Kỷ yếu hội nghị tim mạch 2012



NG QUAN 10
1. NHNG KIN THN GIÚP THEO DÕI LÂU DÀI HONG CA
VAN TIM NHÂN TO 11
2. CP NHT X TRÍ N BNH NHÂN SUY TIM 18
3. U TRÚC NI MC MCH MÁU  BNH
NG 27
4. 
 37
5. T ÁP  BNG 41
6. CHNH TIM BC SINH BNG SIÊU ÂM TIM
THAI 48
7. NHÂN MNG HP VIÊM NÔI TÂM MC DO NM TRÊN VAN NHÂN TO
52
8. HORMONE SINH DC NAM VÀ BNH LÝ RI LON CHUYN HÓA 57
9. HI CHNG TIM THN THIU MÁU 66
10. U TR T ÁP & RI LON LIPID MÁU  BNH NHÂN GÚT 71
11. TING (PRE-DIABETES) 74
12.  KHÁNG INSULIN  I BÉO PHÌ 79
13. NG HP LÂM SÀNG: CHP MCH VÀNH BNG GADOLINIUM 
BNH NHÂN D NG THUC CN QUANG CHA IOD 84
14. NHÂN MNG HP NÚT MCH CP CU BNH NHÂN XUT
HUYI NHN DO V PHÌNH MCH NÃO  BNH VII
HC HU 85
15. NHNG BÀN CÃI V VAI TRÒ CA CHU TR 
HUYM HIN NAY GIA CÁC KHUYU TR
T ÁP 2011. 91
16. MT CH M TIM MCH MU TR D PHÒNG BNH LÝ TIM
MCH DO V 100
17. TI TÂM MC LIBMAN-SACKS) TRONG

HI CHNG ANTIPHOSPHOLIPID 105
18. NG TÝP 2 VÀ CÁC YU T 
C MI NG TÝP 2  BU TR
BNG ATORVASTATIN: KT QU T 3 TH NGHIM LÂM SÀNG NGU
NHIÊN TNT, IDEAL VÀ SPARCL 113
 119
19. PHU THUT CU NI CH U TR TNG MCH CH
CHU MN TÍNH 120
20. NGHIÊN CU ÁP DNG K THUU TR BNH NHÂN SUY
GIM CHI CP TI BNH VI 124
21. PHU THUT XÂM LN TI THIU TRÊN BNH NHÂN TIM BM SINH 131
22. HI CHNG GING TIM SAU PHU THUT TIM NHÂN MT
NG HP BCH PHI TR V TIM TH TRONG
TIM 135
23. T QU K THUT NI SOI LNG NGC CI TIU TR
BNH CÒN NG MCH  TRE EM 139
24. T QU PHU THUT SA TOÀN B BNH THT PHI HAI
NG RA CHO TR EM TI BNH VI 143
25. BNG TAUSSIG-BING: KINH NGHIM PHU THUT SA TOÀN
B T NG HP TI BNH VI 148
26. U QU CA PHI H
BNG BUPIVACAINE VÀ MORPHINE SULPHATE VI GÂY MÊ TRÊN PHU
THUT TIM H  TR EM TI BNH VING 1 152
27. NH NHI PHU THUT TIM H  N
HU PHU TI KHOA TIM MCH 157
28. KT QU U PHU THUT TIM TI BNH VING 2 165
29. V THT TRÁI SAU PHU THUT VAN HAI LÁ 169
30. ÁNH GIÁ KT QU U TR BNH VIÊM TNG MCH MN TÍNH
I 173
 178

31. 
 179
32. 
- 183
33. T ÁP VÀ CÁC CH S NHÂN TRC  I 25-64 TUI TI
 188
34. 
 196
35. NGHIÊN CU GIÁ TR CA HS-CRP VÀ IL-NG GIÁ NGUY
CH TNG QUÁT  BT ÁP NGUYÊN
PHÁT 199
36. NGHIÊN CU T L HUYNG K
THUNG 24 GI 206
37. KHU TR T ÁP TI PHÒNG KHÁM BNH VIN CP
C N 6/2009) 210
38. NGHIÊN CU TÌNH HÌNH VÀ QUN LÝ BT ÁP  CÁN
B TRUNG CAO CP TNH CÀ MAU 217
39. BIN THIÊN HUYT ÁP  BNH NHÂN CAO TU
I BNH VI
C 224
40. NGHIÊN CU CÁC THÔNG S T CHI D
 229
41. NGHIÊN CU QU MÔ HÌNH QUN LÝ, THEO DÕI VÀ
U TR CÓ KIM SOÁT BT ÁP  HÀ NAM 237
42. KIM SOÁT HUYU TR NGOI
TRÚ TI KHOA NI TIM MCH - BNH VI 245
BNH MCH VÀNH 251
43. MI LIÊN QUAN GIA TH I ÁP LC THT TRÁI CUI
 CÁC BNH NHÂN NHP 252
44. N NT-proBNP HUYM NGU

