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გულის არითმია - უნდა გვეშინოდეს თუ არა მისი | ჯანმრთელობა | vidal.ge

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გულის არითმია - უნდა გვეშინოდეს თუ არა მისი

თარიღი: 01 ნოემბერი, 2021

არითმია პათოლოგიური მდგომარეობა, რაც გულის ცემის რითმის დარღვევით გამოიხატება. არითმიის დროს პულსი შეიძლება იყოს ასწრაფებული, შენელებული ან რითმიდან ამოვარდნილი შეკუმშვებით. მოსვენებულ მდგომარეობაში გული უნდა იკუმშებოდეს წუთში 60-85-ჯერ.

გულის არითმია ვითარდება, როცა ელექტრული იმპულსები, რაც იწვევს გულის შეკუმშვას, ფუნქციონირებს არასწორად და აიძულებს გულს იმუშაოს ძალიან სწრაფად ან ძალიან ნელა, არარეგულარულად ან არარითმულად.

არსებობს რამდენიმე ტიპის არითმია, რომელთა შესახებ „ავერსის კლინიკის“ კარდიოლოგი ნათია ნათელაშვილი მოგვითხრობს.

• ბრადიკარდია (ნელი ცემა)
• ტაქიკარდია (სწრაფი ცემა)
• არარითმული არითმია (ექსტრასისტოლური ანუ პულსის გამოტოვება, მოციმციმე არითმია )

არითმიების უმეტესობა არ საჭიროებს სერიოზულ მკურნალობას, თუცა რიგ შემთხვევებში შეიძლება სერიოზული გართულებები მოჰყვეს, რაც დამოკიდებულია არითმიის ფორმაზე.

გულის რითმის ცვლილების მაპროვოცირებელი ფაქტორებია:
• მაღალი არტერიული წნევა
• გულის იშემიური დაავადებები
• კარდიომიოპათიები
• ფარისებრი ჯირკვლის პათოლოგიები
• შაქრიანი დიაბეტი
• დიდი რაოდენობით თამბაქოს, ალკოჰოლისა და ყავის/კოფეინის მოხმარება
• ძლიერი სტრესი
• ზოგი მედიკამენტის ჭარბი დოზით მიღება
• ოპერაციის შემდეგ მდგომარეობა

არითმიის მკურნალობა და დიაგნოსტიკა
ძირითადად, არითმიის დროს გულის არეში იგრძნობთ არარეგულარულად გულის შეკუმშვას, ე.წ. გულის ფრიალს ან შენელებულ გულისცემას, ჩხვლეტის შეგრძნებას, თავბრუსხვევას, ჰაერის უკმარისობას, ზოგად სისუსტესა და დაღლილობას.

შესაძლებელია, რომ ზოგიერთ შემთხვევაში, სიმპტომები ვერც შენიშნოთ ექიმი-კარდიოლოგის მიერ დანიშნული გამოკვლევების გარეშე. დიაგნოსტიკა ხდება ინსტრუმენტული და ლაბორატორიული გამოკვლევებით:
• ელექტროკარდიოგრამა
• ექოკარდიოსკოპია
• ჰოლტერის 24-48 სთ მონიტორინგი
• ელექტროფიზიოლოგიური კვლევა
• ლაბორატორიული ანალიზები

არითმიის სამკურნალოდ სპეცილისტი ნიშნავს მკურნალობის კურსს დიაგნოზის ფორმის შესაბამისად, მედიკამენტურად ან ინვაზიური (ქირურგიული) ჩარევით. „ავერსის კლინიკაში“ ინვაზიური, ქირურგიული მეთოდით მკურნალობა მიმდინარეობს უახლესი გაიდლაინების თანახმად

რადიოსიხშირული (RF) აბლაცია - არითმიის სამკურნალოყველაზე გავრცელებული და უნივერსალური მეთოდი. კათეტერის წვერს მიეწოდება მაღალი სიხშირის ელექტრული დენი, რაც იწვევს კათეტერის შეხების ზედაპირზე ქსოვილის გახურებას და გარკვეული ტემპერატურის მიღწევის შემდეგ ხდება ამ ქსოვილის განადგურება, ე.წ. „მოწვა“.

კრიოაბლაცია - რადიოსიხშირული (RF) აბლაციის შემდეგ მეორე ყველაზე გავრცელებული მეთოდი. ამ შემთხვევაში სპეციალური კათეტერის შიგნით ხდება აზოტის ოქსიდის მიწოდება, რაც იწვევს კათეტერის შეხების ზედაპირზე ქსოვილის გაყინვას.

არსებობს აგრეთვე ენერგიის სხვა წყაროები, რომლებიც გაცილებით იშვიათად გამოიყენება, მაგ. მიკროტალღურიაბლაცია, ლაზერულიაბლაცია, ულტრაბგერითაბლაცია და ა.შ.

არსებობს აგრეთვე ალკოჰოლითაბლაცია, როდესაც ქსოვილის დაზიანება არა თერმულად, არამედ ქიმიურად ხდება.

დღეს აქტიური შესწავლის და გამოცდის ფაზაშია ე.წ. პულსურიველითაბლაცია (Pulsed Field Ablation), რომლის უპირატესობაა მხოლოდ კუნთოვანი ქსოვილის შერჩევითი დაზიანება და ე.წ. „გვერდითი დაზიანების“ არარსებობა.

კარდიოლოგის რჩევა
არითმიების დიდი ნაწილი დამოკიდებულია გულის სხვა დაავადებებთან, ამიტომ რეკომენდებულია ცხოვრების ჯანსაღი წესი, რაც გულისხმობს აქტიურ ცხოვრებას, ჯანსაღ კვებას, მოწევისა და ალკოჰოლისგან თავის შეკავებას.

გაითვალისწინეთ, დაუშვებელია მედიკამენტების თვითნებურად (კარდიოლოგის გარეშე) მიღება ან/და დოზის ცვლილება.