{"id":31067,"date":"2023-05-03T16:03:23","date_gmt":"2023-05-03T09:03:23","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=31067"},"modified":"2023-05-04T17:35:16","modified_gmt":"2023-05-04T10:35:16","slug":"rung-nhi-va-thang-diem-cha2ds2-vas","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/03\/rung-nhi-va-thang-diem-cha2ds2-vas\/","title":{"rendered":"Rung nh\u0129 (AF) v\u00e0 thang \u0111i\u1ec3m CHA2DS2-VASc cho nguy c\u01a1 \u0111\u1ed9t qu\u1ef5"},"content":{"rendered":"

Rung nh\u0129 (AF) l\u00e0 m\u1ed9t nh\u1ecbp x\u00e1o tr\u1ed9n c\u1ef1c k\u1ef3 ph\u1ed5 bi\u1ebfn th\u01b0\u1eddng \u0111\u01b0\u1ee3c xem nh\u01b0 r\u1ed1i lo\u1ea1n nh\u1ecbp nhanh tr\u00ean th\u1ea5t m\u1ea1n t\u00ednh \u1edf b\u1ec7nh nh\u00e2n l\u1edbn tu\u1ed5i. N\u00f3 \u0111\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi ph\u1ee9c b\u1ed9 QRS kh\u00f4ng \u0111\u1ec1u v\u00e0 m\u1ea5t t\u00ednh \u0111\u1ed3ng b\u1ed9 v\u1edbi s\u1ef1 co c\u1ee7a t\u00e2m nh\u0129. Ph\u00e2n t\u1ea7ng nguy c\u01a1 theo thang \u0111i\u1ec3m CHA2<\/sub>DS2<\/sub>-VASc \u0111\u01b0\u1ee3c l\u1ea5y l\u00e0m c\u01a1 s\u1edf cho vi\u1ec7c ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb ch\u1ed1ng \u0111\u00f4ng.<\/strong><\/p>\n

\"rung-nhi\"
\n1. \u0110\u1ea1i c\u01b0\u01a1ng rung nh\u0129 (AF)<\/h2>\n

1.1 D\u1ecbch t\u1ec5
\n<\/strong>Kho\u1ea3ng 1-2% d\u00e2n s\u1ed1 n\u00f3i chung s\u1ebd tr\u1ea3i qua m\u1ed9t l\u1ea7n rung nh\u0129, m\u00e0 l\u00e0m cho n\u00f3 tr\u1edf th\u00e0nh lo\u1ea1i r\u1ed1i lo\u1ea1n nh\u1ecbp tim ph\u1ed5 bi\u1ebfn nh\u1ea5t. T\u1ef7 l\u1ec7 AF t\u0103ng theo tu\u1ed5i, c\u00f3 t\u1edbi 10% d\u00e2n s\u1ed1 \u1edf \u0111\u1ed9 tu\u1ed5i 70 tr\u1ea3i qua n\u00f3. \u0110\u00e0n \u00f4ng th\u01b0\u1eddng b\u1ecb \u1ea3nh h\u01b0\u1edfng nhi\u1ec1u h\u01a1n so v\u1edbi ph\u1ee5 n\u1eef.
\n1.2 Nguy\u00ean nh\u00e2n
\n<\/strong>Rung nh\u0129 (AF) g\u00e2y ra b\u1edfi c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 n\u1ec1n c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i th\u00e0nh nguy\u00ean nh\u00e2n do tim v\u00e0 kh\u00f4ng do tim.
\n– Nguy\u00ean nh\u00e2n do tim
\n<\/strong>Nguy\u00ean nh\u00e2n do tim th\u01b0\u1eddng g\u1eb7p nh\u1ea5t c\u1ee7a AF l\u00e0 m\u1ed9t khi\u1ebfm khuy\u1ebft van hai l\u00e1. Nguy\u00ean nh\u00e2n do tim kh\u00e1c c\u00f3 th\u1ec3 bao g\u1ed3m t\u0103ng huy\u1ebft \u00e1p, suy tim sung huy\u1ebft n\u1eb7ng, b\u1ec7nh tim thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9, v\u00e0 b\u1ec7nh c\u01a1 tim.
\n– Nguy\u00ean nh\u00e2n kh\u00f4ng do tim
\n<\/strong>Nguy\u00ean nh\u00e2n kh\u00f4ng tim ph\u1ed5 bi\u1ebfn nh\u1ea5t c\u1ee7a AF l\u00e0 b\u1ec7nh ph\u1ed5i nh\u01b0 thuy\u00ean t\u1eafc ph\u1ed5i v\u00e0 COPD<\/a>, c\u01b0\u1eddng gi\u00e1p, r\u1ed1i lo\u1ea1n \u0111i\u1ec7n gi\u1ea3i nh\u01b0 h\u1ea1 kali m\u00e1u, ho\u1eb7c c\u00e1c ch\u1ea5t \u0111\u1ed9c h\u1ea1i nh\u01b0 r\u01b0\u1ee3u, thyroxine, triptans, theophylline, ho\u1eb7c sildenafil.<\/p>\n

