Cov txheej txheem txo qis plhu

Kev rho tawm lub plawv yog ib txoj kev uas siv los ua caws pliav hauv thaj chaw me me hauv koj lub plawv uas yuav koom nrog koj cov teeb meem mob plawv. Qhov no tuaj yeem tiv thaiv lub cim hluav taws xob tsis txaus lossis cov suab sib dhos tsis txhob txav los ntawm lub siab.

Thaum ua cov txheej txheem, cov xaim me me hu ua cov electrodes tau muab tso rau hauv koj lub siab los ntsuas koj lub plawv hluav taws xob. Thaum qhov chaw ntawm cov teeb meem pom, cov ntaub so ntswg ua qhov teeb meem raug rhuav tshem.

Muaj ob txoj hauv kev rau kev ua lub siab txo ablation:

• Radiofrequency ablation siv hluav taws xob kub kom tshem tawm thaj chaw muaj teeb meem.
• Cryoablation siv huab cua txias heev.

Cov txheej txheem ib yam dab tsi uas koj muaj yuav yog nyob ntawm seb hom kev ua qoj txawv txav uas koj muaj.

Cov txheej txheem txo lub plawv mob hauv lub tsev kho mob los ntawm cov neeg ua haujlwm tau kawm. Qhov no suav nrog kev kho plawv (kws kho mob plawv), kws tshaj lij, thiab kws saib xyuas neeg mob. Lub chaw teeb tsa muaj kev nyab xeeb thiab tswj hwm kom koj txoj kev pheej hmoo yog tsawg li sai tau.

Koj yuav muab cov tshuaj rau koj (ua kom loog) ua ntej cov txheej txheem los pab koj so.

• Cov tawv nqaij ntawm koj lub caj dab, caj npab, lossis puab tais yuav raug muab ntxuav zoo thiab ua rau loog nrog kev ua kom zoo nkauj.
• Tom ntej no, tus kws kho mob yuav txiav me me hauv daim tawv nqaij.
• Lub raj me me, hloov pauv (kav raj xa dej) yuav ntxig los ntawm qhov kev txiav no rau hauv ib qho ntawm cov hlab ntshav hauv thaj chaw. Tus kws kho mob yuav siv cov duab xoo hluav taws xob kom zoo saib xyuas cov raj catheter hauv koj lub siab.
• Qee lub sij hawm ntau dua ib tus catheter xav tau.

Thaum cov raj txuas rau hauv qhov chaw, koj tus kws kho mob yuav tso cov electrodes me me hauv ntau qhov chaw ntawm koj lub siab.

• Cov hluav taws xob no txuas nrog rau cov kev soj ntsuam uas tso cai rau tus kws kho plawv qhia qhov chaw hauv koj lub siab ua teeb meem rau koj lub plawv atherosclerosis. Feem ntau, muaj ib lossis ntau qhov tshwj xeeb.
• Thaum qhov chaw ntawm cov teeb meem tau pom, ib txoj kab catheter siv los xa hluav taws xob (lossis qee zaum txias) lub zog rau thaj chaw muaj teeb meem.
• Qhov no tsim qhov caws pliav me me uas ua rau lub plawv tsis haum teeb meem.

Catheter ablation yog ib tug txheej txheem ntev. Nws tuaj yeem ntev 4 lossis ntau teev teev. Thaum lub sij hawm tus txheej txheem koj lub siab yuav raug saib xyuas kom zoo.Tus kws kho mob tej zaum yuav nug koj yog tias koj muaj cov tsos mob txawv sijhawm hauv tus txheej txheem. Cov tsos mob uas koj yuav xav yog:

• Qhov cub me ntsis thaum cov tshuaj tau txhaj
• Lub plawv dhia ceev lossis lub plawv dhia
• Lub Cim Txhab Zog
• Hlawv thaum hluav taws xob siv hluav taws xob

Mob ablation yog siv los kho qee yam teeb meem kev mob plawv hauv lub plawv uas cov tshuaj tsis tswj. Cov teeb meem no tau txaus ntshai yog tias tsis kho lawv.

Cov tsos mob tshwm sim ntawm cov teeb meem hauv lub plawv tuaj yeem suav nrog:

• Kev mob hauv siab
• Tsaus muag
• Qaug plawv qeeb lossis nrawm (palpitations)
• Lub teeb muag taub hau, kiv taub hau
• Paleness
• Ua tsis taus pa
• Hla kev ntaus - hloov pauv ntawm cov qauv ntawm tus mem tes
• Tawm hws

Qee qhov teeb meem hauv lub plawv yog:

• AV raum rov qab tachycardia (AVNRT)
• Cov kab mob txuas ntxiv, xws li Wolff-Parkinson-White syndrome
• Atrial fibrillation
• Atrial nrov nrov
• Hlaus tachycardia

Catheter ablation feem ntau muaj kev nyab xeeb. Tham nrog koj tus kws kho mob txog cov teeb meem uas tsis tshua pom no:

• Los ntshav lossis tso ntshav sib xyaw qhov twg coj txoj raj txuas
• Cov ntshav txhaws uas mus rau cov hlab ntsha hauv koj txhais ceg, lub siab, lossis lub hlwb
• Kev puas tsuaj rau cov leeg ntshav uas cov catheter tau tso
• Kev puas tsuaj rau lub plawv li qub
• Kev puas tsuaj rau cov hlab ntshav ntawm cov hlab ntshav (cov hlab ntshav uas nqa ntshav rau koj lub plawv)
• Esophageal atrial fistula (qhov sib txuas uas tsim ntawm koj txoj hlab pas thiab ib feem ntawm koj lub siab)
• Kua dej ncig lub plawv (mob tamponade)
• Plawv nres
• Vagal lossis phrenic cov leeg puas

Qhia koj tus kws khomob paub txhua yam tshuaj uas koj siv, txawm yog tshuaj lossis tshuaj ntsuab uas koj mus yuav yam tsis muaj daim ntawv xaj yuav tshuaj.

