{"id":15033,"date":"2020-06-17T18:44:06","date_gmt":"2020-06-17T16:44:06","guid":{"rendered":"https:\/\/kojqiqi.com\/?page_id=15033"},"modified":"2020-07-30T12:06:19","modified_gmt":"2020-07-30T10:06:19","slug":"trajtimi-i-ritmit-te-zemres-pacemaker","status":"publish","type":"page","link":"https:\/\/kojqiqi.com\/sherbimet\/trajtimi-i-ritmit-te-zemres-pacemaker\/","title":{"rendered":"Trajtimi i ritmit t\u00eb zemr\u00ebs – Pacemaker"},"content":{"rendered":"
\n
\n
\n
\n
\n
\n
\n

\u00a0<\/strong>Pacemaker – Bateria e zemr\u00ebs – Schrittmacher<\/span><\/span><\/strong><\/p>\n

\u00a0Pacemaker (pejsmejker\u00ebt-Bateria e zemr\u00ebs) jan\u00eb aparate me nj\u00eb funksion shum\u00eb t\u00eb nd\u00ebrlikuar dhe me nj\u00eb madh\u00ebsi jo t\u00eb madhe (rreth 3×3 cm dhe 3 mm trash\u00ebsi). <\/span>Mbi 1 million Pacemaker implantohen \u00e7do vit n\u00eb bot\u00eb. <\/span>K\u00ebto aparate vendos\u00ebn tek ata persona t\u00eb cil\u00ebt kan\u00eb \u00e7rregullime t\u00eb ndryshme t\u00eb ritmit t\u00eb zemr\u00ebs.<\/span><\/span><\/strong><\/p>\n

\"\"<\/a><\/p>\n

Nj\u00eb zem\u00ebr e sh\u00ebndosh n\u00eb qet\u00ebsi tkurr\u00ebt rreth 60 her\u00eb n\u00eb minut. <\/span>Tek \u00e7rregullimet e ritmit, kjo frekuenc\u00eb e rregullt\u00eb e zemr\u00ebs del nga normaliteti. <\/span>Me \u00e7rregullime t\u00eb ritmit si term i p\u00ebrgjith\u00ebsh\u00ebm, p\u00ebrfshihen shum\u00eb s\u00ebmundje. <\/span>Zemra mund t\u00eb rrah shpejt, ngadal\u00eb apo t\u00eb ket\u00eb ngecje.\u00a0\u00a0 <\/span><\/span><\/strong><\/p>\n

Zemra si organ muskulor \u00ebsht\u00eb i ndar\u00eb n\u00eb kat\u00ebr dhoma, dy atriume dhe dy barkushe (ventrikuli) t\u00eb ndara n\u00eb an\u00ebn e majt\u00eb dhe t\u00eb djatht\u00eb. Ky organ funksion si nj\u00eb pomp\u00eb q\u00eb pranon gjakun nga periferia e trupit dhe organet e tjera, d\u00ebrgon n\u00eb mushk\u00ebri p\u00ebr oksigjenim, pranon prap\u00eb nga mushk\u00ebria dhe d\u00ebrgon p\u00ebrs\u00ebri n\u00eb periferi dhe organe tjera si: truri, veshkat, m\u00ebl\u00e7ia, trakti digjestiv, etj. P\u00ebr t\u00eb kryer k\u00ebt\u00eb funksion si pomp\u00eb thith\u00ebse dhe zbrazje. Zemra tkurret prej 60 deri n\u00eb 80 her\u00eb n\u00eb minut\u00eb n\u00eb qet\u00ebsi, dhe rrit\u00eb frekuenc\u00ebn e vet\u00eb mbi 100 her\u00eb n\u00eb minut\u00eb gjat\u00eb aktiviteteve sportive apo n\u00eb situata t\u00eb ndryshme stresi. P\u00ebr t\u2019u tkurrur, zemra merr informacionin nga qeliza specifike q\u00eb gjend\u00ebn n\u00eb zem\u00ebr. K\u00ebto qeliza formojn\u00eb nj\u00eb rrjet\u00eb elektrike q\u00eb gjendet n\u00eb zem\u00ebr dhe koordinon qelizat e tjera muskulore t\u00eb zemr\u00ebs. Kjo qend\u00ebr e quajtur nyja atriale (nyja sinusale), gjend\u00ebt n\u00eb atrium, n\u00eb hierarki si qendra m\u00eb e lart\u00eb. M\u00eb posht\u00eb pasojn\u00eb nyja atrioventrikluare, rrjeti i HIS q\u00eb ndahet n\u00eb an\u00ebn e majt\u00eb dhe t\u00eb djatht\u00eb dhe rrjeti i purkinj\u00ebve. N\u00ebse nuk funksion kjo qend\u00ebr, funksionin e saj e marrin qendra t\u00eb tjera t\u00eb vendosura hierarkisht m\u00eb posht\u00eb me nj\u00eb frekuenc\u00eb gjithmon\u00eb m\u00eb t\u00eb ul\u00ebt.<\/p>\n