Rung nh\u0129 l\u00e0 do nh\u1ecbp tim nhanh v\u00e0o l\u1ea1i c\u1ee7a t\u00e2m nh\u0129, th\u01b0\u1eddng \u1edf c\u00e1c khu v\u1ef1c g\u1ea7n c\u00e1c t\u0129nh m\u1ea1ch ph\u1ed5i. \u0110i\u1ec1u n\u00e0y c\u00f3 ngh\u0129a r\u1eb1ng c\u00e1c xung \u0111i\u1ec7n kh\u00f4ng lan truy\u1ec1n theo c\u00e1ch th\u1ee9c sinh l\u00fd b\u00ecnh th\u01b0\u1eddng, t\u1ee9c l\u00e0 b\u1eaft \u0111\u1ea7u t\u1eeb n\u00fat xoang, di chuy\u1ec3n qua t\u00e2m nh\u0129, v\u00e0 b\u01b0\u1edbc sang t\u00e2m th\u1ea5t; \u0111\u00fang h\u01a1n l\u00e0, ch\u00fang di chuy\u1ec3n nhi\u1ec1u l\u1ea7n theo m\u1ed9t \u0111\u01b0\u1eddng tr\u00f2n trong t\u00e2m nh\u0129, m\u00e0 g\u00e2y ra kh\u1eed c\u1ef1c c\u01a1 tim t\u00e2m nh\u0129 li\u00ean t\u1ee5c. \u0110i\u1ec1u n\u00e0y d\u1eabn \u0111\u1ebfn m\u1ed9t t\u1ea7n s\u1ed1 nh\u0129 l\u00e0 350-600 nh\u1ecbp m\u1ed7i ph\u00fat. Khi c\u01a1 tim co m\u1ed9t c\u00e1ch kh\u00f4ng \u0111\u1ed3ng b\u1ed9, t\u00e2m nh\u0129 th\u1ef1c hi\u1ec7n ch\u1ee9c n\u0103ng b\u01a1m c\u1ee7a ch\u00fang kh\u00f4ng c\u00f2n hi\u1ec7u qu\u1ea3. \u0110i\u1ec1u n\u00e0y d\u1eabn \u0111\u1ebfn gi\u1ea3m cung l\u01b0\u1ee3ng tim l\u00e0 15% \u1edf nh\u1eefng ng\u01b0\u1eddi kh\u1ecfe m\u1ea1nh, v\u00e0 th\u1eadm ch\u00ed nhi\u1ec1u h\u01a1n \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n suy tim tr\u01b0\u1edbc \u0111\u00f3. B\u1edfi v\u00ec n\u00fat nh\u0129 th\u1ea5t \u0111\u00f3ng vai tr\u00f2 nh\u01b0 m\u1ed9t n\u00fat ch\u1eb7n, kh\u00f4ng ph\u1ea3i m\u1ecdi k\u00edch th\u00edch h\u00ecnh th\u00e0nh trong t\u00e2m nh\u0129 \u0111\u1ec1u d\u1eabn truy\u1ec1n \u0111\u1ebfn t\u00e2m th\u1ea5t. C\u00e1c d\u1eabn truy\u1ec1n n\u00e0y, th\u01b0\u1eddng kh\u00f4ng \u0111\u1ec1u, t\u1ea7n s\u1ed1 th\u1ea5t th\u01b0\u1eddng dao \u0111\u1ed9ng trong kho\u1ea3ng 100-160 bpm.<\/p>\n

