.

, ,

. ,

, /

1.

2.

( )

3.

4.

5.

6.

7.

1.

2.

3.

4.

(, )

QT, BRUGADA .

( ) /

. Ia c

. -
.

. P
QRS P
, .
P
.

.
a c (
), - ,
.

1.

(, , )

.

,
(.
), .

. (
If) 5mg 7.5mg
.
().
,
-, ,
, , ..
-.

2.

( )

RR.
.
.

3.

1% - 3%

( Valsalva,
.) ,
.
-,
().

4.


, .

.
,
.
50%.
.
2:1.

(repetitive tachycardia)

(incessant tachycardia) (
).

.
: - ( 20mg x
2, 50mg x2, 25 50mg x 1),
( 40 80mgX2, 60mg x 3), 0.25mg x 1.

:
,
. a, Ic

().
.
: ,
, ,
().

5.

, .

P .
P PP, PR RR
.

.

().

.

6.


.
.
,
, , .

( , Valsalva,
) ""
.

, .
(, ,
)
(50 Joules).

, ,
().
.

(1 2mg ) (
60-70%),
Ia, Ic III, .


,

.
( Ia, c, )

,
.

.
>80 8.8%
.

, , , .
( 7
), (
) .

.
.

, .


9


,
CHA2DS2 (Cardiac failure, Hypertension, Age, Diabetes, Stroke2).
, , >75
.
.
CHADS score > 2
( ) R 2-3, 2.5. CHADS
score 0-1 CHA2DS2-VASc :
Riskfactor
Congestiveheartfailure/LV
dysfunction(
)
Hypertension()
Age75(75)
Diabetesmellitus(
)
Stroke/TIA/TE(,
,)
Vasculardisease()
Age6574(6574)
Sexcategory[ieFemalegender]
()

Score
1

1
2
1
2
1
1
1

(CHA2DS2-VASc
score: 0) 75 325mg .
(CHA2DS2-VASc score: 1)
, .
CHA2DS2-VASc score: 2

INR 15 30 .
European Medicine Agencies ( EMA )
, Dabigatran ( )
Rivaroxaban ( ),
,
. (
10

Rely ), Dabigatran 150mg

, ,

. Dabigatran 110mg ,
,
.
H Rivaroxaban 20mg ,
,
, ,


( ROCKET

AF ).

,
( monitoring ) . ,

IR.

,
.


,
100-325mg 75mg .

.

- ( , , , , ,
,

,
11

,)

 (, )

.
,

( ).

.

( <24-48

,
INR).

300-600mg
. 600mg
.
50-70% 24 .
1-2mg 50-60%.

12-24 .
vernakalant (
)
(<7 ,
<48-72 ) 50% 10-12
.
.

12


.
,
.

( ).


, .
.

,
.
.
.

- ,

, ,





.

.


.


13

,

( ,
).

,
,
.


.

,
.
( )
.
(atrioventricular nodal reentry tachycardia AVNRT - 50% )
(atrioventricular reentry tachycardia - AVRT).

1.

14

 (Atrioventricular nodal reentry tachycardia-AVNRT)

, , ( -).
-
(, , ),
( - ).
,
.
( , Valsalva)

.

(D/C cardioversion)
20 - 50 Joules.
:

.

,
.

.

15

, , , -
.

, , -
().
,

c (, ),
().

2.

(Atrioventricular reentry tachycardia-AVRT)

.

. 90%
( His)
(
).
,
QRS (
- ).


16

 (
).
( ) .

(D/C cardioversion).
20-50 Joules
.

Ia, Ic III ().

WPW ,
(

), .

(85-99%)
.

3.

RP'
125 - 200 /.
RP'

17

 (PJRT)
.

, ,
.
.

. .

(atypical AVNRT - fast : slow tachycardia).
.

4.

70 - 130 /.

(, ,
).
.

.

18

.
,
, .
,
(, , , ),
.

. R
on T
QT .

,
.

19

 -,

,
c ( )
.

().

. . 48
, 60
.

48
(0.6%).

,
.

(<30%). ,
180-220/.
20


.
,
.
, 2 4050%.
,
,
.

(
, )
.
5%.

.

.

21



.
,
.
, .

.

.
48
.

.
,
.
, .

.
20%
.
22

 . Holter

,
.

.

,
.
.

,
.

:
1. .
2.
.
3. /

4. ,
.
23



.

,
.

(, , -
),
.

(..
, , ...).
,
,
,
.
, ,
, ,

.

24

 :

80
( CAST, ESVEM, SWARD) .
-,

.

:
:

. , ,

.
:
,
,

.

25

()

(90%) (98%).

.

10%
. ,
.
:
(70%
RVOT-VT). 12
.

.

, - ().

- .

.

26

 :
20-40 stress

. ,
QRS ( 120-140ms).

,
.
.

.

.
.
,
.
,

(..

),

,
Wolff-Parkinson-White,
( R on T).

27

 ,

.

QT, BRUGADA
.
QT, Brugada

.

QT
QT
QT

. .
QT
1:10000.
QT
(, , )
( QT).
:
QT
28

 .

.
.
>80

QT.
QT

-,
.
, ,
.
-
-

QT. -
.
LQT1 LQT2,
LQT3. -
,
.

29





. ,
LQT1, LQT2 LQT3
.

BRUGADA
Brugada

.

ST V1-V3.
:
.


.

30



,
. 5-10%
.
(-CPVT)
1978.
,
30% .

.

. -
, 10.5% .

,
.

31

:
.

: 6 mg
1-2


.


1218mg 1-2
.

(<50kg): 0.050.1 mg/kg (
: 6 mg).

>50kg


: 0.25mg/kg
2
(

20mg)
(

120-240mg
24 (

)
32



15 ):
0.35mg/kg 2
(

25mg)
:
0.25 mg/kg 2
.


0.35 mg/kg
15

: 2.5-5mg
2
(


15 ):
5-10mg (0.15mg/kg)

:
0.1-0.3 mg/kg/
2 .

5mg
0.25mg 5
.
0.125mg
6
1 mg
,

80-320mg

(

0.125 0.25mg

80320mg

(

33

300mg
30-45 .

1.2
gr

)
600mg



10gr.

200-400
mg

100-200mg

100-200mg

300-600mg

300-600mg

1-3 mg/ 2
.
2-5 .


5mg
:
0.01-0.1 mg/kg/
10 .
1 mg
, 3 mg

40-240mg
24 (

34

5 mg/ 2

2.5-5 mg 2-5
(
: 15
mg 10-15
)
50-200 mcg/kg/
100
mcg/kg/
<60
kg: 0.01 mg/kg
10

25-100mg

100-200mg

60 kg: 1 mg
10

10

1-1.5 mg/kg
2-3 ,

0.5-0.75 mg/kg
5-10 .

1-4
mg/
: 1
mg/kg (
100 mg).

2050 mcg/kg/

Vernakalant

3mg/kg 15
.
2mg/kg
15


5mg 7.5mg

35

36