NG NGN HN  BNH NHÂN HI CHNG VÀNH CP258
45. CHT NHP  BNH NHÂN TR
TUI 264
46. NGHIÊN CM LÂM SÀNG VÀ DU CH M SINH HC CA
TP TI BNH VI
KHOA THÀNH PH C 270
47. NGHIÊN CU GIÁ TR  TRONG VINH V TRÍ TC
NGHNG MCH VÀNH  BNH NHÂN NHP ST
CHÊNH LÊN 276
48. NGHIÊN CU NG DNG TIÊU CHUN MI TRONG CHI MÁU
P  BHT NGC 282
49. NHN XÉT HIU QU U TR CA THUC STREPTOKINASE  BNH
NHÂN NHP CÓ ST CHÊNH LÊN TI BNH VI
KHOA TNG 288
50. NGHIÊN CU N MYELOPEROXIDASE HUYI LIÊN
QUAN VI M NNG  BNH NHÂN NHP 292
51. YU T NG TRONG NHP TI KHOA HSCC
BNH VIN NINH THUN 298
52. NGHIÊN CM MT S YU T  BÁO NGUY
C BI, DA THEO
M FRAMINGHAM CHO MT S NG DO VIN Y HC
NG QUN LÝ 308
53. M LÂM SÀNG CA NHP  BNH NHÂN LN TUI
TI BNH VI 313
54. NGHIÊN CU GIÁ TR S HI PHN ST TRONG VI
HIU QU U TR NG BNH NHÂN
NHP 317
55. 

 323

56. 
 330
57. NGHIÊN CU GIÁ TR CA BRAIN NATRIURETIC PEPTIDE TRONG TIÊN
NG SM NHP CÓ ST CHÊNH LÊN 335
58. NGHIÊN CU HIU QU LÂM SÀNG CA THIÊN S H 
U TR T NGC NH 340
59. THEO DÕI NGN HN VÀ TRUNG HN BNH MCH VÀNH  I TR
TI BNH VIC 346
TIM MCH CAN THIP 349
60. NHN XÉT KT QU U CHP VÀ CAN THING MCH
VÀNH TI BNH VING I HC HU 350
61. NG DN CA SIÊU
ÂM TRONG BUNG TIM (ICE) 354
62. RÚT NGN THI GIAN CA - BÓNG TRONG CAN THIP MCH VÀNH TIÊN
PHÁT  BNH NHÂN NHP ST CHÊNH LÊN TI BNH
VINH 362
63. U ÁP DNG B U
TR BNH NHÂN SUY TIM TI BNH VII HC HU 371
64. NG PH VÀ CÁC YU T K THUT
TRONG TRIT B NG DN TRUYN PH BNG SÓNG CAO TN 377
65.  C VÀ CÁC NGHIM PHÁP TRONG
TRIT B NG DN TRUYN PH BNG SÓNG CAO TN TI TRUNG
TÂM TIM MCH HU 383
66. C  B MT TRONG TO NHP VÙNG
NG RA THT PHI 388
67. U QU U CA VIC TRIN KHAI CAN THIP BÍT NG
NG MCH BNG AMPLATZER VÀ NONG HNG MCH PHI BNG
BÓNG QUA DA TI BNH VIN NHI NGH AN 394
68. NG DÙ TI BNH VIN NG 2 398
69. NG DT MÁY TO NHP TIM TRÊN BNH NHÂN RI LON NHP

