Arrhythmias

Arhythmia waa cillad xagga garaaca wadnaha ah (garaaca wadnaha) ama garaaca wadnaha. Wadnuhu wuu garaaci karaa si dhakhso leh (tachycardia), aad u gaabiya (bradycardia), ama si aan caadi ahayn.

Arhythmia wuxuu noqon karaa mid aan dhib lahayn, calaamad u ah dhibaatooyinka kale ee wadnaha, ama khatar degdeg ah oo caafimaadkaaga ah.

Caadi ahaan, wadnahaagu wuxuu u shaqeeyaa sidii mashiin dhiig u keena sambabaha iyo jirka intiisa kale.

Si looga caawiyo inay taasi dhacdo, wadnahaagu wuxuu leeyahay nidaam koronto oo hubiya inuu qandaraasyo (tuujiyo) si habsami leh.

• Dareenka korantada ee tilmaamaya wadnahaaga inuu qandaraas yeesho wuxuu ka bilaabmaa aag wadnaha ka mid ah oo loo yaqaan 'sinoatrial node' (oo sidoo kale loo yaqaanno sinus node ama SA node). Tani waa wadnaha wadnaha wadnaha.
• Digniintu waxay ka tagaysaa node SA waxayna ku dhex socotaa wadnaha iyadoo loo marayo marin koronto oo la dejiyay.
• Farriimaha neerfaha ee kaladuwan waxay u muujinayaan wadnahaaga inuu garaaco gaabis ama dhakhso badan.

Arrhythmias waxaa sababa dhibaatooyinka nidaamka wadnaha wadista wadista.

• Calaamado aan caadi ahayn (dheeraad ah) ayaa dhici kara.
• Calaamadaha korantada ayaa laga yaabaa inay xannibaan ama gaabis yihiin.
• Calaamadaha korontada waxay ku maraan wadooyin cusub ama kala duwan wadnaha.

Qaar ka mid ah sababaha caadiga ah ee garaaca wadnaha aan caadiga ahayn waa:

• Heerarka aan caadiga ahayn ee kaalshiyamka ama walxaha kale ee jirka ku jira
• Wadne qabad, ama muruqa wadnaha oo waxyeello ka soo gaadhay wadne qabad hore
• Cudurka wadnaha ee jira dhalashada (lagu dhasho)
• Wadno istaag ama wadne weynaaday
• Qanjirka 'thyroid' qanjirka 'firfircoon'

Arrhythmias sidoo kale waxaa sababi kara walxaha qaarkood ama daroogooyinka, oo ay ku jiraan:

• Khamriga ama daroogada kiciyaha
• Daawooyinka qaarkood
• Sigaar cabista (nikotiinka)

Qaar ka mid ah laxanka wadnaha ee aan caadiga ahayn waa:

• Cudurka 'atrial fibrillation' ama ruxitaanka
• Atrioventricular nodal reentry tachycardia (AVNRT)
• Qalliinka wadnaha ama 'atrioventricular block'
• Tachycardia wadnaha badan
• Paroxysmal supraventricular tachycardia
• Xanuun sanka ah
• Villricular fibrillation ama wadnaha tachycardia
• Wolff-Parkinson-White syndrome

Markaad qabtid arrhythmia, garaaca wadnahaaga wuxuu noqon karaa:

• Aad u gaabis ah (bradycardia)
• Deg deg ah (tachycardia)
• Aan caadi ahayn, aan sinnayn, oo suurto gal ah garaacis dheeri ah ama laga booday

Arhythmia wuu joogi karaa waqtiga oo dhan ama wuu imaan karaa wuuna tagi karaa. Waxaad dareemi kartaa ama ma dareemi kartid calaamado marka arrhythmia jiro. Ama, waxaad ogaan kartaa oo keliya calaamadaha markaad firfircoon tahay.

Calaamaduhu waxay noqon karaan kuwo aad u fudud, ama waxay noqon karaan kuwo daran ama xitaa nafta halis geliya.

Calaamadaha caamka ah ee dhici kara marka arrhythmia la joogo waxaa ka mid noqon kara:

• Laab xanuun
• Suuxdin
• Madax wareer, dawakhaad
• Midab ahaan
• Kalsooni-darrada (dareemidda wadnahaaga oo si dhakhso ah ama aan caadi ahayn u garaaca)
• Neefta oo kugu yaraata
• Dhidid

Bixiyaha daryeelka caafimaad wuxuu ku dhageysan doonaa wadnahaaga stethoscope wuxuuna dareemi doonaa garaaca wadnahaaga. Cadaadiska dhiiggaagu wuxuu noqon karaa mid hooseeya ama caadi ah ama xitaa sarreeya natiijada raaxo darrada awgeed.

ECG ayaa noqon doonta tijaabada ugu horeysa ee la sameeyo.

Qalabka la socodka wadnaha waxaa badanaa loo isticmaalaa in lagu aqoonsado dhibaatada laxanka, sida a:

• Holter Monitor (meesha aad ku xirato qalab diiwaan geliya oo keydiya garaaca wadnahaaga 24 ama saacado ka badan)
• Kormeeraha dhacdada ama rikoodhka loop (oo la xidho 2 toddobaad ama ka badan, halkaas oo aad ku duubto garaaca wadnahaaga marka aad dareento qaafiyad aan caadi ahayn)
• Fursadaha kale ee kormeerka muddada-dheer

Echocardiogram waxaa mararka qaarkood lagu amraa in lagu baaro cabirka ama qaab dhismeedka wadnahaaga.

