Me yasa LBBB yana da muhimmanci?
Haɗin hagu mai shinge abu ne mai mahimmanci a kan electrocardiogram (ECG) , wanda ya nuna cewa ba a rarraba wutar lantarki ta wutar lantarki a fadin ventricles na zuciya a hanya ta al'ada.
Abin da ke sanya Block Branch Bundle?
Ƙungiyar rassan za a iya ɗauka a matsayin wani ɓangare na na'urar lantarki ta "wiring." Su ne hanyoyi na lantarki wanda aka tsara don yada zuciya ta wutar lantarki ta hanyar ventricles.
Wannan yana tabbatar da cewa haɗin gwiwar ventricles biyu an hade.
Tare da hagu na reshen reshe, sashin layin da ke raba wutar lantarki zuwa hagu na ventricle yana ɓangare ko gaba ɗaya an katange. Wannan rikici ya jinkirta dakatar da na'urar ta ventricle hagu. A sakamakon haka, an yi amfani da ventricle mai kyau, kuma ya fara kwangila, kafin a fara ventricle hagu.
Domin zuciya ta yi nasara kamar yadda ya kamata, duka ventricles ya yi kwangila a lokaci guda. Don haka hagu na reshe reshe zai iya rage yawancin zuciya. Wannan raguwa ta dacewa na zuciya zai iya zama maras muhimmanci a cikin wanda zuciyarsa ta kasance ta al'ada, amma zai iya samun tasiri sosai ga mutanen da ke da wasu cututtukan zuciya-musamman gazawar zuciya .
Binciken Block Branch Block Branch
Rashin shinge na sashin hagu yana kawo canje-canjen halayen akan ECG, don haka likitoci zasu iya gano wannan yanayin ta hanyar nazarin ECG kawai.
Yankin ECG da ake kira ƙwayar QRS yana wakiltar wutar lantarki da aka raba a fadin ventricles. Yawancin lokaci, saboda duka ventricles ana motsa su a lokaci guda, ƙwayar QRS tana da zurfi-kullum, tsakanin 0.08 da 0.1 seconds a tsawon lokaci. Tare da shinge na shinge na hagu, ƙwayar QRS ta fi girma, sau da yawa fiye da 0.12 seconds.
Bugu da ƙari kuma, rikodin tsarin ECG ya nuna nau'ukan "ra'ayoyin 12" (da ake kira "mai jagoranci") na aikin wutar lantarki, kuma likitoci zasu iya nazarin wadannan ɗakunansu daban-daban don samun ra'ayi game da wurin da matsaloli na zuciya ke ciki. Tare da shinge na shinge na shinge, ƙwayar QRS mai zurfi ta bayyana a cikin wasu masu jagoranci, kuma ƙasa a wasu. Ta hanyar bincikar tsawon lokacin QRS, da kuma yadda ya dace da nau'o'in ECG, yana da sauƙin sauƙin gano ƙwaƙwalwar reshe mai shinge lokacin da yake a yanzu.
Me ya sa Ginin Mahimmin Block na Ƙauren Hagu ya bar?
Haɓakar shinge na hagu shi ne muhimmiyar ganowa don dalilai biyu.
Na farko, ƙwaƙwalwar reshe na shinge mafi sau da yawa yana faruwa ne saboda sakamakon ƙananan zuciya. Saboda haka idan an samo shi, to akwai yiwuwar wasu mahimmancin yanayin zuciya na zuciya.
Abu na biyu, kamar yadda muka gani a baya, hagu na hagu reshe yana iya sa zuciya ya yi aiki mara kyau a cikin mutanen da ke da wasu cututtukan zuciya.
Hagu na Lamin Hagu na Ƙaura da kuma Cutar Zuciya
Haɗarin shinge mai shinge yafi rinjaye tsofaffi. An samo shi a kasa da kashi 1 cikin dari na mutane a cikin shekaru 50; a bambanta, kimanin kashi 6 cikin 100 na 'yan shekaru 80 sun bar rassan reshe.
Yawancin mutanen da ke dauke da suturar sutura suna da wasu nau'i na cututtukan zuciya. A cikin nazarin Framingham, batutuwa da suka haɗu da ƙwayar sashi sun kasance kimanin shekarun 62, kuma suna da muhimmanci ƙwarai da yawa da suka kamu da hawan jini , cututtukan zuciya da cututtukan zuciya , ko cututtuka na maganin jini (CAD) . A gaskiya ma, a lokacin binciken Framingham, kashi 89 cikin 100 na mutanen da suka ci gaba da suturar sashi sun kasance an gano su da wani nau'i na cututtuka na zuciya da jijiyoyin jini.
Abin da ake nufi shi ne cewa kowa, na kowane zamani, wanda aka samu ya bar rassan reshe ya kamata ya sami kimantawa na zuciya don neman ƙwayar zuciya.
Wannan kimantaccen ya kamata ya hada da akalla sakonnin echocardiogram , kuma idan hadarin haɗari sun kasance don CAD, dole ne a yi la'akari sosai da nazarin karfafa / thallium . Cutar da ke cikin kwakwalwa ta musamman na LBBB sun haɗa da hauhawar jini, CAD, rashin zuciya, hyperiophic cardiomyopathy , ko cututtukan zuciya .
Idan babu wani cututtukan zuciya da aka gano bayan binciken ƙwaƙwalwar zuciya a cikin mutumin da ke da shinge mai shinge, musamman ma a cikin mutane a kasa da 50, zangon ya nuna cewa yana da kyau sosai. A cikin waɗannan lokuta, ƙuƙwalwar reshe na ƙuƙwalwar hagu yana da kyau a ɗauka a matsayin mai ladabi, binciken ECG wanda ya faru.
