{"id":1116,"date":"2014-07-08T00:08:56","date_gmt":"2014-07-07T22:08:56","guid":{"rendered":"http:\/\/aritmije.kbcsm.hr\/?p=1116"},"modified":"2020-04-03T19:27:32","modified_gmt":"2020-04-03T17:27:32","slug":"radiofrekventna-ablacija-srca","status":"publish","type":"post","link":"http:\/\/aritmije.kbcsm.hr\/radiofrekventna-ablacija-srca\/","title":{"rendered":"Radiofrekventna ablacija srca"},"content":{"rendered":"<div id='av_section_1'  class='avia-section alternate_color avia-section-huge avia-no-shadow  avia-full-stretch av-section-color-overlay-active avia-bg-style-scroll  avia-builder-el-0  el_before_av_one_full  avia-builder-el-first   container_wrap sidebar_right' style='background-repeat: no-repeat; background-image: url(http:\/\/aritmije.kbcsm.hr\/wp-content\/uploads\/2020\/03\/aritmije-kbcsm-header_5.jpg);background-attachment: scroll; background-position: top center;  '  data-section-bg-repeat='stretch'><div class='av-section-color-overlay-wrap'><div class='av-section-color-overlay' style='opacity: 0.7; background-color: #000000; '><\/div><div class='container' ><main  role=\"main\" itemprop=\"mainContentOfPage\"  class='template-page content  av-content-small alpha units'><div class='post-entry post-entry-type-page post-entry-1116'><div class='entry-content-wrapper clearfix'>\n<div class='flex_column_table av-equal-height-column-flextable -flextable' ><div class=\"flex_column av_three_fourth  flex_column_table_cell av-equal-height-column av-align-middle av-zero-column-padding first  avia-builder-el-1  avia-builder-el-no-sibling  \" style='border-radius:0px; '><div  style='padding-bottom:0px; font-size:70px;' class='av-special-heading av-special-heading-h1  blockquote modern-quote  avia-builder-el-2  avia-builder-el-no-sibling  av-inherit-size '><h1 class='av-special-heading-tag '  itemprop=\"headline\"  >Radiofrekventna ablacija srca<\/h1><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div><\/div><\/div><!--close column table wrapper. Autoclose: 1 -->\n<\/div><\/div><\/main><!-- close content main element --><\/div><\/div><\/div><div id='after_section_1'  class='main_color av_default_container_wrap container_wrap sidebar_right' style=' '  ><div class='container' ><div class='template-page content  av-content-small alpha units'><div class='post-entry post-entry-type-page post-entry-1116'><div class='entry-content-wrapper clearfix'>\n<div class=\"flex_column av_one_full  flex_column_div av-zero-column-padding first  avia-builder-el-3  el_after_av_section  el_before_av_one_half  avia-builder-el-first  \" style='border-radius:0px; '><section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='avia_textblock  '   itemprop=\"text\" ><p style=\"text-align: justify;\"><strong>Radiofrekventna ablacija<\/strong>\u00a0je zahvat koji omogu\u0107ava lije\u010denje mnogo vrsta ubrzanog sr\u010danog rada (tahikardija). Posebnom kateterskom elektrodom (ablacijski kateter) koja se uvodi u srce, isporu\u010duje se radiofrekventna energija (frekvencija 300-500kHz, energija 10-50 watta, trajanje svake zasebne aplikacije je varijabilno) na malom podru\u010dju sr\u010danog mi\u0161i\u0107a koji je odgovoran za nastanak nepravilnog sr\u010danog rada (aritmije). Radiofrekventna energija na taj na\u010din toplinom uzrokuje trajno mikroo\u0161te\u0107enje na tkivu. Tako o\u0161te\u0107eno tkivo nije vi\u0161e u mogu\u0107nosti provoditi impulse koji su odgovorni za aritmiju ili znatno smanjuje njihovu pojavu. Ova metoda kod nekih aritmija omogu\u0107uje trajno izlje\u010denje pacijenta.