Dr. Svetoslav Kurtev: Arrhythmia ua rau mob stroke

Cov txheej txheem:

Dr. Svetoslav Kurtev: Arrhythmia ua rau mob stroke
Dr. Svetoslav Kurtev: Arrhythmia ua rau mob stroke
Anonim

Koj puas muaj palpitations, hla, yooj yim qaug zog, ua tsis taus pa, tsis muaj zog, tsis muaj zog mus rau lub cev qhuav dej, koj puas mob hauv siab? Cov no yog cov kev tsis txaus siab ntawm atrial fibrillation - feem ntau mob plawv arrhythmia. Tus kab mob no feem ntau tsis muaj qhov tshwm sim tshwm sim, uas yog vim li cas nws tseem tsis paub thiab tsis kho.

Nyob rau hauv qee cov neeg mob, cov tsos mob tsis qhia meej lossis luv luv ntawm atrial fibrillation tau pom, tsis muaj kev tsis txaus siab. Vim li no, hauv ntau tus neeg mob, tus mob tsuas yog kuaj pom thawj zaug thaum mob stroke.

Hais txog qhov ua rau, kuaj mob thiab kev kho mob ntawm atrial fibrillation, peb tham nrog kws kho plawv Dr. Svetoslav Kurtev, tus thawj coj ntawm lub Department of "Electrocardiostimulation thiab Electrophysiology" ntawm Cardiology Clinic ntawm UMBAL "Alexandrovska".

Yav dhau los, nws ua haujlwm ntawm SBALSSZ "St. Ekaterina, MBAL "Tota Venkova" - Gabrovo thiab National Cardiology Tsev Kho Mob. Nws tshwj xeeb hauv electrophysiology hauv Szeged, Hungary. Dr. Kurtev yog tus pabcuam hauv plawv plawv ntawm Department of Internal Diseases ntawm Sofia University.

Dab tsi yog atrial fibrillation, Dr. Kurtev?

- Atrial fibrillation yog ib qho ntawm feem ntau kaw arrhythmias hnub no. Nws yog arrhythmia ntau zaus uas lub atrium xyaum poob nws txoj haujlwm vim tias nws tsis tuaj yeem ua qhov kev cog lus txaus.

Nws yog vim muaj kev cuam tshuam hauv hluav taws xob stimulation ntawm atria. Thaum lub hauv paus chiv keeb thiab kev sib kis ntawm excitatory impulses cuam tshuam, muaj kev hloov hauv lub plawv dhia thiab, raws li, nyob rau hauv lub mem tes. Cov no hloov lub plawv dhia ib txwm thiab raug xa mus rau arrhythmias.

Cov kev hloov pauv ua rau muaj ntau qhov tsis sib haum xeeb ntawm tus kheej ntawm lub atria thiab ua rau tsis muaj peev xwm cog lus rau tag nrho atrium, uas yog hu ua atrial "flutter" lossis "flutter".

Cov kev kho mob tshwm sim ntawm atrial fibrillation yog dab tsi?

- Kev kho mob tshwm sim feem ntau yog palpitations, palpitations, ua tsis taus pa, yooj yim nkees. Tab sis qee zaum hom arrhythmia no yog asymptomatic kiag li.

Raws li thawj cov tsos mob uas tshwm sim tiag tiag yog qhov teeb meem ntawm kev kho tsis tau kho atrial fibrillation thiab feem ntau cov no yog qee yam xwm txheej embolic thiab feem ntau ntawm lawv yog mob stroke.

Qee lub sijhawm xws li emboli, uas tsim nyob rau hauv lub atrium vim nws tsis ua haujlwm, tuaj yeem cuam tshuam rau lub qhov muag, daim siab, lub ntsws, tuaj yeem mus rau txhua lub hauv nruab nrog cev uas muaj cov ntshav hlab ntsha thiab ua rau muaj kev sib tsoo ischemic.

Dab tsi ua rau tus kab mob no?

