{"id":31103,"date":"2023-05-03T16:04:07","date_gmt":"2023-05-03T09:04:07","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=31103"},"modified":"2023-05-04T16:33:38","modified_gmt":"2023-05-04T09:33:38","slug":"kiem-soat-nhip-va-su-dung-chong-dong-dieu-tri-rung-nhi-esc","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/03\/kiem-soat-nhip-va-su-dung-chong-dong-dieu-tri-rung-nhi-esc\/","title":{"rendered":"Ki\u1ec3m so\u00e1t nh\u1ecbp v\u00e0 s\u1eed d\u1ee5ng ch\u1ed1ng \u0111\u00f4ng trong \u0111i\u1ec1u tr\u1ecb rung nh\u0129 &#8211; ESC"},"content":{"rendered":"<p><strong>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. Ki\u1ec3m so\u00e1t nh\u1ecbp trong \u0111i\u1ec1u tr\u1ecb rung nh\u0129 nh\u1eb1m \u0111i\u1ec1u ch\u1ec9nh l\u1ea1i t\u1ea7n s\u1ed1 th\u1ea5t b\u1ecb thay \u0111\u1ed5i do rung nh\u0129 ( m\u00e0 kh\u00f4ng g\u1eb7p ph\u1ea3i trong nh\u1ecbp xoang) nh\u1eb1m l\u00e0m gi\u1ea3m ho\u1eb7c h\u1ebft tri\u1ec7u ch\u1ee9ng, c\u1ea3i thi\u1ec7n huy\u1ebft \u0111\u1ed9ng, ph\u00f2ng ng\u1eeba suy tim (b\u1ec7nh c\u01a1 tim do nh\u1ecbp nhanh) v\u00e0 gi\u1ea3m bi\u1ebfn c\u1ed1 tim m\u1ea1ch.<\/strong><\/p>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"alignnone wp-image-31109 size-medium\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/AtrialFib_share-218x300.jpg\" alt=\"dieu-tri-rung-nhi\" width=\"218\" height=\"300\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/AtrialFib_share-218x300.jpg 218w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/AtrialFib_share-744x1024.jpg 744w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/AtrialFib_share-768x1057.jpg 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/AtrialFib_share-1116x1536.jpg 1116w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/AtrialFib_share-1488x2048.jpg 1488w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/AtrialFib_share-scaled.jpg 1860w\" sizes=\"(max-width: 218px) 100vw, 218px\" \/><\/p>\n<h2>1. C\u00e1c nguy\u00ean t\u1eafc ch\u00ednh c\u1ee7a \u0111i\u1ec1u tr\u1ecb rung nh\u0129:<\/h2>\n<ul>\n<li>S\u1eeda ch\u1eefa b\u1ea5t k\u1ef3 y\u1ebfu t\u1ed1 nguy c\u01a1 c\u00f3 th\u1ec3 \u0111\u1ea3o ng\u01b0\u1ee3c, ch\u1eb3ng h\u1ea1n nh\u01b0 s\u1ef1 m\u1ea5t c\u00e2n b\u1eb1ng \u0111i\u1ec7n gi\u1ea3i v\u00e0 c\u01b0\u1eddng gi\u00e1p<\/li>\n<li>. Ki\u1ec3m so\u00e1t nh\u1ecbp \u0111\u1ec3 kh\u00f4i ph\u1ee5c nh\u1ecbp xoang v\u00e0 ki\u1ec3m so\u00e1t t\u1ed1c \u0111\u1ed9 \u0111\u1ec3 gi\u1ea3m nh\u1ecbp tim.<\/li>\n<li>D\u1ef1 ph\u00f2ng thuy\u00ean t\u1eafc do huy\u1ebft kh\u1ed1i v\u1edbi thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng.