Hlaus tachycardia

Ventricular tachycardia (VT) yog lub plawv dhia ceev ceev uas pib hauv qis hauv qab ntawm lub plawv (ventricles).

VT yog tus mem tes hla ntau tshaj 100 tus neeg tauj ib feeb, nrog tsawg kawg 3 lub plawv dhia ib zaug.

Tus mob tuaj yeem loj hlob zuj zus tuaj thaum ntxov lossis qeeb dhau ntawm kev mob plawv. Nws kuj yuav tshwm sim hauv cov neeg nrog:

• Cardiomyopathy
• Lub plawv tsis ua hauj lwm
• Kev phais lub plawv
• Myocarditis
• Lub plawv mob muaj txiaj ntsig

VT tuaj yeem tshwm sim yam tsis muaj mob plawv.

Caws pliav nqaij tuaj yeem tsim nyob rau hauv cov leeg ntawm txoj hlab ntsws hnub, lub hlis, lossis xyoo tom qab lub plawv nres. Qhov no tuaj yeem ua rau ventricular tachycardia.

VT tuaj yeem tshwm sim los ntawm:

• Cov tshuaj tiv thaiv tsis zoo (siv los kho lub plawv tsis txaus)
• Hloov ntshav chemistry (xws li cov poov tshuaj qis)
• Hloov pH (kua qaub-puag)
• Tsis muaj oxygen txaus

"Torsade de pointes" yog daim ntawv tshwj xeeb ntawm VT. Feem ntau nws yog vim muaj mob plawv los yog siv qee yam tshuaj kho.

Koj tuaj yeem muaj cov tsos mob yog tias lub plawv dhia thaum ntu VT ceev heev lossis kav ntev dua ob peb feeb. Cov tsos mob tuaj yeem suav nrog:

• Hauv siab tsis xis nyob (angina)
• Tsaus muag (syncope)
• Lub teeb taws lossis kiv taub hau
• Hnov ntawm kev hnov ​​mob plawv (dhia tawm hauv siab)
• Ua tsis taus pa

Cov tsos mob yuav pib thiab nres dheev. Hauv qee kis, tsis muaj tsos mob.

Tus kws kho mob yuav saib xyuas:

• Cov mem tes tsis muaj
• Tsis nco qab
• Li no lossis ntshav siab
• Cov mem tes maj ceev

Kev ntsuam xyuas uas tej zaum yuav siv los kuaj txog ventricular tachycardia suav nrog:

• Holter saib
• ECG
• Txoj kev tshawb no mob electrophysiology (EPS)
• Kev soj ntsuam lub suab nrog lub ntsuas suab lossis lub twj

Koj kuj tseem tuaj yeem tso ntshav tshuaj thiab lwm yam kev kuaj mob.

Kev kho yog nyob ntawm cov tsos mob, thiab hom mob plawv.

Yog ib tug neeg mob VT muaj kev nyuaj siab, lawv yuav tsum:

• Kev cawm siav
• Cardioversion (xaim hluav taws xob)
• Cov tshuaj noj (xws li lidocaine, procainamide, sotalol, lossis amiodarone) muab los ntawm txoj hlab ntshav

Tom qab ntu ntawm VT, cov kauj ruam mus rau tom ntu txuas ntxiv.

• Cov tshuaj kho mob qhov ncauj yuav xav tau kev kho mob ntev. Txawm li cas los xij, cov tshuaj no yuav muaj kev phiv loj heev. Lawv tau siv tsawg dua li lwm txoj kev kho mob yog tsim.
• Cov txheej txheem rhuav tshem lub plawv cov ntshav uas ua rau lub plawv tsis zoo (hu ua ablation) tuaj yeem ua.
• Xav kom siv tshuaj ua kom tau cardioverter defibrillator (ICD). Nws yog ib qho cuab yeej siv cuam tshuam uas tshawb pom lub neej puas, lub plawv dhia ceev. Lub plawv dhia tsis zoo no hu ua arrhythmia. Yog tias nws tshwm sim, ICD ceev nrooj xa hluav taws xob mus rau lub plawv kom hloov cov atherosclerosis rov qab mus rau qhov qub. Qhov no hu ua defibrillation.

Qhov tshwm sim yog nyob ntawm lub siab mob thiab cov tsos mob.

Tentyularia mob hlab ntsha tuaj yeem tsis ua mob rau qee tus neeg. Txawm li cas los xij, nws tuaj yeem tsim kev tuag taus. Nws yog ib qho ua kom mob plawv tuag sai sai.

Mus rau chav kho mob maj nrawm lossis hu rau tus npawb xov tooj xwm ceev hauv nroog (xws li 911) yog tias koj mob nkees sai, tsis khov, tsaus muag, lossis mob hauv siab. Tag nrho cov no yuav yog cov pa ventricular tachycardia.

Hauv qee kis, kev tiv thaiv tus kab mob no tsis tuaj yeem tiv thaiv. Hauv lwm qhov xwm txheej, nws tuaj yeem tiv thaiv los ntawm kev kho mob plawv thiab zam qee yam tshuaj.

Dav tachycardia dav; V tach; Tachycardia - ventricular

• Implantable cardioverter defibrillator - muaj paug

• Implantable cardioverter-defibrillator
• Plab hlaus tsis tau tiv thaiv kab mob

Al-Khatib SM, Stevenson WG, Ackerman MJ, li al. 2017 AHA / ACC / HRS Kev taw qhia rau kev tswj hwm cov neeg mob nrog ventricular arrhythmias thiab kev tiv thaiv ntawm kev mob plawv sai li sai tau: ib daim ntawv tshaj tawm ntawm American College of Cardiology / American Heart Association Task Force ntawm kev soj ntsuam cov kev coj ua thiab Lub Plawv Cov Neeg Koom Tes [luam tawm txoj kev txhim kho tshwm J Am Coll Cardiol. 2018; 72 (14): 1760]. J Am Coll CardiolCov. Xyoo 2018; 72 (14): 1677-1749. PMID: 29097294 pubmed.ncbi.nlm.nih.gov/29097294/.

Epstein EF, DiMarco JP, Ellenbogen KA, Estes NA 3rd, li al. 2012 ACCF / AHA / HRS tsom xyuas kev hloov kho tshiab koom rau hauv ACCF / AHA / HRS 2008 cov lus qhia rau kev kho khoom siv ntawm kev mob plawv dhia tsis zoo: ib daim ntawv tshaj tawm ntawm American College ntawm Cardiology Foundation / American Heart Association Task Force ntawm Kev Coj Qhia thiab Lub plawv dhia. Lub Neej. J Am Coll CardiolCov. 2013; 661 (3): e6-75. PMID: 23265327 pubmed.ncbi.nlm.nih.gov/23265327/.

Garan H. Ventricular arrhythmias. Hauv: Goldman L, Schafer AI, eds. Goldman-Cecil TshuajCov. 26th ed. Philadelphia, PA: Elsevier; 2020: chap 59.

Olgin JE, Tomaselli GF, Zipes DP. Qhov quav 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 39.