I thinlung chu a na lutuk ang maiin i hria em? RVR hmanga A-fib chungchang i zir dawn teh ang! (RVR hmanga Atrial Fibrillation tih a ni) .

I thinlung chu mi â ang maiin a thawk ang maiin i inhriat ngai em, a nih loh leh i rilruah thil mak tak tak i nei ang tih i hre ngai em? A nih loh leh thawk harsa emaw, luak chhuak emaw angin i inhria em? Chûngte chu thil dang mai a ni lo mai thei. Vawiin hian he harsatna hi thinlunga lo awm thin, chu chu thinlung thawk mumal lo leh rang tak tak, `(Atrial Fibrillation with Rapid Ventricular Rate)` emaw, a tawi zawngin `(A-fib with RVR)` emaw an tih chungchang kan sawi dawn a ni. Hlau suh, hei hi hriat chian a pawimawh hle.

RVR hmanga A-fib hi eng nge ni tak tak?

A awlsam zawngin, `(A-fib with RVR)` tih hi i thinlung rhythm, a nih loh leh i beating pattern a dik lo tihna a ni. Kan thinlungah hian upper chamber pahnih kan nei a, chu chu atria kan ti a. Heng `(atria)` te hi thinlung thawk tura hrilhtu electrical signal te intanna hmun a ni. Mahse `(Atrial Fibrillation)` vei mi pakhatah chuan heng electrical signal te hi a buai a, a out of order a, upper chamber `(atria)` te chu a inzawm nghal vat thin. Mi pakhatin mi â ang maia drum a vuak ang mai a ni.

Tunah chuan heng electrical signal chaotic tak takte hi thinlung hnuai lam chamber pahnih, ventricles-ah an kal ta a ni. Tichuan chu ventricles te beating chu a mumal lo va , a rang hle bawk . Chu chu ``A-fib with RVR'' an tih chu a ni. Chumi awmzia chu thinlung hi minute khatah vawi 100 aia tam a thawk tihna a ni.

Tui pump ang maiin han ngaihtuah teh. A thawk tha lo a nih chuan a mamawh thisen chu taksaah a pump thei lo. Chu chu `(A-fib with RVR)` i neih chuan a thleng thin. Thinlung hian thisen a khat tur hian hun a nei tawk lo a, chuvangin taksaah oxygenated thisen a pump tling thei lo.

Hetiang dinhmun hi engtiang chiahin nge a awm?

Hei hi mi tlemte chauhin natna a vei niin i ngai mai thei. Mahse a nihna takah chuan ``Atrial Fibrillation`` hi heart rhythm abnormalities zingah chuan a tam ber a ni. America ang ram statistics i en chuan mi maktaduai tam takin he natna hi an tuar a ni. Hetiang dinhmun hi Sri Lanka-ah pawh hmuh tur a awm nasa hle.

Hei hi eng symptoms nge ni? Engtin nge kan hriat theih ang?

Mi zawng zawng hian symptom inang an nei vek lo. Mi thenkhat chuan natna lanchhuahna nei lovin an nei thei bawk. Mahse, a lan chhuah dan tlangpui thenkhat chu:

• Heart palpitations : I thinlung chu i rilru chhungah a na emaw, a na emaw ang maiin a awm thei.
• Luak chhuak : I lu a inher ang maiin a awm thei a, a chang chuan ding thei lo khawpin a awm thei.
• Passing out: Mi thenkhat chuan he natna hi a nasat chuan an hriatna an hloh thei a, an tlu thei bawk.
• Chest pain : A rilru a buai emaw, a press emaw ang maia natna a awm thei.
• Thâwk hah : Tlemte i chau lai chauh ni lovin, i ding reng lai pawhin thawk harsa i ti thei.
• Lungkham fo thin`(Lungkhamna)`: Chhan awm lovin hlauhna leh lungkhamna i nei thei.
• Chauhna : Eng ang pawhin mut mah la, chau leh nunna nei loin i la inhria thei.

Heng symptoms te hi a chang chuan a na lo hle thei a, a chang chuan a na hle thei bawk. Chuvangin hetiang thil hi i tawn chuan doctor pan a tha ber .

Engvangin nge hetiang hi a lo awm? A chhan engte nge ni?

`A-fib with RVR` thlen thei thil engemaw zat a awm. A bulpui berte chu:

• Coronary artery disease : Hei hian thinlunga thisen petu thisen kalna kawng (arteries) a block tihna a ni.
• Thisen sang : "High blood pressure" tih thumal hi kan hre vek.
• Heart failure : Thinlung hian taksaah thisen a pump tling thei lo.
• Obstructive sleep apnea: Mut laiin thawk a chawlhsan a, chu chu bengchheng tak a ni.
• Heart surgery : He risk hi heart surgery thenkhat hnuah pawh ni engemaw zat emaw kar engemaw zat emaw chhung chu a awm thei.

