
dharikkaavunna cardioverter defibrillator

pettennulla hridayasthambhanam (skaa) varaanulla saadhyathayulla rogikalkkulla oru noonn-invasive, baahya upakaranamaan warable cardioverter defibrillator (dablyusidi). ithu doctormark avarude rogiyude aritmik apakadasaadhyatha vilayiruthaanum uchithamaaya padhathikal thayyarakkanum samayam nalkunnu. ithu oru paattatthinu nalkia upakaranamaan. upakaranathinte sangraham, athinte saankethikavidya, soochanakal enniva 2017ll prasidheekarikkukayum ehra shaasthrarekhaasamithiyil avalokanam cheyyukayum cheythu.
vivaranam.
oru inbilt defibrillator ulla oru baahya upakaranamaan warable cardioverter defibrillator (dablyusidi). hraswakaala apakadasaadhyatha laghookaranathinaayi pettennulla hridayasambandhamaaya maranathinu (ezz. sii. dii) thaalkkaalika apakadasaadyathayulla rogikalum ithinu sasthrakriya aavashyamillaathavarumaaya rogikal dablyu. sii. dii shareerathil nerittu dharikkunnu. implaantabil cardioverter defibrillator (aii. sii. dii) udan sthaapikkaan kazhiyunnillengil oru dablyu. sii. dii oru thaalkkaalika chikitsa oopshanaanu. ezz. sii. diyude apakadasaadhyathayekkurich nirantharam vishamikkathe saadhaarana jeevitam thudaraan dablyu. sii. dii rogikale praptharaakkunnu.
dablyu. sii. dii oru noonn-invasive medical upakaranamaan. oru vestt, oru electrode beltt, oru monittar enniva ithil adangiyirikkunnu. electrode belttulla vesttu divasam muzhuvan vasthrangalkk keezhil dharikkunnu. kulikkumbozho kulikkumbozho maathrame dablyu. sii. dii neekkam cheyyendathulloo. monittar araykku chuttum allengil tholil oru strappinu mukaliloo dharikkam. vesttinteyum electrode belttinteyum akathalangalil sthaapichirikkunna electrodukalum vayarukalum nerittu charmmathilaanu. monittar nirantharam hridayamidippum thaalavum rekhappeduthunnu. ventricular tachycardia (vidi) allengil ventricular fibrilation (vf) polulla jeevan apakadappeduthunna cardiac aritmiya kandethiyaal, saadhaarana hridaya thaalathe punasthaapikkunnathinaayi defibrillator onno athiladhikamo chikitsa shokkukal nalkunnu. hridayasthambhanathinum defibrillation edayilulla samayam athijeevanavumaayi nerittu bandhappettirikkunnathil, oru sambhavam phalapradamaakunnathinu eathaanum minitukalkkullil oru chikitsa shock nalkanam. chikilsayillaathe kadannupokunna oro minittilum, rogi athijeevikkunnathinulla saadhyatha 7-10% kurayunnu. jeevanu bheeshaniyaaya cardiac aritmiya kandethunnathu muthal chikilsayude shock svayameva nalkunnathu vare, dablyu. sii. dick saadhaaranayaayi oru minittil thaazhe maathrame aavashyamulloo. ezz. sii. diyil ninnu punarujjeevippikkunna rogikalkkulla aadya chikitsa shock vijaya nirakk 98 sathamaanamaanu. dablyu. sii. dii pravartthikkaan kaanikalil ninno emarjansi udyogastharil ninno edapedal aavasyamilla.
american koleju oof cardiology, american hart association, europian sosaitti oof cardiology (essy/aahaa/asc), europian sosaitti oof cardiology (asc) maargganirddeshangal 2015lum 2021lum, american hart association, american koleju oof cardiology, hart rhythm sosaitti (aahaa/aaku/manikkoor) maargganirddeshangal 2017ll ninnulla maargganirddeshangal ennivayil ninnulla 2006leeii anthaaraashtra samyuktha maarganirddeshangalil essidy thadayunnathinu dablyusidi upayogam shupaarsha cheiyunnu. internaashanal sosaitti phoor hart aandu lung transplantation (ishault) hridayamaatta shasthrakriyaykkulla avarude maarganirddeshangalil hridayamaattathinaayi kaathirikkunna rogikalkku oru bridge therapyayi dharikkaavunna ekstenal defibrilettarukal shupaarsha cheiyunnu. yunaittad kingdatthil (yuke) solil ninnulla dablyusidi life vestt 2017 muthal prathimasa vaadaka adisthaanathil thaalkkaalika upayogathinu labhyamaan.
