Pacemaker - chii? Sei chinodzora kurova? mutengo kushanda

Pacemaker - kuti sokuona zvokurapa? Chokutanga, ndiko vakasiyana wemagetsi kuti normalizes mwoyo tsandanyama. Heart pacemaker anopa optimum nhamba maronda anodiwa kuti kwomuzvarirwo upenyu. The Chishandiso anokwanisa kukurira electrophysiological dissociation pamusoro atria uye ventricles, vanonzi atrioventricular misa, uye nokudaro dzikamisa mwoyo.

History chokusika

Pacemaker - izvi nokuda physiologist? Sezvo mudziyo ichi inogona kushandiswa mashoko kwaitwa pamusoro pathological pezvakaitwa munyika kumwoyo womunhu muviri? Kushandisa simba remagetsi pulses kubvisa arrhythmias vatsvakurudzi vakashamiswa mukupera kwezana remakore rechi19. Zvisinei, kushaya zvigadzirwa nokuda generating zvemagetsi anotumira ari kushoma ukoshi haabvumirwi kunyange kutanga kutsvakurudza mirayiridzo iyi.

Chete yokutanga yezana remakore rechi20, vanachiremba, masayendisiti anogona kutanga kudzidza matambudziko magetsi nomunhu mumwoyo basa. Mumwe piyona munharaunda iyi yaiva mutsvakurudzi Italian Luigi Galvani. Papera physiologists Russian N. E. Vvedensky uye Yu. M. Chagovets rakatanga kudzidza mukana kwokushandisa simba remagetsi zvinoerera kuti kurapwa vamwe zvirwere mwoyo.

Muna 1927, imwe American cardiologist Albert Hyman akaita rakagadzirirwa yokutanga Electro-zvokuimba mudziyo kwenyika kuramba mudanga mutinhimira mwoyo womunhu. The muchina kuremerwa magiramu anodarika mazana matatu, kuti mudziyo iri yakaturikwa unokosha bhandi uye zvakavanzwa pasi zvipfeko. Zvisinei, pacemaker kwaiitwa zvakanaka, munguva pfupi yave kwakatangwa Serial kugadzirwa.

kutanga zvabuda

Pacemaker - zviri pamusoro Alberta Haymena, Musiki chikwata nevamwe vake pakubata cardiac arrhythmia? Chokutanga, ichi ndicho danho rokutanga refu Nzira kudzidza magetsi okugadzira unyanzvi, izvo zvinogona kuiswa pa basa zvokurapa.

Kushanda kunoita rinodhaka Hyman mu pakaita dambudziko kwakaitika muna 1951, apo avhiyiwa akakwanisa kuponesa kushivirira yepamusoro transverse mwoyo nechigumbuso uye arrhythmia Zvikamu. Kunyange zvakadaro, murwere akanga kwenguva refu muchipatara, sezvo akanga asina yaizotamira takasununguka ane kumbonyanya kura midziyo pamusoro muviri uye, uyezve, aida kugara achitarisirwa kuti vanachiremba.

Rinodhaka-kudyara

World Cardiology Center vakabatana kuumba tsindirana magetsi stimulator, izvo achafunga anopfuura 80 magiramu. Muna 1958 rimwe boka remasayendisiti Swedish, akatungamirirwa Dr. Rune Elmqvist akasika maduku "Siemens-El." Stimulator akaiswa mujeri iri dzimba mutete-akavakirirwa yakagadzirwa titanium chiwanikwa uye kunogona akaisa pasi ganda. Zvisinei, simba kudyiwa pamusoro Swedish kuvamba yaiva duku - the bhatiri inopa kupomba kwemwedzi 18 chete, pashure iyo murwere akamanikidzwa kuita kuvhiyiwa kutsiva simba rive.

Creation mudzimba Eks

Pakupedzisira, chinodzora kurova - chii kubva nemaonero varwere pachavo? Chokwadi, ichi ndicho chiridzwa zveruponiso, kunosvika upenyu varwere cardiac kutambura kubva siyana mwoyo mutinhimira vachivavhiringidza. Heart tsandanyama kushanda zvakanaka inzwi - ndiko kuti mudanga kushanda yose kweropa ezvinhu muviri.