<\/p>\n<p style=\"text-align: justify;\"><strong>Koje se aritmije mogu lije\u010diti kateterskom radiofrekventnom ablacijom?<\/strong><\/p>\n<p style=\"text-align: justify;\"><strong>Paroksizmalne supraventrikulse tahikardije<\/strong>\u00a0(PSVT), koje uklju\u010duju:<\/p>\n<ul style=\"text-align: justify;\">\n<li>Wolf-Parkinson-White sindrom (WPW sindrom, AVRT)<\/li>\n<li>Atrioventrikularna nodalna kru\u017ena tahikardija (AVNRT)<\/li>\n<li>Atrijska tahikardija (AT)<\/li>\n<li>Undulacija atrija (UA)<\/li>\n<\/ul>\n<p style=\"text-align: justify;\"><strong>Ventrikularne tahikardije<\/strong>\u00a0(VT) i ventrikularne ekstrasistole (VES)<\/p>\n<p style=\"text-align: justify;\"><strong>Atrijska fibrilacija<\/strong>\u00a0(AF)<\/p>\n<p style=\"text-align: justify;\">Nekoliko dana prije procedure potrebno je\u00a0<strong>prestati uzimati odre\u0111ene lijekove<\/strong>\u00a0u dogovoru s kardiologom-elektrofiziologom (lijekovi protiv zgru\u0161avanja, neki antiaritmici). Savjetujte se s Va\u0161im lije\u010dnikom u vezi prestanka uzimanja nekih lijekova nekoliko dana prije planirane procedure, ako Vam druga\u010dije nije re\u010deno.<\/p>\n<p style=\"text-align: justify;\"><strong>RF ablacija<\/strong>\u00a0je terapijska procedura koja se obi\u010dno nastavlja nakon dijagnosti\u010dkog elektrofiziolo\u0161kog ispitivanja srca (<em>vidi\u00a0<a href=\"http:\/\/aritmije.kbcsm.hr\/elektrofiziolosko-ispitivanje-srca\/\">elektrofiziolo\u0161ko ispitivanje srca<\/a><\/em>). Prije po\u010detka RF ablacije pacijent mo\u017ee primiti venozno sedativ i\/ili lijek protiv bolova. Primjena radiofrekventne energije op\u0107enito ne izaziva bol, ali je mogu\u0107a pojava nelagode u prsi\u0161tu ili osje\u0107aj pe\u010denja, \u0161to nestaje nakon prekida dovoda RF energije i\/ili primjene lijekova.<\/p>\n<p style=\"text-align: justify;\"><a href=\"http:\/\/aritmije.kbcsm.hr\/elektrofiziolosko-ispitivanje-srca\/\"><em>Elektrofiziolo\u0161ko ispitivanje srca<\/em><\/a><\/p>\n<p style=\"text-align: justify;\">Ablacijska kateterska elektroda uvodi se\u00a0 u srce naj\u010de\u0161\u0107e kroz preponsku venu ili arteriju do srca. Nakon toga istom elektrodom locira se ishodi\u0161te aritmije (tzv. mapping) i primjeni radiofrekventna energija.<\/p>\n<p style=\"text-align: justify;\">Po zavr\u0161etku procedure, lije\u010dnik ponovno poku\u0161a izazvati aritmiju, te ako se ona ne izaziva, procedura se zavr\u0161ava. Ako se ipak ponovno izazove aritmija, primjena RF energije se ponavlja.<\/p>\n<p style=\"text-align: justify;\"><strong>Trajanje procedure<\/strong>\u00a0varira od pacijenta do pacijenta, ovisno o aritmiji o kojoj se radi. Tipi\u010dno procedura traje dva ili vi\u0161e sati.