<\/li>\n<\/ul>\n<h2>2. Ki\u1ec3m so\u00e1t nh\u1ecbp<\/h2>\n<p>M\u1ee5c ti\u00eau c\u1ee7a ki\u1ec3m so\u00e1t nh\u1ecbp l\u00e0 \u0111\u1ec3 thi\u1ebft l\u1eadp l\u1ea1i nh\u1ecbp xoang. B\u1ec7nh nh\u00e2n rung nh\u0129 \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i d\u1ef1a tr\u00ean huy\u1ebft \u0111\u1ed9ng:<br \/>\n<strong>2.1 B\u1ec7nh nh\u00e2n huy\u1ebft \u0111\u1ed9ng kh\u00f4ng \u1ed5n \u0111\u1ecbnh:<\/strong><br \/>\nB\u1ec7nh nh\u00e2n huy\u1ebft \u0111\u1ed9ng kh\u00f4ng \u1ed5n \u0111\u1ecbnh n\u00ean \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng <a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/soc-dien-ngoai-long-nguc-trong-cap-cuu\/\">kh\u1eed rung \u0111\u1ed3ng b\u1ed9<\/a> b\u1eb1ng \u0111i\u1ec7n kh\u1ea9n c\u1ea5p (DC).<br \/>\n<strong>2.2. B\u1ec7nh nh\u00e2n huy\u1ebft \u0111\u1ed9ng \u1ed5n \u0111\u1ecbnh:<\/strong><br \/>\nQu\u1ea3n l\u00fd b\u1ec7nh nh\u00e2n huy\u1ebft \u0111\u1ed9ng \u1ed5n \u0111\u1ecbnh ph\u1ee5 thu\u1ed9c ch\u1ee7 y\u1ebfu v\u00e0o th\u1eddi gian kh\u1edfi ph\u00e1t c\u1ee7a AF:<br \/>\n\u2022 AF (&lt;48 gi\u1edd):<br \/>\n\u2022 AF s\u1ebd ch\u1ea5m d\u1ee9t khi kh\u00f4i ph\u1ee5c l\u1ea1i nh\u1ecbp xoang, ho\u1eb7c kh\u1eed rung b\u1eb1ng thu\u1ed1c ho\u1eb7c b\u1eb1ng s\u1ed1c \u0111i\u1ec7n.<br \/>\n\u2022 AF (&gt; 48 gi\u1edd ho\u1eb7c th\u1eddi gian kh\u00f4ng r\u00f5):<br \/>\n\u2022 N\u1ebfu AF \u0111\u00e3 k\u00e9o d\u00e0i h\u01a1n 48 gi\u1edd c\u00f3 nguy c\u01a1 h\u00ecnh th\u00e0nh huy\u1ebft kh\u1ed1i nh\u0129 tr\u00e1i t\u0103ng \u0111\u00e1ng k\u1ec3.<br \/>\n\u2022 \u0110i\u1ec1u tr\u1ecb li\u00ean quan \u0111\u1ebfn vi\u1ec7c k\u1ebft h\u1ee3p warfarinin v\u1edbi \u0111i\u1ec1u tr\u1ecb b\u1eafc c\u1ea7u trong 3 tu\u1ea7n tr\u01b0\u1edbc khi kh\u1eed rung, v\u00e0 l\u00ean \u0111\u1ebfn 4 tu\u1ea7n sau khi kh\u1eed rung<br \/>\n\u2022 TEE \u0111\u01b0\u1ee3c khuy\u1ebfn kh\u00edch \u0111\u1ec3 lo\u1ea1i b\u1ecf huy\u1ebft kh\u1ed1i ti\u1ec3u nh\u0129 tr\u00e1i n\u1ebfu \u0111i\u1ec1u tr\u1ecb ch\u1ed1ng \u0111\u00f4ng ch\u01b0a \u0111\u01b0\u1ee3c ti\u00eam trong v\u00f2ng \u00edt nh\u1ea5t 3 tu\u1ea7n tr\u01b0\u1edbc khi kh\u1eed rung<\/p>\n<h2>3. Ph\u01b0\u01a1ng ph\u00e1p ki\u1ec3m so\u00e1t nh\u1ecbp \u0111i\u1ec1u tr\u1ecb rung nh\u0129<\/h2>\n<p><strong>3.1. Kh\u1eed rung \u0111i\u1ec7n<\/strong><br \/>\n\u2022 Th\u1ef1c hi\u1ec7n v\u1edbi kh\u1eed rung \u0111\u1ed3ng b\u1ed9 b\u1eb1ng \u0111i\u1ec7n.<br \/>\n\u2022 Trong th\u1ee7 thu\u1eadt n\u00e0y, 120-150J cho c\u00e1c thi\u1ebft b\u1ecb hai pha v\u00e0 200 J cho c\u00e1c thi\u1ebft b\u1ecb m\u1ed9t pha \u0111\u01b0\u1ee3c d\u00f9ng cho b\u1ec7nh nh\u00e2n \u0111ang \u1ed5n \u0111\u1ecbnh, th\u1eddi gian trong \u0111\u00f3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u khi\u1ec3n b\u1edfi m\u1ed9t ECG t\u00edch h\u1ee3p \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o th\u1eddi \u0111i\u1ec3m t\u1ed1i \u01b0u trong chu k\u1ef3 tim (\u0111\u1ed3ng b\u1ed9 h\u00f3a).<br \/>\n\u2022 N\u1ebfu kh\u00f4ng th\u00e0nh c\u00f4ng, n\u0103ng l\u01b0\u1ee3ng ph\u1ea3i \u0111\u01b0\u1ee3c t\u0103ng d\u1ea7n.<br \/>\n<strong>3.2. Kh\u1eed rung b\u1eb1ng thu\u1ed1c<\/strong><br \/>\n\u2022 Thu\u1ed1c ch\u1ed1ng lo\u1ea1n nh\u1ecbp s\u1eed d\u1ee5ng cho b\u1ec7nh nh\u00e2n m\u00e0 kh\u00f4ng c\u00f3 b\u1ea5t k\u1ef3 b\u1ec7nh l\u00fd tim m\u1ea1ch n\u00e0o; nh\u1ea5t l\u00e0 l thu\u1ed1c nh\u00f3m Ic, v\u00ed d\u1ee5, flecainide v\u00e0 propafenone.