Hemi atan hian tute nge hlauhawm ber?

Mi thenkhat chuan he natna hi an nei tam zawk. He category-ah hian i tel ve em tih en rawh:

• Kum 50 chunglam : He hlauhawmna hi kum upat deuh deuhin a pung zel.
• Body mass index (BMI) 30 aia sang nei mi : Hei hian an san zawng aiin an thau lutuk tihna a ni.
• Mut theih lohna (obstructive sleep apnea) nei te.
• Zu in tam : Nitin emaw, zu in tam emaw chuan a hlauhawmna a sang zawk.
• Caffeine ei tam lutuk : Nilengin coffee emaw tea emaw in tam lutuk hi a tha lo bawk.
• I chhungkuaa mi pakhatin ``A-fib'' a neih chuan : Genetic influence a awm thei bawk.

Hriat reng tur: Heng risk factor pakhat emaw a aia tam emaw i neih hian ``A-fib with RVR'' i nei ngei ang tihna a ni lo. Amaherawhchu, hengte hi kan hriat chian a pawimawh.

Hei hian eng harsatna nge a thlen theih?

`A-fib with RVR` hi uluk taka enkawl a nih loh chuan harsatna hlauhawm tak tak a awm thei.

• Thinlung hnuai lam pindan thisen a khat hun tihtlem.
• Heart muscle hian oxygen a mamawh tam zawk a ni .
• Cardiomyopathy : Lung ruh chak lo leh lian lo tihna a ni.
• Stroke : Thinlung chhungah thisen zam a lo awm a, thluak lamah a kal a, thisen kalna kawng (artery) a tikhawlo a nih chuan stroke a awm thei. Hei hi complication hlauhawm ber a ni .
• Thisen sang hniam .
• Congestive heart failure a awm a .

Chuvangin he natna hi hriat chian a, enkawlna zawng vat a pawimawh hle.

Engtin nge hei hi hriat chhuah a nih? Eng test nge tih thin?

A chunga kan sawi tak symptoms i neih chuan doctor i hmuh hunah a enfiah ang che a, i medical history a zawt ang che, chutah chuan test eng emaw zat a order ang a, i natna chu finfiah turin a ti ang.

Test hman tlanglawn ber berte chu:

• Electrocardiogram (ECG or EKG) : Hei hian thinlunga electric hnathawh dan a record a. `(A-fib with RVR)` a awm leh awm loh chiang takin a hre thei.
• Echocardiogram : Hei hi thinlung ultrasound scan ang a ni. Thinlung chamber leh valve te a thawk tha em tih te, thinlung hi engzat nge a lian tih te a enfiah thei a ni.
• Cardiac CT scan emaw MRI scan : Hengte hian thinlung insiam dan chipchiar zawkin a hriattir thei a ni.
• Thisen test : Hengte hian thyroid harsatna leh thisena electrolyte inthlak danglamna ang chi thilte hriatchhuahna kawngah a pui thin.

Hei hi eng enkawl dan nge ni ang?

Thu lawmawm tak chu RVR hmanga A-fib enkawlna tha tak tak a awm tih hi a ni. I doctor hian thil tum lian tak pahnih a nei a, chungte chu i natna lan chhuah dan control a, a chunga kan sawi tak complication te hi a lo awm loh nan a ni.

A hnuaia mite hi enkawlna atan an hmang ber a ni:

• Electrolytes inthlauhna : Taksa chhunga electrolytes potassium leh magnesium te pung emaw tlahniam emaw hian thinlung rhythm a nghawng thei a, chuvangin a enkawl dan tur dik taka vawn that nan enkawlna hman a ni.
• Damdawi : Hemi enkawlna ber chu damdawi a ni.

Eng damdawi/enkawlna nge hman?

`A-fib with RVR` atan hian damdawi chi hrang hrang pek a ni a:

• Beta-blockers : Entirnan, metoprolol (Lopressor® emaw Toprol®XL) te hi a ni. Hengte hian heart rate tlem a tihtlem bakah heart pressure tihziaawmna hmangin hna an thawk a ni.
• Calcium channel blocker : Entirnan, diltiazem (Diltzac® emaw Cardizem® emaw) te hi a ni. Hetiang damdawi chi hian heart muscle cell-a calcium lut tur control-in heart rate a ti hniam bawk.
• Antiarrhythmics : Entirnan, amiodarone (Pacerone® emaw Cordarone® emaw) emaw digoxin (Lanoxin® emaw Cardoxin®) emaw. Chûngte chuan thinlung rhythm mumal lo chu siam ṭha leh tûrin a ṭanpui a ni.

