I-flutter ye-Atrial iyigqirha ye-cardiac arrhythmia edibeneyo kwiindlela ezininzi ukuya kwi- fibrillation ye-atrial . I-flutter ye-Atrial ibonakaliswa yimpembelelo ngokukhawuleza kagesi ephuma kwi-atria, ekhokelela kwizinga lentliziyo eliqhelekileyo elisoloko lilinganiselwa kwisiqingatha sexabiso le-atrial. Kwi-flutter yeerriyali, izinga le-atrial lidla ngokukhawuleza li-300 beats ngomzuzu, kwaye isantya se-ventricular sinama-150 beats ngomzuzu.
Ngenxa yokuba le arhythmia ivela kwi-atria, ithathwa njengoluhlobo lwe -tachycardia engaphezulu .
Sibanzi
I-flutter ye-Atrial ngumhlobo wokuhlaziya i-arrhythmia ; kwenzeka xa umgudu wombane "uvalelwa" kwisiphaluka ngaphakathi kwentliziyo, kwaye uqala ukujikeleza ngeenxa zonke kwaye ujikeleze eso siphaluka. Nge-flutter ye-atrial, i-circuit reentrant iyinkulu kakhulu edlalwa ngaphakathi kwi-atrium efanelekileyo, kwaye ngokuqhelekileyo ilandela indlela yokuziphatha.
Eli qiniso lisoloko lenza i-flutter ye-atrial ngokufanelekileyo ngokufanelekileyo kwiprogram ye- inflation . Ngokudala ukukhutshwa kwindawo ethile kwindawo leyo, indlela yokujikeleza isenokuphazamiseka, kwaye i-flutter ye-atrial ayinakwenzeka.
Iimpawu
Isantya senhliziyo esiphuthumayo esivame ukuveliswa yi-flutter ye-atrial ngokuqhelekileyo ikhokelela ekubanjweni kweentlanzi , ukuxakeka , ukukhathala, kunye ne- dyspnea (ukuphefumla).
Njengokuba kuninzi i-arrhythmias, ii-episodes ze-flutter ye-atrial zivame ukuza zize zenzeke ngokukhawuleza kwaye zingalindelekanga.
Ukuba isigulane esinomkhuhlane we-atrial sinesifo se- coronary disease , isantya senhliziyo esheshayo kunokubeka uxinzelelo olwaneleyo kwi-heart muscle ukuze kubangele i- angina . I-flutter ye-Atrial ingabangela ukuphazamiseka ngokukhawuleza kweempawu kubantu abanesifo senhliziyo .
Ukufaneleka
Ngenxa yokuba iimpawu ezivelisayo zingenakuze zinyanzeliswe, i-flutter yearriyiti iya kuba yi-arrhythmia ebalulekileyo nangona yonke into eyenzayo yayibangela ukubethelwa, i-dizziness kunye ne-dyspnea.
Kodwa ingxaki enkulu enxulumene ne-flutter ye-atrial kukuba, njengokuba kunjalo nge-fibrillation ye-atrial, le-arrhythmia ivame ukudala ukwakheka kwe-thrombus (i-blood clots) kwi-atria. Amacwecwe egazi angakwazi ukuphazamiseka ( embolize ) kwaye enze izibetho . Ngoko abantu abane-flutter ye-atrial, njengabo abane-fibrillation ye-atrial, banomngcipheko omkhulu wengozi.
Ukongezelela, i-flutter ye-atrial ivame ukuba "i-bridge arrhythmia" kwi-fibrillation ye-atrial. Okokuthi, abantu abane-flutter ye-atrial baya kuqhubeka behlakulela ukukhupha i-fibrillation engapheliyo.
Izinto zobungozi
Nangona nabani na ongakwazi ukuhlakulela i-flutter yegazi, akusiyo i-arrhythmia evamile. Kuncinci kangako, ngokomzekelo, kunefayili ye-atrial.
Abantu abanokuthi bahlakulele i-flutter yearriyali bafana nabo banakho ukuvelisa i-fibrillation ye-agriyo. Ezi zibandakanya abantu abagqithiseleyo, okanye abanesifo somphunga (kubandakanywa ne- pulmonary embolus ), i- apnea yokulala , i- sinus syndrome , i- pericarditis , okanye i- hyperthyroidism . I-flutter ye-Atrial ibonakala nakwabantu abaye bahlinzwa ngokutsha kwentliziyo.
Ukuxilongwa
Ukuchonga i-flutter ye-venitri ngokuchanekileyo. Ifuna nje ukuthatha i-arrhythmia kwi- ECG , kwaye ifuna izinto ezibizwa ngokuthi "amagagasi e-flutter." Amagagasi e-Flutter ayimpawu ebonakalayo kwi-ECG emela umtshini wombane ojikelezayo kwaye ujikeleze i-circuit reentrant circuit.
Unyango
Ngomnye umzekelo omkhulu, unyango lwe-flutter ye-atrial lifana nelo le-fibrillation ye-atrial. Loo nto yodwa kukuba, xa kuthelekiswa ne-fibrillation ye-atrial, ukusebenzisa i-ablation yonyango ekupheliseni i-flutter ye-atrial kulula ukuba iyenze.