<br \/>\n\u2022 N\u1ebfu b\u1ec7nh nh\u00e2n c\u00f3 b\u1ea5t k\u1ef3 b\u1ec7nh l\u00fd tim m\u1ea1ch n\u00e0o tr\u01b0\u1edbc \u0111\u00f3, amiodaron s\u1ebd hi\u1ec7u qu\u1ea3 h\u01a1n c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c d\u00f9ng; Tuy nhi\u00ean, thu\u1ed1c n\u00e0y mang m\u1ed9t nguy c\u01a1 t\u00e1c d\u1ee5ng ph\u1ee5.<br \/>\n<strong>3.3 Ki\u1ec3m so\u00e1t t\u1ed1c \u0111\u1ed9<\/strong><br \/>\nKi\u1ec3m so\u00e1t t\u1ed1c \u0111\u1ed9 nh\u1eb1m m\u1ee5c \u0111\u00edch l\u00e0m ch\u1eadm nh\u1ecbp th\u1ea5t v\u00e0 do \u0111\u00f3 tr\u00e1nh b\u1ec7nh c\u01a1 tim do nh\u1ecbp nhanh g\u00e2y ra, v\u00e0 l\u00e0m gi\u1ea3m c\u1ea3m gi\u00e1c \u0111\u00e1nh tr\u1ed1ng ng\u1ef1c. Ki\u1ec3m so\u00e1t t\u1ed1c \u0111\u1ed9 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng:<br \/>\n<strong>3.3.1. Ch\u1eb9n beta<\/strong><br \/>\n\u2022 Th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nh\u01b0 \u0111i\u1ec1u tr\u1ecb h\u00e0ng \u0111\u1ea7u khi kh\u00f4ng c\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh, bi\u1ec7t l\u00e0 bi\u1ec7t n\u1ebfu AF th\u1ee9 ph\u00e1t sau c\u01b0\u1eddng gi\u00e1p.<br \/>\n\u2022 V\u00ed d\u1ee5: Esmolol, propranolol, metoprolol<br \/>\n<strong>3.3.2. Ch\u1eb9n k\u00eanh canxi kh\u00f4ng dihydropyridin (CCB):<\/strong><br \/>\n\u2022 C\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng n\u1ebfu thu\u1ed1c ch\u1eb9n beta b\u1ecb ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh, nh\u01b0 \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n COPD.<br \/>\n\u2022 Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh \u1edf b\u1ec7nh nh\u00e2n c\u00f3 r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng th\u1ea5t tr\u00e1i, v\u00ec ch\u00fang c\u00f3 hi\u1ec7u \u1ee9ng co \u00e2m t\u00ednh.<br \/>\n\u2022 V\u00ed d\u1ee5: Diltiazem v\u00e0 verapamil<br \/>\n<strong>3.3.3. Digitalis (digoxin):<\/strong><br \/>\n\u2022 C\u00f3 th\u1ec3 s\u1eed d\u1ee5ng \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb rung nh\u0129 \u0111i k\u00e8m suy tim. N\u00f3 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng m\u1ed9t m\u00ecnh ho\u1eb7c v\u1edbi thu\u1ed1c ch\u1eb9n beta.<\/p>\n<h2>4. Ch\u1ed1ng \u0111\u00f4ng d\u00e0i h\u1ea1n<\/h2>\n<p>C\u00f4ng t\u00e1c ph\u00f2ng ch\u1ed1ng thuy\u00ean t\u1eafc do huy\u1ebft kh\u1ed1i \u1edf b\u1ec7nh nh\u00e2n rung nh\u0129 l\u00e0 \u0111i\u1ec1u quan tr\u1ecdng nh\u1ea5t v\u00ec t\u0103ng nguy c\u01a1 c\u1ee7a h\u1ecd v\u1ec1 bi\u1ebfn c\u1ed1 t\u1eafc m\u1ea1ch, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u0111\u1ed9t qu\u1ef5.<br \/>\n<strong>&#8211; Rung nh\u0129 do van<\/strong><br \/>\nCh\u1ed1ng \u0111\u00f4ng d\u00e0i h\u1ea1n l\u00e0 c\u1ea7n thi\u1ebft b\u1ea5t k\u1ec3 bao nhi\u00eau \u0111i\u1ec3m CHA2DS2-VASC.