A pawimawh ber chu! `(A-fib)` i neih chuan thinlung chhungah thisen zam a lo awm theihna chance a sang hle. Heng thisen zamte hi thluaka a kal chuan `(Stroke)` a awm thei a ni. Chuvangin, anticoagulants , a nih loh leh "thisen tithianghlimtu" kan tih hi a ni deuh ber.

Mi thenkhat, heng thisen tithianghlimtu damdawi ei chhunzawm thei lo tan chuan thisen zam a lo awm loh nan left atrial appendage closure tih hming pu thil bik tih theih a ni.

A châng chuan damdawi hmang chauha he natna hi thunun a harsa ṭhin. Chutiang hunah chuan enkawl dan dang a ngai mai thei:

• Catheter ablation : Hei hian thinlung chhunga electrical signal erratic lo chhuahna hmunte zawn chhuah a, ke emaw kut emaw kaltlangin catheter te tak te (thin tube) chu thinlung chhungah dahin, erratic signal lo chhuahna hmunte chu ‘disabling’ a ni. Tichuan signal erratic te chu a lo kal tawh lo.
• Pacemaker : Mi thenkhat chuan an heart rate control nan an vun hnuaiah device te tak te an dah a. Hei hi pacemaker an ti a. A bik takin heart rate a hniam lai hian electrical signal a thawn thin.
• Electrical cardioversion : Hei hian hun rei lote chhunga anesthetic pek a, pawn lam atanga controlled electrical shock chu thinlungah thlen a, chu chuan thinlung rhythm a siam tha nghal vek a ni.
• Maze procedure : Hei hi a buaithlak deuh a ni. Electrical signal kalna tur kawng dik siam turin thinlung atria-ah hian incision te te siam a ni. Hei hi heart surgery dang neih laiin tih a ni tlangpui.

Enkawlna hian side effect a nei em?

Damdawi dang ang bawkin, he `(A-fib with RVR)` enkawlna hmang hian side effect emaw complication emaw a awm thei. Mahse, mi zawng zawngah a thleng lo va, a tlangpuiin minor an ni.

• Damdawi atanga : Mi thenkhat chuan lu na, thisen sang, luak chhuak, leh pum na te an nei thei.
• Catheter ablation ang chi kalphung hian cardiac tamponade a thlen thei a, a tlem berah chuan heart attack a thlen thei bawk.
• Pacemaker hian a chang chuan hna a thawk tha thei lo.
• Maze procedure hnuah thla engemaw zat chhung chu heart palpitations emaw ``A-fib'' emaw a lo awm leh thei .

Hemi chungchang hi i doctor chuan a hriattir ang che. Ngaihtuah buai a ngai lo, a chhan chu doctor-te chuan heng hlauhawmnate hi tih tlem an tum fo thin.

Engtiang chiahin nge enkawl hnuah ka dam leh ang?

Hei hi i enkawlnaah a innghat tak zet a ni. Damdawi thenkhat, intravenous (IV) damdawi te hian i heart rate a ti hniam thei a, minute tlemte chhungin i rilru a hahdam tan thei bawk . Enkawlna dangte chuan hna an thawk rei thei hle. A pawimawh ber chu i doctor thupek dik taka zawm hi a ni.

Engtin nge he risk hi ka tihziaawm theih ang?

`(A-fib with RVR)` i vei theihna tur tihtlem nan thil engemaw zat i tih theih a awm. Hengte hi i dinhmun tan chauh ni lovin, i hriselna zawng zawng tan pawh a tha a ni:

• Kar khatah minute 150 tal exercise chak tawk lo : kea kal, cycle khalh, tui chawi hi a tha.
• Thinlung hrisel ei tur: I eitur ah thlai, thei, legumes, whole grains, leh sangha te telh la. Oil, chi leh sugar te tihtlem rawh.
• Zu in tlem : A theih ang anga tihtlem a tha ber.
• Zuk leh hmuam thilte chu pumpelh vek rawh : I zuk chuan bansan rawh.
• Damdawi lam harsatna dang thisen sang, cholesterol sang, mut theih lohna, zunthlum i neih chuan control tha rawh.

`(A-fib with RVR)` ka neih chuan eng nge ka beisei ang?

`(A-fib with RVR)` i nei tih i hriat chuan a tithinur deuh thei. Mahse, hei hi enkawl theih leh nun tha tak i neih theihna tur dinhmun a ni tih hre reng ang che . A pawimawh ber chu a hmaa kan sawi tawh ang khan nunphung hrisel tak takte hi din a, i doctor-in damdawi a pek ang chiah kha ei la, a tul chuan enkawlna bik zawng rawh.

Enkawl loh chuan natna khirh tak tak, thinlung natna, thinlung chak lohna emaw, stroke emaw a thlen thei a ni. Catheter ablation ang chi enkawlna hi mi tam takah a hlawhtling tih hmuhchhuah a ni. Maze procedure hian 80% atanga 90% velin hlawhtlinna a nei a, hun rei tak chhung chu symptoms atanga relief a pe thei bawk.