Haɗe Block na Block da kuma Sakamako na Heartbeat
A cikin shinge na shinge na hagu, ƙwararrun ƙwararrakin zuciya guda biyu suna motsawa ta hanyar motsi ta wutar lantarki a cikin jerin, maimakon a lokaci guda. Watau, ventricle na hagu ne ke motsawa kawai bayan da aka ƙaddamar da ventricle mai kyau. Sabili da haka, shinge mai shinge yana da asarar haɗin daidaituwa tsakanin ƙananan ventricles guda biyu, wanda ya rage karfin zuciya. Zuciya dole ne ya yi aiki da wuyar gaske don samun damar iya yin famfo.
A yarinya, masu lafiya da hagu na shinge, har ma a cikin tsofaffi wadanda ke da ƙwayar shinge wanda zasu iya samun ciwon zuciya, rashin daidaituwa a cikin kwakwalwa na zuciya ya zama maras kyau, kuma shaidu na yanzu suna nuna cewa hagu mai launi reshe kanta ba ya sanya matsala a cikin wadannan mutane.
Duk da haka, a cikin mutanen da suke da ciwon zuciya da haɓakar haɓaka mai haɓaka mai haɓaka mai hagu wanda aka rage zuwa kasa da kashi 35 cikin dari, hagu na reshen reshe zai iya haifar da mahimmanci a cikin ƙwayar zuciya. Wannan rageccen haɓaka zai iya ƙara yawan ciwon zuciya, kuma ya tabbatar da bayyanar cututtuka.
Yin amfani da farfajiyar resynchronisation na zuciya (CRT) ya kamata a yi la'akari sosai a cikin mutane kamar wannan. CRT wani nau'i ne na mai ɗaukar nau'in gyare-gyare wanda ya sake daidaita rikici na ventricles, kuma zai iya inganta ingantaccen zuciya ta jiki a cikin mutanen da ke da shinge na shinge da kuma rashin nasara na zuciya.
Kwancen Bincike na Gwaninta na Farko da Hagu na Ƙaura
Maganin da aka saba da shi yana sa zuciya daga gwanin kafa wanda yake a hannun dama na ventricle. Saboda tayin lantarki (wanda a cikin wannan yanayin ya fito ne daga na'urar bugun zuciya) yana ƙarfafa ƙwararrun ventricle kafin hagu na ventricle, haɗin da suke da dindindin a cikin halayen shinge suna haifar da shinge mai shinge mai shinge.
A cikin 'yan shekarun nan, wasu shaidu sun nuna cewa mutane tare da raguwar haɓaka masu haɓaka na hagu, waɗanda suke da masu cin gashin hankali mai cin gashin kai wadanda ke da haɗari duka ko mafi yawan lokuta, na iya samun haɓaka ƙin ƙusar zuciya ta hanyar ƙaddamar da haɓakaccen hagu damfara reshe. Saboda haka, wasu masana yanzu suna amfani da masu amfani da CRT (wanda ya guje wa shinge mai shinge mai haɗin gwiwa) wanda zai kauce wa mutane tare da rage yawan raunin ejection waɗanda suke dogara ga dindindin masu riko.
Shin Block Branch Block Require a Pacemaker Permanent?
Sai dai idan akwai dalilin da za a saka mai ɗauka na CRT don sake sarrafa aikin ventricles, yawancin mutanen da ke cikin shinge na sashin layi bazai buƙatar mai buƙata ba.
Duk da haka, a wasu lokuta gaban hagu na reshe reshe yana nuna ƙarin ƙwayar cuta na tsarin kula da wutar lantarki. A irin waɗannan mutane, sigin na lantarki na zuciya zai iya zama rushewa a hanyoyi da dama, kuma gagarumar bradycardia (jinkirta zuciya) zai iya ci gaba, kuma za'a iya buƙatar mai ɗauka na dindindin. Saboda wannan dalili kawai, mutanen da ke dauke da shinge na sashi suna tabbatar da cewa suna da dubawar likita.
Kalma Daga
Haɗin hagu na sashin hagu yana da lalata tsarin tsarin motsi na zuciya. Duk wanda aka bincikarsa tare da hagu na reshe ya kamata ya sami kimantawa na zuciya don nemo cutar cututtukan da ke buƙatar magani. Kuma a wasu lokuta-musamman a mutanen da suke da rashin zuciya a cikin haɗin ginin shinge na sashin jiki-rassan shinge na kanta zai iya buƙatar magani tare da mai ɗaukar hoto na CRT.
Duk da haka, idan cikakken bincike na zuciya ya nuna babu cututtukan zuciya, toshe hagu na reshe mai yiwuwa ana iya la'akari da shi azaman rashin lafiya.
> Sources:
> Badheka AO, Singh V, Patel NJ, et al. QRS Duration on Electrocardiography and Mortality Cardiovascular (daga Gudanar da Lafiya Neman Gina Survey-III). Am J Cardiol 2013; 112: 671.
> Curtis AB, Worley SJ, Adamson PB, et al. Bcingricular Pacing don Ƙunƙwirar Atrioventricular da Tsarin Dama. N Engl J Med 2013; 368: 1585.
> Imanishi R, Seto S, Ichimaru S, et al. Ƙididdigar Ƙwararren Ƙwaƙwalwar Ƙirƙashin Ƙarƙashin Ƙafacciyar Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarya. Am J Cardiol 2006; 98: 644.
> Schneider JF, Thomas HE Jr, Kreger BE, et al. Sabuwar Block-Block Block: Sabon Framingham. Ann Intern Med 1979; 90: 303.