<br \/>\n<strong>&#8211; Rung nh\u0129 kh\u00f4ng do van<\/strong><br \/>\nNguy c\u01a1 n\u00e0y \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 b\u1eb1ng thang \u0111i\u1ec3m CHA2DS2-VASC c\u1ee7a Hi\u1ec7p h\u1ed9i tim m\u1ea1ch ch\u00e2u \u00c2u (ESC):<br \/>\n0 \u0111i\u1ec3m: nguy c\u01a1 th\u1ea5p v\u00e0 kh\u00f4ng nh\u1ea5t thi\u1ebft \u0111\u00f2i h\u1ecfi ph\u1ea3i ch\u1ed1ng \u0111\u00f4ng.<br \/>\n\u2022 1 \u0111i\u1ec3m: nguy c\u01a1 v\u1eeba ph\u1ea3i (CHA2DS2-VASC t\u1eeb 1 tr\u1edf l\u00ean), ch\u1ed1ng \u0111\u00f4ng th\u01b0\u1eddng tr\u1ef1c s\u1ebd ph\u1ea3i \u0111\u01b0\u1ee3c xem x\u00e9t &#8211; tr\u1eeb khi c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 ch\u1ec9 d\u1ef1a tr\u00ean gi\u1edbi t\u00ednh n\u1eef.<br \/>\n\u2022 T\u1eeb 2 \u0111i\u1ec3m tr\u1edf l\u00ean: Ch\u1ed1ng \u0111\u00f4ng l\u00e0 b\u1eaft bu\u1ed9c.<br \/>\nC\u00e1c lo\u1ea1i thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng<br \/>\n<strong>4.1. Warfarin<\/strong><br \/>\n\u2022 T\u1ea1i M\u1ef9, h\u1ea7u h\u1ebft c\u00e1c b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng warfarin (t\u00ean th\u01b0\u01a1ng hi\u1ec7u Coumadin), \u0111\u00f2i h\u1ecfi s\u1ef1 ki\u1ec3m so\u00e1t v\u00e0 theo d\u00f5i m\u1ee9c INR m\u1ee5c ti\u00eau t\u1eeb 2-3 th\u01b0\u1eddng xuy\u00ean.<br \/>\n<strong>4.2. Thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng \u0111\u01b0\u1eddng u\u1ed1ng Novel (NOAC)<\/strong><br \/>\n\u2022 C\u00f3 nh\u1eefng thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng \u0111\u01b0\u1eddng u\u1ed1ng m\u1edbi h\u01a1n c\u00f3 s\u1eb5n \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 c\u00f3 hi\u1ec7u qu\u1ea3. Ch\u00fang kh\u00f4ng y\u00eau c\u1ea7u theo d\u00f5i INR.<br \/>\n\u2022 Nh\u1eefng thu\u1ed1c n\u00e0y bao g\u1ed3m:<br \/>\n\u2022 Dabigatran: \u1ee9c ch\u1ebf tr\u1ef1c ti\u1ebfp thrombin<br \/>\n\u2022 Rivaroxaban: \u1ee9c ch\u1ebf y\u1ebfu t\u1ed1 Xa<br \/>\n\u2022 Apixaban: \u1ee9c ch\u1ebf y\u1ebfu t\u1ed1 Xa<\/p>\n<h2>5. Ti\u00ean l\u01b0\u1ee3ng<\/h2>\n<p>Ti\u00ean l\u01b0\u1ee3ng rung nh\u0129 m\u1ea1nh ph\u1ee5 thu\u1ed9c nhi\u1ec1u v\u00e0o b\u1ec7nh ti\u1ec1m \u1ea9n v\u00e0 ch\u1ee9c n\u0103ng tim. Nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb rung nh\u0129 v\u00e0 h\u1eb9p hai l\u00e1 c\u00f3 nguy c\u01a1 t\u1eafc m\u1ea1ch do huy\u1ebft kh\u1ed1i cao g\u1ea5p 4 l\u1ea7n so v\u1edbi b\u1ec7nh nh\u00e2n rung nh\u0129 kh\u00f4ng do van tim. H\u01a1n n\u1eefa, nguy c\u01a1 t\u1eafc m\u1ea1ch huy\u1ebft kh\u1ed1i \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh \u0111\u1ee3t b\u1ec7nh v\u00e0 t\u1ef7 l\u1ec7 t\u1eed vong c\u1ee7a b\u1ec7nh. C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb kh\u00e1c nhau, ki\u1ec3m so\u00e1t nh\u1ecbp ho\u1eb7c ki\u1ec3m so\u00e1t t\u1ed1c \u0111\u1ed9, kh\u00f4ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ti\u00ean l\u01b0\u1ee3ng, ngo\u1ea1i tr\u1eeb nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb suy tim, ng\u01b0\u1eddi \u0111\u01b0\u1ee3c h\u01b0\u1edfng l\u1ee3i nhi\u1ec1u h\u01a1n t\u1eeb \u0111i\u1ec1u tr\u1ecb ki\u1ec3m so\u00e1t nh\u1ecbp li\u00ean t\u1ee5c. Nguy c\u01a1 \u0111\u1ed9t qu\u1ef5 c\u00f3 th\u1ec3 gi\u1ea3m kho\u1ea3ng 60% th\u00f4ng qua \u0111i\u1ec1u tr\u1ecb thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng v\u1edbi li\u1ec1u l\u01b0\u1ee3ng th\u00edch h\u1ee3p.