aii. sii. dii. kku kaathirikkunna rogikalkkum, neekkam cheyyenda aii. sii. dii ulla rogikalkkum (udha.jii.anubadha kaaranam), allengil aii. sii. dii. undakaan kazhiyaatha, ennaal ezz. sii. dii. yude shanikamaaya apakadasaadyathayulla rogikal. dablyu. sii. dii doctormark avarude rogiyude cardiac arithamik risk vilayiruthaanum uchithamaaya chikitsa padhathikal thayyarakkanum oru aakramanathmaka cardiac nadapadikramatthinu munbo sheshamo (baipas sarjari, stent playsment allengil hart traansplaant polullava) allengil myocardial infaarkshanushesham (mye) ezz. sii. dii. kku uyarnna apakadasaadyathayulla rogikalil cardiac outtputtu nireekshikkaanum samayam anuvadikkunnu.
saadhaarana oru dablyu. sii. dii. dharikkunna samayam ekadesham 3 maasamaanengilum athu rogiyude aavasyangaleyum chikilsikkunna doctorude kurippadiyeyum aasrayichirikkunnu.
charithram.
1947ll hridaya defibrillation upayogam aarambhichu-aadyam thuranna nenjilum patthu varshathinu sesham uyarnna oorjja nilakalulla adanja nenjiloodeyum. 1972-ll, 1000 wolt vare uyarnna oorjja nila nalkunna portable yoonittukalude vikasanathethudarnnu, 30 juul vare kuranja oorjjam nalkunna intra cardiac electrodukalulla cardiac defibrillation sthaapichu. johns hopkins sarvakalashaalayil doctormaaraaya mirovsky mover sahapravarthakarum implaantabil cardioverter defibrilettarukal (icd) vikasippikkaan thudangi, 1980 aayappozhekkum aadyathe manushyanil oru icd sthaapikkaan avarkk kazhinju. varshangalayi, icd kooduthal mechappeduthukayum ippol oru saadhaarana autpeshyant prakriyayayi maarukayum cheythu. oru aii. sii. diyude nerittulla rogaprathirodha implaanteshanu parimithappedutthunna gadakangalundu. udaaharanathinu, ezz. sii. dii. yude uyarnna apakadasaadhyatha thaalkkaalikamaayirikkaam, ithu aajeevanantha upayogathinaayi uddeshichittulla oru implaanteshane ethirkkum. nilavile maargganirddeshangal anusarichu (udha.jii.2015lum 2021lum ulla eiii. ezz. sii. maargganirddeshangal prakaram oru rogi hridayasambandhamaaya sambhavangalkk sesham kuranjathu 40 muthal 90 divasamenkilum kaathirikkanam (udha.jii.oru icd implaant cheyyaanulla theerumaanathinu munbu myocardial infarction allengil idathu ventricular function kurayunna puthuthayi roganirnayam cheytha hridayasthambhanam). aii. sii. dii. kku samanamaaya defibrillation savisheshathakalulla oru baahya, dharikkaavunna cardioverter-defibrillator eee rogikale ezz. sii. diyil ninnu samrakshikkunnathinu "bridge" aayi upayogikkaavunna oru pariharamaayirikkum.