<\/p>\n<\/div><\/section><\/div>\n<div class=\"flex_column av_one_half  flex_column_div av-zero-column-padding first  avia-builder-el-5  el_after_av_one_full  el_before_av_one_half  column-top-margin\" style='border-radius:0px; '><div  class='avia-video avia-video-16-9   av-lazyload-immediate  av-lazyload-video-embed  '   itemprop=\"video\" itemtype=\"https:\/\/schema.org\/VideoObject\"  data-original_url='https:\/\/www.youtube.com\/watch?v=Ue2saUft5zc' ><script type='text\/html' class='av-video-tmpl'><div class='avia-iframe-wrap'><iframe title=\"Elektrofiziolo\u0161ko ispitivanje srca\" width=\"1500\" height=\"844\" src=\"https:\/\/www.youtube.com\/embed\/Ue2saUft5zc?feature=oembed&autoplay=0&loop=0&controls=1&mute=0\" frameborder=\"0\" allow=\"accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen><\/iframe><\/div><\/script><div class='av-click-to-play-overlay'><div class=\"avia_playpause_icon\"><\/div><\/div><\/div><\/div>\n<div class=\"flex_column av_one_half  flex_column_div av-zero-column-padding   avia-builder-el-7  el_after_av_one_half  el_before_av_one_full  column-top-margin\" style='border-radius:0px; '><div  class='avia-video avia-video-16-9   av-lazyload-immediate  av-lazyload-video-embed  '   itemprop=\"video\" itemtype=\"https:\/\/schema.org\/VideoObject\"  data-original_url='https:\/\/www.youtube.com\/watch?v=g3xrPdVNlhM&t=28s' ><script type='text\/html' class='av-video-tmpl'><div class='avia-iframe-wrap'><iframe title=\"Ablacijsko lije\u010denje tahiaritmija\" width=\"1500\" height=\"844\" src=\"https:\/\/www.youtube.com\/embed\/g3xrPdVNlhM?start=28&feature=oembed&autoplay=0&loop=0&controls=1&mute=0\" frameborder=\"0\" allow=\"accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen><\/iframe><\/div><\/script><div class='av-click-to-play-overlay'><div class=\"avia_playpause_icon\"><\/div><\/div><\/div><\/div>\n<div class=\"flex_column av_one_full  flex_column_div av-zero-column-padding first  avia-builder-el-9  el_after_av_one_half  el_before_av_masonry_gallery  avia-builder-el-last  column-top-margin\" style='border-radius:0px; '><section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='avia_textblock  '   itemprop=\"text\" ><p style=\"text-align: justify;\">Po zavr\u0161etku procedure kateterske elektrode se vade van, te se zaustavlja krvarenje kra\u0107im pritiskom na krvne \u017eile putem kojih su elektrode postavljene. Nakon zaustavljanja krvarenja, ubodna mjesta se prekriju sterilnim zavojima, te se pacijent le\u017ee\u0107i vra\u0107a na odjel. Ovisno o kojoj se aritmiji radilo, jesu li punktirane vene ili arterija, potrebno je nakon zahvata mirovati u krevetu 6-24 sata kako ubodna mjesta ne bi prokrvarila. Na ubodna mjesta ponekad se postavljaju vre\u0107ice s pijeskom koje dodatno vr\u0161e pritisak i spre\u010davaju pojavu krvarenja. Za to vrijeme obavljanje nu\u017ede, hranjenje i higijena osigurani su uz krevet.<\/p>\n<p style=\"text-align: justify;\">Pacijenti nakon RF ablacije zbog primjene sedativa i lijekova protiv bolova mogu osje\u0107ati umor.<\/p>\n<p style=\"text-align: justify;\"><strong>Komlikacije RF ablacije.<\/strong>\u00a0Komplikacije kod RF ablacija vrlo su rijetke i razli\u010dite kod razli\u010ditih procedura. Brojke su ukupne uklju\u010duju\u0107i i kompleksne procedure.