{"id":30878,"date":"2023-05-03T14:55:41","date_gmt":"2023-05-03T07:55:41","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=30878"},"modified":"2023-05-04T16:34:07","modified_gmt":"2023-05-04T09:34:07","slug":"dieu-tri-nhip-nhanh-that","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/03\/dieu-tri-nhip-nhanh-that\/","title":{"rendered":"\u0110i\u1ec1u tr\u1ecb nh\u1ecbp nhanh th\u1ea5t"},"content":{"rendered":"

Nh\u1ecbp nhanh th\u1ea5t l\u00e0 r\u1ed1i lo\u1ea1n nh\u1ecbp nhanh khi c\u00f3 tr\u00ean 3 ph\u1ee9c b\u1ed9 th\u1ea5t li\u00ean ti\u1ebfp, c\u00f3 t\u1ea7n s\u1ed1 t\u1eeb > 100 c\/ph \u0111\u1ebfn 250 c\/ph, th\u01b0\u1eddng c\u00f3 ph\u1ee9c b\u1ed9 QRS r\u1ed9ng (\u2265120 msec) xu\u1ea5t hi\u1ec7n khi ho\u1ea1t \u0111\u1ed9ng kh\u1eed c\u1ef1c \u1edf th\u1ea5t ch\u1eadm b\u1ea5t th\u01b0\u1eddng, c\u00f3 ngu\u1ed3n g\u1ed1c ngo\u00e0i h\u1ec7 th\u1ed1ng d\u1eabn truy\u1ec1n b\u00ecnh th\u01b0\u1eddng. M\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb nh\u1ecbp nhanh th\u1ea5t l\u00e0 ng\u0103n ng\u1eeba \u0111\u00f4\u0323t t\u01b0\u0309, thay v\u00ec ch\u1ec9 \u0111\u01a1n gi\u1ea3n la\u0300 ng\u0103n ch\u1eb7n lo\u1ea1n nh\u1ecbp.<\/strong><\/p>\n

1. \u0110i\u1ec1u tr\u1ecb nh\u1ecbp nhanh th\u1ea5t<\/h2>\n

1.1. B\u1ec7nh nh\u00e2n kh\u00f4ng \u1ed5n \u0111\u1ecbnh
\n<\/strong>– Khi b\u1ec7nh nh\u00e2n kh\u00f4ng \u1ed5n \u0111\u1ecbnh, nh\u01b0ng c\u00f2n \u0111\u00e1p \u1ee9ng v\u1edbi nh\u1eadn bi\u1ebft huy\u1ebft \u00e1p v\u00e0\/ho\u1eb7c m\u1ea1ch, ng\u01b0\u1eddi ta khuy\u1ebfn c\u00e1o ph\u01b0\u01a1ng ph\u00e1p sau:
\n\u2022 Chuy\u1ec3n nh\u1ecbp \u0111\u1ed3ng b\u1ed9 kh\u1ea9n c\u1ea5p: s\u1ed1c \u0111\u1ed3ng b\u1ed9 100 \u0111\u1ebfn 200 joules (m\u1ed9t pha) ho\u1eb7c 50 \u0111\u1ebfn 100 joules (2 pha), v\u1edbi chu\u1ea9n \u0111\u1ed9 n\u0103ng l\u01b0\u1ee3ng t\u0103ng l\u00ean n\u1ebfu c\u1ea7n thi\u1ebft.
\n\u2022 N\u1ebfu ph\u1ee9c b\u1ed9 QRS v\u00e0 s\u00f3ng T kh\u00f4ng th\u1ec3 n\u00e0o ph\u00e2n bi\u1ec7t \u0111\u01b0\u1ee3c ch\u00ednh x\u00e1c, c\u1ea7n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng kh\u1eed rung ngay l\u1eadp t\u1ee9c.
\n\u2022 S\u1eed d\u1ee5ng m\u00ea ho\u1eb7c gi\u1ea3m \u0111au t\u0129nh m\u1ea1ch m\u1ed9t trong c\u00e1c thu\u1ed1c sau: barbiturate, benzodiazepins, midazolam, propofon.
