Cudurka 'atrial fibrillation' ama ruxitaanka

Cudurka 'atrial fibrillation ama flutter' waa nooc caadi ah oo garaaca wadnaha aan caadiga ahayn. Qaafiyadda wadnaha ayaa dhakhso badan badanaana aan caadi ahayn.

Markaad si fiican u shaqeyneyso, 4-ta qol ee wadnaha qandaraaska (isku ururin) qaab habaysan.

Astaamaha korontada ayaa qalbigaaga ku haaya inuu u shubo xaddiga saxda ah ee dhiigga baahida jidhkaaga. Calaamadaha ayaa ka bilaabmaya aag loo yaqaan 'sinoatrial node' (oo sidoo kale loo yaqaan 'sinus node ama SA node').

Fibilillation-ka wadnaha, wadnaha wadnaha wadnaha ma aha mid joogto ah. Tani waa sababta oo ah qanjirka 'sinoatrial node' ma xukumayo garaaca wadnaha.

• Qaybaha wadnuhu kuma qandaraas karaan qaab abaabulan.
• Natiijo ahaan, wadnuhu ma soo saari karo dhiig ku filan si uu u daboolo baahida jirka.

Xilliga wareega ee 'atrial flutter', ventricles (qeybta hoose ee qolka wadnaha) way garaaci karaan si deg deg ah, laakiin qaab caadi ah.

Dhibaatooyinkan ayaa saameyn ku yeelan kara ragga iyo dumarka labadaba. Waxay ku sii badan yihiin da'da sii kordheysa.

Sababaha caadiga ah ee fibrillation-ka maskaxda waxaa ka mid ah:

• Isticmaalka aalkolada (gaar ahaan cabitaanka badan)
• Cudurka halbowlayaasha wadnaha
• Wadne qabad ama qalliin looga gudbo
• Wadno istaag ama wadne weynaaday
• Cudurka wadnaha wadnaha (badanaa badiyaa mitirka waalka)
• Dhiig kar
• Daawooyin
• Qanjirka 'thyroid' qanjirka 'thyroid' (hyperthyroidism)
• Cudurka 'Pericarditis'
• Xanuun sanka ah

Waxaa laga yaabaa inaadan ka warqabin in wadnahaagu uusan u garaacin qaab caadi ah.

Calaamaduhu waxay u bilaaban karaan ama istaagi karaan si lama filaan ah. Tani waa sababta oo ah fibrillation-ka maskaxda ayaa laga yaabaa inuu istaago ama uu kaligiis bilaabo.

Calaamadaha waxaa ka mid noqon kara:

• Garaaca wadnaha oo dareemaya deg deg, tartan, garaacid, boodbood, aan caadi ahayn, ama aad u gaabiya
• Dareen dareemida garaaca wadnaha (wadna garaac)
• Jahwareer
• Dawakhaad, madax-wareer
• Suuxdin
• Daal
• Lumida awooda jimicsiga
• Neefta oo kugu yaraata

Bixiyaha xanaanada caafimaadka ayaa laga yaabaa inuu maqlo garaaca wadnaha oo dhakhso ah isagoo dhageysanaya wadnahaaga stethoscope. Garaaca wadnahaagu wuxuu dareemi karaa dhakhso, sinnaan la'aan, ama labadaba.

Qiyaasta garaaca wadnaha ee caadiga ah waa 60 illaa 100 garaac daqiiqaddii. Fiblillation-ka ama afuufka wadnaha, garaaca wadnaha wuxuu noqon karaa 100 illaa 175 garaac daqiiqad kasta. Cadaadiska dhiiggu wuxuu noqon karaa mid caadi ah ama hooseeya.

ECG (tijaabo diiwaangalinaysa dhaqdhaqaaqa korantada wadnaha) waxaa laga yaabaa inay muujiso cillad aan caadi ahayn ama qulqulka wadnaha.

Haddii garaaca wadnahaaga aan caadiga ahayn yimaado oo tago, waxaa laga yaabaa inaad u baahato inaad xirato kormeere khaas ah si loo ogaado dhibaatada. Kormeerku wuxuu diiwaangeliyaa garaaca wadnaha muddo wakhti ah.

• Kormeerka dhacdada (3 illaa 4 toddobaad)
• Holter Monitor (Imtixaan 24-saac ah)
• Rikoodh loop lagu rakibay (kormeer balaaran)

Tijaabooyinka lagu ogaado cudurka wadnaha waxaa ka mid noqon kara:

• Echocardiogram (sawirka ultrasound ee wadnaha)
• Tijaabooyin lagu baaro dhiiga muruqa wadnaha
• Tijaabooyinka lagu barto nidaamka korontada ee wadnaha

Daaweynta wadnaha iyo wadnaha (Cardioversion treatment) waxaa loo isticmaalaa in wadnaha dib loogu celiyo qaab caadi ah isla markiiba. Waxaa jira laba ikhtiyaar oo daaweyn ah:

• Koronto ayaa ku garaacaysa wadnahaaga
• Daawooyinka lagu bixiyo xididka

Daaweyntan waxaa loo samayn karaa sidii habab deg-deg ah, ama horay loo sii qorsheeyey.

Daawooyinka maalin kasta laga qaato afka waxaa loo isticmaalaa:

• Tartiib garaaca wadnaha aan caadiga ahayn - Daawooyinkan waxaa ka mid noqon kara beta-blockers, calcium channel blockers, iyo digoxin.
• Ka ilaali fibrillation-ka wadnaha -- Daawooyinkani waxay si fiican ugu shaqeeyaan dad badan, laakiin waxay ku yeelan karaan waxyeelo daran. Cudurka 'atrial fibrillation' ayaa ku soo noqda dad badan, xitaa inta ay qaadanayaan daawooyinkan.