Muna 1960, Soviet academician A. N. Bakulev akatendeukira vaitungamirira hwokugadzira nzvimbo Soviet Union zvinganaka pakusikwa mano cardiac Kudzikamiswa. Yokutanga mapurisa vakabvuma Design Bureau yakarurama kukura mune zvokuimba engineering, waiva mamiriro mupomerwi vachida. Munguva pfupi kwesayenzi miedzo, uye muna December 1961 yokutanga Russian akagadzirwa pacemaker EKS-2 "Mosquito" akanga vakabudirira muchibereko murwere kutambura kubva wakakwana misa atrioventricular mwoyo ruzivo EKS ivhu dzakasikwa, akaita. Pacemaker "Mosquito" rakanyorwa kwemakore 15, zviuru zvevanhu vanorwara vakaponeswa yakavimbika vakasiyana mudziyo.

A mukuru chikamu kufa nokuda zvemwoyo muSoviet Union kwakaratidza kuguma kwemakore 50, kwakatanga kusviba. The pacemaker komoyo, iyo akaongororazve kubva varwere aiwanzova akanaka, angotanga mukurumbira.

New nguva akavandudzika, hunhu mudzimba Eks akavandudzika. Panopera ra1962, ivhu itsva, Bazi Health pachii Serial kugadzirwa. Saka, vakasikwa Russia mwoyo pacemaker, wongororo pamusoro unhu zvakanga zvakanaka, vakatanga kubereka mumapoka akawanda mune zvokurapa profile.

kunze kardiostimulirovanie

Asati muchibereko pacemaker kudyara, murwere anogona kugamuchira rubatsiro rokutanga pamwe zvokunze kuonana mudziyo zvinosanganisira ndiro mbiri izvo riri kumativi maviri mubhokisi, mumwe pamberi mwoyo uye mumwe ari shure, pazasi rworuboshwe chipasa. Zvechivhurumukira nomunyika sternum, hunokonzera kumeso tsandanyama kuti kubata kumativi ose, uyewo mwoyo tsandanyama. Nzira iyi zvinokonzera kusagadzikana murwere, asi sezvo nzira pfupi pamusoro Kudzikamiswa nomwoyo exchange kwakakodzera. Zvakaipira zvokunze dzishande unyanzvi kuri pakuti murwere harifaniri kusiyiwa vasina akavatarisa, kunyanya kana afenda. Kugadzwa pacemaker vanoshanda pahwaro wechigarire, zvinoda hapana dzidzo chaiyo, izvo zvinotora kwevhiki dzakawanda.

Temporary endocardial kurudziro

Nheyo Migumisiro akadaro pomwoyo ndizvo okutanga ari vachiongorora electrode mumwoyo mhango. For akavhiyiwa izvi pave chena akagadzirwa kondakita uye vachiongorora pacharo, iro riri kurwira nomukombiyuta venous mugero pamwoyo. Mugumo electrode iri kuiswa mune zvakanaka atrium, uye ayo pakatarisana, proximal kuguma chokuita externally kunobva, zvinowanisa zvemagetsi nomunhu.

Kugadzwa chinodzora kurova zvisiri zvechigarire unowanzoshandiswa apo pasina nguva yokuti okunyanyisa nzira. Pashure normalization of cardiac murwere anogona mberi kuti muchibereko zano zvachose.

Sezvo akasima zvachose pacemaker

Pacemaker nokuti muchibereko oparesheni inova kuvhiyiwa duku, rakagadzirirwa kushandiswa kwenguva refu. Muchibereko Kazhinji kuitwa pasi zvomunharaunda yokutindivadza. The yose muitiro yakakamurwa muzvikamu akawanda. Chokutanga, ane incision ganda uye zvinyama uye tsinga voga. Ipapo moyo rinoitwa neuwandu electrodes kuti anoiswa mumwoyo makamuri. Pashure pokukurukurirana of conductors ari vachiongorora mashoko ose: nehanya, pacing chikumbaridzozve, imwe optimum urongwa shinda, conductive pulses. Zvino Kuda kutamba of electrodes kunoitika, mubhedha achiumbwa kuti pacemaker uye akasima mudziyo.