\n\u2022 C\u00e1c b\u1ec7nh nh\u00e2n tr\u1edf n\u00ean kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng \u0111\u00e1p \u1ee9ng ho\u1eb7c v\u00f4 m\u1ea1ch c\u1ea7n \u0111i\u1ec1u ch\u1ec9nh theo h\u1ed3i s\u1ee9c tim ph\u1ed5i chu\u1ea9n v\u00e0 kh\u1eed rung ngay l\u1eadp t\u1ee9c v\u1edbi n\u0103ng l\u01b0\u1ee3ng cao v\u00e0 theo ph\u00e1c \u0111\u1ed3 (l\u01b0u \u0111\u1ed3 4)
\n1.2.B\u1ec7nh nh\u00e2n \u1ed5n \u0111\u1ecbnh
\n<\/strong>C\u00f3 th\u1ec3 cho vi\u1ec7c x\u00e1c \u0111\u1ecbnh ch\u1ea9n \u0111o\u00e1n, \u0111i\u1ec1u tr\u1ecb \u0111\u1ea1t \u0111\u01b0\u1ee3c ti\u00eau ch\u00ed cho lo\u1ea1n nh\u1ecbp chuy\u00ean bi\u1ec7t.
\n– Nh\u1ecbp nhanh th\u1ea5t ho\u1eb7c coi nh\u01b0 nhanh th\u1ea5t, ph\u01b0\u01a1ng ph\u00e1p sau \u0111\u00e2y \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o:
\n+ C\u00e1c thu\u1ed1c ch\u1ed1ng lo\u1ea1n nh\u1ecbp Class I v\u00e0 III th\u01b0\u1eddng \u0111\u01b0\u1ee3c gi\u00e0nh ri\u00eang cho c\u00e1c lo\u1ea1n nh\u1ecbp tr\u01a1 ho\u1eb7c t\u00e1i ph\u00e1t nh\u01b0 tr\u00ecnh b\u00e0y d\u01b0\u1edbi \u0111\u00e2y
\n+ Chuy\u1ec3n nh\u1ecbp c\u1ea5p thi\u1ebft ho\u1eb7c kh\u00f4ng c\u1ea5p thi\u1ebft th\u01b0\u1eddng l\u00e0 ph\u00f9 h\u1ee3p.
\n+ Gi\u1ea3m \u0111au c\u00f3 \u00fd th\u1ee9c nh\u01b0 tr\u00ean.
\n+ S\u1ed1c \u0111\u1ed3ng b\u1ed9 kh\u1edfi \u0111\u1ea7u 100 \u0111\u1ebfn 200 j (1 pha) ho\u1eb7c 50 \u0111\u1ebfn 100 j (2 pha)
\n+ S\u1ed1c nh\u1eafc l\u1ea1i \u1edf n\u0103ng l\u01b0\u1ee3ng cao h\u01a1n c\u00f3 th\u1ec3 khi c\u1ea7n thi\u1ebft.
\n– B\u1ea5t k\u1ef3 tr\u1ea1ng th\u00e1i k\u1ebft h\u1ee3p n\u00e0o \u0111\u1ec1u c\u1ea7n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb, g\u1ed3m thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 tim, suy tim, r\u1ed1i lo\u1ea1n \u0111i\u1ec7n gi\u1ea3i ho\u1eb7c nhi\u1ec5m \u0111\u1ed9c thu\u1ed1c.
\n– B\u1ec7nh nh\u00e2n c\u00f3 h\u1ed9i ch\u1ee9ng \u0111\u00e3 bi\u1ebft c\u1ee7a VT c\u00f3 tim b\u00ecnh th\u01b0\u1eddng v\u1ec1 c\u1ea5u tr\u00fac, c\u00e1c thu\u1ed1c calcium channel blockers ho\u1eb7c beta blockers c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng.
\n– N\u1ebfu s\u1eed d\u1ee5ng thu\u1ed1c ch\u1eafc ch\u1eafn c\u00f3 nguy c\u01a1 t\u1ed5n th\u01b0\u01a1ng huy\u1ebft \u0111\u1ed9ng c\u1ea7n s\u1ed1c chuy\u1ec3n nh\u1ecbp ngay.