1986ll emm. steefan hailman laari bowling life coor sthaapikkukayum aadyathe dharikkaavunna cardioverter-defibrilettarinte (dablyu. sii. dii) vikasanam aarambikkukayum cheythu. ithinu life vestt ® ennu perittu. americayileyum europileyum multy-sentar, multinaashanal klinikkal pareekshanangalil (veyarit, byroad) moonnu varshathekku eee dablyu. sii. dii vipulamaayi pareekshichu. eee phalangal dablyu. sii. dii mechappeduthunnathinna upayogichu, koodaathe ezz. sii. dii. kku uyarnna apakadasaadyathayulla, aii. sii. dick anuyojyamallaatha allengil orennam vaangaan visammathikkunna muthirnna rogikalkkaayi dablyu. sii. dii. upayogikkunnathinu 2001 ll eph. dii. eiii amgeekaarathinulla adisthaanam koodiyaayirunnu. 14 varshathinusesham (2015), ezz. sii. dii. kku uyarnna apakadasaadyathayullavarum aii. sii. dii. kku apekshikkaathavarum maathaapithaakkalude sammatham illaathathinaal sveekarikkaathavarumaaya kuttikalil dablyu. sii. dii. upayogikkunnathinu eph. dii. eiii. anumathi labhichu. 2000-ll, fda amgeekaarangalkku munbu, dablyusidiykku ithinakam europian ce-certification labhichirunnu.
1986ll emm. steefan hailman laari bowling life coor sthaapikkukayum aadyathe implaantabil cardioverter defibrillator (icd) vikasippicha muun intech jeevanakkaarude oru teaminoppam doublucidy vikasanam aarambikkukayum cheythu. americayileyum europileyum 17 pradhana medical sentarukalil moonnu varshathekku dablyu. sii. dii vipulamaayi pareekshichu. aaa pareekshanangalil ninnu shekharicha klinikkal daatta amerikkayil dablyu. sii. dii upayogikkunnathinaayi fda amgeekaaram nedaan life sekkarine anuvadichu.
2001ll, fta ettavum ayussutta dharikkaavunna cardioverter defibrilatorinu (model 2000) amgeekaaram nalki. life coor bisinesses 2006 ll soul medical corporation 2012 ll asahi cassay etteduthu. 2015 leeii kanakkanusarichu, life sestt america, europe, jappan, austreliya, israel, singapur ennividangalil labhyamaayirunnu.
soul medical korppareshan, athesamayam oru asahi kaasi group kambani, 2006 ll life coor bisinesses etteduthu. yunaittad kingdom, yunaittad stetts, europe, jappan, lokamembaadumulla mattu niravadhi rajyangal ennividangalil dablyusidi life vestt vipananam cheiyunnu. soul parayunnathanusarichu, lokamembaadumulla 200,000-ladhikam rogikalkku ettavum jeevanrakshikkuna marunnu ® nirddeshichittundu.
yunaittad stetsile insurance pariraksha.
hrudrogam varaanulla uyarnna apakadasaadyathayulla rogikalkkaayi modiyulla medical upakaranangalayi (dme) vaanijya, samsthaana, federal padhathikal ulppede yunaittad stetsile mikka aarogya padhathikalum dablyusidi ulkkollunnu, avayil iva ulppedunnu
dablyu. sii. diyude pravartthana samvidaanam.
sukhakaravum bharam kuranjathumaaya kazhukaan kazhiyunna oru vasthram, oru electrode beltt, oru monittar enniva dablyu. sii. diyil adangiyirikkunnu.
baattariyil pravartthikkunna monittar tholil oru strapillo araykku chuttumulla holstariloo (athippazham) dharikkan kazhiyum. 1 umm 2 umm). monittar electrocardiography (iii. sii. jii) electrodukalil ninnu daatta shekharikkukayum chikilsikkunna doctor prograam cheiyunna munkootty aasoothranam cheytha krameekaranangalkkanusarich uchithamaaya kanakkukoottalukal nadathukayum cheiyunnu. defibrillation oorjjathinulla kappaasittarukalum ithil adangiyirikkunnu. sthirasthithi krameekaranam ithaanu 1) vidi kandethal 150-199 beettukal/minitt; 2) vf kandethal ≤200 beettukal/minitt. monittarilulla oru alaram module, jeevan apakadappeduthunna hridayasambandhamaaya sambhavathinte (aritmiya) saahacharyathil kelkkaavunnathum drishyavum sparsikkunnathumaaya (vibration) escalation alaram sequence upayogichu rogiye ariyikkunnu.