Iziqendu eziPhambili
Kwizigulane ezinesiganeko esichukumisayo, i-flutter ye-atrial ingamiswa ngokukhawuleza nge- cardioversion yamandla kagesi, okanye ngokulawula ngokugqithisileyo izidakamizwa ezithintekayo (ngokuqhelekileyo, ibutilide okanye i-holidelide).
Ukuba iimpawu zinzima ngexesha lesiganeko esichukumisayo, ukunciphisa intlawulo yenhliziyo kungabalulekile xa ulungiselela amalungiselelo enhliziyo. Oku kunokuthi kwenziwe ngokukhawuleza ngokulawula ama-intravenous doses of calcium blockers diltiazem okanye i-verapamil, okanye i- beta blocker esmolol esebenza ngokukhawuleza. Ezi zi yobisi kufuneka zisetyenziswe, nangona kunjalo, kwizigulane ezinokukhubazeka kwentliziyo.
Kwexesha elide unyango
Xa isiqendu esicacile senziwe, isinyathelo esilandelayo kukuzama ukucima ezinye iiprosethi ze-flutter ye-atrial. Kule nto kubalulekile ukukhangela, kwaye uphathise, nayiphi na into eguquguqukayo, efana ne-hyperthyroidism, i-apnea yokulala, okanye ukukhuluphala. I-Hyperthyroidism inokulawulwa ngokwaneleyo kwiintsuku ezimbalwa, kwaye ukulala ngokuphalaza kubuye kuphuluzwe ngaphakathi ngexesha elifanelekileyo. Nangona ubukhulu becala buyinto eguquguqukayo ye-flutter ye-atrial, ngokwemigqaliselo yesenzo ngokuqhelekileyo ayiguquki ngokwaneleyo okanye ngokukhawuleza ukwenzela ukuzuza unyango lwe-arrhythmia-ke ezinye iindlela zokuyilawula kufuneka zisetyenziswe.
Ukuba akukho nto eyenziwa ngokukhawuleza kubangelwa, kufuneka ukuba unyango olungapheliyo lwe-antiarrhymic treatment. Ukunyanga okungapheliyo kwe-flutter ye-atrial ngokubanzi kubandakanya ukukhupha i-arrhythmia kunye neziyobisi, okanye ukusebenzisa i-inflation treatment.
Izidakamizwa ze-Antiarrhymic zinezinga eliphumelelayo lokuphumelela nge-flutter ye-atrial - kuphela i-20% ukuya kwi-30% yezigulane eziphathwe neziyobisi zilawulwa ngempumelelo emva konyaka wonyango. Ngenxa yalesi sizathu, kwaye ngenxa yezinto ezinobuthi ezininzi eziqhelekileyo zonyango lweziyobisi, i-inflation ye-ablation yinkqubo yokukhetha unyango lwe-atrial.
Ngethamsanqa, njengoko kuphawuliwe kwangaphambili, ukuphuma kwe-flutter ye-atrial ngokuqhelekileyo kuyinkqubo ecacileyo, kunye nezinga elihle kakhulu lempumelelo-ngaphezulu kwama-90%. Kwisikhulu esikhulu sezigulane ezine-arrhythmia, i-ablation kufuneka iqwalaselwe ngamandla.
Ekubeni i-ablation isebenze kakuhle, i-"control-control strategy" (isetyenziselwa i-fibrillation ye-atrial) ayifanelekanga ukuba i-flutter ye-atrial ayimfuneko. Isicwangciso sokulawula isantya sithetha ukuvumela ukuba i-arrhythmia ivele, kwaye ilawule intlawulo yenhliziyo eyenza, ukunciphisa iimpawu.
Ukulawula izinga lentliziyo kwi-flutter ye-atrial kunzima kakhulu kunokuba kunesibindi se-acrivrization, kwaye ngokuqhelekileyo kudinga ukusetyenziswa kwe-blocka blockers kunye ne-calcium blockers. Ngesinye isihlandlo, ukufumana intlawulo yenhliziyo phantsi kolawulo kuyimfuneko ukuba utshabalalise inkqubo yesimo esiqhelekileyo yentliziyo ukudala i- block block , uze ufake i- pacemaker ukuseka isantya senhliziyo esinqinileyo. Ngokucacileyo, ukukrazula i-flutter ye-atrial ngokupheleleyo kunye nenkqubo yokuqhelisa iqhelekileyo yinkqubo enokukhetha kakhulu.
Kwiimeko apho isicwangciso sokulawula isantya sisetyenziswe, kunjalo, unyango olungapheliyo lwe-antiticoagulation lucetyiswa ukuba lunqande ukuphazamiseka, njengokuba kunesibindi sokuphefumula.
Imithombo:
Wellens HJ. Ulawulo lwexesha eliqhelekileyo lwe-flutter ye-atrial. Uhambo luka 2002; 106: 649.
UGranada J, uUribe W, uChh PH, et al. Isiganeko kunye nokuqikelelwa kwe-flutter ye-atrial kubonke abantu. J Am Coll Cardiol 2000; 36: 2242.