Hetiang dinhmun hi eng chen nge a daih ang?

``(A-fib with RVR)`` hi a chang chuan kum tam tak chhung a daih thei a ni. Mi thenkhat tan chuan he natna hi a awm fo dan leh a rei zawng hi hun kal zelah a pung thei a ni. Chuvang chuan doctor thurawn zawm chhunzawm zel a, checkup neih reng a pawimawh.

Engtin nge ka in enkawl ang?

I hriselna chu i kutah a awm. Hei hi hre reng ang che:

• Damdawi doctor-in a pek zawng zawng chu dik tak leh a hun takah ei vek tur a ni. Ni khat pawh lo tlai tawh suh.
• Follow-up appointment ruahman saah doctor hmu rawh. Engtin nge i awm tih hriat a pawimawh hle.
• Exercise neih fo thin ang che. Nitin kea kal ang chi thil awlsam tak pawh hian i nunphung a tichangtlung thei a, nitin hna pawh awlsam zawkin a thawk thei bawk.

Engtikah nge Doctor ka hmuh ang?

Heng symptoms zinga pakhat tal i neih leh chuan, emaw, a thar i neih chuan doctor pan nghal rawh:

• A rilru a na.
• I chawlh laiin minute khatah i heart rate chu 100 aia tam a nih chuan.
• Luak chhuak thei.
• Thâwk harsa.

Engtikah nge Emergency Treatment Unit (ETU) ah ka kal ang ?

Heng symptoms te hi i neih chuan Emergency Treatment Unit (ETU) ah i kal hmasa tur a ni :

• Stroke symptoms : Lu na tak tak, mitdelna, tawng harsa, kal harsa, leh hmai sir khat tlak.
• Thisen tithianghlimtu (blood thinners) avanga thisen chhuak tam lutuk: Luak sen, ek sen emaw dum emaw kal, zun sen.
• Chhung na emaw, heart attack emaw cardiac arrest emaw chhinchhiahna dang : Thâwk hah lutuk, pum na lutuk, leh thawk hah.

Doctor hnenah eng zawhna nge ka zawh ang?

Doctor i tlawh hunah i dinhmun chiang taka i hriat theih nan heng zawhnate hi i zawt thei ang:

• Doctor (follow-up) vawi engzat nge ka hmuh ngai?
• Nunphung inthlâk danglamna aṭanga rah chhuah hmuh theih nân eng chen nge hun a duh?
• Eng damdawi nge min recommend? Chumi chhan chu eng nge ni?
• Cardioversion, ablation, maze procedure ang chi enkawlna ka nei tur em ni?

Thinlung thawk mumal lo tih hriat hian lungngaihna a thlen thei a ni. Mahse, he natna hi enkawlna tha tak tak ``A-fib with RVR'' tih a awm. I doctor chuan i tana tha tur enkawlna tur thlang turin a pui thei che a ni. I doctor a hun taka i hmuh a, i damdawi pek ang chiah i ei hian i hriselna venhimna kawngah i pui thei ang.

Take-Home Message: Hriat reng tur pawimawh ber berte

Okay, chuvangin kan sawi tawh atang khan i hriat reng tur thenkhat chu khaikhawm ila:

• ``(A-fib with RVR)`` tih hi thinlung rhythm a mumal lo va, a beat chak em em thin a ni.
• I rilru natna, luak chhuak, thawk harsa tih ang chi symptoms i neih chuan doctor thurawn la ngei ang che.
• Hei hi thil engemaw zat vang a ni thei a, chung zingah chuan thisen sang leh lung natna te pawh a tel.
• Stroke hi he thila harsatna hlauhawm ber pakhat a nih avangin thisen tithianghlim thei damdawi ei hi a pawimawh hle.
• Enkawl dan hrang hrang a awm a, damdawi leh catheter ablation te pawh a awm.
• Nunphung hrisel taka inthlak danglamna (ei leh in tha, exercise lak, leh meizuk bânsan) hian he natna hi thunun kawngah kawng thui tak a zawh a ni.
• Damdawi hi doctor-in a sawi ang chiah chiah ei tur a ni. Date ruat saah doctor nen follow-up neihpui tur a ni.
• Emergency warning signs (stroke symptoms, thisen chhuak nasa, rilru na tak) i neih chuan damdawi inah kal nghal rawh.

Nangmah chauh i ni lo. Hetiang dinhmun neia khawsa mi tam tak an awm. Enkawlna dik leh nunphung dik tak i neih chuan nang pawhin nun hrisel i hmang thei ang. Doctor te biak a, i harsatna sutkian hlau suh.

` Lung na, lung natna, A-fib, RVR, thinlung thawk chak, rilru na, stroke