Nidaam loo yaqaan ablation radiofrequency ablation ayaa loo isticmaali karaa in lagu nabaro aagagga ku yaal wadnahaaga halkaasoo ay ka dhalanayaan dhibaatooyinka garaaca wadnaha. Tani waxay ka hortagi kartaa calaamadaha korantada ee aan caadiga ahayn ee sababa cillad aan caadi ahayn ama qulqulaya inay ku dhex socdaan wadnahaaga. Waxaad u baahan kartaa wadnaha wadnaha ka dib qalliinkan. Dhammaan dadka qaba fibrillation-ka wadnaha ayaa loo baahan doonaa inay bartaan sida loo maareeyo xaaladdan guriga.

Dadka qaba atrial fibrillation waxay badanaa u baahan doonaan inay qaataan daawooyinka khafiifiya dhiiga. Daawooyinkan tare ayaa loo adeegsan jiray yareynta halista ah inuu ku dhaco xinjirowga dhiigga ee jidhka ku dhex socda (oo sababi kara istaroog, tusaale ahaan). Wadna garaaca wadnaha ee aan caadiga ahayn ee ku dhaca cilladda atrial fibrillation ayaa ka dhigaysa xinjirowga dhiigga inay u badan tahay inay samaysmaan.

Daawooyinka khafiifiya dhiigga waxaa ka mid ah heparin, warfarin (Coumadin), apixaban (Eliquis), rivaroxaban (Xarelto), edoxaban (Savaysa) iyo dabigatran (Pradaxa). Daawooyinka lidka ku ah sida aspirin ama clopidogrel sidoo kale waa loo qori karaa. Si kastaba ha noqotee, khafiifiyeyaasha dhiigga ayaa kordhiya fursadda dhiig-baxa, marka qof walbaa ma isticmaali karo.

Ikhtiyaar kale oo looga hortagi karo istaroogga oo loogu talagalay dadka aan si ammaan ah u qaadan karin daawooyinkan ayaa ah Qalabka loo yaqaan 'Watchman Device', oo ay dhowaan ansixisay hay'adda FDA. Kani waa tallaal yar oo u eg qaab dambiil oo la dhigo gudaha wadnaha si looga joojiyo aagga wadnaha ee xinjirowga intiisa badani sameeyaan. Tani waxay xaddideysaa xinjirooyinka sameysmaya.

Bixiyahaagu wuxuu tixgelin doonaa da'daada iyo dhibaatooyinka kale ee caafimaad markii uu go'aaminayo hababka kahortagga istaroogga ee adiga kugu habboon.

Daaweyntu badanaa way xakamayn kartaa cilladan. Dad badan oo qaba fibrillation-ka wadnaha ayaa si aad ah ugu wanaagsan daaweynta.

Qalitaanka Atrial fibrillation wuxuu u eg yahay inuu soo noqdo oo ka sii daro. Waxaa laga yaabaa inay ku soo noqoto dadka qaarkood, xitaa iyadoo la daaweynayo.

Qallooca dillaaca una socdaala maskaxda wuxuu sababi karaa istaroog.

Wac adeeg bixiyahaaga haddii aad isku aragto astaamaha cilladda wadnaha ama boodboodka.

Kala hadal adeeg bixiyahaaga talaabooyinka lagu daaweynayo xaaladaha sababa kala-goynta wadnaha iyo duulaanka. Ka fogow cabitaanka badan.

Fibrillation auricular; A-fib; Afib

• Atril fibrillation - dheecaan
• Wadnaha wadnaha - dheecaan
• Qaadashada warfarin (Coumadin, Jantoven) - waxa aad weydiiso dhakhtarkaaga

• Wadnaha - qaybta dhexe
• Wadnaha - aragtida hore
• Halbowlayaasha wadnaha dambe
• Halbowlayaasha wadnaha
• Nidaamka wadista wadnaha

Janaayo CT, Wann LS, Calkins H, iyo al. 2019 AHA / ACC / HRS cusbooneysiinta diiradda ee 2014 AHA / ACC / HRS tilmaamaha loogu talagalay maareynta bukaannada qaba fibrillation-ka: Warbixinta Kulliyadda Caafimaadka Wadnaha ee Mareykanka / Ururka Wadnaha Wadnaha ee Mareykanka ee Tilmaamaha Tababbarka Caafimaadka iyo Bulshada Wadnaha Wadnaha wadashaqaynta Bulshada Dhakhaatiirta Qalliinka 'Thoracic Surgeons'. Wareegga. 2019; 140 (6) e285. PMID: 30686041 pubmed.ncbi.nlm.nih.gov/30686041.

Meschia JF, Bushnell C, Boden-Albala B, iyo al. Tilmaamaha ka hortagga aasaasiga ah ee istaroogga: bayaan loogu talagalay xirfadlayaasha daryeelka caafimaadka ee ka socda Ururka Wadnaha Mareykanka / Ururka Stroke American. Faalig 2014; 45 (12): 3754-3832. PMID: 25355838 pubmed.ncbi.nlm.nih.gov/25355838.

Morady F, Zipes DP. Cudurka 'Atrial fibrillation': astaamaha caafimaad, qaababka, iyo maaraynta. Gudaha: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Cudurka Wadnaha ee Braunwald: Buug-tilmaameedka Daaweynta Wadnaha iyo Xididdada. 11aad. Philadelphia, PA: Elsevier; 2019: cutubka 38.

Zimetbaum P. Wadna xanuunka wadnaha ee 'Supraventricular arrhythmias'. Gudaha: Goldman L, Schafer AI, eds. Daawada Goldman-Cecil. 26aad. Philadelphia, PA: Elsevier; 2020: baab 58.