\n– N\u1ebfu ch\u01b0a ch\u1eafc ch\u1eafn v\u1ec1 ch\u1ea9n \u0111o\u00e1n c\u1ea7n h\u1ed9i ch\u1ea9n v\u1edbi b\u00e1c s\u1ef9 chuy\u00ean khoa.
\n– N\u1ebfu kh\u00f4ng c\u00f3 \u0111i\u1ec1u ki\u1ec7n th\u00ec \u0111i\u1ec1u tr\u1ecb ngay b\u1eb1ng chuy\u1ec3n nh\u1ecbp s\u1ed1c \u0111i\u1ec7n.
\n1.3.Nh\u1ecbp nhanh th\u1ea5t tr\u01a1 v\u00e0 t\u00e1i ph\u00e1t
\n<\/strong>N\u1ebfu t\u00e1i ph\u00e1t ho\u1eb7c dai d\u1eb3ng sau chuy\u1ec3n nh\u1ecbp c\u1ea7n \u0111i\u1ec1u tr\u1ecb thu\u1ed1c v\u00e0 \u0111\u00e1nh gi\u00e1 c\u00e1c b\u1ec7nh c\u0103n nh\u01b0: thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 tim, b\u1ea5t th\u01b0\u1eddng \u0111i\u1ec7n gi\u1ea3i, v\u00e0 nhi\u1ec5m \u0111\u1ed9c thu\u1ed1c.
\nChuy\u1ec3n nh\u1ecbp ho\u1eb7c kh\u1eed rung c\u1ea7n \u0111\u01b0\u1ee3c nh\u1eafc l\u1ea1i khi c\u1ea7n thi\u1ebft \u1edf c\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 huy\u1ebft \u0111\u1ed9ng kh\u00f4ng \u1ed5n \u0111\u1ecbnh.
\n– \u0110\u1ed1i v\u1edbi c\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 VT t\u00e1i ph\u00e1t ho\u1eb7c VT b\u1ec7nh c\u0103n ch\u01b0a r\u00f5 r\u00e0ng, ng\u01b0\u1eddi ta khuy\u1ebfn c\u00e1o nh\u01b0 sau:
\n\u2022 Amiodarone: 150 mg ti\u00eam t\u0129nh m\u1ea1ch trong 10 ph\u00fat, duy tr\u00ec b\u1eb1ng truy\u1ec1n 1mg\/ph trong 6 gi\u1edd, sau \u0111\u00f3 0.5 mg\/ph\u00fat.
\n\u2022 Procainamide: 15 \u0111\u1ebfn 18 mg\/kg, truy\u1ec1n ch\u1eadm trong 25-30 ph\u00fat, sau duy tr\u00ec 1-4 mg\/min b\u1eb1ng truy\u1ec1n ti\u1ebfp theo), l\u1ef1a ch\u1ecdn thay th\u1ebf amiodarone.
\n\u2022 Lidocaine: ti\u00eam t\u0129nh m\u1ea1ch 1 \u0111\u1ebfn 1.5 mg\/kg trong 2 \u0111\u1ebfn 3 ph\u00fat, \u0111\u1eb7c bi\u1ec7t n\u1ebfu thi\u1ebfu m\u00e1u c\u01a1 tim c\u1ee5c b\u1ed9 \u0111\u01b0\u1ee3c nghi ng\u1edd.
\n\u2022 Metoprolol: 5 \u0111\u1ebfn 10 mg t\u0129nh m\u1ea1ch \u1edf b\u1ec7nh nh\u00e2n c\u00f3 huy\u1ebft \u00e1p \u1ed5n \u0111\u1ecbnh v\u00e0 lo\u1ea1n nh\u1ecbp t\u00e1i ph\u00e1t. Do kh\u1ea3 n\u0103ng th\u00fac \u0111\u1ea9y t\u1ed5n th\u01b0\u01a1ng huy\u1ebft \u0111\u1ed9ng, beta blockers c\u1ea7n \u0111\u01b0\u1ee3c cho trong ho\u00e0n c\u1ea3nh c\u00f3 th\u1ec3 kh\u1eed rung kh\u1ea9n c\u1ea5p n\u1ebfu c\u1ea7n thi\u1ebft.
