Vachricular tachycardia

Ventricular tachycardia (VT) waa garaaca wadnaha oo deg deg ah oo ka bilaabma qolalka hoose ee wadnaha (ventricles).

VT waa garaaca wadnaha oo ka badan 100 garaac daqiiqaddii, ugu yaraan 3 wadna garaac aan caadi ahayn oo xiriir ah.

Xaaladdu waxay u horumari kartaa sidii hore ama dambe oo dhibaato ah oo wadne qabad ah. Waxay sidoo kale ku dhici kartaa dadka qaba:

• Wadna xanuunka
• Wadne istaag
• Qalliinka wadnaha
• Myocarditis
• Cudurka wadnaha ee wadnaha

VT wuxuu dhici karaa wadne xanuun la'aan.

Nudaha nabarku waxay ku samaysan karaan muruqyada muruqyada maalmo, bilo, ama sannado kadib wadno qabad. Tani waxay u horseedi kartaa ventricular tachycardia.

VT sidoo kale waxaa sababi kara:

• Daawooyinka anti-arrhythmic (waxaa lagu daaweeyaa garaaca wadnaha aan caadiga ahayn)
• Isbeddelada kiimikada dhiigga (sida heer potassium oo hooseeya)
• Isbedelada pH (acid-base)
• La'aanta ogsijiin ku filan

"Torsade de pointes" waa qaab gaar ah oo VT ah. Badanaa waxaa sabab u ah cudurada wadnaha ee lagu dhasho ama isticmaalka dawooyinka qaarkood.

Waxaad yeelan kartaa calaamado haddii garaaca wadnaha inta lagu jiro dhacdada VT uu aad u dhakhso badan yahay ama soconayo in ka badan dhowr ilbiriqsi. Calaamadaha waxaa ka mid noqon kara:

• Xanuun laabta (angina)
• Suuxdin (syncope)
• Madax wareer ama wareer
• Dareen dareemida garaaca wadnaha (wadna garaac)
• Neefta oo kugu yaraata

Calaamaduhu si lama filaan ah ayey u bilaaban karaan una joogsan karaan. Xaaladaha qaarkood, ma jiraan wax astaamo ah.

Bixiyaha xanaanada caafimaadka ayaa eegi doona:

• Garaaca wadnaha
• Miyir beelid
• Cadaadis dhiig oo caadi ah ama hooseeya
• Garaaca wadnaha

Tijaabooyinka loo isticmaali karo in lagu ogaado tachycardia ventricular waxaa ka mid ah:

• Holter kormeer
• ECG
• Daraasada cilmiga wadnaha ee wadnaha (EPS)
• Lasocodka laxanka oo leh rikoodh loop ama qalab

Waxa kale oo laga yaabaa inaad leedahay kiimiko dhiig leh iyo baaritaanno kale.

Daaweyntu waxay kuxirantahay astaamaha, iyo nooca wadna xanuunka.

Haddii qof qaba VT uu dhibaataysan yahay, waxay u baahan karaan:

• CPR
• Kala-wareejinta wadnaha (shoogga korantada)
• Daawooyinka (sida lidocaine, procainamide, sotalol, ama amiodarone) oo lagu bixiyo xididka

Kadib dhacdada VT, talaabooyin ayaa loo qaadayaa si loo sii wado dhacdooyin dheeri ah.

• Daawooyinka afka laga qaato ayaa loo baahan karaa daaweyn muddo dheer ah. Si kastaba ha noqotee, daawooyinkani waxay yeelan karaan waxyeelo daran. Waxaa loo isticmaalaa si ka yar sida daaweynta kale loo horumariyo.
• Nidaam lagu burburinayo unugyada wadnaha ee keena garaaca wadnaha aan caadiga ahayn (oo loo yaqaan ablation) ayaa la samayn karaa.
• Qalab beddelka wadnaha ee qalabka wax lagu beddelo (ICD) ayaa lagu talin karaa. Waa aalad la beeray oo ogaata wax kasta oo nafta halis gelinaya, garaaca wadnaha oo deg deg ah. Garaaca wadnahan aan caadiga ahayn waxaa loo yaqaan 'arrhythmia'. Haddii ay dhacdo, ICD waxay si deg deg ah ugu dirtaa shoog koronto wadnaha si ay u bedesho laxanka si caadi ah. Tan waxaa lagu magacaabaa defibrillation.