- Peb, kws kho mob, tseem tsis tau paub meej txog qhov ua rau mob arrhythmia. Tab sis categorically, qhov peb pom yog hais tias nws muaj feem xyuam rau lub hnub nyoog - atrial fibrillation yog pom nyob rau hauv 8% ntawm Bulgarians tshaj 70 xyoo.

Tej zaum qhov chaw hauv myocardium, qee qhov kev laus txheej txheem tau tshwm sim, ntawm kev tsim fibrosis, uas hloov cov qauv ntawm lub atrium thiab ua rau raws nraim hom arrhythmia. Tau kawg, muaj lwm yam laj thawj.

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Muaj tseeb tiag, txhua yam kab mob plawv hnyav tuaj yeem ua rau atrial fibrillation. Cov neeg mob uas muaj cov thyroid dysfunction kuj feem ntau tawm ntawm lub suab.

Mob ntshav qab zib yog qhov muaj feem pheej hmoo rau qhov tshwm sim ntawm ischemic plawv kab mob thiab yog li ua rau sab laug ventricular tsis ua haujlwm, uas tuaj yeem ua rau atrial fibrillation.

Tseem muaj cov caj ces. Cawv, txawm tias me me, kuj ua rau muaj kev pheej hmoo ntawm atrial fibrillation. Qhov ua rau tus kab mob tuaj yeem ua rau muaj kev ntxhov siab thiab lub cev.

Nrog rau txhua lub plawv dhia nrawm, puas yuav tsum muaj lub teeb liab los ua kom peb raug mob ntawm atrial fibrillation?

- Tau kawg tsis yog, tab sis nws tseem zoo kom muaj kws kho plawv kuaj xyuas koj. Atrial fibrillation los ntawm ntau hom.

thawj daim ntawv yog hu ua paroxysmal atrial fibrillation uas tshwm sim nyob rau ib lub sij hawm, uas tej zaum yuav nyob rau hauv 48 teev, mus txog rau 7 hnub, thiab daws nws tus kheej los yog nrog tshuaj. Tom ntej no yog hu ua mob plawv atrial fibrillation.

Nws kav ntev dua 7 hnub, mus txog rau ib xyoos. Hom kawg yog mob atrial fibrillation, uas yog tas mus li thiab tsis tu ncua. Nyob ntawd, lub caij nyoog ntawm tus neeg mob rov qab los ntawm qhov ntswg, tshwj xeeb tshaj yog tias nws tau tawm ntawm lub suab ntau tshaj 1 xyoos, tsawg heev, kuv txawm hais tsis tau.

Qhov kev cia siab rau tus neeg mob li cas?

- Qhov txaus ntshai tshaj plaws thiab tsis txaus siab yog cov teeb meem embolic, qhov teeb meem yog ischemic embolic strokes. Qhov ntawd yog qhov teeb meem loj tiag tiag, thiab peb tab tom tsom tsis ntau ntawm kev ua kom peb cov neeg mob nyob rau hauv lub qhov ntswg qhov ntswg, tab sis ntawm kev tiv thaiv qhov teeb meem no.

Vim yog tias cov teeb meem embolic raug tiv thaiv kom txaus, lub neej expectancy ntawm peb cov neeg mob yog tib yam txawm hais tias lawv nyob rau hauv lub sinus atherosclerosis los yog atrial fibrillation. Tab sis yog tsis tiv thaiv tus kab mob no ces kev tuag nce 3-4 npaug thiab raws li muaj kev tsis taus…

Thiab dab tsi yuav tsum tau tiv thaiv cov neeg mob zoo li no?

- Cov neeg mob feem ntau xav tau cov tshuaj tiv thaiv kab mob mus tas li thiab yuav tsum tau noj tshuaj txhua hnub

Txawm tias yuav tsum kho li cas yuav tsum tau txiav txim siab los ntawm kws kho plawv raws li kev ntsuas kev pheej hmoo uas siv cov qauv tshwj xeeb.