TIM CHM TI BNH VI
(6/2009  4/2011) 403
70. T QU SNG MCH PHI BNG BÓNG
QUA DA  TR T N 24 THÁNG TUI 408
71. NGHIÊN CU HIU QU CA STENT PH THUU TR NHI
P 413
72. T QU CHP, CAN THING MCH VÀNH
QUA DA TI BNH VINH 419
73. HONG TIM MCH CAN THIP BNH VIN T
2009  2011 423
74. KT QU Y MÁY TO NHN TI BNH VIN
NH KIÊN GIANG 428
75. 
 433
76. U TIN HÀNH K THUT TO NHN TI BNH VIN
I HC HU 439
 444
77. KHO SÁT RI LON NHP TIM  BNH NHÂN HI CHNG VÀNH CP
TI BNH VIK LK T N 04/2011 445
78. NGHIÊN CU RI LON NHP TIM  BNH NHÂN BNH TIM THIU MÁU
CC B MN TÍNH BN TIM 24 GI 453
79. NGHIÊN CU RI LON NHP TIM VÀ HING KHÔNG GIM HAY
GIM HUYT ÁP V T ÁP BNG
N TIM VÀ HUYT ÁP 24 GI 460
80. N SINH LÝ TIM, HIU QU U TR B
NG SÓNG TN S RADIO CA RI LON NHP THT PHI VÀ THT
TRÁI 464
81. NGHIÊN CU NG DN SINH LÝ H CH
U TR MT S RI LON NHP THT BNG SÓNG CÓ
TN S RADIO 469

82. NGHIÊN CU BIN THIÊN NHP TIM VÀ HING KHÔNG GIM HAY
GIM HUYT ÁP V T ÁP BNG
HOLTER HUYN TIM 24 GI 476
83. NGHIÊN CU BIN THIÊN NHP TIM BT ÁP
NGUYÊN PHÁT TRÊN 40 TUI 480
84. NGHIÊN CU MT S M CA SUY TIM MN TÍNH TI KHOA
NI TIM MCH BNH VIK LK T THÁNG 10/2010 
04/2011 484
85. -
 493
86. NGHIÊN CU MT S YU T NG  BNH NHÂN SUY TIM
MT CP 498
87. NGHIÊN CU HI CH KHI NG TI BNH VIN
I HC HU 506
88. NGHIÊN CU BIN THIÊN NHP TIM THEO THI GIAN VÀ THEO PH TN
S  NG 514
89. NGHIÊN CU N PRO-B TYPE NATRIURETIC PEPTIDE (PRO-BNP)
CA BNH NHÂN SUY TIM MN TÍNH 520
90. 

- 525
91. U QU CU TR 
C HOC PHI HCH TRONG NHP NHANH KCH
PHÁT TRÊN THT CÓ PHC B QRS HP TI BNH VI
2010 - 2011 534
92. NGHIÊN CU RI LON NHN TIM LIÊN TC 24 GI 
BNH NHÂN SUY THN MN LC MÁU CHU K 540
93. KHO SÁT RI LON NHP VÀ THI
HUYNG BNG HOLTER ECG 24 GI 546
94. NGHIÊN CU VAI TRÒ D T T DO TIM BNG KT HP LUÂN

PHIÊN SÓNG T VÀ NT-PROBNP  BNH NHÂN SUY TIM 550
95. NGHIÊN CU TÌNH HÌNH RI LON NHP TIM TRONG CNG TI
MT S TNH MIN BC VIT NAM 557
96. TÌM HIU MI LIÊN QUAN GIN TH MUI LON
NHP TH B MT  BNH NHÂN NH 563
I CHNG TIM M- 569
97. NG MCH CNH  I CAO TUI 570
98. NHN XÉT TRIU CHNG VÀ CÁC YU T LIÊN QUAN TI BNH NHÂN
CHU TR NI TRÚ TI KHOA THN KINH BNH VIÊN
THANH NHÀN 576
99. NHN XÉT TRIU CHNG VÀ CÁC YU T LIÊN QUAN  BNH NHÂN
TAI BIN MU TR TI KHOA THN KINH
BNH VIN THANH NHÀN 581
100. 