<\/p>\n<ul>\n<li style=\"text-align: justify;\">komplikacije vezane uz punkcijsko mjesto katetera, krvo\u017eilni pristup: krvarenje, hematom, infekcija, embolija, pseudoaneurizma, arterio-venska fistula, perforacija \u017eile \u2013 2-4%<\/li>\n<li style=\"text-align: justify;\">mehani\u010dke ozljede srca s kateterom \u2013 perforacija, tamponada, perikardni izljev, ozljeda valvula, koronarnog sinusa, infarkt miokarda \u2013 1-2%<\/li>\n<li style=\"text-align: justify;\">tromboembolija, uklju\u010duju\u0107i mo\u017edani udar, sistemsku emboliju, plu\u0107nu emboliju (<1%)<\/li>\n<li style=\"text-align: justify;\">plu\u0107na hipertenzija nakon ablacije fibrilacije atrija zbog stenoze plu\u0107nih vena<\/li>\n<li style=\"text-align: justify;\">ozljeda nervusa frenikusa kod modifikacije sinusnog \u010dvora ili RFA fibrilacije atrija<\/li>\n<li style=\"text-align: justify;\">fistula jednjaka i lijevog atrija nakon ablacije fibrilacije atrija \u2013 0,01-2%<\/li>\n<li style=\"text-align: justify;\">poreme\u0107aji provo\u0111enja impulsa u bilo kojem dijelu provodnog sr\u010danog sustava \u2013 AV blokovi 1-3%<\/li>\n<li style=\"text-align: justify;\">pojava novih aritmija<\/li>\n<li style=\"text-align: justify;\">smrtni ishod \u2013 oko 0,1-0,3%<\/li>\n<\/ul>\n<\/div><\/section><\/div>\n<div id='av-masonry-1' class='av-masonry  noHover av-fixed-size av-large-gap av-hover-overlay-active av-masonry-animation-active av-masonry-col-5 av-caption-always av-caption-style- av-masonry-gallery     ' style='background-color:#191919; ' ><div class='av-masonry-container isotope av-js-disabled ' ><div class='av-masonry-entry isotope-item av-masonry-item-no-image '><\/div><a href=\"http:\/\/aritmije.kbcsm.hr\/wp-content\/uploads\/2014\/07\/Aritmije-KBCSM-1-1030x580.jpg\" id='av-masonry-1-item-1119' data-av-masonry-item='1119' class='av-masonry-entry isotope-item post-1119 attachment type-attachment status-inherit hentry  av-masonry-item-with-image' title=\"Aritmije KBCSM-1\"  itemprop=\"thumbnailUrl\" ><div class='av-inner-masonry-sizer'><\/div><figure class='av-inner-masonry main_color'><div class=\"av-masonry-outerimage-container\"><div class=\"av-masonry-image-container\" style=\"background-image: url(http:\/\/aritmije.kbcsm.hr\/wp-content\/uploads\/2014\/07\/Aritmije-KBCSM-1-705x397.jpg);\" title=\"Aritmije KBCSM-1\" ><\/div><\/div><\/figure><\/a><!--end av-masonry entry--><a href=\"http:\/\/aritmije.kbcsm.hr\/wp-content\/uploads\/2014\/07\/Aritmije-KBCSM-2-1030x580.jpg\" id='av-masonry-1-item-1120' data-av-masonry-item='1120' class='av-masonry-entry isotope-item post-1120 attachment type-attachment status-inherit hentry  av-masonry-item-with-image' title=\"Aritmije KBCSM-2\"  itemprop=\"thumbnailUrl\" ><div class='av-inner-masonry-sizer'><\/div><figure class='av-inner-masonry main_color'><div class=\"av-masonry-outerimage-container\"><div class=\"av-masonry-image-container\" style=\"background-image: url(http:\/\/aritmije.kbcsm.hr\/wp-content\/uploads\/2014\/07\/Aritmije-KBCSM-2-705x397.jpg);\" title=\"Aritmije KBCSM-2\" ><\/div><\/div><\/figure><\/a><!--end av-masonry entry--><a href=\"http:\/\/aritmije.kbcsm.hr\/wp-content\/uploads\/2014\/07\/Aritmije-KBCSM-3-1030x687.jpg\" id='av-masonry-1-item-1121' data-av-masonry-item='1121' class='av-masonry-entry isotope-item post-1121 attachment type-attachment status-inherit hentry  av-masonry-item-with-image' title=\"Aritmije KBCSM-3\"  itemprop=\"thumbnailUrl\" ><div class='av-inner-masonry-sizer'><\/div><figure class='av-inner-masonry main_color'><div class=\"av-masonry-outerimage-container\"><div class=\"av-masonry-image-container\" style=\"background-image: url(http:\/\/aritmije.kbcsm.hr\/wp-content\/uploads\/2014\/07\/Aritmije-KBCSM-3-705x470.jpg);\" title=\"Aritmije KBCSM-3\" ><\/div><\/div><\/figure><\/a><!