Thaum lub hnub ua ntej cov txheej txheem:

• Nug koj tus kws kho mob saib koj yuav siv cov tshuaj twg hnub phais mob.
• Qhia rau koj tus kws kho mob yog tias koj noj tshuaj aspirin, clopidogrel (Plavix), prasugrel (Effient), ticagrelor (Brilinta), warfarin (Coumadin), lossis lwm cov ntshav ua kom ntshav zoo xws li apixaban (Eliquis), rivaroxaban (Xarelto), dabigatran (Pradaxa) thiab edoxaban (Savaysa).
• Yog tias koj haus luam yeeb, nres ua ntej cov txheej txheem. Nug koj tus kws khomob kom pab yog tias koj xav tau.
• Qhia koj tus kws kho mob yog tias koj muaj mob khaub thuas, mob khaub thuas, kub taub hau, mob pob txuv, lossis lwm yam mob.

Hnub ntawm txheej txheem:

• Feem ntau koj yuav tsum tsis txhob haus cawv los yog noj dab tsi tom qab ib tag hmo hmo ua ntej koj txoj kev.
• Siv cov tshuaj uas koj tus kws kho mob tau hais kom koj nqa nrog lub pas dej me me.
• Luag yuav qhia rau koj paub thaum mus txog hauv tsev kho mob.

Kev txo qis los ntshav tso rau ntawm thaj chaw uas tus ntsaws qhov quav tau ntsaws rau hauv koj lub cev. Koj yuav cia nyob hauv txaj tsawg kawg yog 1 teev. Koj yuav tsum tau nyob hauv txaj kom txog 5 lossis 6 teev. Koj lub plawv atherosclerosis yuav raug tshuaj xyuas thaum lub sijhawm no.

Koj tus kws kho mob yuav txiav txim siab seb koj puas tuaj yeem mus tsev nyob tib hnub, lossis yog tias koj yuav xav tau nyob hauv tsev kho mob ib hmos rau kev tshuaj xyuas lub plawv. Koj yuav xav tau ib tug neeg thauj koj mus tsev tom qab koj txoj kev.

Ntawm 2 lossis 3 hnub tom qab koj txoj kev kuaj mob, koj yuav muaj cov tsos mob no:

• Nkees
• Achy zoo nkaus li hauv siab
• Hla lub plawv dhia, lossis lub sijhawm thaum koj lub plawv dhia ceev ceev lossis tsis xwm yeem.

Koj tus kws kho mob yuav khaws koj cov tshuaj noj, lossis muab cov tshiab rau koj uas pab tswj koj lub plawv dhia.

Qeb ua tiav tau sib txawv raws li hom teeb meem lub plawv ua raws li tau kho.

Catheter ablation; Radiofrequency catheter ablation; Cryoablation - mob ablation; AV nodal reentrant tachycardia - mob ablation; AVNRT - mob ablation; Wolff-Parkinson-Dawb Syndrome - mob ablation; Atrial fibrillation - mob ablation; Atrial nrov nrov - mob ablation; Ventricular tachycardia - mob ablation; VT - mob ablation; Arrhythmia - mob ablation; Kev mob plawv tsis zoo - lub plawv nres

• Angina - tawm hauv
• Angina - thaum koj mob hauv siab
• Antiplatelet tshuaj - P2Y12 inhibitors
• Cov tshuaj aspirin thiab kab mob plawv
• Atrial fibrillation - paug tawm
• Butter, margarine, thiab roj ua noj
• Cov roj khov thiab txoj kev ua neej
• Tswj koj cov ntshav siab
• Kev noj haus cov rog piav qhia
• Cov lus qhia zaub mov nrawm
• Plawv nres - tso tawm
• Kab mob hauv lub plawv - yam txaus ntshai
• Lub plawv tsis ua haujlwm - tso tawm
• Lub plawv khiav ceev - paug
• Yuav nyeem daim ntawv zaub mov li cas
• Noj ntsev tsawg
• Mediterranean noj

Calkins H, Hindricks G, Cappato R, li al. 2017 HRS / EHRA / ECAS / APHRS / SOLAECE tus kws tshaj lij pom zoo cov lus ntawm catheter thiab phais ablation ntawm atrial fibrillation. Lub plawv dhia ceev ceevCov. 2017; 14 (10): e275-e444. PMID: 28506916 pubmed.ncbi.nlm.nih.gov/28506916/.

Ferreira SW, Mehdirad AA. Kev kuaj mob electrophysiology thiab cov txheej txheem electrophysiologic. Hauv: Sorajja P, Lim MJ, Kern MJ, eds. Kern's Cardhe Catheterization Phau Ntawv QhiaCov. 7 tus ed. Philadelphia, PA: Elsevier; 2020: chap 7.

Miller JM, Tomaselli GF, Zipes DP. Kev kho rau tus mob plawv dhia tsis xwm yeem. 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 36.