2009 589
101. -
 595
102. NH VNG MCH CNH BNG SIÊU ÂM DOPPLER 
BNH NHÂN TT ÁP VÀ CÁC YU T LIÊN QUAN 603
103. NGHIÊN CU BILAN LIPID MÁU  BÊNH NHÂN HI CHNG MCH
VÀNH CP TI BNH VIK LK 608
104. NGHIÊN CU HI CHNG CHUYN HÓA  BNH NHÂN BNG
MCH VÀNH CP TI BNH VIK LK 617
105. MT S M DCH T HC BNG C
 THÀNH PH BUÔN MA THUK LK 625
106. HI CHNG CHUYN HÓA  BNH NHÂN N TRÊN 45 TU
HUYT ÁP TI BNH VING 631
107. PHÁT HIT ÁP VÀ BIN TIM  
U TR TI KHOA TIM MCH BNH VIN THANH

NHÀN 637
108. NGHIÊN CU N APO AI, APO B VÀ CH S APO B/APO AI 
I CAO TUI CÓ HI CHNG CHUYN HÓA 644
109. T QU U CHNH LIPIDE MÁU CA SIMVASTATIN 
BNH NHÂN CÓ YU T CH 650
110. 

 656
111. NGHIÊN CU TÌNH HÌNH THA CÂN, BÉO PHÌ CI LN TRONG
CI TNH QUNG NAM 662
112. BNG  BNG TYPE 2 669
113. CÁC YU T CH  I THA CÂN, BÉO PHÌ 677
114. NGHIÊN CU CH S LIPID MÁU  BNH NHÂN N T ÁP
U TR NGOI TRÚ TI BNH VI
NGUYÊN 683
115. HI CHNG CHUYI T 45 TUI TR 
NG HUYT TI HUYN CU NGANG TNH TRÀ VINH 690
116. GIÁ TR N NT-pro BNP TRONG D BÁO B
NG 698
117. LIÊN QUAN N NT-proBNP HUY SUY TIM
LÂM SÀNG  BNG KHÔNG T ÁP 705
118. N NT-proBNP HUYT THANH VÀ RI LON CHT
TRÁI  BT ÁP
714
119. NGHIÊN CU N PRO-B TYPE NATRIURETIC PEPTIDE (PRO-BNP)
CA BNH NHÂN SUY TIM MN TÍNH 727
120.  S MT CÁ CHÂN  CÁNH TAY TRONG CH
BNG MCH NGOI BIÊN CHI I  B
NG TÝP 2 733
121. NHM LÂM SÀNG, CN LÂM SÀNG NHI MÁU NÃO 

BNG 739
122. NGHIÊN CU N INTERLEUKIN  1 BÊTA HUYT THANH  BNH
NHÂN GÚT NGUYÊN PHÁT 745
123. NGHIÊN CU N INTERLEUKIN-6 HUYT THANH TRÊN BNH
NHÂN VIÊM KHP DNG THP 754
124. KHO SÁT N HAPTOGLOBIN HUYT THANH  BNH NHÂN SUY
THÂN MN CUI 759
125. M LÂM SÀNG VÀ CN LÂM SÀNG  BNH NHÂN SUY THN
MU TR BO TN TI BNH VIN
C KHÔNG CÓ HI CHNG CHUYN HÓA 765
126. NGHIÊN CU TÌNH TRNG SUY MÒN  BNH NHÂN SUY TIM MN 772
- 779
127. NGHIÊN CM LÂM SÀNG, CN LÂM SÀNG BCH
PHI V LC CH HOÀN TOÀN  TR EM 780
128. 
 785
129. NGHIÊN CU S I CNG MCH CH BNG SIÊU ÂM TRÊN
BT ÁP NGUYÊN PHÁT 792
130. NGHIÊN CU S BII CA HUYNG MNG
P VÀ XÂM NHP  BNH NHI SC DO
ST XUT HUYT DENGUE 799
131. NGHIÊN CA BII HÌNH THÁI VÀ CHC
T TRÁI TRÊN B
 806
132. U TR NHP TIM 816
133.  . 818
134. U KHO SÁT HÌNH THÁI VÀ CHT TRÁI BNG
SIÊU ÂM DOPPLER TIM  PH N CÓ THA CÂN - BÉO PHÌ 824
135. M LÂM SÀNG VÀ SIÊU ÂM DOPPLER TIM CA CÒN NG
MCH  TR I KHOA NHI BNH VIN TRUNG

