kubhekwa kwe-atrial fibrillation, futhi ngokuvamile kudinga ukusebenzisa inhlanganisela ye-beta blockers ne-calcium blockers. Ngesinye isikhathi, ukuthola izinga lokushaya kwenhliziyo kuyadingeka ukuba uqede uhlelo lokuziphatha oluvamile lwe- heart ukudala i- heart block , bese ufaka i- pacemaker ukudala isilinganiso senhliziyo esinqinile. Ngokusobala, ukukhipha umcibisholo we-atrial ngokugcwele ngenqubo yokuphumula kubhekwa inkambo yezenzo ezithandekayo kakhulu.
Ezimweni lapho amasu okulawula isilinganiso esetshenziswa khona, noma kunjalo, ukuphathwa kwe-anticoagulation engapheli kunconywa ukuvimbela isifo, njengoba kuhambisana nokufibhala kwe-atrial.
Imithombo:
I-Wellens HJ. Ukuphathwa kwe-Contemporary of flutter atrial. Ukujikeleza kuka-2002; 106: 649.
U-Granada J, u-Uribe W, u-Chyou PH, no-al. Isimo kanye nokubikezela kwe-flutter ye-atrial kubantu abaningi. J Am Coll Cardiol 2000; 36: 2242.