--end av-masonry entry--><a href=\"http:\/\/aritmije.kbcsm.hr\/wp-content\/uploads\/2014\/07\/Aritmije-KBCSM-4-1030x773.jpg\" id='av-masonry-1-item-1122' data-av-masonry-item='1122' class='av-masonry-entry isotope-item post-1122 attachment type-attachment status-inherit hentry  av-masonry-item-with-image' title=\"Aritmije KBCSM-4\"  itemprop=\"thumbnailUrl\" ><div class='av-inner-masonry-sizer'><\/div><figure class='av-inner-masonry main_color'><div class=\"av-masonry-outerimage-container\"><div class=\"av-masonry-image-container\" style=\"background-image: url(http:\/\/aritmije.kbcsm.hr\/wp-content\/uploads\/2014\/07\/Aritmije-KBCSM-4-705x529.jpg);\" title=\"Aritmije KBCSM-4\" ><\/div><\/div><\/figure><\/a><!--end av-masonry entry--><a href=\"http:\/\/aritmije.kbcsm.hr\/wp-content\/uploads\/2014\/07\/Aritmije-KBCSM-5-1030x580.jpg\" id='av-masonry-1-item-1123' data-av-masonry-item='1123' class='av-masonry-entry isotope-item post-1123 attachment type-attachment status-inherit hentry  av-masonry-item-with-image' title=\"Aritmije KBCSM-5\"  itemprop=\"thumbnailUrl\" ><div class='av-inner-masonry-sizer'><\/div><figure class='av-inner-masonry main_color'><div class=\"av-masonry-outerimage-container\"><div class=\"av-masonry-image-container\" style=\"background-image: url(http:\/\/aritmije.kbcsm.hr\/wp-content\/uploads\/2014\/07\/Aritmije-KBCSM-5-705x397.jpg);\" title=\"Aritmije KBCSM-5\" ><\/div><\/div><\/figure><\/a><!--end av-masonry entry--><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Radiofrekventna ablacija je zahvat koji omogu\u0107ava lije\u010denje mnogo vrsta ubrzanog sr\u010danog rada (tahikardija).<\/p>\n","protected":false},"author":1,"featured_media":1117,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"spay_email":""},"categories":[39],"tags":[65,49,70,72,69,71],"jetpack_featured_media_url":"http:\/\/aritmije.kbcsm.hr\/wp-content\/uploads\/2020\/04\/Aritmije-kbcsm-ablacija1500x720.jpg","_links":{"self":[{"href":"http:\/\/aritmije.kbcsm.hr\/wp-json\/wp\/v2\/posts\/1116"}],"collection":[{"href":"http:\/\/aritmije.kbcsm.hr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/aritmije.kbcsm.hr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/aritmije.kbcsm.hr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/aritmije.kbcsm.hr\/wp-json\/wp\/v2\/comments?post=1116"}],"version-history":[{"count":5,"href":"http:\/\/aritmije.kbcsm.hr\/wp-json\/wp\/v2\/posts\/1116\/revisions"}],"predecessor-version":[{"id":1601,"href":"http:\/\/aritmije.kbcsm.hr\/wp-json\/wp\/v2\/posts\/1116\/revisions\/1601"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/aritmije.kbcsm.hr\/wp-json\/wp\/v2\/media\/1117"}],"wp:attachment":[{"href":"http:\/\/aritmije.kbcsm.hr\/wp-json\/wp\/v2\/media?parent=1116"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/aritmije.kbcsm.hr\/wp-json\/wp\/v2\/categories?post=1116"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/aritmije.kbcsm.hr\/wp-json\/wp\/v2\/tags?post=1116"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}