Aibrial fibrillation a i ʻole flutter

ʻO ka fibrillation Atrial a i ʻole ka flutter kahi ʻano maʻamau o ka naʻau kūlohelohe. Wikiwiki ka puʻuwai a wikiwiki pinepine ʻole.

Ke hana maikaʻi nei, nā keʻena 4 o ka ʻaelike puʻuwai (kaomi) i kahi ala hoʻonohonoho.

Kuhikuhi nā hōʻailona uila i kou puʻuwai e pīpī i ka nui o ke koko no nā makemake o kou kino. Hoʻomaka nā hōʻailona ma kahi i kapa ʻia ʻo node sinoatrial (i kapa ʻia ʻo sinus sinus a i ʻole SA node).

I ka atrial fibrillation, ka uila impulse o ka puʻuwai ʻaʻole maʻamau. ʻO kēia no ka mea ʻaʻole kaohi ka pona sinoatrial i ka mana o ka naʻau.

• ʻAʻole hiki i nā ʻāpana o ka puʻuwai ke ʻaelike i kahi kumu hoʻonohonoho.
• ʻO ka hopena, ʻaʻole hiki i ka puʻuwai ke paipū i ke koko e lawa ai nā pono o ke kino.

I ka flutter atrial, hiki i nā ventricle (nā lumi puʻuwai o lalo) ke paʻi wikiwiki loa, akā i kahi ʻano maʻamau.

Hiki i kēia mau pilikia ke hoʻopili i nā kāne a me nā wahine. Ua lilo lākou i mea maʻamau me ka hoʻonui ʻana o ka makahiki.

ʻO nā kumu maʻamau o ka atrial fibrillation nā:

• Hoʻohana ʻalekohola (ʻo ka inu pia paha)
• Maʻi maʻi ʻaʻai Coronary
• Ka hōʻeha puʻuwai a i ʻole ka puʻuwai holo ʻiʻo puʻuwai
• Hewa ʻole ka puʻuwai a i ʻole he puʻuwai hoʻonui
• ʻO ka maʻi valves puʻuwai (ʻo ka pinepine o ka mitral valve)
• Hypertension
• Nā Lapaʻau
• Kelepona thyroid overactive (hyperthyroidism)
• Pericarditis
• Maʻi maʻi sinus

ʻAʻole paha ʻoe e ʻike ʻaʻole e kuʻi ana kou puʻuwai i kahi kumu maʻamau.

E hoʻomaka a kū paha nā ʻōuli. ʻO kēia no ka mea e kū a hoʻomaka paha ʻo atrial fibrillation iā ia iho.

Pākuʻi ʻia paha nā ʻōuli:

• Pulse i manaʻo wikiwiki, heihei, kuʻi, pīpī, paʻewa, a lohi paha
• ʻO ka manaʻo o ka naʻau e kuʻi ka puʻuwai (palpitations)
• Huikau
• Puʻupuʻu, ʻālohilohi
• Mauleʻa
• Ka luhi
• Lilo o ka hiki ke hoʻoikaika kino
• Pokole o ka hanu

Lohe paha ka mea lawelawe olakino i kahi puʻuwai wikiwiki i ka hoʻolohe ʻana i kou puʻuwai me kahi stethoscope. E wikiwiki paha kāu pulse, pālua ʻole, a i ʻole ʻelua paha.

ʻO ka helu maʻamau o ka naʻau he 60 a 100 mau paʻi i kēlā me kēia minuke. I ka fibrillation atrial a i ʻole ka flutter, 100 a 175 paha ka nui o ka puʻuwai i kēlā me kēia minuke. Kūleʻa a haʻahaʻa paha ke kahe o ke koko.

Hiki i kahi ECG (kahi hōʻike e hoʻopaʻa i ka hana uila o ka puʻuwai) ke hōʻike i ka fibrillation atrial a i ʻole ka flutter atrial.

Inā hele a hele aku kou puʻuwai puʻuwai ʻole, pono ʻoe e komo i kahi nānā kūikawā e ʻike pono i ka pilikia. Hoʻopaʻa ka mea nānā i nā mele o ka puʻuwai i kahi manawa.

• Nānā hanana (3 a 4 mau pule)
• Holter monitor (hōʻoia 24-hola)
• Mea hoʻopaʻa loop implanted (nānā hoʻonui ʻia)

ʻO nā hoʻāʻo e ʻike i nā maʻi puʻuwai e komo pū paha:

• Echocardiogram (kiʻi ultrasound o ka puʻuwai)
• Nā hoʻāʻo e nānā ai i ka lako o ka puʻuwai puʻuwai
• Nā hoʻāʻo e hoʻopaʻa i ka ʻōnaehana uila o ka puʻuwai

Hoʻohana ʻia ka lāʻau Cardioversion e hoʻihoʻi i ka puʻuwai i kahi mele maʻamau i kēia manawa. ʻElua mau koho no ka mālama ʻana:

• Hoʻoweliweli nā uila i kou puʻuwai
• Nā lāʻau i hāʻawi ʻia ma o ka aa

Hana ʻia kēia mau ʻano hana e like me ke ʻano o ka ulia pōpilikia, a i ʻole hoʻolālā ʻia ma mua o ka manawa.

Lawe ʻia nā lāʻau i kēlā me kēia lā e ka waha e:

• E hoʻolohi i ke kuʻi puʻuwai kū ʻole - Hiki i kēia mau lāʻau ke hoʻopili i nā beta-blockers, nā blockers calcium, a me digoxin.
• Kāohi i ka fibrillation atrial mai ka hoʻi ʻana -- Hana maikaʻi kēia mau lāʻau i nā poʻe he nui, akā hiki iā lākou ke loaʻa nā hopena koʻikoʻi. Hoʻi ʻo Atrial fibrillation i nā poʻe he nui, ʻoiai lākou e lawe nei i kēia mau lāʻau.