electrode belttil, varandathum pashayillaathathumaaya naalu iii. sii. jii electrodukal rogiyude hridayamidippu thudarchayaayi nireekshikkunnu. moonnu defibrillation electrodukal vasthrathil sthaapichittundu, onnu nenjil (ekadesham hridayathinte mukalbhaagathu), rund purakil (tholinte bledukalkkidayil). rund swatantra isiji leedukal nalkunna iii. sii. jii electrodukal nenjil vesttinte ullil sthaapikkunnu. oru chikitsa shock nalkunnathinumumbu, dry defibrillator electrodukal chikilsayil ninnu charmmathe parikkil ninnu samrakshikkaan conductive jell yaanthrikamaayi vinyasikkunnu. oro sequencinum thudarchayaayi anchu shokkukal vare nalkaan dablyu. sii. dick kazhiyum. aritmiya aarambhich oru minittinullil saadhaaranayaayi jeevan rakshikkunna therapy sambhavikkunnu.chikilsayude oru kramam aarambhikkumbol rogiykku munnariyipp nalkunnu.jii. sairan alaarangalum samsara vivarangalum. oresamayam monittarilulla rund prathikarana buttonukal amarthunnathiloode, rogikk aval/avan bodhavaanmaaraayirikkunnathi kaalam nyaayeekarikkaatha shock delivari thadayaan kazhiyum. rogi prathikarikkunnillenkil, udha.jii.aritmiya kaaranam rogikk bodham nashtappettathinaal, defibrillation electrodukalkku keezhil ninnu jell yaanthrikamaayi puranthallappedunnu. aritmiya svayam pariharikkappettal, chikilsayude shock nalkilla. kazhchakkaaril ninnulla nadapadi aavasyamilla, pakshe defibrillation samayat rogiye sparsikkaruthennum emarjansi doctore vilikkanamennum shabda vivarangal vazhi avarkk munnariyipp nalkunnu.
rogiykku dablyu. sii. dii. kku rund baattarikal labhikkunnu. onnu monittar pravarthippikkaan upayogikkum, mattonn dainamdina maattisthaapikkaanaayi charging steshanil sthaapikkum. oru mobail phoon nettvarkkiloode nirmmathaavil ninnu samrakshitha daattaabesilekk daatta kaimarunnathinulla electronic savisheshathakal charging steshanil adangiyirikkunnu. sradheyamaaya iii. sii. jii sequenceukalo chikilsakalo oru surakshita serverilekku yaanthrikamaayi kaimaattam cheyyappedunnu. chikitsa nalkunna doctorq passwade parirakshitha axus vazhi avaa kaananum vishakalanam cheyyaanum kazhiyum. oru rogikk oru dablyu. sii. dii kaimaarunnathinumumbu, krithyamaaya iii. sii. jii signal kandethunnathinayi rogiyude arayil dablyu. sii. dii gadippikkukayum dablyu. sii. dii shariyaayi kaikaaryam cheiyunnuvennu urappakkaan rogikk vishadamaaya pariseelanam labikkukayum cheiyunnu.
klinikkal pareekshanangalilum niravadhi anthaaraashtra vipananaananthara padanangalilum dablyu. sii. diyude falapraptiyum falapraptiyum pareekshichittundu. dablyu. sii. dii shariyaayi dharikkukayum iii. sii. jii signal kandethal opttimal aakukayum cheythaal, aadyathe shokkinte vijaya nirakk ekadesham 98 sathamaanamaanu. athinaal, vii. tii, vii. eph enniva chikilsikkunnathil dablyu. sii. dii oru aii. sii. dii pole falapradamaanu. dablyu. sii. dii. yill chikilsayilulla rogikalil ekadesham 90 sathamaanavum hridayasthambhanam nadannu oru varsham kazhinjittum jeevichirippundennu deerghakaala thudarpadanangal kaanikkunnu.
dablyu. sii. dii oru aakramanaathmakamallaatha vasthramaayathinaal, upayogathinum shock deliveric sesham parikkukaloo paadukalo avasheshikkunnilla. phalapradamaaya samrakshanathinaayi, dablyu. sii. dii 24 manikkoor dharikkukayum vyakthiparamaaya shuchithvathinaayi maathram neekkam cheyyukayum venam.
automated ekstenal defibrillator (eiii. iii. dii), implaantabil cardioverter defibrillator (aii. sii. dii) ennivayumaayi dablyu. sii. diyude thaarathamyam.