 832
136. A VNG VÒNG VAN HAI LÁ
VÀ PHÂN SUT T SUY TIM NYHA 838
137. NGHIÊN CUVNG VÒNG VAN HAI LÁQUA SIÊU ÂM M-MODE
TRÊN BNH NHÂN SUY TIM TÂM THU 846
138. TÌM HIU V HÌNH THÁI TIM VÀ ÁP LNG MCH PHI BNG SIÊU
ÂM DOPPLER TIM  B 853
139. KT QU U NGHIÊN CU CHT
TRÁI  BNH NHÂN BÉO PHÌ DNG NAM BNG SIÊU ÂM DOPPLER MÔ 859
140. GIÁ TR NG TRUNG HN CA CH S VÔI HÓA VÀ M
HNG MCH VÀNH VI K THUT MSCT 64 LÁT CT 865
141. NGHIÊN CU V
CHT PHI  BNH NHÂN B 871
142. NGHIÊN CU S BII N CK, CK-MB VÀ TROPONIN T TRONG
MÁU  TR M CÓ NGT 880
143. RI LON NHP TIM VÀ BIN THIÊN NHN TIM
 BT ÁP 886
144. NGHIÊN CU HÌNH THÁI VÀ CHT TRÁI  BNH NHÂN
YI LN TI BNH VIC BNG
NH 894
145. NGHIÊN CU TÌNH TRA VÀ B DÀY LP NI TRUNG MC
NG MCH CNH CA PH N T ÁP TI
 BNH 902
146. NGHIÊN CU S BII ÁP LT QUA
CH NU TR SC ST XUT HUYT DENGUE TI
BNH VING C 909
147. 
 917
148. 
 920

149. NGHIÊN CU HÌNH NH BNH LÝ QUA CHP MCH NÃO S HOÁ XOÁ NN
(DSA)  BNH VII HC HU 925
150. KHO SÁT TN NG MCH CNH BNG SIÊU ÂM DOPPLER
 BT ÁP TI BNH VIC NGÃ
BY 933
151. KHO SÁT HÌNH THÁI VÀ CHT TRÁI BNG SIÊU ÂM DOPPLER
TIM  BNH NHÂN NG TYP 2 TI BNH VIN 121 QK9-C
942


















NG QUAN
NHNG KIN THN GIÚP THEO DÕI LÂU DÀI HONG
CA VAN TIM NHÂN TO

T Mng





im bò, van








- Edwards, Medtronic-
- 
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
 



-
--
-

 



 


              -


Thi gian sông thêm cc thay van tim nhân to



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

57 64 % sau thay van


% và 65%).
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

- 
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



- 
                    


 




 



       



(mmHg)
Chênh áp trung bình
(mmHg)
Starr-Edward
11 - 57
20 - 28
Medtronic-Hall
27 - 49
8,2 - 15,4
St.Jude Medical
7,3 - 39
3,5 - 26
Bjork-Shiley

16 - 58
7,8 - 20
Hancock
16 - 49
8,7 - 20,1
Carpentier-Edwards
21 - 73
9 - 27
Hommogreffe
12 - 27
5 - 12
                   




(mmHg)
Chênh áp trung bình
(mmHg)
Starr-Edward
8 - 18
3 - 7
Medtronic-Hall
12 - 13
3,1 - 3,5
St.Jude Medical
4 - 20
1,2 - 7
Bjork-Shiley
3,1 - 2,8

0,4 - 8,2
Hancock
6,9 - 22,8
2,1 - 7,7
Carpentier-Edwards
3,4 - 14
1,2 - 8,6


  
 
- - 
 
- -
-
nhân 
- 
 



     




 
không hoàn toàn)





9. 

Tan máu

 



-
-Hall (1977), Omniscience (1978), Bjork-Shiley (1982).

v
 




  -    -
-
 
          

 

máu âm tính


 peptostreptoccous


-


b) Legionellae: L. pneumophila
c) Ricketsiae: Coxiella burnetti 
d) Chlamydea: C. psitaci
e) Brucella: B. abortus



ày.

Hancock II (1982), Van bò Carpentier--

 



- 



6% -  -


 

Van ghép t  ng mch ch và mng vì van không có s chênh áp,
không tan máu, không có tai bin huyt khi tc mc s dng cho tr nhng

thi vi v ng mch phi hoc khi cn phi cu trúc
li bung tng máu tht phi. Phu thut viên phi thành tht van này. H ng
mch ch t vn nng xut hin  32% b 8. T l không phi phu
thut thay l- 9%) k thut bo qung
li s ci thin v tui th c cnh tranh ct qu v lâu
t rõ.
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n. Siêu âm
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                 
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

vòng van.




