Atrial fibrillation (AF), atrial flutter, AV-nodal reentry tachycardia (AVNRT) me ka pane wikiwiki o ka ventricular, atrial ectopic tachycardia a me preexcitation syndromes (AVRT) i hui pū ʻia me AF a i ʻole ventricular tachyarrhythmias (VTA) he mau arrhythmias maʻamau i nā maʻi pilikia. ʻO ka pinepine, hiki ke ʻike i ka arrhythmia i lalo mai ka 12-lead surface electrocardiogram, ka nānā kino a me ka pane ʻana i nā maneuvers a i ʻole nā ​​​​lāʻau lapaʻau. I ka hemodynamics unstable, hōʻike koke ʻia ka DC-cardioversion. Hiki ke hoʻololi i ka AF i ka sinus rhythm (SR) me ka hoʻohana ʻana i nā lāʻau antiarrhythmic. Loaʻa iā Amiodarone ka helu hoʻololi i ka AF a hiki i ka 80%. He lāʻau lapaʻau hou no ka hoʻololi ʻana i ka AF he vernakalant. ʻO ka hoʻomaʻamaʻa koʻikoʻi o ka atrial flutter (Aflut) ma nā wahi mālama koʻikoʻi e pili ana i ka hōʻike hōʻike. Hiki ke hoʻololi pinepine ʻia i ka cardioverted iā SR me nā ʻenehana DC ma lalo o 50 joules. I ka tachycardia paʻakikī paʻakikī, inā paʻa ka hemodynamically o ka mea maʻi, pono e hoʻomaka ka mālama ʻana me ka hana vagal. Inā hoʻomau ka tachycardia a kāpae ʻia ka atrial flutter, ʻōlelo ʻia ka hoʻohana ʻana i ka adenosine (6 mg e like me ka wikiwiki iv bolus). ʻO ka hoʻopau kūleʻa ʻana ma o ka hana vagal a i ʻole adenosine e hōʻike ana he AVNRT a i ʻole AVRT. Inā ʻaʻohe pane i ka adenosine (ʻoiai ma hope o ka lua o ka bolus) ua ʻōlelo ʻia kahi lāʻau ʻoi aku ka lōʻihi (e like me verapamil, diltiazem). ʻO nā lāʻau lapaʻau e like me procainamide, sotalol, amiodarone a i ʻole magnesium e ʻōlelo ʻia no ka mālama ʻana i nā pts VTA. Eia naʻe, i kēia lā wale nō ka amiodarone ka lāʻau i koho ʻia ma VTA pts a maikaʻi nō hoʻi i nā pts me hoʻopauʻia-kū kūʻē i ka hopu ʻana i waho o ka haukapila.

ʻO Dietrich Andresen, Hans-Joachim Trappe *
Klinik für Kardiologie, Allgemeine Innere Medizin und konservative Intensivmedizin, Vivantes Klinikum am Urban und im Friedrichshain, Berlin, Kelemänia;
* Medizinische Klinik II (Kardiologie und Angiologie), Ruhr-Universität Bochum, Herne, Kelemania