\n– VT t\u00e1i ph\u00e1t nhi\u1ec1u, ph\u1ee9c t\u1ea1p c\u00f3 th\u1ec3 t\u0103ng l\u00ean do li\u00ean quan \u0111\u1ebfn thi\u1ebfu m\u00e1u c\u01a1 tim c\u1ee5c b\u1ed9, h\u1ea1 kali, nhi\u1ec5m \u0111\u1ed9c digitalis v\u00e0 VT \u0111a h\u00ecnh c\u00f3 hay kh\u00f4ng c\u00f3 QT d\u00e0i. T\u1ea5t c\u1ea3 nh\u1eefng \u0111i\u1ec1u \u0111\u00f3 c\u00f3 tr\u1ecb li\u1ec7u chuy\u00ean bi\u1ec7t ph\u00f9 h\u1ee3p.
\n1.4. B\u1ec7nh nh\u00e2n c\u00f3 m\u00e1y ph\u00e1 rung t\u1ef1 \u0111\u1ed9ng<\/a> (ICD: Implantable Cardioverter Defibrillator).\u00a0<\/em>
\n<\/strong>\u1ede b\u1ec7nh nh\u00e2n mang ICD c\u00f3 m\u1ed9t s\u1ed1 bi\u1ebfn ch\u1ee9ng c\u00e1 bi\u1ec7t cho VT
\n– ICD \u0111\u1ec3 c\u1eaft c\u01a1n VT ho\u1eb7c VF kh\u00f4ng c\u00f3 hi\u1ec7u qu\u1ea3.
\n– C\u1ea7n m\u1eddi b\u00e1c s\u1ef9 chuy\u00ean khoa \u0111\u1ebfn ki\u1ec3m tra ICD b\u1eb1ng m\u00e1y ch\u01b0\u01a1ng tr\u00ecnh.
\n– N\u1ebfu b\u1ec7nh nh\u00e2n \u1ed5n \u0111\u1ecbnh, d\u1ee5ng c\u1ee5 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c l\u01b0\u1ee3ng gi\u00e1 trong qu\u00e1 tr\u00ecnh VT.
\n– Thi\u1ebft b\u1ecb c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c kh\u1edfi k\u00edch b\u1eb1ng tay \u0111\u1ec3 ph\u00f3ng ra tr\u1ecb li\u1ec7u \u0111i\u1ec1u tr\u1ecb.
\n– Tr\u1ecb li\u1ec7u c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c l\u00e0m b\u1ea5t ho\u1ea1t \u0111\u1ec3 tr\u00e1nh ph\u00f3ng \u0111i\u1ec7n c\u1ee7a thi\u1ebft b\u1ecb kh\u00f4ng ph\u00f9 h\u1ee3p.
\n– C\u00e1c th\u00f4ng s\u1ed1 x\u00e1c \u0111\u1ecbnh tr\u1ecb li\u1ec7u c\u1ee7a thi\u1ebft b\u1ecb c\u00f3 th\u1ec3 quy\u1ebft \u0111\u1ecbnh cung c\u1ea5p tr\u1ecb li\u1ec7u ph\u00f9 h\u1ee3p h\u01a1n v\u00e0 tr\u00e1nh tr\u1ecb li\u1ec7u kh\u00f4ng ph\u00f9 h\u1ee3p.
\n– N\u1ebfu kh\u00f4ng c\u00f3 b\u00e1c s\u1ef9 kinh nghi\u1ec7m v\u1ec1 ICD. C\u00e1ch x\u1eed l\u00fd c\u00f3 th\u1ec3 nh\u01b0 sau:
\n+ Ch\u1ee9c n\u0103ng ICD hi\u1ec7u qu\u1ea3: C\u1ea7n l\u01b0\u1ee3ng gi\u00e1 t\u1eadp trung t\u00ecm b\u1eb1ng ch\u1ee9ng kh\u1edfi k\u00edch lo\u1ea1n nh\u1ecbp (nh\u01b0 thi\u1ebfu m\u00e1u tim c\u1ee5c b\u1ed9, suy tim m\u1ea5t b\u00f9 c\u1ea5p, r\u1ed1i lo\u1ea1n \u0111i\u1ec7n gi\u1ea3i ho\u1eb7c c\u00e1c thay \u0111\u1ed5i c\u1ee7a thu\u1ed1c.