\"\"<\/a><\/p>\n

\u00c7rregullimet e ritmit t\u00eb zemr\u00ebs mund t\u00eb jen\u00eb t\u00eb ndryshme. Ato mund t\u00eb manifestohen si ritme shum\u00eb t\u00eb ngadalshme (bradykarde), ritme t\u00eb \u00e7rregullta (arrytmien), ritme jo t\u00eb kordinuara si form\u00eb blloku me grada t\u00eb ndryshme (AV Blok I, II, III) , Sick Sinus Syndrom etj, apo edhe \u00e7rregullime t\u00eb ritmit me nj\u00eb frekuenc\u00eb t\u00eb shpejt\u00eb (tahikardien).<\/p>\n

\u00c7rregullimet e shpejta t\u00eb ritmit q\u00eb kane origjinen n\u00eb atrium, mund t\u00eb jen\u00eb shum\u00eb t\u00eb pak\u00ebnd\u00ebshme, mir\u00ebpo nuk jan\u00eb t\u00eb rrezik\u00ebshme p\u00ebr jet\u00ebn, derisa \u00e7rregullimet q\u00eb dalin nga barkushet mund t\u00eb shkaktojn\u00eb vdekjen e papritur.<\/p>\n

Tek k\u00ebto s\u00ebmundje t\u00eb ritmit t\u00eb zemr\u00ebs, zemra nuk funksionon n\u00eb m\u00ebnyr\u00eb t\u00eb rregullt dhe si pasoj\u00eb e k\u00ebsaj edhe organet e tjera, si\u00e7 \u00ebsht\u00eb truri, nuk furnizohen mjaftuesh\u00ebm me gjak.<\/p>\n

Ritmi i ngadalsh\u00ebm n\u00ebn 40 n\u00eb minut, apo pauset mbi 4 sekonda ,shkaktojn\u00eb nj\u00eb furnizim jo adekuat t\u00eb trurit me gjak, me \u00e7rast pacientet humbin vetdijen (synkope).<\/p>\n

Lodhja, marramendja, mungesa e koncentrimit apo edhe humbja e vet\u00ebdijes, jan\u00eb shenja q\u00eb mund t\u00eb paraqiten tek k\u00ebta persona.<\/p>\n

\u00c7far\u00eb jan\u00eb shkaktar\u00ebt e \u00e7rregullimit t\u00eb ritmit?<\/strong><\/p>\n

Kur zemra nuk ka nj\u00eb rit\u00ebm t\u00eb rregullt, shkaktar\u00ebt mund t\u00eb jen\u00eb t\u00eb ndrysh\u00ebm. N\u00ebse musuli i zemr\u00ebs \u00ebsht\u00eb i demtuar nga Infarkti apo ndonje infekcion, ajo zon\u00eb e zemr\u00ebs zhvillon nj\u00eb plag\u00eb n\u00ebp\u00ebr t\u00eb cil\u00ebn nuk mund te perqohen impulset elektrike. K\u00ebto plage q\u00eb quhen Fibroza mund t\u00eb shkaktohen edhe nga tensioni i lart\u00eb i gjakut.<\/p>\n