<\/p>\n<p><strong>T\u00e0i li\u1ec7u tham kh\u1ea3o:<\/strong> B\u1ec7nh H\u1ecdc Tim M\u1ea1ch Lecturio<\/p>\n","protected":false},"excerpt":{"rendered":"<p>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. Ki\u1ec3m so\u00e1t nh\u1ecbp trong \u0111i\u1ec1u [&hellip;]<\/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":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Ki\u1ec3m so\u00e1t nh\u1ecbp v\u00e0 s\u1eed d\u1ee5ng ch\u1ed1ng \u0111\u00f4ng trong \u0111i\u1ec1u tr\u1ecb rung nh\u0129 - ESC<\/title>\n<meta name=\"description\" content=\"Ki\u1ec3m so\u00e1t nh\u1ecbp trong \u0111i\u1ec1u tr\u1ecb rung nh\u0129 nh\u1eb1m \u0111i\u1ec1u ch\u1ec9nh l\u1ea1i t\u1ea7n s\u1ed1 th\u1ea5t b\u1ecb thay \u0111\u1ed5i do rung nh\u0129 nh\u1eb1m l\u00e0m gi\u1ea3m ho\u1eb7c h\u1ebft tri\u1ec7u ch\u1ee9ng.\" \/>\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=\"Ki\u1ec3m so\u00e1t nh\u1ecbp v\u00e0 s\u1eed d\u1ee5ng ch\u1ed1ng \u0111\u00f4ng trong \u0111i\u1ec1u tr\u1ecb rung nh\u0129 - ESC\" \/>\n<meta property=\"og:description\" content=\"Ki\u1ec3m so\u00e1t nh\u1ecbp trong \u0111i\u1ec1u tr\u1ecb rung nh\u0129 nh\u1eb1m \u0111i\u1ec1u ch\u1ec9nh l\u1ea1i t\u1ea7n s\u1ed1 th\u1ea5t b\u1ecb thay \u0111\u1ed5i do rung nh\u0129 nh\u1eb1m l\u00e0m gi\u1ea3m ho\u1eb7c h\u1ebft tri\u1ec7u ch\u1ee9ng.\" \/>\n<meta property=\"og:url\" content=\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/03\/kiem-soat-nhip-va-su-dung-chong-dong-dieu-tri-rung-nhi-esc\/\" \/>\n<meta property=\"og:site_name\" content=\"Vinmec\" \/>\n<meta property=\"article:published_time\" content=\"2023-05-03T09:04:07+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-05-04T09:33:38+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/AtrialFib_share-218x300.jpg\" \/>\n<meta name=\"author\" content=\"Dai Tran Van\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Dai Tran Van\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"5 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/03\/kiem-soat-nhip-va-su-dung-chong-dong-dieu-tri-rung-nhi-esc\/\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/03\/kiem-soat-nhip-va-su-dung-chong-dong-dieu-tri-rung-nhi-esc\/\",\"name\":\"Ki\u1ec3m so\u00e1t nh\u1ecbp v\u00e0 s\u1eed d\u1ee5ng ch\u1ed1ng \u0111\u00f4ng trong \u0111i\u1ec1u tr\u1ecb rung nh\u0129 - ESC\",\"isPartOf\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\"},\"datePublished\":\"2023-05-03T09:04:07+00:00\",\"dateModified\":\"2023-05-04T09:33:38+00:00\",\"author\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/b99bd843f29d91903ec9b6d18e47b0e2\"},\"description\":\"Ki\u1ec3m so\u00e1t nh\u1ecbp trong \u0111i\u1ec1u tr\u1ecb rung nh\u0129 nh\u1eb1m \u0111i\u1ec1u ch\u1ec9nh l\u1ea1i t\u1ea7n s\u1ed1 th\u1ea5t b\u1ecb thay \u0111\u1ed5i do rung nh\u0129 nh\u1eb1m l\u00e0m gi\u1ea3m ho\u1eb7c h\u1ebft tri\u1ec7u ch\u1ee9ng.