\n+ Ph\u00f3ng \u0111i\u1ec7n c\u1ee7a ICD \u0111\u01b0\u1ee3c l\u1eadp l\u1ea1i, v\u1edbi vi\u1ec7c c\u1eaft lo\u1ea1n nh\u1ecbp th\u00e0nh c\u00f4ng ti\u1ebfp sau khi VT t\u00e1i ph\u00e1t
\n+ Trong tr\u1ea1ng th\u00e1i n\u00e0y, b\u1eb1ng ch\u1ee9ng c\u1ee7a lo\u1ea1n nh\u1ecbp kh\u1edfi k\u00edch c\u1ea7n \u0111\u01b0\u1ee3c t\u00ecm ki\u1ebfm m\u1ed9t c\u00e1ch t\u00edch c\u1ef1c v\u00e0 ng\u0103n ch\u1eb7n lo\u1ea1n nh\u1ecbp b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p thu\u1ed1c nh\u01b0 tr\u00ecnh b\u00e0y tr\u00ean. N\u1ebfu t\u00e1i l\u1ea1i nhi\u1ec1u l\u1ea7n c\u1ea7n ph\u1ea3i \u0111i\u1ec1u tr\u1ecb \u1edf \u0111\u01a1n v\u1ecb ch\u0103m s\u00f3c t\u00edch c\u1ef1c.
\n– Ch\u1ee9c n\u0103ng ICD kh\u00f4ng hi\u1ec7u qu\u1ea3: C\u00f3 th\u1ec3 do ng\u01b0\u1ee1ng kh\u1eed rung t\u0103ng do b\u1ec7nh n\u1ec1n ti\u1ebfn tri\u1ec3n ho\u1eb7c c\u00e1c thu\u1ed1c \u0111i\u1ec1u tr\u1ecb. Ho\u1eb7c c\u01a1n lo\u1ea1n nh\u1ecbp l\u00e0 SVT th\u01b0\u1eddng l\u00e0 AF
\n+ B\u1ea5t ch\u1ea5p l\u00fd do, \u0111\u00f2i h\u1ecfi theo d\u00f5i s\u00e1t, l\u01b0\u1ee3ng gi\u00e1 thi\u1ebft b\u1ecb v\u00e0 th\u01b0\u1eddng l\u00e0m suy y\u1ebfu tr\u1ecb li\u1ec7u \u0111\u1ebfn t\u1eadn khi c\u00e1c v\u1ea5n \u0111\u1ec1 \u0111\u01b0\u1ee3c kh\u00e1m ph\u00e1.
\n– ICD kh\u00f4ng ph\u00f3ng \u0111i\u1ec7n:
\n+ Ch\u1ee9c n\u0103ng kh\u00f4ng ph\u00f9 h\u1ee3p, t\u1ea7n s\u1ed1 nh\u1ecbp nhanh c\u00f3 th\u1ec3 th\u1ea5p h\u01a1n t\u1ea7n s\u1ed1 l\u1eadp tr\u00ecnh.
\n+ Ho\u1eb7c thi\u1ebft b\u1ecb nh\u1eadn d\u1ea1ng nh\u1ea7m l\u00e0 SVT n\u00ean kh\u00f4ng ph\u00f3ng \u0111i\u1ec7n
\n+ Khi ICD kh\u00f4ng ho\u1ea1t \u0111\u1ed9ng v\u00e0 kh\u00f4ng c\u00f3 m\u00e1y ch\u01b0\u01a1ng tr\u00ecnh \u0111\u1ec3 ki\u1ec3m tra ho\u1eb7c b\u1ec7nh nh\u00e2n kh\u00f4ng \u1ed5n \u0111\u1ecbnh v\u1ec1 huy\u1ebft \u0111\u1ed9ng, \u0111i\u1ec1u ch\u1ec9nh kh\u1edfi \u0111\u1ea7u c\u1ea7n ti\u1ebfp t\u1ee5c nh\u01b0 kh\u00f4ng c\u00f3 c\u1ea5y ICD. ICD c\u1ea7n \u0111\u01b0\u1ee3c l\u01b0\u1ee3ng gi\u00e1 khi b\u1ec7nh nh\u00e2n \u0111\u00e3 \u1ed5n \u0111\u1ecbnh.