\u00c7rregullimit e ritmit mund t\u00eb jen\u00eb edhe thjesht\u00eb si simptom q\u00eb shkaktohet nga funkcioni i ult\u00eb i zemr\u00ebs,\u00a0 funkcioni i rritur i gjendr\u00ebs tiroide, mbipesha, diabeti apo pausat e frymarrj\u00ebs gjat\u00eb koh\u00ebs s\u00eb gjumit (Sleep Apnoe Syndrom).<\/p>\n

Nje rol t\u00eb r\u00ebndsish\u00ebm ka edhe p\u00ebrb\u00ebrja gjenetike. Nj\u00eb pjes\u00eb e pacienteve trash\u00ebgojn rrjete t\u00eb shumta elektrike t\u00eb cilat bartin informacionin n\u00eb rrug\u00eb t\u00eb ndryshme nga atriumi n\u00eb ventrikul. K\u00ebto rrug\u00eb t\u00eb ndryshme shkaktojn\u00eb rit\u00ebm t\u00eb shpejt dhe t\u00eb \u00e7rregullt t\u00eb zemr\u00ebs.<\/p>\n

Diagnostifikimi<\/b><\/p>\n

Me ndihm\u00ebn e EKG n\u00eb qet\u00ebsi, duke ngarkuar pun\u00ebn e zemr\u00ebs (Ergometri) apo duke regjistruar ritmin e zemr\u00ebs p\u00ebr nje kohe me t\u00eb gjate (Holter). P\u00ebr diagnsotifikim mund t\u00eb ndihmojn edhe kontrollet tjera siq jan\u00eb analizat laboratorike, MRT, CT, Echokardiografia apo Koronografia.<\/p>\n

Terapia<\/span><\/b><\/p>\n

Kjo varet nga lloji i \u00e7rregullimit t\u00eb ritmit. S\u00eb pari provohet terapia medikamentoze, psh me Betablocker apo m\u00eb pas duke provuar klassat e ndryshme t\u00eb terapis ritmike t\u00eb zemr\u00ebs n\u00eb kombinime dhe doza t\u00eb ndryshme. Rrjetet e tep\u00ebrta elektrike ne zem\u00ebr mund edhe t\u00eb mbyllen me metoden e Ablacionit duke p\u00ebdorur ftohjen apo nxemjen p\u00ebrmes nj\u00eb sonde n\u00eb zona t\u00eb caktuara ku ato gjenden- Elektrofiziologjia e zemr\u00ebs. <\/span><\/p>\n

Kjo metode quhet EPS<\/b>– Electrophysiology Study dhe p\u00ebrdor\u00ebt tek :<\/span><\/p>\n

AF<\/span><\/b>– A<\/b>trial F<\/b>ibrillation<\/span><\/p>\n

WPW<\/span><\/b>– W<\/b>olff-P<\/b>arkinson-W<\/b>hite Syndrom,<\/span><\/p>\n

AVNRT<\/span><\/b>– AV<\/b> N<\/b>odal R<\/b>eentrant T<\/b>achycardia<\/span><\/p>\n

VT<\/span><\/b> \u2013 V<\/b>entricular T<\/b>achycardia<\/span><\/p>\n

\u00c7far\u00eb jan\u00eb Pacemaker\u00ebt?<\/span><\/strong>
\nJan\u00eb aparate t\u00eb cilat mund t\u00eb vendos\u00ebn tek k\u00ebta persona. <\/span>Ata marrin funksionin e k\u00ebtyre qelizave dhe i japin informacionin zemr\u00ebs kur t\u00eb kontraktohet. M\u00eb ndihm\u00ebn e tyre, mund t\u2018i ndihmohet k\u00ebtij grupi t\u00eb pacient\u00ebve t\u00eb zhvillojn\u00eb nj\u00eb jet\u00eb normale dhe at\u00eb m\u00eb mir\u00eb se m\u00eb \u00e7do medikament tjet\u00ebr.<\/p>\n