1. hridayathinte thaalam vishakalanam cheiyunnathinum defibrillation aavashyamaano ennu oopparettare ariyikkunnathinum roopakalppana cheytha portable electronic upakaranangalaan automated ekstenal defibrilettarukal (eiii. iii. dii). hridayasthambhanathinu anjjaathamaaya apakadasaadyathayulla saadhaarana janasamkhyayile vyakthikalkkayi uddeshichullava saadhaaranayaayi pothusthalangalilum phastt responder aambulansukalilum labhyamaan. saadhaaranakkaarude upayogathinaayi roopakalppana cheythirikkunna eiii. iii. dii. kall oopparettarkku pinthudaraan lalithamaaya audiyo, vishwal nirddeshangal nalkunnu. rogiyude nenjil oru oopparettar sthaapicha electrode paadukal nireekshanatthinum defibrillation vendiyaanu. aii. sii. dii, dablyu. sii. dii ennivayil ninnu vyathyasthamayi, ezz. sii. dii thadayunnathinu oru eiii. iii. dick oru kaazhchakkaarante udanadi pravartthanam aavasyamaanu.
2. mukalil vivarichathupole thaalkkaalika upayogathinaayi uddeshichittullathum ezz. sii. dii. kku ariyappedunna shanikamaaya apakadasaadhyathayullathumaaya rogikalkkaayi uddeshichullathaanu dablyu. sii. dii. kall.oru rogiyude hridayasambandhamaaya prasnangal theerchayaayum sthiramaanennum deerghakaala samrakshanamaanennum vyakthamaakunnathuvare rogikalil ezz. sii. dii thadayunnathinulla anuyojyamaaya chikitsa oopshanaanu dablyu. sii. dii.[36]
3. hridayathinte valath ventriclelekku nayikkunna nenjil gadippichirikkunna electronic upakaranangalaan implaantabil cardioverter-defibrilettarukal (icd). ezz. sii. dii. yude sthiramaaya apakadasaadyathayulla rogikalkku vendiyaanu avaa uddeshikkunnathu. oru aii. sii. dii., oru dablyu. sii. dii. pole, emarjansi defibrillation vazhi cardiac aritmiyas kandethunnathinum avasanippikkunnathinum roopakalppana cheythittullathaanu. niravadhi apakadasaadhyathakalumaayum rogaavasthayumaayum bandhappettirikkunna aii. sii. dii. sthaapikkunnathinu vipulamaaya aakramanathmaka sasthrakriya aavasyamaanu. athinaal, oru aii. sii. diyude theerumaanam shradhaapoorvvam edukkanam. oru rogiyude hridayasambandhamaaya prasnangal theerchayaayum sthiramaanennum deerghakaala samrakshanamaanennum vyakthamaakunnathuvare rogikalil ezz. sii. dii thadayunnathinulla anuyojyamaaya chikitsa oopshanaanu dablyu. sii. dii.
dablyu. sii. dii. yumayi thaalkkaalikamaayi jeevikkuka.
ashupathriyil ninnu discharge cheyyappedunna ezz. sii. dii. yude uyarnna apakadasaadyathayulla rogikale avarude hridayasambandhamaaya prashnangalekkurichum marakamaaya falangalekkurichum nirantharam vishamikkathe mikka saadhaarana dainamdina pravarthanangalilekkum madangaan dablyu. sii. dii anuvadikkunnu. dablyu. sii. dii. gadippicha rogikalude jeevithanilavaram anweshikkunna oru munkaala padanatthil bhooribhaagam perkkum chalanathmakatha (68 sathamaanam), svayam paricharanam (83 sathamaanam), dainamdina dinacharya (75 sathamaanam), vedana (64 sathamaanam), maanasikarogyam (57 sathamaanam) ennivayude kaaryatthil oru vaikalyavum anubhavappettillenn kandethi. dablyu. sii. dii. kku arhatayullah rogikalil vishaadavum uthkandayum vilayiruthunna mattoru padanatthil yadhaarthathil dablyu. sii. dii. labhicha rogikalil vishada skorukal mechappeduthunnathinulla pravanatha kandethi.
nilavil yukeyil dablyu. sii. diyude upayogathekkurichu oru patanam aarambhichu.