\n+ D\u1ee5ng c\u1ee5 ph\u00f3ng \u0111i\u1ec7n kh\u00f4ng c\u00f3 VT. Ch\u1ec9 ra thi\u1ebft b\u1ecb r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng, c\u1ea7n \u0111\u01b0\u1ee3c kh\u1ea3o s\u00e1t b\u1eb1ng l\u1eadp tr\u00ecnh l\u1ea1i ho\u1eb7c l\u00e0m b\u1ea5t ho\u1ea1t ICD c\u00e0ng s\u1edbm c\u00e0ng t\u1ed1t.
\n– B\u1ea5t ho\u1ea1t ICD
\n<\/strong>+ Trong m\u1ed9t s\u1ed1 t\u00ecnh tr\u1ea1ng \u0111\u00e3 m\u00f4 t\u1ea3 tr\u00ean, n\u00f3 c\u00f3 th\u1ec3 c\u1ea7n thi\u1ebft \u0111\u1ec3 l\u1eadp tr\u00ecnh l\u1ea1i ho\u1eb7c l\u00e0m b\u1ea5t ho\u1ea1t ICD.
\n+ N\u1ebfu kh\u00f4ng c\u00f3 b\u00e1c s\u1ef9 chuy\u00ean khoa, d\u00f9ng nam ch\u00e2m \u0111\u1ec3 l\u00ean tr\u00ean thi\u1ebft b\u1ecb c\u00f3 th\u1ec3 \u1ee9c ch\u1ebf ph\u00f3ng \u0111i\u1ec7n c\u1ee7a thi\u1ebft b\u1ecb.
\n+ Theo d\u00f5i tim li\u00ean t\u1ee5c c\u1ea7n ti\u1ebfp t\u1ee5c trong khi nam ch\u00e2m \u0111\u1eb7t \u1edf v\u1ecb tr\u00ed, do b\u1ec7nh nh\u00e2n kh\u00f4ng \u0111\u01b0\u1ee3c b\u1ea3o v\u1ec7 kh\u1ecfi c\u00e1c lo\u1ea1n nh\u1ecbp nguy hi\u1ec3m.
\n– Thi\u1ebft b\u1ecb c\u1ea7n \u0111\u01b0\u1ee3c l\u01b0\u1ee3ng gi\u00e1 \u0111\u1ea7y \u0111\u1ee7 \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh nguy\u00ean nh\u00e2n r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng tr\u01b0\u1edbc khi cho ICD ho\u1ea1t \u0111\u1ed9ng tr\u1edf l\u1ea1i.<\/p>\n

\"dieu-tri-nhip-nhanh-that\"
\n2. \u0110i\u1ec1u tr\u1ecb nguy\u00ean nh\u00e2n<\/h2>\n


\n<\/strong>Sau khi hay \u0111\u1ed3ng th\u1eddi v\u1edbi vi\u1ec7c \u0111i\u1ec1u tr\u1ecb nh\u1ecbp nhanh th\u1ea5t c\u1ea7n \u0111i\u1ec1u tr\u1ecb nguy\u00ean nh\u00e2n n\u1ebfu c\u00f3 th\u1ec3.
\n2.1.Nh\u1ed3i m\u00e1u c\u01a1 tim
\n<\/strong>– C\u00f3 VT ch\u1ee9ng t\u1ecf \u0111\u00e3 c\u00f3 b\u1ec7nh c\u01a1 tim thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 m\u1ea1n t\u00ednh ho\u1eb7c nh\u1ed3i m\u00e1u tr\u01b0\u1edbc \u0111\u00f3. C\u1ea7n xem x\u00e9t ch\u1ee5p v\u00e0 can thi\u1ec7p m\u1ea1ch v\u00e0nh th\u1ee9 ph\u00e1t.