Hiki ke hoʻohana ʻia kahi kaʻina hana i kapa ʻia ka hoʻopau ʻana i ka radiofrequency e hōʻino i nā wahi i loko o kou puʻuwai kahi e hoʻomaka ai nā pilikia o ka puʻuwai. Hiki i kēia ke pale i nā hōʻailona uila pono ʻole e kumu i ka fibrillation atrial a i ʻole ka lele ʻana mai ka neʻe ʻana i loko o kou puʻuwai. Pono paha ʻoe i ka pacemaker puʻuwai ma hope o kēia kaʻina hana. Pono nā poʻe āpau me ka fibrillation atrial e aʻo pehea e mālama ai i kēia ʻano ma ka home.

ʻO ka poʻe me ka fibrillation atrial e pono pinepine e lawe i nā lāʻau lahilahi o ke koko. Hoʻohana ʻia kēia mau lāʻau e hoʻoliʻiliʻi i ka makaʻu o ka hoʻomohala ʻana i kahi ʻōpū o ke koko e hele i ke kino (a hiki ke kumu i kahi hahau, no ka laʻana). ʻO ke kaʻina puʻuwai kūlike ʻole e hana ʻia me ka fibrillation atrial e hana hou ʻia ai nā clots koko.

ʻO nā lāʻau lapaʻau lahilahi ke koko me heparin, warfarin (Coumadin), apixaban (Eliquis), rivaroxaban (Xarelto), edoxaban (Savaysa) a me dabigatran (Pradaxa). Hiki ke kuhikuhi ʻia nā lāʻau Antiplatelet e like me aspirin a i ʻole clopidogrel. Eia nō naʻe, hoʻonui nā mea lahilahi o ke koko i ka manawa o ke kahe ʻana o ke kahe, no laila ʻaʻole hiki i nā mea āpau ke hoʻohana iā lākou.

ʻO kekahi koho pale pale ahulau no ka poʻe hiki ʻole ke lawe palekana i kēia mau lāʻau lapaʻau ʻo ia ka Watchman Device, i ʻae ʻia e ka FDA. ʻO kēia kahi implant-form implant i hoʻokomo ʻia i loko o ka puʻuwai e ālai ai i ka wahi o ka puʻuwai kahi o ka hapa nui o nā clots e hana ai. Kuhi kēia i nā clots form form.

E noʻonoʻo kāu mea hāʻawi i kou mau makahiki a me nā pilikia olakino ʻē aʻe i ka hoʻoholo ʻana i nā ʻano hana pale stroke ʻoi aku ka maikaʻi no ʻoe.

Hiki i ka mālama ʻana ke kaohi pinepine i kēia maʻi. Hana maikaʻi nā poʻe he nui me ka fibrillation atrial me ka lāʻau.

Hoʻihoʻi ʻo Atrial fibrillation i ka hoʻi a ʻinoʻino. E hoʻi paha ia i kekahi poʻe, ʻoiai me ka lāʻau.

ʻO nā ʻōpala i haki a hele i ka lolo hiki ke hōʻeha i ka maʻi ʻōiwi.

Kāhea i kāu mea hāʻawi inā loaʻa iā ʻoe nā ʻōuli o atrial fibrillation a i ʻole flutter.

E kamaʻilio i kāu mea hoʻolako e pili ana i nā ʻanuʻu e mālama ai i nā kūlana e kumu ai ka fibrillation atrial a me ka flutter. Pale i ka inu pia.

Auricular fibrillation; A-fib; ʻO Afib

• Aibrial fibrillation - hoʻokuʻu
• Hoʻomaʻamaʻa i ka puʻuwai - hoʻokuʻu
• Lawe iā warfarin (Coumadin, Jantoven) - he aha e nīnau aku ai i kāu kauka

• Puʻuwai - ʻāpana ma waena o ka waena
• Puʻuwai - ʻike mua
• Nā aʻa puʻuwai posterior
• Nā aʻa puʻuwai mua
• ʻŌnaehana hoʻoneʻe o ka puʻuwai

Ianuali CT, Wann LS, Calkins H, et al. Ua hoʻokumu ʻo 2019 AHA / ACC / HRS i ka hoʻohou o ka 2014 AHA / ACC / HRS alakaʻi no ka mālama ʻana i nā mea maʻi me ka fibrillation atrial: kahi hōʻike o ka American College of Cardiology / American Heart Association Task Force e pili ana i nā kuhikuhi a me ka Heart Rhythm Society ma ka laulima ʻana me ka Society of Thoracic Surgeons. Kaapuni. 2019; 140 (6) e285. PMID: 30686041 pubmed.ncbi.nlm.nih.gov/30686041.

Meschia JF, Bushnell C, Boden-Albala B, et al. Nā ʻōkuhi no ka pale mua ʻana i ka hahau: kahi ʻōlelo no ka poʻe ʻoihana ola kino mai ka American Heart Association / American Stroke Association. Hahau. 2014; 45 (12): 3754-3832. PMID: 25355838 pubmed.ncbi.nlm.nih.gov/25355838.

Morady F, Zipe DP. Aibrial fibrillation: nā hiʻohiʻona maʻi, nā ʻano hana, a me ka hoʻokele. I: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. ʻO ka maʻi puʻuwai ʻo Braunwald: kahi puke o ka lāʻau Cardiovascular. 11th hua. Piladelapia, PA: Elsevier; 2019: chap 38.

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.