Mune zvimwe zviitiko, kudyara hakurevi midzi pakarepo, kunogona kuva zvishoma kurambwa, asi chokutsva akakurumidza yaserera nokupesvedzera kwakajairika zvinodhaka, uye murwere anoramba kurarama kujairana noupenyu.

The chikuru mabasa ari pacemaker

The mudziyo ndiyo wemagetsi achitaurwa nevanopinda chitsidzo simbi dzimba. The microprocessor iri dzinofambiswa pedyo bhatiri akagadzirirwa kwemakore mashoma. Nheyo kushanda mudzimba Eks ndiko kupindura pasina nguva marwadzo mwoyo tsandanyama murwere. The pacemaker chakagadzirirwa kuti kupomba akatuma ake zvemagetsi uropi, anenge paanombononoka - nguva musiyano iri hundredths mashoma yechipiri.

Panguva dzose mashandiro mwoyo mudziyo achiita asina hanya - anotumira kupomba. Pane boka pacemakers kuti anokwanisa kuchinja kakawanda. In Integrated Switch mudziyo kwakadaro, nehanya nokuchinja murwere basa. Kutaura zvazviri, izvi kumhanyisa Switch, imwe accelerometer, iyo anopindura kuchinja ECG parameters uye respiratoria. Panguva yechiitwa mwoyo pacemaker anotumira nomunhu speeded kumusoro.

Achangobuda yemashoko ECS vanokwanisa kuchengeta umboo pamusoro basa mwoyo, izvo zvinogona zvino kuva goho kune tarisisa kana digitaalinen vezvenhau kuti ongororo. chinhu ichi kunoita chiremba kuti ndipe Zvakanyanya Kunaka Panguva Yepamuviri zvokurapa kurapa, uyewo kusarudza parameters ari pacemaker kushanda. Revision zviridzwa dzakadaro dziitwe kanenge kamwe mwedzi mitanhatu ose. Pacemaker, mutengo installation riri nyore kuti munhu ane avhareji mari zvinogona kutsiviwa kana zvakakodzera.

Transesophageal pacing

Nokuti nechirwere kuti arrhythmia zviitiko varwere yokuedzwa gadziriro rinoshandiswa ane vachiongorora. inokosha kondakita ane electrically conductive muromo iri rakapinzwa yegurokuro. The vachiongorora anomiswa panguva kunyorerana mwoyo, kana panzvimbo kuruboshwe atrium, pamwe yegurokuro. jenareta, izvo anomurwira pulses dzakasiyana maitikiro iri ipapo anobatidzwa. Zvinoreva kutsvakurudza kwakadaro ndiko kuziva pamberi nechirwere chemwoyo. Palpitations pasi pokudzora dzemagetsi pulses anogona kuratidza Kurambwa mwoyo tsandanyama mutoro.

Transesophageal pacing zvakakwana nokudenga, rinogona kubatsira rokuongorora dzakasiyana-siyana cardiac zvirwere. Mune zvimwe zviitiko Tees kubvumira kurapwa: kupfura paroxysmal tachycardia, kusunga atrial flutter, kuita kwenguva dzishande pamwe bradyarrhythmias, achiperekedzwa nguva nenguva kupomba, kubvisa sinus kurwara syndrome. Vamwe manipulations zvinobvira chete zvakadzama vachiongorora nzvimbo yegurokuro.

Pacemaker: mutengo kushanda

Kugadzwa pacemaker muRussia hungada kubva 65 kusvika 650 zviuru rubles. mari iyi inosanganisira mari mudziyo pachayo, kuti muchibereko mari uye postoperative nguva. Pacemaker pacharo, mutengo zvakatemwa nokuda mugadziri, anogona kuva vanganzi pasi (20 zviuru. Kwiza.). Pakusarudza mienzaniso inowanika kumurwere. Zviri nani kuwana chinodzora kurova, wongororo izvo kunyanya kunaka. Izvi mudziyo Makambani Medtronic, StJudeMedical, Guidant uye Biotronic.