ʻO Wolff-Parkinson-White syndrome (WPW)

ʻO Wolff-Parkinson-White (WPW) kahi maʻi kahi aia he ala uila hou aʻe i ka puʻuwai e alakaʻi i nā manawa o ka wikiwiki o ka naʻau (tachycardia).

ʻO ka maʻi ʻo WPW kekahi o nā kumu maʻamau o ka pilikia wikiwiki o ka naʻau i nā pēpē a me nā keiki.

ʻO ka maʻamau, ukali nā hōʻailona uila i kekahi ala i loko o ka puʻuwai. Kōkua kēia i ka puʻuwai e hoʻokau pinepine. Pale kēia i ka puʻuwai mai ka loaʻa ʻana o nā kuʻi keu a i ʻole ke kuʻi koke ʻana.

I ka poʻe me ka maʻi maʻi WPW, hele kekahi o nā hōʻailona uila o ka puʻuwai i kahi ala keu. Hiki paha i kēia ke kumu o ka wikiwiki wikiwiki o ka naʻau i kapa ʻia ʻo supraventricular tachycardia.

ʻO ka hapa nui o ka poʻe me ka maʻi ʻoWWW ʻaʻohe pilikia puʻuwai ʻē aʻe. Eia nō naʻe, ua pili kēia ʻano me nā ʻano maʻi puʻuwai ʻē aʻe, e like me ka anomalia ʻo Ebstein. Ke holo nei kekahi ʻano o ke ʻano i loko o nā ʻohana.

ʻEhia ka manawa o ka wikiwiki o ka puʻuwai wikiwiki e like me ke kanaka. ʻO kekahi poʻe me ka maʻi maʻi ʻo WWW he mau ʻāpana wale nō o ka wikiwiki o ka puʻuwai. Loaʻa i ka poʻe ʻē i ka helu wikiwiki o ka naʻau i hoʻokahi a i ʻole ʻelua mau manawa o ka pule a ʻoi. Eia kekahi, ʻaʻohe paha hōʻailona, ​​no laila ʻike ʻia kēlā ʻano ke hana ʻia kahi hoʻāʻo puʻuwai no kekahi kumu ʻē aʻe.

Loaʻa i kahi kanaka me kēia maʻi maʻi:

• ʻO ka ʻeha o ka umauma a i ʻole ke kūpaʻa o ka umauma
• Puʻupuʻu
• ʻĀlohilohi
• Mauleʻa
• Palpitations (kahi manaʻo o ka puʻuwai ʻana o kou puʻuwai, e wikiwiki a i ʻole maʻamau)
• Pokole o ka hanu

ʻO kahi hoʻokolohua kino i hana ʻia i ka wā tachycardia e hōʻike i ka wikiwiki o ka puʻuwai ma mua o 100 mau kuʻi i kēlā me kēia minuke. ʻO ka nui o ka puʻuwai maʻamau he 60 a 100 mau paʻi i kēlā me kēia minuke i nā mākua, a ma lalo o 150 mau kī i kēlā me kēia minuke i nā keiki hānau hou, nā pēpē, a me nā keiki liʻiliʻi. E maʻamau a haʻahaʻa paha ke kahe o ke koko i ka hapanui o nā hihia.

Inā ʻaʻohe tachycardia o ke kanaka i ka manawa o ka hoʻokolohua, maʻamau paha nā hopena. ʻIke ʻia paha ke ʻano me kahi ECG a i ʻole me ka nānā ʻana o ECG ambula, e like me kahi nānā Holter.

Hana ʻia kahi hoʻokolohua i hoʻopaʻa ʻia i kahi electrophysiologic study (EPS) me ka hoʻohana ʻana i nā catheters i kau ʻia i ka puʻuwai. Hiki ke kōkua i kēia hoʻāʻo e ʻike i kahi o ke ala uila hou.

ʻO nā lāʻau, ʻo ia hoʻi nā lāʻau antiarrhythmic e like me procainamide a i ʻole amiodarone, hiki ke hoʻohana ʻia e kaohi a pale ai i ka puʻuwai wikiwiki.