1.3 Ph\u00e2n lo\u1ea1i<\/strong>
\nLi\u00ean quan \u0111\u1ebfn s\u1ef1 kh\u1edfi ph\u00e1t v\u00e0 th\u1eddi gian c\u1ee7a b\u1ec7nh, c\u00e1c d\u1ea1ng rung nh\u0129 (AF) c\u00f3 th\u1ec3 ph\u00e2n bi\u1ec7t nh\u01b0 sau:
\n\u2022 L\u1ea7n \u0111\u1ea7u bi\u1ec3u hi\u1ec7n AF: L\u1ea7n \u0111\u1ea7u ti\u00ean ch\u1ee9ng ki\u1ebfn AF.
\n\u2022 AF k\u1ecbch ph\u00e1t: AF m\u00e0 ch\u1ea5m d\u1ee9t trong v\u00f2ng 7 ng\u00e0y ho\u1eb7c sau khi \u0111i\u1ec1u tr\u1ecb ho\u1eb7c m\u1ed9t c\u00e1ch t\u1ef1 nhi\u00ean.
\n\u2022 AF dai d\u1eb3ng: AF li\u00ean t\u1ee5c trong h\u01a1n 7 ng\u00e0y.
\n\u2022 AF dai d\u1eb3ng k\u00e9o d\u00e0i: AF li\u00ean t\u1ee5c trong h\u01a1n 1 n\u0103m.
\n\u2022 AF th\u01b0\u1eddng tr\u1ef1c: AF m\u00e0 kh\u00f4ng \u0111i\u1ec1u tr\u1ecb sau quy\u1ebft \u0111\u1ecbnh chung c\u1ee7a b\u1ec7nh nh\u00e2n v\u00e0 b\u00e1c s\u0129.<\/p>\n

M\u1ed9t ph\u00e2n lo\u1ea1i kh\u00e1c c\u1ee7a rung nh\u0129 d\u1ef1a tr\u00ean nguy\u00ean nh\u00e2n n\u1ec1n \u0111\u1ec3 ph\u00e2n bi\u1ec7t:
\nRung nh\u0129 do van:<\/strong>
\n\u2022 Nguy\u00ean nh\u00e2n ph\u1ed5 bi\u1ebfn nh\u1ea5t l\u00e0 h\u1eb9p van hai l\u00e1. \u0110\u00e2y l\u00e0 lo\u1ea1i AF n\u00ean \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c ch\u1ed1ng
\n\u0111\u00f4ng \u0111\u01b0\u1eddng u\u1ed1ng b\u1ea5t k\u1ec3 nguy c\u01a1 bi\u1ebfn c\u1ed1 t\u1eafc m\u1ea1ch do huy\u1ebft kh\u1ed1i (thang \u0111i\u1ec3m CHADVASC).
\nRung nh\u0129 kh\u00f4ng do van:
\n<\/strong>\u2022 Rung nh\u0129 \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n m\u00e0 kh\u00f4ng c\u00f3 s\u1ef1 tham gia c\u1ee7a van tim<\/p>\n

2. \u0110\u1eb7c \u0111i\u1ec3m l\u00e2m s\u00e0ng v\u00e0 thang \u0111i\u1ec3m CHA2DS2-VASc<\/strong><\/h2>\n