Pacemaker\u00ebt p\u00ebrb\u00ebhen nga nj\u00eb baterie, nj\u00eb qend\u00ebr q\u00eb ka funksionin e nyj\u00ebs atriale, t\u00eb cilat jan\u00eb t\u00eb vendosura n\u00eb nj\u00eb kuti metalike dhe Sondat (elektrodat, fije teli) q\u00eb vendos\u00ebn n\u00ebp\u00ebr nj\u00eb en\u00eb t\u00eb gjakut (ven\u00eb) n\u00eb zem\u00ebr. P\u00ebrmes k\u00ebtyre telave Pacemaker jep informacionin n\u00eb rast nevoje direkt n\u00eb zem\u00ebr dhe si pasoj\u00eb e k\u00ebsaj zemra kontraktohet dhe punon si pomp\u00eb n\u00eb m\u00ebnyr\u00eb t\u00eb rregullt.<\/p>\n

\"\"<\/a><\/p>\n

Jet\u00ebgjat\u00ebsia e Pacemakerit \u00ebsht\u00eb prej 5 deri n\u00eb 10 vite, var\u00ebsisht nga ajo se sa shpesh k\u00ebrkohet aktiviteti i tij n\u00eb zem\u00ebr. Pas zbrazjes s\u00eb bateris\u00eb s\u00eb Pacemakerit, b\u00ebhet nd\u00ebrrimi i saj. Gjat\u00eb k\u00ebtij intervenimi, nd\u00ebrrohet vet\u00ebm bateria (gjeneratori), nd\u00ebrsa elektrodat nuk nd\u00ebrrohen.<\/span><\/p>\n

Pacemakeri vendoset zakonisht n\u00ebn klavikul\u00eb, n\u00eb an\u00ebn e majt\u00eb apo t\u00eb djatht\u00eb t\u00eb gjoksit. N\u00ebn nj\u00eb anestezion lokal b\u00ebhet nj\u00eb prerje e l\u00ebkur\u00ebs me nj\u00eb gjat\u00ebsi rreth 3 cm. P\u00ebrmes en\u00ebs s\u00eb gjakut (ven\u00ebs) vendosen elektrodat (telat) var\u00ebsisht nga nevoja nj\u00eb apo dy direkte n\u00eb zem\u00ebr. Vendosja e elektrodave b\u00ebhet n\u00ebn rrezet r\u00ebntgen duke u par\u00eb n\u00eb nj\u00eb ekran. Ato fiksohen n\u00eb muskulatur\u00eb t\u00eb zemr\u00ebs dhe b\u00ebhet matja e tyre. K\u00ebto elektroda konektohen, pastaj n\u00eb Pacemaker. Pacemaker s\u00eb bashku me elektroda vendos\u00ebn n\u00ebn muskulatur\u00eb. Pas vendosjes s\u00eb Pacemakerit, b\u00ebhet programimi i tij p\u00ebr secilin pacient individualisht. Gjat\u00eb gjith\u00eb operacionit, pacienti \u00ebsht\u00eb i zgjuar, komunikon dhe nuk ka dhimbje, p\u00ebrpos nj\u00eb gjilp\u00ebre q\u00eb n\u00eb fillim kur i jepet medikamenti kund\u00ebr dhimbjeve.<\/span><\/p>\n