eathu pravartthanangal saadhyamaan ennathinekkurichulla chodyangalkku, chikitsa nalkunna doktarumaayi koodiyaalochikkaan nirmmaathaav shupaarsha cheiyunnu. dablyu. sii. diyil ninnulla oru munnariyipp nashtappedaanulla saadhyatha kaaranam uchathilullathum koodaathe/allengil uyarnna vibration parithasthithikalile pravartthanangal ozhivaakkaanum nirmmaathaav upadeshikkunnu.
upayogakshamathayude vilayiruthal.
pettennulla hridayasthambhanathinu (skaa) saadhyathayullathum implaantabil defibrilatorinu yogyarallathavarum allengil nirasikkunnavarumaya rogikalkkulla oru oopshanaanu warable cardioverter defibrillator. skaa apakadasaadyathayulla oru upavibhaagathile rogikalkku saadhaarana medical chikilsayumaayi thaarathamyappeduthumbol dharikkaavunna cardioverter defibrillator vaidyashaasthraparamaayi maathrame aavashyamulloo ennu chila cardiologistukal sammathikkunnu, ennirunnaalum medical maargganirddeshangal dablyu. sii. dii. kku gunangalulla sariyaaya roganirnayathekkurichu vyakthamaaya dhaarana nalkunnu.
2018 januvariyil, chila yoonittukalile ariyappedunna thakararumaayi bandhapetta oru suraksha munnariyipp fda purappeduvichu, ithu doublucidy oru chikitsa shock nalkunnathil ninnu thadayum. oru prathyeka pishak sandesham drishyamaanenkil upakaranangal maattisthaapikkaan upayokthaakkalkk nirddesham nalkunna oru ashayavinimayam soul munbu (2017 septambaril) purappeduvichirunnu, ithu thakaraarine soochippikkunnu. upakaranathinte thudarnnulla ellah kayattumathikalilum munnariyippinte pakarppukal ulppeduthiyittundu.
kramarahithamaya niyantritha pareekshanatthinte phalangal american koleju oof cardiology 67-aamath vaarshika shaasthra sessionil (2018 vasanthakaalath) avatharippichu. hridayaaghaathathinu sheshamulla rogikalil dablyu. sii. dii pettennulla hridayasambandhamaaya maranam kurachuvennu kaanikkunnathin praadhamika phalatthil patana phalangal mathiyaya thelivukal kaanichilla. dablyu. sii. dii dharicha groupil 1.6 sathamaanam perr pettennulla hridayasthambhanam moolam marichu, dablyu. sii. dii dharikkaattha groupil 2.4 sathamaanam perr marichu, ithu sthithivivarakkanakkukali kaaryamaaya vyathyaasamalla.
oru dablyu. sii. dii. labhikkunnathin soochanakal.
yukeyil prathimasa vaadaka upakaranamaayi nirddeshikkaavunnathum ezz. sii. dii. yude apakadasaadhyathayullathumaaya ellah rogikalkkum thaalkkaalika chikilsayaayi dablyu. sii. dii saadhaaranayaayi shupaarsha cheiyunnu.
2006leeii aaku/aahaa/eskiyude anthaaraashtra maargganirddeshangal anusarichu, 2015lum 2021lum esky 2017ll dablyusidiyil ninnu prayojanam nediyekkaavunna rogikalil aahu/aaku/manikkoor ulppedunnu
idathu ventricular pump systolic function (elvf) ≤35 sathamaanam kuranja rogikal
puthuthayi roganirnayam nadatthiya ischemic hart failer rogikk kuranja ejection fraction (echu. eph. aarr. iii. eph)
ventricular fibrilation (vf) allengil susthira ventricular tachycardia (vidi) ulla rogikal
hridayamaatta shasthrakriyaykaayi kaathiripp pattikayilulla rogikal
rogikalkkulla kaathiripp samayam kuraykkuka
dilated cardiomayoppathy (dcm), newyork hart association (envaiechu) ghattam II-III hridayasthambhana rogikal ulppede kuranja ejection fraction ulla puthuthayi roganirnayam nadatthiya noonn-ischemic hart failer rogi
garbhaavasthayile cardiomayoppathy (periparttam sem. mee/ppcm) yude apakadasaadyathayulla ghattathilulla rogikal
2006 muthal ishaalt hridayamaatta shasthrakriyaykkulla maarganirddeshangalil dablyu. sii. dii. kku onnaam klaas supaarshayaayi pattikappedutthiyittundu. ithinartham ashupathriyil ninnu discharge cheyyappedunna hridayamaatta shasthrakriyaykaayi kaathirikkunna rogikalkku traansplaant sweekarikkunnathuvare kaathirikkunna samayam kuraykkunnathinu dharikkaavunna defibrillator labhikkanam ennaanu. thannirikkunna avasthayil ithu prayojanakaravum upayogapradavum phalapradavumaanennu thelivukalum pothuvaaya sammathavum ulla nadapadikramangalilo chikilsakalilo onnaanu dablyu. sii. dii.
