Bated mweya: zvikonzero uye kurapwa

Kunyura mwoyo - kurapa chirwere ichi mumakore achangopfuura excites pfungwa dzakawanda cardiac vanachiremba vanovhiya, uye vamwe "mwoyo" pakati unyanzvi. Ndechipi chikonzero, chii zviratidzo chirwere ichi ngozi, sei kurapa nayo - Ndivo chete dzimwe nyaya ichifarirwa vomunyika yedu. Hapana chakavanzika zvikuru vakawanda vanhu vane chirwere chakadai "mwoyo kunyura". Zviratidzo, Mabatirwo chevarwere mishonga, pekuhwa- nda specialized masangano, diagnoses - izvi pfungwa dzinofanira kuongorora kuti munhu ane zviratidzo chirwere. Zvinotevera pfungwa dzimwe emwedzi wenyaya.

Bated mweya: zvikonzero uye kurapwa

Kukonzera pfungwa "kupera" iri mumwoyo basa rinogona kuva akasiyana siyana mutinhimira uye conduction nenyonganiso. Vamwe inoti izvi regai zvinoda mishonga kupindira, uye mamwe marudzi kunonoka ari kuonekwa uye kunokwanisa kuurayisa. Kusiyanisa supraventricular uye ventricular arrhythmias.

supraventricular arrhythmias

Hazvina vakurumidze Kugwina mwoyo. Chikonzero ndechokuti tsime kuti iri mune atria uye pulmonary mutsinga negomba uye atrioventricular Junction. Pashure wakadaro rutapudzo hunoshamisa anogona kuva kukwana kana zvakakwana postextrasystolic kumbomira. Kakawanda vakurumidze anorova kumbomira refu pashure yemaguta rutapudzo anogona kupa kunzwa wasvava, nokuvhiringidzirwa mwoyo.

Independent kunotoda zvinorevei siyana ava arrhythmias, kunze Muzviitiko kana kuonekwa ari kutanga kumhanya supraventricular tachycardias, atrial flutter kana atrial fibrillation.

Pasina STRUCTURAL urema mumwoyo tsandanyama supraventricular extrasystoles vavashandire haisi kuzvireva. Muzviitiko apo vari pamwe zvaikosha kuzviitira kusanzwa, Beta-blockers, verapamil, sedatives zvinogona kushandiswa.

Kazhinji supraventricular extrasystoles vari kuratidzwa huru chirwere (dystonia, chisingaperi obstructive pulmonary chirwere, electrolyte wenyonganyonga), zvino chirwere zvinoda chakagadziridzwa uye mabatiro chaicho muitiro.

Ventricular fibrillation extrasystolic

Ventricular extrasystoles - netarisiro Kugwina mwoyo pachinhu huru mutinhimira kwakamutsa kupomba yomuka makumbo kana misiyano chiputu bazi mufurati, Orion kana Purkinje kushanda myocardium. Pashure azvaiitwa yekudyidzana vangangoona kuva zvizere compensatory kumbomira, iyo, sezvo zvakaita atrial vakurumidze anorova, akanzwa muchimiro "kupera". Ventricular pezvakaitwa pasina gradation ose makemikari mwoyo chirwere hachisi chikonzero ngozi pakarepo rufu, saka untreated. Anosiyiwa vari varwere hwakanaka nhaka syndromes (vachiberekwa elongation kana kupfupikisa kuti QT, Brugada urwere, etc.).

Kunyura kwomwoyo, chikonzero uye zviratidzo izvo vanoonekwa kuitika somugumisiro isingawanzowanikwi mwoyo mutinhimira.
A zvinoitika kwemwoyo akatsunga mukati 60 kusvika 100 ukapisa murwi paminiti. Vasiri tava kuderera mwoyo munguva hope, kana kufema zvakadzama muna vatambi.

Kana kutyora chero dariro uye chizvarwa cardiac kupomba hwapedyo pathological bradycardia, izvo zvinogona symptomatic, asymptomatic, uye vakawanda vanoda kurapwa.

The zvinokonzera bradycardia

Kusiyanisa pakati pezviri uye zvimwewo zvinokonzera bradycardia.
Dzomunyika Zvikonzero dzinosanganisira:

• kukwegura
• nechirwere chemwoyo;
• connective tishu chirwere;
• vachiberekwa zvirwere, kusanganisira kusava nesimba atrioventricular raiva pedyo nebundu;
• tsandanyama amyloidosis;
• kuvhiya kunotevera (orthotics mavharuvhu, mwoyo transplantation) ;
• zvirwere (diphtheria, rheumatic mwoyo chirwere, chepfu ropa, sefivha).

Nezvinenge zvaitika kuti bradycardia dzinosanganisira:

• kurovedza muviri;
• elektrotonus vagal wakarodzwa (vasovagal kudzima magetsi, somuenzaniso, supersensibly carotid sinus);
• zvinodhaka (Beta-blockers, karusiyamu gwara blockers, digoxin, lithium, antiarrhythmic vamiririri);
• kokeini;
• hypokalemia;
• hyperkalemia;
• chetsinga zvirwere (CNS bundu, vakawedzera intracranial kumanikidzwa);
• Pakumbotadza kufema syndrome.