\"\"<\/a><\/p>\n

Operacioni zgjat\u00eb prej 30 deri 60 minuta, var\u00ebsisht nga anatomia e pacientit. Dy or\u00eb pas operacionit pacienti mund t\u00eb l\u00ebviz\u00eb. Pacienti lirohet n\u00eb po t\u00eb nj\u00ebjt\u00ebn dit\u00eb n\u00eb sht\u00ebpi. Mir\u00ebpo, zakonisht mund t\u00eb q\u00ebndroj\u00eb nj\u00eb nat\u00eb n\u00eb spital dhe t\u00eb nes\u00ebrmen b\u00ebhet nj\u00eb kontroll dhe nj\u00eb programim p\u00ebrfundimtar i Pacemakerit. Pacient\u00ebt me Pacemaker duhet rregullisht t\u00eb b\u00ebjn\u00eb kontrolle tek mjeku p\u00ebrgjegj\u00ebs.<\/p>\n

\"\"<\/a><\/p>\n

Pas operacionit, secili pacient merr nj\u00eb let\u00ebrnjoftim t\u00eb Pacemakerit, n\u00eb t\u00eb cilin jan\u00eb t\u00eb vendosura t\u00eb dh\u00ebnat e pacientit, Pacemakerit, elektrodave, programimi dhe t\u00eb dh\u00ebna tjera teknike.<\/p>\n

Pes\u00eb dit\u00eb pas operacionit mund t\u00eb b\u00ebhet banj\u00eb, nd\u00ebrsa larja e thjesht\u00eb me dush, mund t\u00eb b\u00ebhet q\u00eb t\u00eb nes\u00ebrmen. L\u00ebvizja e kraharorit ku \u00ebsht\u00eb vendosur Pacemakeri duhet b\u00ebr\u00eb me kujdes p\u00ebr dy jav\u00ebt n\u00eb vazhdim. Vendosja e duarve pas kok\u00ebs duhet m\u00ebnjanur gjat\u00eb k\u00ebsaj kohe.<\/p>\n

Pacient\u00ebt pas operacionit duhet kujdesur p\u00ebr plag\u00ebn, n\u00eb rast se ajo skuqet, fryhet apo nuk \u00ebsht\u00eb e that\u00eb dhe ka dhimbje duhet patjet\u00ebr t\u00eb paraqiten tek mjeku.<\/p>\n

Pacemakermbajt\u00ebsit n\u00ebse nuk kan\u00eb s\u00ebmundje t\u00eb tjera, b\u00ebjn\u00eb jet\u00eb normale. Ata mund t\u00eb b\u00ebjn\u00eb aktivitete sportive, mund t\u00eb notojn\u00eb, mund t\u00eb shkojn\u00eb n\u00eb sauna, mund t\u00eb udh\u00ebtojn\u00eb me auto, anije, tren apo aeroplan\u00eb. Vozitja e automjetit \u00ebsht\u00eb e lejuar, zakonisht q\u00eb nga dita kur pacienti lirohet nga spitali, edhe p\u00ebrdorja e rripit t\u00eb siguris\u00eb n\u00eb auto nuk \u00ebsht\u00eb e ndaluar, p\u00ebrkundrazi duhet v\u00ebn\u00eb patjet\u00ebr. Me nj\u00eb fjal\u00eb, t\u00eb gjitha aktivitet jan\u00eb t\u00eb lejuara.<\/p>\n

Pacient\u00ebt me Pacemaker pa merak mund t\u2019i p\u00ebrdorin k\u00ebto mjete: t\u00eb shikojn\u00eb TV, t\u00eb d\u00ebgjojn\u00eb radion apo mjete tjera audio\/vizuale, thar\u00ebsen e flok\u00ebve, makin\u00eb elektrike t\u00eb rruajtjes, brusha elektrike t\u00eb dh\u00ebmb\u00ebve apo mjete tjera n\u00eb banj\u00eb, lavatriqe, thar\u00ebse rrobash, thith\u00ebse elektrike, mikroval\u00ebn, pjatalar\u00ebsen, telefonat, printer\u00ebt, kompjuter\u00ebt si dhe shum\u00eb mjete tjera elektrike n\u00eb kuzhin\u00eb apo n\u00eb zyr\u00eb. P\u00ebrdorja e telefonave mobil \u00ebsht\u00eb e lejuar, por q\u00eb gjat\u00eb telefonat\u00ebs t\u00eb mbahet n\u00eb an\u00ebn tjet\u00ebr ku gjend\u00ebt Pacemakeri. Edhe pas telefonat\u00ebs preferohet q\u00eb telefonat mobil mos t\u00eb mbahen n\u00eb af\u00ebrsi, por n\u00eb an\u00ebn e kund\u00ebrt t\u00eb Pacemakerit.<\/p>\n