\n2.2. C\u00e1c nguy\u00ean nh\u00e2n kh\u00e1c
\n<\/strong>– Nh\u01b0 r\u1ed1i loan \u0111i\u1ec7n gi\u1ea3i, c\u00e1c tr\u1ea1ng th\u00e1i r\u1ed1i lo\u1ea1n chuy\u1ec3n h\u00f3a kh\u00e1c\u2026 c\u1ea7n
\nx\u00e1c \u0111\u1ecbnh nhanh ch\u00f3ng v\u00e0 \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi<\/p>\n

3. Bi\u1ebfn ch\u1ee9ng<\/h2>\n

– Bi\u1ebfn ch\u1ee9ng ch\u1ee7 y\u1ebfu c\u1ee7a VT l\u00e0 r\u1ed1i lo\u1ea1n huy\u1ebft \u0111\u1ed9ng d\u1eabn \u0111\u1ebfn tr\u1ee5y m\u1ea1ch, s\u1ed1c tim v\u00e0 nh\u1ed3i m\u00e1u c\u01a1 tim sau nh\u1ecbp nhanh do t\u0103ng nhu c\u1ea7u ti\u00eau th\u1ee5 \u00f4 xy ho\u1eb7c \u0111\u00e3 c\u00f3 b\u1ec7nh m\u1ea1ch v\u00e0nh ti\u1ec1m \u1ea9n.
\n– \u0110i\u1ec1u tr\u1ecb bi\u1ebfn ch\u1ee9ng theo c\u00e1c ph\u00e1c \u0111\u1ed3 chuy\u00ean bi\u1ec7t.<\/p>\n

T\u00e0i li\u1ec7u tham kh\u1ea3o:<\/strong><\/p>\n

Ph\u00e1c \u0111\u1ed3 b\u1ec7nh vi\u00ean Nh\u00e2n d\u00e2n 115<\/p>\n

 <\/p>\n

B\u1ec7nh H\u1ecdc Tim M\u1ea1ch Lecturio<\/p>\n","protected":false},"excerpt":{"rendered":"

Nh\u1ecbp nhanh th\u1ea5t l\u00e0 r\u1ed1i lo\u1ea1n nh\u1ecbp nhanh khi c\u00f3 tr\u00ean 3 ph\u1ee9c b\u1ed9 th\u1ea5t li\u00ean ti\u1ebfp, c\u00f3 t\u1ea7n s\u1ed1 t\u1eeb > 100 c\/ph \u0111\u1ebfn 250 c\/ph, th\u01b0\u1eddng c\u00f3 ph\u1ee9c b\u1ed9 QRS r\u1ed9ng (\u2265120 msec) xu\u1ea5t hi\u1ec7n khi ho\u1ea1t \u0111\u1ed9ng kh\u1eed c\u1ef1c \u1edf th\u1ea5t ch\u1eadm b\u1ea5t th\u01b0\u1eddng, c\u00f3 ngu\u1ed3n g\u1ed1c ngo\u00e0i h\u1ec7 th\u1ed1ng d\u1eabn truy\u1ec1n […]<\/p>\n","protected":false},"author":16,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[7,33],"tags":[],"yoast_head":"\n\u0110i\u1ec1u tr\u1ecb nh\u1ecbp nhanh th\u1ea5t - Vinmec<\/title>\n<meta name=\"description\" content=\"M\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb nh\u1ecbp nhanh th\u1ea5t (VT) l\u00e0 ng\u0103n ng\u1eeba \u0111\u00f4\u0323t t\u01b0\u0309, thay v\u00ec ch\u1ec9 \u0111\u01a1n gi\u1ea3n la\u0300 ng\u0103n ch\u1eb7n lo\u1ea1n nh\u1ecbp.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"\u0110i\u1ec1u tr\u1ecb nh\u1ecbp nhanh th\u1ea5t - 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