Wolff-Parkinson-White syndrome (WPW)

Wolff-Parkinson-White (WPW) syndrome yog ib qho mob uas muaj hluav taws xob ntxiv nyob rau hauv lub plawv uas ua rau lub sij hawm ntawm lub plawv dhia ceev ceev (tachycardia).

WPW syndrome yog ib qho kev mob siab ntsig txog cov teeb meem plawv dhia nrawm hauv cov menyuam mos thiab menyuam yaus.

Feem ntau, cov xaim hluav taws xob ua raws qee yam ntawm lub plawv. Qhov no pab lub plawv khiav ceev xwm yeem. Qhov no tiv thaiv lub plawv tsis txhob muaj cov neeg ntaus lossis neeg ntaus uas yuav muaj dhau sai.

Hauv cov neeg muaj mob WPW syndrome, qee qhov hluav taws xob lub plawv nqes mus rau ib qho ntxiv. Qhov no yuav ua rau lub plawv dhia ceev ceev hu ua supraventricular tachycardia.

Feem ntau cov neeg muaj tus mob WPW tsis muaj lwm yam kev mob plawv. Txawm li cas los xij, tus mob no tau txuas nrog lwm yam kev mob plawv, xws li Ebstein anomaly. Ib hom mob no kuj tseem muaj hauv tsev neeg.

Yuav ua li cas lub plawv dhia ceev ceev txawv nyob ntawm tus neeg. Qee cov neeg uas muaj tus mob WPW tsuas muaj ob peb ntu kev mob plawv sai. Lwm tus yuav muaj lub plawv dhia nrawm ib zaug lossis ob zaug ib asthiv lossis ntau dua. Tsis tas li, tej zaum yuav tsis muaj cov tsos mob txhua, yog li muaj mob tshwm sim thaum kuaj lub plawv yog ua rau lwm qhov laj thawj.

Tus neeg muaj tus mob no yuav muaj:

• Hauv siab mob lossis hauv siab nruj
• Kiv taub hau
• Lub Cim Txhab Zog
• Tsaus muag
• Palpitations (qhov hnov ​​ntawm koj lub siab ntaus, feem ntau sai lossis tsis xwm yeem)
• Ua tsis taus pa

Qhov kev kuaj mob rau lub cev thaum lub tachycardia rov tshwm sim yuav pom lub plawv dhia nrawm dua 100 tus neeg tauj ib feeb. Lub plawv dhia li 60 mus txog 100 neeg ntaus ib feeb nyob rau hauv cov neeg laus, thiab qis dua 150 npliag tauj ib feeb hauv cov menyuam mos, menyuam mos, thiab cov menyuam yaus. Ntshav siab yuav rov zoo li qub lossis qis dua hauv feem ntau.

Yog tias tus neeg tsis muaj tachycardia thaum lub sijhawm kuaj, cov txiaj ntsig yuav ua tau zoo li qub. Qhov xwm txheej yuav kuaj pom nrog ECG lossis nrog kuaj mob ECG thauj neeg mob, xws li Holter saib.

Ib qho kev sim hu ua kev kawm electrophysiologic (EPS) yog ua tiav siv cov ntsuas uas tau muab tso rau hauv lub plawv. Qhov kev ntsuas no yuav pab txheeb xyuas qhov chaw nyob ntawm cov kab hluav taws xob ntxiv.

Cov tshuaj noj, tshwj xeeb cov tshuaj antiarrhythmic xws li procainamide lossis amiodarone, tuaj yeem siv los tswj lossis tiv thaiv lub plawv dhia ceev.

Yog tias lub plawv dhia tsis rov zoo li qub nrog kev kho mob, kws kho mob tuaj yeem siv hom kev kho hu ua hluav taws xob cardioversion (kev poob siab).

Kev kho mus sij hawm ntev rau WPW syndrome feem ntau yog catheter ablation. Txoj kev ua no suav nrog kev ntxig cov raj (catheter) rau hauv cov hlab ntshav los ntawm kev txiav me me ze ze lub puab tais mus txog thaj chaw mob plawv. Thaum lub ntsis tau nce mus txog lub plawv, thaj chaw me me uas ua rau lub plawv dhia nrawm yog rhuav tshem siv tshwj xeeb zog lub zog hu ua radiofrequency lossis los ntawm kev ua kom khov nws (cryoablation). Qhov no tau ua tiav ua ib feem ntawm kev kawm electrophysiologic (EPS).

Qhib lub plawv phais kom hlawv lossis khov rau txoj hauv kev ntxiv ntxiv kuj tseem yuav kho tau qhov mob ruaj khov rau WPW syndrome. Feem ntau, txoj kev ua no tsuas yog ua tiav yog tias koj xav tau kev phais plawv rau lwm yam.

Catheter ablation kho cov kev tsis zoo no rau hauv cov neeg feem coob. Qhov ua tau zoo ntawm cov txheej txheem nyob nruab nrab ntawm 85% txog 95%. Qhov ua tiav tau zoo yuav sib txawv raws qhov chaw thiab tus naj npawb ntawm cov ntxiv.

Teeb meem yuav suav nrog:

• Teeb meem ntawm kev phais
• Lub plawv tsis ua hauj lwm
• Txo ntshav siab (tshwm sim los ntawm lub plawv dhia nrawm)
• Sab sij huam tshuaj

Cov mob uas hnyav heev tshaj plaws ntawm lub plawv dhia ceev yog ventricular fibrillation (VF), uas yuav ua rau poob siab lossis tuag tau. Qee zaum nws tuaj yeem tshwm sim hauv cov neeg nrog WPW, tshwj xeeb yog tias lawv tseem muaj atrial fibrillation (AF), uas yog lwm yam kev txawv txav ntawm lub plawv. Hom plawv dhia ceev no xav tau kev kho mob ceev thiab cov txheej txheem hu ua cardioversion.

Hu koj tus kws kho mob yog hais tias:

• Koj muaj tsos mob ntawm tus mob WPW.
• Koj muaj cov kev tsis zoo no thiab cov tsos mob mob heev dua lossis tsis txhim kho nrog kev kho mob.

Tham nrog koj tus kws kho mob seb cov neeg hauv koj tsev neeg puas yuav tsum raug txheeb xyuas txog cov ntawv muaj mob ua ntu zus ntawm tus mob no.

Preexcitation syndrome; WPW; Tachycardia - Wolff-Parkinson-Dawb syndrome; Arrhythmia - WPW; Kev mob plawv tsis zoo - WPW; Lub plawv dhia ceev ceev - WPW

• Ebstein lub anomaly
• Holter plawv saib
• Kev ua tiav ntawm lub siab

Dalal AS, Van Hare GF. Kev ntxhov siab ntawm tus nqi thiab lub plawv sib luag. Hauv: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Phau Ntawv ntawm PediatricsCov. 21st ed. Philadelphia, PA: Elsevier; 2020: cha 462.

Tomaselli GF, Zoos DP. Txoj kev ua rau tus neeg mob nrog mob plawv arrhythmias. Hauv: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Plawv Lub Plawv: Phau Ntawv Qhia Txog Cov Tshuaj Mob plawvCov. 11th ed. Philadelphia, PA: Elsevier; 2019: chap 32.

Zimetbaum P. Supraventricular mob arrhythmias. Hauv: Goldman L, Schafer AI, eds. Goldman-Cecil TshuajCov. 26th ed. Philadelphia, PA: Elsevier; 2020: chap 58.