Cil\u00ebt jan\u00eb Pacemaker\u00ebt ?<\/strong><\/p>\n

Pacemaker\u00ebt\u00a0 mund t\u00eb jen\u00eb me funksione t\u00eb ndryshme dhe mund t\u00eb jen\u00eb njedhom\u00ebsh, dydhom\u00ebsh dhe tredhom\u00ebsh me nj\u00eb, dy apo edhe tri Sonda (Elektroda) n\u00eb atriumin e djatht\u00eb, ventrikulin e djatht\u00eb dhe t\u00eb majt\u00eb. P\u00ebr em\u00ebrtimin e pacemaker\u00ebve p\u00ebrdor\u00ebt NBG Code q\u00eb tregon vendndodhj\u00ebn e Elektrod\u00ebs, numrin e dhomave, funksionin e pacemakerit.<\/p>\n

AAI, VVI, DDD etj<\/p>\n

AAI<\/strong>– Pacemaker nj\u00ebdhom\u00ebsh me nj\u00eb sond\u00eb n\u00eb atriumin e djatht\u00eb<\/p>\n

VVI<\/strong>– Pacemaker nj\u00ebdhom\u00ebsh me nj\u00eb sond\u00eb n\u00eb ventrikulin e djatht\u00eb<\/p>\n

DDD<\/strong>– Pacemaker dydhom\u00ebsh me dy sond\u00eb, n\u00eb atriumin dhe ventrikulin e djatht\u00eb<\/p>\n

ICD<\/strong>– I<\/strong>mplantable C<\/strong>ardioverter D<\/strong>efibrillator:\u00a0Pacemaker q\u00eb mund t\u00eb jet\u00eb nj\u00ebdhom\u00ebsh apo dydhom\u00ebsh dhe ka funksionin plot\u00ebsues t\u00eb defibrillatorit.<\/p>\n

CRT-D<\/strong> C<\/strong>ardiac R<\/strong>esynchronization T<\/strong>herapy D<\/strong>efibrillator:\u00a0Pacemaker q\u00eb \u00ebsht\u00eb tredhom\u00ebsh dhe p\u00ebrpos funksionit t\u00eb defibrillatorit ka edhe funksionin e sinkronizimit t\u00eb zemr\u00ebs.<\/p>\n

 <\/p>\n

ICD<\/strong> mund te ket\u00eb nje apo edhe dy Sonde ( n\u00eb Atrium dhe ventrikul).\u00a0CRT-D<\/strong> ka tri sonda ( atriumin e djathte, dhe ventrikulin e djathte dhe te majt\u00eb). Ka funkcionin e sinkronizimit t\u00eb zemr\u00ebs dhe nj\u00ebkoh\u00ebsisht edhe funkcionin e defibrillatorit.<\/p>\n

T\u00eb gjitha k\u00ebto aparate natyrisht q\u00eb kan\u00eb funkcionin e thjesht\u00eb te pacemakerit poashtu.<\/p>\n

 <\/p>\n

MICRA TPS –<\/strong> nga 2013 kan\u00eb dalur edhe pacemaker\u00ebt e ri, pa sonde me nj\u00eb madh\u00ebsi shum\u00eb t\u00eb vog\u00ebl 2-3 cm dhe implantohen direkt n\u00eb zem\u00ebr. Nj\u00eb sistem i ri nga Medtronic System.<\/p>\n