\u2022 Rung nh\u0129 th\u01b0\u1eddng kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng trong th\u1eddi gian d\u00e0i tr\u1eeb khi tri\u1ec7u ch\u1ee9ng ho\u1eb7c bi\u1ebfn ch\u1ee9ng ti\u1ebfn
\ntri\u1ec3n.
\n\u2022 C\u00e1c tri\u1ec7u ch\u1ee9ng m\u00e0 b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 g\u1eb7p l\u00e0 \u0111\u00e1nh tr\u1ed1ng ng\u1ef1c, nh\u1ecbp tim kh\u00f4ng \u0111\u1ec1u, \u0111au th\u1eaft ng\u1ef1c,
\nkh\u00f3 th\u1edf, ch\u00f3ng m\u1eb7t, cho\u00e1ng v\u00e1ng, v\u00e0 ng\u1ea5t.
\n\u2022 \u0110\u00f4i khi rung nh\u0129 ch\u1ec9 ph\u00e1t hi\u1ec7n ra sau nh\u1eefng bi\u1ebfn ch\u1ee9ng ch\u00ednh:
\n\u2022 Suy tim c\u1ea5p (ph\u00f9 ph\u1ed5i).
\n\u2022 Bi\u1ebfn c\u1ed1 t\u1eafc m\u1ea1ch do huy\u1ebft kh\u1ed1i: \u0111\u1ed9t qu\u1ef5\/TIA, nh\u1ed3i m\u00e1u th\u1eadn, nh\u1ed3i m\u00e1u l\u00e1ch, v\u00e0 thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 chi c\u1ea5p t\u00ednh.
\nPh\u00e2n t\u1ea7ng nguy c\u01a1 \u0111\u1ed9t qu\u1ef5
\n<\/strong>M\u1ed9t bi\u1ebfn ch\u1ee9ng quan tr\u1ecdng li\u00ean quan \u0111\u1ebfn rung nh\u0129 l\u00e0 nguy c\u01a1 t\u1eafc m\u1ea1ch do huy\u1ebft kh\u1ed1i. Khi t\u00e2m nh\u0129 kh\u00f4ng th\u1ec3 ph\u00f3ng \u0111i\u1ec7n ph\u1ed1i h\u1ee3p, n\u00f3 d\u1eabn \u0111\u1ebfn m\u1ed9t s\u1ef1 co kh\u00f4ng hi\u1ec7u qu\u1ea3; Ch\u00fang “quiver” hay l\u00e0 fibrillate, d\u1eabn \u0111\u1ebfn \u1ee9 m\u00e1u trong t\u00e2m nh\u0129 v\u00e0 t\u0103ng nguy c\u01a1 h\u00ecnh th\u00e0nh c\u1ee5c m\u00e1u \u0111\u00f4ng. R\u1ee7i ro n\u00e0y c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 b\u1eb1ng thang \u0111i\u1ec3m CHA2DS2-VASC; k\u1ebft qu\u1ea3 c\u00e0ng cao, nguy c\u01a1 h\u00ecnh th\u00e0nh huy\u1ebft kh\u1ed1i c\u00e0ng cao.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n
\u00a0<\/strong><\/td>\nY\u1ebfu t\u1ed1 nguy c\u01a1<\/strong><\/td>\n\u0110i\u1ec3m<\/strong><\/td>\n<\/td>\n<\/tr>\n
C: Congestive heart failure<\/td>\n\u00a0<\/strong>Suy tim sung huy\u1ebft<\/strong>: <\/strong>suy tim tr\u00ean l\u00e2m s\u00e0ng, ho\u1eb7c c\u00f3 b\u1eb1ng ch\u1ee9ng kh\u00e1ch quan r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng th\u1ea5t tr\u00e1i m\u1ee9c \u0111\u1ed9 trung b\u00ecnh \u0111\u1ebfn n\u1eb7ng, ho\u1eb7c HCM.<\/td>\n1<\/td>\n\u00a0Suy tim m\u1ea5t b\u00f9 g\u1ea7n \u0111\u00e2y b\u1ea5t k\u1ec3 ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u th\u1ea5t tr\u00e1i (v\u00ec v\u1eady bao g\u1ed3m c\u1ea3 HFrEF v\u00e0 HFpEF), ho\u1eb7c c\u00f3 s\u1ef1 xu\u1ea5t hi\u1ec7n suy gi\u1ea3m ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i t\u1eeb v\u1eeba \u0111\u1ebfn n\u1eb7ng tr\u00ean h\u00ecnh \u1ea3nh h\u1ecdc (d\u00f9 c\u00f3 hay kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng).<\/td>\n<\/tr>\n
H : Hypertension<\/td>\nT\u0103ng huy\u1ebft \u00e1p**<\/strong><\/td>\n1<\/td>\n\u00a0Ti\u1ec1n s\u1eed t\u0103ng huy\u1ebft \u00e1p c\u00f3 th\u1ec3 g\u00e2y ra s\u1ef1 thay \u0111\u1ed5i v\u1ec1 m\u1ea1ch m\u00e1u d\u1eabn \u0111\u1ebfn \u0111\u1ed9t qu\u1ef5, huy\u1ebft \u00e1p \u0111ang \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t t\u1ed1t h\u00f4m nay kh\u00f4ng c\u00f3 ngh\u0129a s\u1ebd lu\u00f4n \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t t\u1ed1t trong 1 th\u1eddi gian d\u00e0i. Huy\u1ebft \u00e1p m\u1ee5c ti\u00eau t\u1ed1i \u01b0u nh\u1eb1m gi\u1ea3m gi\u1ea3m t\u1ed1i \u0111a nguy c\u01a1 \u0111\u1ed9t qu\u1ef5 do thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9, t\u1eed vong v\u00e0 c\u00e1c bi\u1ebfn c\u1ed1 tim m\u1ea1ch kh\u00e1c l\u00e0 120-129\/<\/td>\n<\/tr>\n
A : Age<\/td>\nTu\u1ed5i >=75<\/strong><\/td>\n2<\/td>\nCh\u1ec9 t\u00ednh m\u1ed9t trong hai \u0111\u1eb7c \u0111i\u1ec3m ho\u1eb7c >75\u00a0 ho\u1eb7c 65-74 tu\u1ed5i. \u0110\u1ed9 tu\u1ed5i <65 tu\u1ed5i: t\u00ednh l\u00e0 0 \u0111i\u1ec3m<\/td>\n<\/tr>\n
Tu\u1ed5i 65-74<\/strong><\/td>\n1<\/td>\n<\/tr>\n
D :<\/p>\n

