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რა არის მოციმციმე არითმია

თარიღი: 06 დეკემბერი, 2020

მოციმციმე არითმია - 10 ყველაზე ხშირად დასმული კითხვა

წინაგულთა ფიბრილაცია ანუ მოციმციმე არითმია ერთ-ერთი ყველაზე გავრცელებული და საყურადღებო არითმიაა. ამ არითმიის შესახებ 10 საინტერესო შეკითხვას ნიუ ჰოსპიტალსის არითმიების ცენტრის ხელმძღვანელი ზვიად მათოშვილი უპასუხებს.

 

1. რა არის მოციმციმე არითმია და როგორ უნდა დადგინდეს დიაგნოზი?
მოციმციმე არითმია - არითმიის სახეობაა როდესაც გული სრულიად არარიტმულად და ქაოტურად იკუმშება. მისი დიაგნოსტიკა საკმაოდ მარტივია და სტანდარტული კარდიოლოგიური კვლევები (მაგალითად არითმიის დროს გადაღებული კარდიოგრამა) საკმარისია დიაგნოზის დასადგენად.

2. რა არის მოციმციმე არითმიის მიზეზი?
მას მხოლოდ ერთი გამომწვევი მიზეზი არ აქვს. ხშირად ეს არის გულის სხვადასხვა (მათ შორის სარქვლოვანი) დაავადება, ფარისებრი ჯირკვლის ფუნქციის დარღვევები, ელექტროლიტების დისბალანსი, თამბაქო-ალკოჰოლის მოხმარება, ჭარბი წონა, ძილის აპნოე და ა.შ. იშვიათად შეიძლება მოციმციმე არითმია სრულიად უმიზეზოდ განვითარდეს.

3. რა ჩივილები აქვს მოციმციმე არითმიას?
სისუსტე, გულის ფრიალი, აჩქარებული გულისცემის შეგრძნება, დაღლილობა, ქოშინი, უჰაერობა, თავბრუსხვევა და ა.შ. ძალზედ იშვიათად პაციენტს შესაძლოა არ ჰქონდეს ჩივილები. ჩივილების სიმძაფრეს განსაზღვრავს არითმიის დროს გულისცემის სიხშირე და პაციენტის ინდივიდუალური მგრძნობელობა.

4. რა რისკები ახლავს მოციმციმე არითმიას?
ამ არითმიის დროს იზრდება გულის უკმარისობის განვითარების, თრომბის წარმოქმნის და იშემიური ინსულტის რისკი. ამასთან მოციმციმე არითმია დამოუკიდებლად ზრდის სიკვდილობას.

5. როგორ ხდება მისი მკურნალობა?
მკურნალობა იწყება მედიკამენტური თერაპიით. ანტიარითმიულ მკურნალობასთან ერთად, აუცილებელია თრომბის წარმოქმნის რისკის შეფასება და შესაბამისი „სისხლის გამათხელებელი“ პრეპარატის შერჩევა. უხშირესად მედიკამენტური თერაპია არ არის საკმარისი სიმპტომების გასაკონტროლებლად. ამ შემთხვევაში რეკომენდებულია აბლაცია.

6. რა არის აბლაცია?
აბლაცია პროცედურაა რომელიც არითმიის კერების მოშორებას გულისხმობს. პროცედურა ტარდება ადგილობრივი ანესთეზიით, ბარძაყიდან ჩხვლეტით (გაჭრის გარეშე). ხდება გულში არითმიების კერების „მოწვა“ (რადიოსიხშირული აბლაცია), ან „გაყინვა“ (კრიო აბლაცია).

7. როგორია გართულებების ალბათობა და რამდენად შედეგიანია პროცედურა?
მოციმციმე არითმიის აბლაციის დროს სახიფათო გართულებების ალბათობა 1-2%-ია. ერთი აბლაციის ეფექტურობა დაახლოებით 70%-ია. საჭიროების შემთხვევაში შესაძლებელია ჩატერდეს განმეორებითი აბლაცია, თუმცა პირველივე აბლაციის შემდეგ პაციენტების უმრავლესობას აქვს მნიშვნელოვანი შედეგი. პაციენტის დროული ვიზიტი არითმოლოგთან პრინციპულად მნიშვნელოვანია. რაც უფრო ადრე იკეთებს პაციენტი აბლაციას აქვს უკეთესი შედეგი. ძალიან დაგვიანებულ შემთხვევებში აბლაცია არაეფექტურია.

8. რა ხანგრძლივობისაა აბლაცია და რამდენ ხანს ყოვნდება პაციენტი კლინიკაში?
მოციმციმე არითმიის აბლაცია საშუალოდ გრძელდება საათნახევარს. სტანდარტულად პაციენტი კლინიკაში რჩება ერთი დღე-ღამე და შემდეგ მიბრძანდება სახლში.

9. აბლაციის შემდეგ რამდენ ხანს გრძელდება შეზღუდვები?
სტანდარტულად პაციენტებს ეძლევათ რეკომენდაცია რომ 10-14 დღე თავი შეიკავონ ფიზიკური დატვირთვისგან და იცხოვრონ სახლის პირობებში. რამე განსხვავებული შეზღუდვები საჭირო არ არის.

10. საჭიროა თუ არა მედიკამენტების გაგრძელება მოციმციმე არითმიის აბლაციის შემდეგ?
როგორც მინიმუმ რამდენიმე თვე ეს აუცილებელია. ამის შემდეგ ხდება პაციენტის რისკების შეფასება. თუ პაციენტს აქვს თრომბის განვითარების სხვა რისკები, მაგალითად გადატანილი ინსულტი, დიაბეტი და ა.შ. მედიკამენტების ხანგრძლივად მიღება აუცილებელია. წარმატებული აბლაციის შემდეგ, დაბალი რისკის პაციენტებთან მედიკამენტური მკურნალობის შეწყვეტა შესაძლებელია.