Natiijadu waxay kuxirantahay xaalada wadnaha iyo astaamaha.

Tachycardia-da 'Ventricular tachycardia' dadka qaar kuma sababi karto calaamado. Si kastaba ha noqotee, waxay noqon kartaa mid dilaa ah. Waa sababaha ugu weyn ee dhimashada wadnaha lama filaan ah.

Aad qolka gargaarka degdegga ah ama wac nambarka degdegga ee maxalliga ah (sida 911) haddii aad isku aragto garaaca wadnaha oo degdeg ah, aan caadi ahayn, suuxsan tahay, ama feedho xanuun kugu hayo. Kuwaas oo dhami waxay noqon karaan calaamadaha tachycardia ventricular.

Xaaladaha qaarkood, cilladda lama hor istaagi karo. Xaaladaha kale, waxaa looga hortagi karaa iyadoo la daaweeyo dhibaatooyinka wadnaha iyo ka fogaanshaha daawooyinka qaarkood.

Tachycardia ballaaran-adag; V tach; Tachycardia - wadnaha

• Qalabaynta qalabka wax lagu beddelo ee 'cardioverter defibrillator' - dheecaan

• Qalabka beddelka wadnaha-qalajiyaha
• Qalabaynta wadnaha ee la beeri karo

Al-Khatib SM, Stevenson WG, Ackerman MJ, et al. Tilmaamaha 2017 ee AHA / ACC / HRS ee loogu talagalay maareynta bukaannada qaba arrhythmias-ka wadnaha iyo ka hortagga geerida wadnaha ee lama filaanka ah: warbixin ka socota Kuliyadda Caafimaadka Wadnaha ee Mareykanka / Ururka Wadnaha ee Wadnaha ee Mareykanka ee ku saabsan tilmaamaha tababarka daaweynta iyo Bulshada Quluubta Wadnaha [sixitaanka la daabacay ayaa ka muuqda J Am Coll Cardiol. 2018; 72 (14): 1760]. J Am Coll Cardiol. 2018; 72 (14): 1677-1749. PMID: 29097294 pubmed.ncbi.nlm.nih.gov/29097294/.

Epstein EF, DiMarco JP, Ellenbogen KA, Estes NA 3rd, iyo al. 2012 ACCF / AHA / HRS cusboonaysiinta diiradda lagu saaray tilmaamaha ACCF / AHA / HRS 2008 ee loogu talagalay daaweynta qalabka ku saleysan cilladaha wadnaha ee aan caadiga ahayn: warbixin ka socota Kulliyadda Caafimaadka Wadnaha ee Mareykanka / Ururka Wadnaha ee Wadnaha ee Mareykanka ee Tilmaamaha Tababarka iyo Wadna garaaca Bulshada. J Am Coll Cardiol. 2013; 661 (3): e6-75. PMID: 23265327 pubmed.ncbi.nlm.nih.gov/23265327/.

Garan H. Cudurka 'Ventricular arrhythmias'. Gudaha: Goldman L, Schafer AI, eds. Daawada Goldman-Cecil. 26aad. Philadelphia, PA: Elsevier; 2020: baab 59.

Olgin JE, Tomaselli GF, Zipes DP. Ventricular Arrhythmias. Gudaha: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Cudurka Wadnaha ee Braunwald: Buugga Buugta Daawada Wadnaha iyo Xididdada. 11aad. Philadelphia, PA: Elsevier; 2019: baab 39.