Diabetes mellitus<\/td>\n

\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng<\/strong>\u00a0(ho\u1eb7c \u0111ang \u0111i\u1ec1u tr\u1ecb Insulin ho\u1eb7c thu\u1ed1c h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft \u0111\u01b0\u1eddng u\u1ed1ng)<\/td>\n1<\/td>\n\u00a0\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 nguy c\u01a1 \u0111\u00e3 \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh r\u00f5 r\u00e0ng g\u00e2y n\u00ean \u0111\u1ed9t qu\u1ef5. Nguy c\u01a1 \u0111\u1ed9t qu\u1ef5 c\u00f3 li\u00ean quan \u0111\u1ebfn th\u1eddi gian m\u1eafc \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng (th\u1eddi gian m\u1eafc c\u00e0ng d\u00e0i, nguy c\u01a1 thuy\u00ean t\u1eafc huy\u1ebft kh\u1ed1i c\u00e0ng cao)<\/td>\n<\/tr>\n
S : Stroke<\/td>\nTi\u00ean s\u1eed \u0110\u1ed9t qu\u1ef5\/TIA\/Thuy\u00ean t\u1eafc m\u1ea1ch n\u00e3o<\/strong><\/td>\n2<\/td>\n\u00a0Ti\u1ec1n s\u1eed \u0111\u1ed9t qu\u1ef5, thuy\u00ean t\u1eafc m\u1ea1ch h\u1ec7 th\u1ed1ng ho\u1eb7c c\u01a1n thi\u1ebfu m\u00e1u n\u00e3o tho\u00e1ng qua (TIA) l\u00e0 nguy c\u01a1 \u0111\u1eb7c bi\u1ec7t cao g\u00e2y \u0111\u1ed9t qu\u1ef5 nh\u1ed3i m\u00e1u n\u00e3o, v\u00ec v\u1eady c\u00f3 tr\u1ecdng s\u1ed1 2 \u0111i\u1ec3m.<\/td>\n<\/tr>\n
V :<\/p>\n

Vascular disease<\/td>\n

B\u1ec7nh m\u1ea1ch m\u00e1u<\/strong>\u00a0(c\u00f3 h\u1eb9p \u0111\u00e1ng k\u1ec3 \u0110MV ho\u1eb7c c\u00f3 ti\u1ec1n s\u1eed Nh\u1ed3i m\u00e1u c\u01a1 tim, b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch ngo\u1ea1i bi\u00ean, c\u00f3 x\u01a1 v\u1eefa \u0111\u1ed9ng m\u1ea1ch ch\u1ee7)<\/td>\n1<\/td>\n\u00a0B\u1ec7nh m\u1ea1ch m\u00e1u [PAD (peripheral arterial disease) ho\u1eb7c nh\u1ed3i m\u00e1u c\u01a1 tim] l\u00e0m t\u0103ng nguy c\u01a1 17 – 22%, \u0111\u1eb7c bi\u1ec7t \u1edf b\u1ec7nh nh\u00e2n ch\u00e2u \u00c1.<\/td>\n<\/tr>\n
S: \u00a0Sex category (female)<\/td>\nGi\u1edbi n\u1eef<\/td>\n1<\/td>\n\u00a0Gi\u1edbi t\u00ednh n\u00ean \u0111\u01b0\u1ee3c xem l\u00e0 y\u1ebfu t\u1ed1 \u0111i\u1ec1u ch\u1ec9nh h\u01a1n l\u00e0 y\u1ebfu t\u1ed1 nguy c\u01a1 c\u1ee7a \u0111\u1ed9t qu\u1ef5<\/td>\n<\/tr>\n
<\/td>\n\u0110i\u1ec3m t\u1ed1i \u0111a<\/td>\n9<\/td>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n

