Atrial fibrillation (AF), atrial flutter, AV-nodal reentry tachycardia (AVNRT) e nang le karabo e potlakileng ea ventricular, atrial ectopic tachycardia le preexcitation syndromes (AVRT) ka linako tse ling e kopantsoe le AF kapa ventricular tachyarrhythmias (VTA) ke arrhythmias e tloaelehileng ho bakuli ba tšohanyetso. Hangata, ho hlahlojoa ha arrhythmia ho ka khoneha ho tloha ho electrocardiogram ea 12-lead surface, tlhahlobo ea 'mele le karabelo ea ho tsamaisa kapa lithethefatsi. Ka hemodynamics e sa tsitsang, hang-hang DC-cardioversion e bontšoa. Phetoho ea AF ho sinus rhythm (SR) e ka khoneha ho sebelisa lithethefatsi tse thibelang mafu. Amiodarone e na le sekhahla sa phetoho ho AF ho fihla ho 80%. Setlhare se secha sa phetoho ea AF se tloaelehile. Phekolo e matla ea atrial flutter (Aflut) maemong a tlhokomelo e matla e ipapisitse le tlhahiso ea bongaka. Hangata e ka fetisetsoa ka katleho ho SR ka matla a DC a ka tlase ho 50 joules. Ka tachycardia e moqotetsane, haeba mokuli a tsitsitse ka mokhoa oa hemodynamically, phekolo e lokela ho qala ka vagal manoeuvre. Haeba tachycardia e phehella 'me flutter ea atrial e sa kenyelelitsoe, tšebeliso ea adenosine (6 mg as rapid iv bolus) e khothalletsoa. Ho felisoa ka katleho ka vagal maneuver kapa adenosine ho bontša hore e ne e le AVNRT kapa AVRT. Haeba ho se na karabelo ho adenosine (esita le kamora bolus ea bobeli) ho khothaletsoa setlhare se nkang nako e telele (mohlala, verapamil, diltiazem). Lithethefatsi tse kang procainamide, sotalol, amiodarone kapa magnesium li khothalletsoa ho phekola VTA pts. Leha ho le joalo, kajeno ke amiodarone feela e leng sethethefatsi se khethiloeng ho VTA pts hape e sebetsa le ho li-pts ho fokotsa matla-e hana ho ts'oaroa ke pelo e tsoang kantle ho sepetlele.

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