Inā ʻaʻole hoʻi ka helu o ka puʻuwai i ka maʻamau me ka lāʻau lapaʻau, hiki i nā kauka ke hoʻohana i kahi ʻano o ka lāʻau i kapa ʻia he cardioversion uila (weliweli)

ʻO ka hoʻomaʻamaʻa wā lōʻihi no ka maʻi ʻo WPW he pinepine ka hoʻopau ʻana i ka catheter. Pili kēia hana i ka hoʻokomo ʻana i ka paipu (catheter) i loko o kahi aa ma o kahi ʻoki liʻiliʻi kokoke i ke aʻa a hiki i ka puʻuwai. Ke hōʻea ka wēlau i ka puʻuwai, hoʻopau ʻia ka wahi liʻiliʻi e hoʻomaka ana i ka wikiwiki o ka puʻuwai me ka hoʻohana ʻana i kahi ʻano ikehu kūikawā i kapa ʻia ʻo radiofrequency a i ʻole e ke anuanu (cryoablation). Hana ʻia kēia ma kahi ʻāpana o kahi noi electrophysiologic (EPS).

Wehe i ka puʻuwai puʻuwai e kuni a hoʻopaʻa ʻia i ke ala keu ke hāʻawi i kahi ola mau no ka maʻi maʻi WPW. I ka hapanui o nā hihia, hana ʻia kēia hana inā pono ʻoe i kahi ʻoki puʻuwai no nā kumu ʻē aʻe.

Hoʻōla ʻo Catheter ablation i kēia maʻi i ka hapa nui o ka poʻe. ʻO ka helu kūleʻa no nā kaʻina hana ma waena o 85% a 95%. E loli ka helu kūleʻa i ka wahi a me ka helu o nā ala keu.

Komo pū nā pilikia:

• Nā pilikia o ke kaha ʻana
• Hewa puʻuwai
• Hoʻoemi i ke koko (hoʻokumu ʻia e ka wikiwiki o ka puʻuwai)
• Nā hopena o nā lāʻau

ʻO ke ʻano ʻoi loa o ka puʻuwai wikiwiki o ka fibrillation ventricular (VF), i alakaʻi wikiwiki ʻia ai i ka haʻalulu a i ʻole ka make. Hiki i kekahi manawa ke hana i nā poʻe me WPW, keu hoʻi inā loaʻa iā lākou ka atrial fibrillation (AF), kahi ʻano ʻē aʻe o ka puʻuwai puʻuwai maʻamau. ʻO kēia ʻano puʻuwai wikiwiki e koi ai i ka hoʻoponopono ulia pōpilikia a me kahi kaʻina i kapa ʻia ʻo cardioversion.

Kāhea i kāu kahu mālama ola inā:

• Loaʻa iā ʻoe nā ʻōuli o ka maʻi maʻi WPW.
• Loaʻa iā ʻoe kēia maʻi a hele a maikaʻi ʻole nā ​​ʻōuli a hoʻomaikaʻi ʻole paha me ka lāʻau.

E kamaʻilio i kāu mea hoʻolako e pili ana inā e nānā ʻia nā lālā o kou ʻohana no nā ʻano hoʻoilina o kēia ʻano.

Preexcitation maʻi maʻi; WPW; Tachycardia - Wolff-Parkinson-White maʻi maʻi; Arrhythmia - WPW; Manaʻo puʻuwai maʻamau - WPW; Kuʻi puʻuwai wikiwiki - WPW

• ʻO anomaly ʻo Ebstein
• Holter puʻuwai nānā
• ʻŌnaehana hoʻoneʻe o ka puʻuwai

ʻO Dalal AS, ʻo Van Hare GF. Hoʻopilikia i ka helu a me ke mele o ka puʻuwai. I: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. ʻO Puka Textbook of Pediatrics ʻo Nelson. 21st ed. Piladelapia, PA: Elsevier; 2020: chap 462.

ʻO Tomaselli GF, Zipe DP. E hoʻokokoke i ka mea maʻi me nā arrhythmia naʻau. I: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. ʻO ka maʻi puʻuwai ʻo Braunwald: He puke aʻo no ka lāʻau Cardiovascular. 11th hua. Piladelapia, PA: Elsevier; 2019: chap 32.

Zimetbaum P. Supraventricular cardiac arrhythmia. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 58.