 <\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
\u0110i\u1ec3m CHA2DS2-VASc<\/strong><\/td>\n<\/td>\nnguy c\u01a1 \u0111\u1ed9t qu\u1ef5 (% m\u1ed7i n\u0103m)<\/strong><\/td>\n<\/tr>\n
<\/td>\n<\/td>\n<\/td>\n<\/tr>\n
0<\/strong><\/td>\nNguy c\u01a1 th\u1ea5p<\/td>\n0<\/strong><\/td>\n<\/tr>\n
1<\/strong><\/td>\n<\/td>\n1,3%<\/strong><\/td>\n<\/tr>\n
2<\/strong><\/td>\nNguy c\u01a1 cao<\/td>\n2,2%<\/strong><\/td>\n<\/tr>\n
3<\/strong><\/td>\n3,2%<\/strong><\/td>\n<\/tr>\n
4<\/strong><\/td>\n4,0%<\/strong><\/td>\n<\/tr>\n
5<\/strong><\/td>\n6,7%<\/strong><\/td>\n<\/tr>\n
6<\/strong><\/td>\n9,8%<\/strong><\/td>\n<\/tr>\n
7<\/strong><\/td>\n9,6%<\/strong><\/td>\n<\/tr>\n
8<\/strong><\/td>\n6,7%<\/strong><\/td>\n<\/tr>\n
9<\/strong><\/td>\n15,2%<\/strong><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

T\u00c0I LI\u1ec6U THAM KH\u1ea2O<\/b><\/p>\n

    \n
  1. ECS 2020 Guidelines for Management of Atrial Fibrillation<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Rung nh\u0129 (AF) l\u00e0 m\u1ed9t nh\u1ecbp x\u00e1o tr\u1ed9n c\u1ef1c k\u1ef3 ph\u1ed5 bi\u1ebfn th\u01b0\u1eddng \u0111\u01b0\u1ee3c xem nh\u01b0 r\u1ed1i lo\u1ea1n nh\u1ecbp nhanh tr\u00ean th\u1ea5t m\u1ea1n t\u00ednh \u1edf b\u1ec7nh nh\u00e2n l\u1edbn tu\u1ed5i. N\u00f3 \u0111\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi ph\u1ee9c b\u1ed9 QRS kh\u00f4ng \u0111\u1ec1u v\u00e0 m\u1ea5t t\u00ednh \u0111\u1ed3ng b\u1ed9 v\u1edbi s\u1ef1 co c\u1ee7a t\u00e2m nh\u0129. Ph\u00e2n t\u1ea7ng nguy c\u01a1 theo […]<\/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":"\nRung nh\u0129 (AF) v\u00e0 thang \u0111i\u1ec3m CHA2DS2-VASc cho nguy c\u01a1 \u0111\u1ed9t qu\u1ef5 - Vinmec<\/title>\n<meta name=\"description\" content=\"Rung nh\u0129 (AF) l\u00e0 m\u1ed9t nh\u1ecbp x\u00e1o tr\u1ed9n c\u1ef1c k\u1ef3 ph\u1ed5 bi\u1ebfn th\u01b0\u1eddng \u0111\u01b0\u1ee3c xem nh\u01b0 r\u1ed1i lo\u1ea1n nh\u1ecbp nhanh tr\u00ean th\u1ea5t m\u1ea1n t\u00ednh \u1edf b\u1ec7nh nh\u00e2n l\u1edbn tu\u1ed5i.\" \/>\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=\"Rung nh\u0129 (AF) v\u00e0 thang \u0111i\u1ec3m CHA2DS2-VASc cho nguy c\u01a1 \u0111\u1ed9t qu\u1ef5 - 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