Xaaladaha la soo xushay, cudurka wadnaha ee loo yaqaan 'coronary angiography' ayaa loo samayn karaa si loo arko sida dhiiggu ugu qulqulo xididdada wadnahaaga.

Tijaabad gaar ah, oo loo yaqaan 'electrophysiology study' (EPS), mararka qaarkood waxaa loo sameeyaa si loogu fiirsado nidaamka korantada wadnaha.

Marka arrhythmia uu daran yahay, waxaad u baahan kartaa daaweyn degdeg ah si aad u soo celiso laxanka caadiga ah. Tan waxaa ka mid noqon kara:

• Daaweynta korantada (defibrillation ama cardioversion)
• Gelinta qalabka wadnaha wadnaha ee muddada gaaban
• Daawooyinka lagaa siiyo xididka ama afka

Mararka qaarkood, daaweynta ka wanaagsan ee loo yaqaan 'angina' ama wadnaha oo istaaga ayaa hoos u dhigi doonta fursaddaada inuu ku dhaco arrhythmia.

Daawooyinka loo yaqaan 'anti-arrhythmic drugs' waa la isticmaali karaa:

• Si looga hortago in arrhythmia mar kale dhacdo
• Si aad uga ilaaliso garaaca wadnahaaga inuu noqdo mid dhakhso badan ama gaabis badan

Daawooyinka qaarkood waxay yeelan karaan waxyeelo. U qaado sida uu kuu qoray adeeg bixiyahaagu. HA JOOJIN qaadashada daawada ama ha badalin qiyaasta adiga oo aan marka hore la hadlin bixiyahaaga.

Daaweynta kale ee looga hortago ama loo daaweeyo laxanka wadnaha aan caadiga ahayn waxaa ka mid ah:

• Ka-goynta Wadnaha, oo loo adeegsado in lagu bartilmaameedsado aagagga ku yaal wadnahaaga oo sababi kara dhibaatooyin wadnahaaga ah
• Qalab beddeli kara qalbiga wadnaha, oo lagu meeleeyo dadka halista sare ugu jira dhimashada wadnaha oo lama filaan ah
• Qalab-wadnaha joogtada ah, waa qalab dareema marka wadnuhu si tartiib ah u garaacayo. Waxay u direysaa calaamad wadnahaaga taasoo ka dhigeysa wadnahaaga inuu garaaco xawaaraha saxda ah.

Natiijadu waxay kuxirantahay dhowr arrimood:

• Nooca arrhythmia ee aad leedahay.
• Haddii aad qabtid cudurka halbowlayaasha wadnaha, wadnaha oo istaaga, ama wadne xanuunka.

Wac adeeg bixiyahaaga haddii:

• Waxaad ku soo baxdaa mid ka mid ah astaamaha lagu garto arrhythmia ee suurtogalka ah.
• Waxaa lagaa helay arrhythmia calaamadahaaguna way kasii darayaan ama HA ku fiicnaanin daaweynta.

Tilaabooyin aad qaado si aad uga hortagto cudurada halbowlayaasha wadnaha waxay yareyn kartaa fursadaada ah inuu ku dhaco arrhythmia.

Laxanka wadnaha oo aan caadi ahayn; Bradycardia; Tachycardia; Sibinta

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

• Wadnaha - qaybta dhexe
• Wadnaha - aragtida hore
• Wadna garaaca caadiga ah
• Bradycardia
• Vachricular tachycardia
• Xannibaadda Atrioventricular - raadinta ECG
• Nidaamka wadista wadnaha

Al-Khatib SM, Stevenson WG, Ackerman MJ, et al. Tilmaamaha 2017 AHA / ACC / HRS ee loogu talagalay maareynta bukaannada qaba arrhythmias-ka wadnaha iyo ka-hortagga dhimashada wadnaha oo lama filaan ah: Soo-koobitaan fulineed: Warbixin ka socota Kulliyadda Caafimaadka Wadnaha ee Mareykanka / Kooxda Wadnaha Wadnaha ee Mareykanka ee Tilmaamaha Tababbarka Caafimaadka iyo Bulshada Wadnaha. Laxanka Wadnaha. 2018; 15 (10): e190-e252. PMID: 29097320 pubmed.ncbi.nlm.nih.gov/29097320/.

Olgin JE. U dhowaanshaha bukaanka ee looga shaki qabo arrhythmia. Gudaha: Goldman L, Schafer AI, eds. Daawada Goldman-Cecil. 26aad. Philadelphia, PA: Elsevier; 2020: baab 56.

Tomaselli GF, Rubart M, Zipes DP. Farsamooyinka wadnaha wadnaha. 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: cutubka 34.

Tracy CM, Epstein AE, Darbar D, iyo al. 2012 ACCF / AHA / HRS cusbooneysiin diiradda lagu saaray ee tilmaamaha 2008 ee daaweynta qalabka ku saleysan cilladaha wadnaha ee aan caadiga ahayn: warbixinta Kulliyadda Mareykanka ee Wadnaha iyo Wadnaha ee Ururka Wadnaha ee Mareykanka ee Tilmaamaha Tababarka. J Am Coll Cardiol. 2012; 60 (14): 1297-1313. PMID: 22975230 pubmed.ncbi.nlm.nih.gov/22975230/.