Nokuti nechirwere kuti bradycardia kushandiswa kuitisa Holter zvichiongororwa, chiitiko counter uye vanyori, implantable mano, uyewo kuita electrophysiological kudzidza.

Mabatirwo bradycardia

Danho rokutanga nderokuziva zvinokonzera uye zvichiita kubviswa bradikaridii zviito zvavo (discontinuation kuti Beta-blockers). Kana pasina bvisika chawo, ungada zvinodhaka jekiseni kana pfupi kana wechigarire pacing).

mishonga

Kuti akurudzire chinokosha kwemwoyo deceleration (nokuti yakareba kupfuura 3 seconds) kushandisa atropine, isoproterenol, aminophylline. Zvisinei, kudya zvinodhaka izvi kungamutsawo arrhythmias, kusanganisira upenyu pangozi ventricular vachivavhiringidza.
In varwere myocardial ischemia uye bradycardia somugumisiro, vanopedza antiischemic kurapa uye vari biding nguva yavo, vachishandisa pacing kana zvakakodzera.

Varwere mwoyo sinus chirwere kadhi uye atrioventricular misa hunoyerwa yokuisa pfupi kana wechigarire pacemaker.
Pane dzakabudirira zvairatidza European kuti kugadzwa pacemakers zvechigarire mune varwere sinus kurwara urwere, atrioventricular nechigumbuso.

dzakasiyana-siyana muviri

Kusiyanisa kuroorwa-yokuvata, hunyambiri-mukamuri,-mukamuri matatu stimulators. Iva rokutanga uye rechipiri electrodes 1 uye 2 (atrial uye / kana kurudyi ventricular). Three-yokuvata mano inoshandiswa biventrikulyatnoy activation uye vane chimwezve mutungamiriri nokuda ventricle kuruboshwe.

Kana kurudyi atrial dzishande ventricular synchronism anonetseka. The ECG panguva iyi iri Logged voga zvakanaka chiputu bazi nechigumbuso.
Pamusoro kweiyi zvose ventricles akachengetedzwa dzavo synchronous oparesheni, cardiac hemodynamics muchiitiko ichi, zvikuru nani.

muchibereko

The chikwata chokutanga kwakadaro yakatangwa muna 1958. Muna zvinotevera ndizvo shanduka yavo. Zvino rechimanjemanje, vashomashoma, yepamusorosoro namano.

Pari, pane chirimwa wepagore kubva 400 kusvika 1,200 muviri muzana miriyoni vemo.

Kardiopribor anoitisa zvemagetsi activation yacho myocardium. Chiratidzo propagates achitevedza cardiac tsandanyama nevanhu vasiri vasiri. Nokufumura kwenguva yakareba kunogona kukonzera zvemagetsi uye zvemaziso zvachinja myocardium. Installation kunodiwa kuti zvinoberekwa stimulator zvakakura zvairatidza.

Features dzishande modes

Panguva yakakodzera ventricular pacing zvemagetsi kupomba rinoshandisirwa kuruboshwe ventricular chakaderedzwa mutengo uye depolarizes medlennoprovodyaschy myocardium. The ECG kunoratidzirwa blockade pamusoro rworuboshwe tsapo yebazi nechigumbuso. Vanaamai vakadaro vane yakaderera ejection chakapatsanurwa pane varwere pasina blockade. Uyewo, kana ichi muitiro kunoitika zvemagetsi cardiac yagadziriswa. Munguva ichangopfuura, pane tsika kuderedza zvairatidza kuti kugadzwa muviri mashoko ane chokuita chinokosha nhamba kumuvengi kuchinja.

Rakavakwa kuti yakadereresa ejection chinokwana aumba pasi Zvakaitwa ventricles. Avhareji - the activation of atria, ipapo vamwe mwoyo. The chemhando akachengetedzwa ejection chikamu panguva kweiyi ari atria uye ventricles zvakasikwa anotenderera.

Kwakaratidza kuti kashoma dzakabudirira atrial fibrillation pavarwere vane atrial activation uye maviri kamuri kupfuura varwere ventricular chete zvinoitwa mudziyo.

Hunyambiri-yokuvata mudziyo, rikaratidzwa pakutsvakurudza uye kwacho, zviri nani varwere mumuviri kushingaira.
Pacemakers vari pari mureza goridhe pakurapa varwere pamwe symptomatic bradycardia. The kutsvaka anopfuurira vakawanda vasiri tichipinda Migumisiro pamusoro myocardium.

mhedziso

Nokudaro, kunyura kwemoyo (akotsira kana mune mamwe mamiriro ezvinhu) - nechirwere ngozi chaizvo. Kana zviratidzo chirwere ichi chokutanga hwobva kutaura muchipatara kuti tiite zvose miedzo uye nokungwarira zvakaipa. The anomhanya kutanga kurapwa uye kudzivirira, kuti hubudirire vachava mishonga.