rogikalkku icd undengilum icd janarettarinte sthaanathu radio therapic thaalkkaalika explantation aavasyamulla prathyeka saahacharyathilum dablyusidi upayogichittundu.
dablyu. sii. diyude falapraapthiyekkurichulla klinikkal pareekshanangal.
europian ce-certification dablyusidi (life vestt ®) yude fda amgeekaarathinum sesham, niravadhi munkaala praabalyavum varaanirikkunna rajistrikalum doublucidy falapraptiyum surakshyum parishodhichu. dablyu. sii. dii upayogicha 30,000-thiladhikam rogikalil ninnulla daatta vipulamaaya vaividhyamaarnna soochanakalkkaayi prasidheekarikkunnu. thaazhepparayunnathil oru bhagam maathrame avatharippichittulloo.
mettaa vishakalanangal
vividha soochanakalil ekadesham 20,000 noonn-overlapping rogikalumaayi thaarathamyappeduthaavunna 11 padanangalude mettaa vishakalanam enguen thudangiyavar prasidheekarichu. motham marananirakk 1.4 sathamaanavum vii. tii/vii. eph nirakk 2.6 sathamaanavum vii. tii/vii. eph sambandhamaaya marananirakk 0.20 sathamaanavum maathramaan ellah rogikalilum avar kandethiyathu. 1.7 sathamaanam rogikalkku (9.1 rogikal/100 rogikal) uchithamaaya chikitsa labhichu, athu 96 sathamaanathil vijayakaramaayirunnu. anuchithamaya shock nirakk 1 sathamaanathil thaazheyaayirunnu.
dablyu. sii. diyude chikitsa nirakk report cheiyunna padanangalude chittayaya cross-indication avalokanavum mettaa vishakalanavum masriyum mattullavarum nadatthi. 2019ll avar 28 padanangalum 30,000thiladhikam rogikalum vishakalanam cheythu. 3 maasathinide, 100 rogikalil 5 perkku uchithamaaya dablyu. sii. dii chikitsa aaghaathangal labhichu, 100 rogikalil 2 perkku maathrame anuchithamaya chikitsa aaghaathangal labhichulloo. thiranjedukkal allengil prasidheekarana pakshapaathatthinte vishakalanam (udha.jii.swathanthravum nirmmaathaav sponsor cheythathumaaya padanangal thammil vyathyaasangalonnumille varaanirikkunnathum munkaala padanangalum thammil vyathyasangalillennum, egger-testt) velippeduthi. rachayithaakkalude abhipraayathil, 3 maasathe fooloo-appiloode dablyu. sii. dii. upayogichu uchithamayi chikilsikkappetta rogikalude nirakk, vishakalanathil ulppeduthiyittulla aarr. sii. tiye apekshichu nireekshana padanangalil ganyavum valare kooduthalumaayirunnu. moonnu maasathinide 100 rogikalil 0.7 enna nilayil marananirakk valare kuravaayirunnu.