\",\"breadcrumb\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/03\/kiem-soat-nhip-va-su-dung-chong-dong-dieu-tri-rung-nhi-esc\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/03\/kiem-soat-nhip-va-su-dung-chong-dong-dieu-tri-rung-nhi-esc\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/03\/kiem-soat-nhip-va-su-dung-chong-dong-dieu-tri-rung-nhi-esc\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"http:\/\/noithathoaphat.in\/ctv\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Ki\u1ec3m so\u00e1t nh\u1ecbp v\u00e0 s\u1eed d\u1ee5ng ch\u1ed1ng \u0111\u00f4ng trong \u0111i\u1ec1u tr\u1ecb rung nh\u0129 &#8211; ESC\"}]},{\"@type\":\"WebSite\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/\",\"name\":\"Vinmec\",\"description\":\"H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"http:\/\/noithathoaphat.in\/ctv\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/b99bd843f29d91903ec9b6d18e47b0e2\",\"name\":\"Dai Tran Van\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/\",\"url\":\"http:\/\/1.gravatar.com\/avatar\/104f3ddcb78816cdc9f1340c38ade413?s=96&d=mm&r=g\",\"contentUrl\":\"http:\/\/1.gravatar.com\/avatar\/104f3ddcb78816cdc9f1340c38ade413?s=96&d=mm&r=g\",\"caption\":\"Dai Tran Van\"},\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/tranvandai2791995gmail-com\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Ki\u1ec3m so\u00e1t nh\u1ecbp v\u00e0 s\u1eed d\u1ee5ng ch\u1ed1ng \u0111\u00f4ng trong \u0111i\u1ec1u tr\u1ecb rung nh\u0129 - ESC","description":"Ki\u1ec3m so\u00e1t nh\u1ecbp trong \u0111i\u1ec1u tr\u1ecb rung nh\u0129 nh\u1eb1m \u0111i\u1ec1u ch\u1ec9nh l\u1ea1i t\u1ea7n s\u1ed1 th\u1ea5t b\u1ecb thay \u0111\u1ed5i do rung nh\u0129 nh\u1eb1m l\u00e0m gi\u1ea3m ho\u1eb7c h\u1ebft tri\u1ec7u ch\u1ee9ng.","robots":{"index":"noindex","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"og_locale":"en_US","og_type":"article","og_title":"Ki\u1ec3m so\u00e1t nh\u1ecbp v\u00e0 s\u1eed d\u1ee5ng ch\u1ed1ng \u0111\u00f4ng trong \u0111i\u1ec1u tr\u1ecb rung nh\u0129 - ESC","og_description":"Ki\u1ec3m so\u00e1t nh\u1ecbp trong \u0111i\u1ec1u tr\u1ecb rung nh\u0129 nh\u1eb1m \u0111i\u1ec1u ch\u1ec9nh l\u1ea1i t\u1ea7n s\u1ed1 th\u1ea5t b\u1ecb thay \u0111\u1ed5i do rung nh\u0129 nh\u1eb1m l\u00e0m gi\u1ea3m ho\u1eb7c h\u1ebft tri\u1ec7u ch\u1ee9ng.","og_url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/03\/kiem-soat-nhip-va-su-dung-chong-dong-dieu-tri-rung-nhi-esc\/","og_site_name":"Vinmec","article_published_time":"2023-05-03T09:04:07+00:00","article_modified_time":"2023-05-04T09:33:38+00:00","og_image":[{"url":"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/AtrialFib_share-218x300.jpg"}],"author":"Dai Tran Van","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Dai Tran Van","Est. reading time":"5 