Feem ntau ntawm cov tshuaj no muaj txiaj ntsig zoo, noj ib zaug lossis ob zaug hauv ib hnub thiab muaj kev phiv tsawg. Ib txwm muaj qhov pheej hmoo ntawm cov teeb meem hemorrhagic, tab sis nws yog ntau zaus qis dua qhov txiaj ntsig tau.

Atrial fibrillation kuaj tau li cas?

- Feem ntau, ib qho electrocardiogram tawm tsam keeb kwm ntawm kev tsis txaus siab qhia qhov kev kuaj mob kom meej meej. Txawm li cas los xij, qee zaum, thaum nws tshwm sim rau lub sijhawm luv luv thiab ploj mus, thiab tus neeg mob tsis tuaj yeem mus ntsib kws kho mob tam sim ntawd thiab ua electrocardiogram, lossis thaum nws mus, nws ploj mus, tom qab ntawd peb siv holter ECG, uas, nyob rau hauv. 24 lossis 48 teev, cov ntaub ntawv tsis tu ncua thiab lub plawv dhia tsis tu ncua.

Qee lub sij hawm, txawm li cas los xij, kev tawm ntawm kev sib dhos yog qhov tsawg dua. Peb muaj nws qhov zoo li qhov teeb meem, tab sis peb tsis tuaj yeem ntes nws txawm tias nyob rau 24-teev holter. Muaj cov tshuab me me hu ua lub voj kaw uas tau cog rau hauv qab ntawm daim tawv nqaij hauv thaj tsam ntawm lub plawv thiab ua rau ECG kaw tas li rau rau lub hlis, ib xyoos, ob.

Ua tsaug rau lub voj kaw peb tuaj yeem rho tawm cov ntaub ntawv hais txog lub plawv dhia, txheeb xyuas nws thiab paub seb puas muaj atrial fibrillation lossis lwm yam kab mob. Lwm txoj kev kuaj mob uas peb siv ntau zaus yog cov pacemakers.

Cov pacemakers lawv tus kheej tuaj yeem tsim los sau cov kev tawm tsam atrial fibrillation. Thiab thaum tus neeg mob tuaj rau kev kuaj xyuas tas li, uas tseem ceeb heev rau nws, peb tuaj yeem pom cov kev tawm tsam no thiab ua kom kuaj tau yooj yim raws li.

Tus kab mob puas kho tau?

- Muaj ob hom kev kho mob. Ib qho yog nrog tshuaj. Cov tshuaj no ua haujlwm kom tswj tau qhov sinus atherosclerosis, thiab feem ntau lawv muaj txiaj ntsig zoo nrog qee qhov kev mob tshwm sim. Qee zaum, txawm li cas los xij, cov tshuaj tsis pab lossis pab tsuas yog ib feem, thiab tom qab ntawd lwm txoj hauv kev yog pulmonary vein ablation.

Nws yog txoj kev nyuaj, tab sis muaj ntau qhov kev paub ntau ntxiv vim tias muaj ntau tus neeg mob. Pulmonary vein ablation yog qhov zoo dua li kev kho tshuaj thiab tau txais txiaj ntsig zoo thiab mus sij hawm ntev.

Cov no yog ob txoj kev kho mob. Tab sis qhov tseem ceeb tshaj plaws yog - txawm tias tus neeg mob zoo siab, nws yuav tsum mus ntsib kws kho mob plawv uas yuav ntsuas nws qhov kev pheej hmoo ntawm embolic thiab ua raws li kev pom zoo rau kev kho mob. Kuv xav hais ntxiv tias kev tiv thaiv kev tiv thaiv coagulant rau cov neeg mob atrial fibrillation yog qhov tseem ceeb heev.

Nws tom qab ntawd txuag ntau ntau rau tus neeg mob thiab kev noj qab haus huv tag nrho. Vim tias cov nqi tsis tas mus pw hauv tsev kho mob vim mob stroke lossis lwm yam teeb meem, lawv tsuas yog pib thaum ntawd.

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