kramarahithamaya niyantritha trial daatta
oljin thudangiyavar aadyamaayi prasidheekaricha vestt trialaanu poost-mye rogikalumaayulla dablyu. sii. dii upayogathil aadyathethum innuvare kramarahithavumaaya niyantritha trial (aarr. sii. tii). 2018ll motham 2,302 rogikale chikilsaykkulla (aii. tii. tii) vishakalanathil ulppeduthi. vestt-stadiyude praadhamika phalam, arrithamik marananirakk, dablyusidi groupil 1.6% aayirunnu. 2.kantrol groupil 4 sathamaanam. 33 sathamaanam relative risk reduction (rrr) undaayirunnittum vyathyasam kaaryamayirunnilla. vestt-stadiyude randaam phalam, ellah kaaranangalalum marananirakk, dablyu. sii. dii groupil 3.1 sathamaanavum kantrol groupil 4.9 shathamaanavumaayirunnu. marananirakkil 36 sathamaanam kuravundaayathode (rrr) eee vyathyasam shradheyamaayirunnu. eee padanatthil sharashari dainamdina dharikkunna samayam prathidinam 14 muthal 18 manikkoor vare mathramaayirunnu, athinaal nireekshana padanangal anusarichu ithu valare kuravaanu. yadhaartha prasidheekaranathinu anubandha anubandhamaayi nalkiyirikkunna oru adhika chikitsa vishakalanam (eiii. tii.), ellah marananirakk anthima pooyintukalilum sthithivivarakkanakku praadhaanyam velippeduthi, angane dablyu. sii. dii. yude upayogathinu anukoola phalangal labhichu. 2020ll prasidheekaricha oru protocol vishakalanathil (ppa), arithamik marananirakkil 62 sathamaanavum ellah kaaranangalalum marananirakkil 75 sathamaanavum kuravundaayi, iva randum pradhana falangalaanu, ithu eiii. tii. vishakalanathil kaanichirikkunna falangalumaayi thaarathamyappeduthaavunnatha.
ezz. sii. dii. kku uyarnna apakadasaadyathayulla rogikalil marananirakk kuraykkunnathinu dablyu. sii. dii valare phalapradamaanennu eee phalangal soochippikkunnu. dainamdina klinikkal parisheelanatthil vijayakaramaya dablyu. sii. dii therapy pradhana gadakangal uyarnna dharikkunna palikkal nirmmaathaav (isad. pii. emm network) nalkunna nireekshana samvidaanathinte upayogavumaanu.
aarogya saankethika vilayiruthalukal (echu. tii. eiii)
eidelsburger sahapravarthakarum 2020 ll oru echu. tii. eyude phalangal prasidheekarichu. rachayithakkal 49 padanangalil ninnulla daatta vishakalanam cheyyukayum deerghakaala risk maanejment thanthrangal nirnnayikkunnathin aavashyamaaya samayat pettennulla hridayasthambhanam undaakunna kesukalil dablyu. sii. dii surakshithavum phalapradavumaaya edapedalaanennum, vii. tii/vii. eph sambhavangal kandethunnathil dablyu. sii. dii vishwasaneeyamaanennum uyarnna thothilulla uchithamaaya shokkukal kaanikkunnuvennum nigamanam cheythu, ithu vijayakaramaya vii. tii/vii. eph avasaanippikkalukalude uyarnna nirakkilekku nayikkunnu.
courtisy sahapravarthakarum 2021-ll mattoru echu. tii. eiii. yill ninnulla phalangal prasidheekarichu. emm. aii allengil aii. sii. dii explantationushesham ezz. sii. dii. ykku apakadasaadyathayulla rogikalil dablyu. sii. diye "staanderd oof cair" maayi thaarathamyam cheiyunna chelavu-falapraapthiyil avar shradha kendreekarichu. vestt padanatthil ninnulla daatta upayogichu rogikalil dablyusidi chelavu kuranja chikitsa oopshanaanennu rachayithakkal kandethi. icd explaanteshanu sheshamulla rogikalil, itaaliyan enhsil ninnulla daatta upayogichu kuranja theevrathayilulla ashupathriyil (paricharana nilavaaram) 3 aazhcha ashupathriyil praveshippikkunnathine apekshichu dablyusidi 1,782 euroyude chelavu laabhikkukayum cheythu. itaaliyan enhsukale sambandhichidatholam dablyusidi upayogam vibhavangalude kooduthal phalapradamaaya upayogathinum klinikkal praakteesil rogiyude paricharanam mechappeduthunnathinum sambhavana cheiyunnuvennu rachayithakkal nigamanam cheythu.
nilavil yukeyil oru echu. tii. eiii nadatthaan padhathiyundu.