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/03\/kiem-soat-nhip-va-su-dung-chong-dong-dieu-tri-rung-nhi-esc\/","url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/03\/kiem-soat-nhip-va-su-dung-chong-dong-dieu-tri-rung-nhi-esc\/","name":"Ki\u1ec3m so\u00e1t nh\u1ecbp v\u00e0 s\u1eed d\u1ee5ng ch\u1ed1ng \u0111\u00f4ng trong \u0111i\u1ec1u tr\u1ecb rung nh\u0129 - ESC","isPartOf":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#website"},"datePublished":"2023-05-03T09:04:07+00:00","dateModified":"2023-05-04T09:33:38+00:00","author":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/b99bd843f29d91903ec9b6d18e47b0e2"},"description":"Ki\u1ec3m so\u00e1t nh\u1ecbp trong \u0111i\u1ec1u tr\u1ecb rung nh\u0129 nh\u1eb1m \u0111i\u1ec1u ch\u1ec9nh l\u1ea1i t\u1ea7n s\u1ed1 th\u1ea5t b\u1ecb thay \u0111\u1ed5i do rung nh\u0129 nh\u1eb1m l\u00e0m gi\u1ea3m ho\u1eb7c h\u1ebft tri\u1ec7u ch\u1ee9ng.","breadcrumb":{"@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/03\/kiem-soat-nhip-va-su-dung-chong-dong-dieu-tri-rung-nhi-esc\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/03\/kiem-soat-nhip-va-su-dung-chong-dong-dieu-tri-rung-nhi-esc\/"]}]},{"@type":"BreadcrumbList","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/03\/kiem-soat-nhip-va-su-dung-chong-dong-dieu-tri-rung-nhi-esc\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"http:\/\/noithathoaphat.in\/ctv\/"},{"@type":"ListItem","position":2,"name":"Ki\u1ec3m so\u00e1t nh\u1ecbp v\u00e0 s\u1eed d\u1ee5ng ch\u1ed1ng \u0111\u00f4ng trong \u0111i\u1ec1u tr\u1ecb rung nh\u0129 &#8211; ESC"}]},{"@type":"WebSite","@id":"http:\/\/noithathoaphat.in\/ctv\/#website","url":"http:\/\/noithathoaphat.in\/ctv\/","name":"Vinmec","description":"H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"http:\/\/noithathoaphat.in\/ctv\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"},{"@type":"Person","@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/b99bd843f29d91903ec9b6d18e47b0e2","name":"Dai Tran Van","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/","url":"http:\/\/1.gravatar.com\/avatar\/104f3ddcb78816cdc9f1340c38ade413?s=96&d=mm&r=g","contentUrl":"http:\/\/1.gravatar.com\/avatar\/104f3ddcb78816cdc9f1340c38ade413?s=96&d=mm&r=g","caption":"Dai Tran Van"},"url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/tranvandai2791995gmail-com\/"}]}},"_links":{"self":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/31103"}],"collection":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/users\/16"}],"replies":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/comments?post=31103"}],"version-history":[{"count":2,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/31103\/revisions"}],"predecessor-version":[{"id":31764,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/31103\/revisions\/31764"}],"wp:attachment":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/media?parent=31103"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/categories?post=31103"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/tags?post=31103"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}