 



3. C




 






 


 


 






phòng v
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 
ti

 
-
 
- 



- - - 100% sau thay
 
%.
- 
45-  - 
- 


1. 
ên siêu âm Doppler tim. , tr. 10-17.
2. William A. Zoghbi, John B. Chambers, Jean G. Dumesnil, Elyse Foster, John S.
Gottdiener, Paul A. Grayburn, Bijoy K. Khandheria, Robert A. Levine, Gerald Ross
Marx, Fletcher A. Miller, Satoshi Nakatani, Miguel A. Quinones, Harry Rakowski, L.
Leonardo Rodriguez, Madhav Swaminathan, Alan D. Waggoner, Neil J. Weissman,
Miguel Zabalgoitia (2009), Recommendations for Evaluation of Prosthetic Valves With
Echocardiography and Doppler Ultrasound, Journal of the American Society of
Echocardiography.

CP NHT X TRÍ N BNH NHÂN SUY TIM

Nguyn Hu Trâm Em, Hu



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 




1-7


 
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
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


n



 


8










- 
- -

- A2DS2VASc =0
thì aspirin 75-



- 
- 
- 
- 



- Suy tim
- 
- 
- 
- 
- -74
- 

2DS2-VASc



1


1

2

1

2

1
-74
1

1

9
CHA2DS2-VASc score



0
1
0
1
422
1,3
2
1230
2,2
3

1730
3,2
4
1718
4,0
5
1159
6,7
6
679
9,8
7
294
9,6
8
82
6,7
9
14
15,2

uroHeart Survey
9



 
-

- -BLED Bleeding

Risk Score)
Ký



-
BLED

100 BN-
H
Hypertension (THA)
1
0
1.13
A
Abnormal renal and liver function



1
1.02
S

1
2
1.88
B

1
3

3.74
L

1
4
8.70
E

1


D











Chú thích:
H -  
A -              

               

S - 

B -  áu).
L -  
E - 
C - 


acenocoumarol (Sintrom)
and phenprocoumon (Marcoumar).

10

                   

arin.





-LY study
11
. Nghiên





d

 

xem xé

               

12





Hình 1 - Dabigatran etexilate







13





Dabigatran

Warfarin duy trì INR 23
RE-LY




   
   

Rivaroxaban
20 mg o.d.
Warfarin
INR 23
ROCKET-AF,
14.000 BN


Không thua kém

    

Apixaban
5 mg b.i.d.
Warfarin
INR 23
ARISTOTLE,
18.205 BN


Hoàn thành vào tháng 4

Apixaban
5 mg b.i.d.
Aspirin

8132 mg o.d. Apixaban
5 mg b.i.d.
Aspirin
8132 mg o.d.
AVERROES
5.600 BN


Apix   


Edoxaban
30 mg/60 mg o.d.
Warfarin
ENGAGE-AF
TIMI 48
20.500 BN


   
3/2012


 
- 
- 

- 
-  
- 



)
 
14,15



u tiên
 gây triu chng nng
Tui tr
Khó kim soát nhp th
Bp nhanh có th phc hi
Suy tim liên quan vi nhp nhanh
Có th 
Bng
c không triu chng
Tui cao (>75 t)

Có ch t c nhp gì
Các qun th t bit (ph ni cao huyt áp)
Tht bi vu tr chuyn nhp
Bng

8
:
 
- 
- 
- 

- 

- 
- 
- 


PIAF
STAF
RACE
AFFIRM

252
200
522
4060


19,6 tháng



61,5
65,8
68
69,7





<6 tháng


phát


2

tái phát cao






55,1%
10%
22,6%

 
60,8%
9%
17,2%


0,317
0,99
0,11
0,08



vo

17-19


 
8,10,20-25



 


 



warfarin 25-  


               


-


 

 




26-30


-
-

 


kh


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



 dig
-xi không dihydropyridine



.
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không dùng kháng .



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 suy tim

 


 


1/ X
 

  

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 
o  

o 

 
                

 ngiotensin),
    




o 

o      

                  

o               -  

o K


 

 
 -3









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