✍ 11🍎🍏 Notes of ECG ✍ | United States America (US)

Create: 2024-02-11 Update: 2024-06-12 06:09:50

‍ 🍎 فیبریلاسیون دهلیزی

🍏 چندین کانون دهلیزی با سرعت ضربان دهلیزی 400 تا 600 ضربان سازی میکنند اما هیچ انقباض دهلیزی موثری اتفاق نمی افتد و فقط دهلیز به لرزش در می آید. ریتم نامنظم نامنظم

در Af ممکن است کمپکلس norrow(باریک) باشد یا wide(پهن) باشد.
چنانچه wide باشد 2 تشخیص دارد:
۱) ابررنسی (RBBB/LBBB)
۲) راه فرعی(WPW)

اگر کوچکترین RR کمتر از 6خانه کوچک باشد Af با راه فرعی هست اگر بیش تر از 6 خانه کوچک باشد Af با ابررنسی هست.
یا اینکه وجود یا عدم وجود امواج دلتا را تشخیص دهید و سپس راه فرعی را تایید یا رد کنید.
چرا مهم است تشخیص دهیم که راه فرعی دارد یا ابررنسی؟؟
گره AV به صورت فیزیولوژیک تعدادی از این ۶۰۰-۴۰۰ضربان دهلیزی را بلوک میکند و نمیگذارد که به بطن برسد و اگر راه فرعی را نتوانیم تشخیص دهیم و داروهای کاهش هدایت گرهAV مثل وراپامیل یا دیژوکسین یا.‌.. بزنیم یقینا هدایت از راه فرعی را افزایش داده ایم بنابراین ضربانات همه به بطن میرسد و بیمار VF خواهد کرد. پس مهم است که راه فرعی را تشخیص دهیم و بهترین گزینه درمان یعنی پروکایین آمید یا آمیودارون را انتخاب کنیم.

و اما ممکن است در Af یک کمپلکسی شبیه به PVC ببینید که با سایر کمپلکس ها فرق دارد که این Af با پدیده آشمن نام دارد.
زمانی Af منظم میشود که همراه با CHB باشد.
و Af بر اساس پاسخ بطنی ممکن است:
Af RVR
ریت بطنی بیش از 100
Af CVR
ریت بطنی 100_60
Af SVR
ریت بطنی زیر 60

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✍ 11🍎🍏 Notes of ECG ✍

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✍ 11🍎🍏 Notes of ECG ✍

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‍ 🍎 فیبریلاسیون دهلیزی

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