\"\"<\/a><\/p>\n

 <\/p>\n

Ku duhet ken\u00eb kujdes Pejsmejkermbajt\u00ebsit?<\/strong>
\nPacemakermbajt\u00ebsit duhet t\u2018i m\u00ebnjanojn\u00eb fushat e forta magnetike do t\u00eb thot\u00eb: t\u00eb mos q\u00ebndrojn\u00eb af\u00ebr antenave q\u00eb d\u00ebrgojn\u00eb val\u00ebt e radiove apo televizioneve, af\u00ebr mjeteve salduese, pllakat me induksion.<\/p>\n

Gjat\u00eb kontrolleve mjek\u00ebsore, mjeku p\u00ebrkat\u00ebs duhet informuar se ju keni nj\u00eb pacemaker t\u00eb implantuar.<\/p>\n

Rezonanca magnetike, terapia e rrezatimit, lithotripsia (thyerja e gur\u00ebve n\u00eb veshk\u00eb apo idh\u00ebz), terapia e elektrostimulimit transkutan t\u00eb nervave, duhen b\u00ebr\u00eb vet\u00ebm pas konsult\u00ebs me mjekun p\u00ebrgjegj\u00ebs (kardiologu apo kardiokirurgu q\u00eb ka implantuar pacemakerin).<\/p>\n

N\u00eb aeroporte para hyrjes n\u00ebp\u00ebr pikat e kontrolleve, duhet treguar let\u00ebrnjoftimi i Pacemakerit.<\/span><\/p>\n

\"\"<\/a><\/p>\n

Shenja e Pacemakerit<\/strong><\/p>\n

N\u00eb rast t\u00eb ndonj\u00eb infeksioni q\u00eb ka prekur Pacemakerinin dhe elektrodat, duhet larguar i gjith\u00eb sistemi dhe duhet vendosur n\u00eb an\u00ebn e kund\u00ebrt. Nxjerrja e elektrodave (sondave, telave) n\u00eb rast t\u00eb ndonj\u00eb defekti apo infeksioni, preferohet t\u00eb kryhet patjet\u00ebr n\u00eb nj\u00eb qend\u00ebr ku mbulohet nga ekipi i kardiokirurgjis\u00eb.<\/p>\n

Ne, tani n\u00eb Millennium Hospital, ofrojm\u00eb t\u00eb gjitha k\u00ebto sh\u00ebrbime 24 or\u00eb n\u00eb dit\u00eb.<\/p>\n

 <\/p>\n

Dr. <\/span>Fatos Kojqiqi <\/span><\/span><\/strong>
\nKardiokirurg <\/span><\/span>
\n+383 (0) 49 740-734 <\/span><\/span>
\n<\/strong>fatos@kojqiqi.com <\/span><\/span><\/a>
\nwww.kojqiqi.com<\/span><\/span><\/strong><\/p>\n

 <\/p>\n<\/div>\n<\/div><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":12208,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_oct_exclude_from_cache":false,"_glsr_average":0,"_glsr_ranking":0,"_glsr_reviews":0,"footnotes":""},"class_list":["post-15033","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/kojqiqi.com\/wp-json\/wp\/v2\/pages\/15033","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kojqiqi.com\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/kojqiqi.com\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/kojqiqi.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kojqiqi.com\/wp-json\/wp\/v2\/comments?post=15033"}],"version-history":[{"count":7,"href":"https:\/\/kojqiqi.com\/wp-json\/wp\/v2\/pages\/15033\/revisions"}],"predecessor-version":[{"id":15128,"href":"https:\/\/kojqiqi.com\/wp-json\/wp\/v2\/pages\/15033\/revisions\/15128"}],"up":[{"embeddable":true,"href":"https:\/\/kojqiqi.com\/wp-json\/wp\/v2\/pages\/12208"}],"wp:attachment":[{"href":"https:\/\/kojqiqi.com\/wp-json\/wp\/v2\/media?parent=15033"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}