Uhlolo Olubanzi Lwe-Fibrillation Yase-Atrial
I-fibrillation ye-atrial ingenye ye- arrhythmias ye- cardiac , futhi kungaba enye yezinto eziphazamisayo kakhulu ukubhekana nazo. Ngenkathi i-fibrillation ye-atrial akuyona eyingozi yokuphila, ngokuvamile ibangela izimpawu ezibalulekile. Okubi nakakhulu, kungabangela izinkinga ezinkulu, ikakhulukazi isifo sohlangothi , futhi (kubantu abanesifo senhliziyo), ukuwohloka kwenhliziyo . Ngaphezu kwalokho, kuyilapho izinketho eziningana zokwelapha zitholakala ekufubeni kwe-atrial, ngokuvamile kuvame ukucaca-ngisho nangokwengqondo abachwephezi-okuyinto yokwelapha okunye kungcono ngaphansi kweziphi izimo.
Uma une-fibrillation ye-atrial, kufanele uzame ukufunda konke ongakwenza mayelana nalokhu ku-arrhythmia-izimpawu zayo, izimbangela zayo, nezinyathelo ezitholakalayo-ukuze usebenze nodokotela wakho ukunquma ukuthi iyiphi indlela yokwelapha efanelekile kuwe.
> Bheka indlela inhliziyo enesisindo se-fib efaniswa nenhliziyo evamile.
Iyini Inhlanhla Ebandleni, Futhi Kungani Kubaluleke Kakhulu?
I-fibrillation ye-atrial iyisimo senhliziyo esingavamile futhi esivamile esiphuthumayo, esibangelwa imishanguzo kagesi ephuthumayo futhi ehlelekile ngaphakathi kwe-atria yenhliziyo ( amakamelo amabili aphezulu enhliziyo ).
Loluhlobo lwemisebenzi kagesi ephuthumayo, ekhukhumezayo enhliziyweni kuthiwa "i-fibrillation."
Lapho i-atria iqalisa ukucubungula, izinto ezintathu zingenzeka:
Okokuqala , isilinganiso senhliziyo sibheke ngokushesha futhi singavamile. I- node ye-AV ibhekwa ngezimiso eziningi ezingavamile zombane ezivela ku-atria, futhi izimpendulo eziningi ezingamatshumi amabili ngomzuzu zithunyelwa ezingxenyeni ze-ventricles, okuholela ekushayweni kwenhliziyo okusheshayo futhi engavamile. Ukushaya kwenhliziyo okusheshayo, okungavamile kuvame ukuveza izimpawu eziphazamisayo.
Okwesibili , lapho ama-atria eseqhwaqhaqhazela, awasekho ngokuvumelana ngokuphumelelayo. Ngakho ukusebenzisana okuvamile phakathi kwe-atria ne-ventricles kulahlekile.
Ngenxa yalokho, inhliziyo isebenza kancane kancane futhi ingaqala ukuhluleka.
Futhi okwesithathu , ngoba i-atria ayisekho ukusebenzisana ngokuphumelelayo, ngemva kwesikhathi (ngokuvamile ngemva kwamahora angaba ngu-24 noma ngaphezulu) ama-clots egazi angase aqale ukwakha ku-atria. Lezi zindwangu zegazi zingagcina ziqede futhi zihambe ezingxenyeni ezihlukahlukene zomzimba, ezifana nobuchopho.
Ngakho-ke, kuyilapho i-fibrillation ye-atrial ngokwayo ivame ukuveza izimpawu ezibalulekile, ukubaluleka kwayo kwangempela ukuthi kukubeka engozini yezokwelapha ezingakhubaza noma zibulale unomphela.
Yini Ebangela Ukufiphala Kwemvelo?
I-fibrillation ye-atrial ingakhiwa yizimo eziningana zenhliziyo, kuhlanganise ne- coronary artery disease (CAD) , ukuphindaphinda kwe-mitral , i- hypertension engapheli, i- pericarditis , ukuhluleka kwenhliziyo, noma cishe noma yiluphi olunye uhlobo lwenkinga yenhliziyo. Le-arrhythmia nayo iyafana ne- hyperthyroidism , i- pneumonia , noma i- pulmonary embolus .
Ukungena kwamamphetamine noma ezinye izikhuthazo (ezifana nezindlela ezibandayo eziqukethe i- pseudoephedrine ) zingabangela ukufucula kwama-atriyali kwabanye abantu, futhi ngemva kokuphuza okumbalwa njengokuphuza okulodwa noma ezimbili-isimo esibizwa ngokuthi "inhliziyo yeholide." Ngenkathi odokotela bathi ngokuvamile i-caffeine nayo ibangela ukuxilongwa kwe-atrial fibrillation, ubufakazi bamuva obuvela ezifundweni zemitholampilo bubonisa ukuthi, kubantu abaningi, akunjalo.
Kuvela ukuthi ingxenye enkulu kakhulu yabantu abane-fridaying fibrillation ayinaso isizathu esithile esikhombisayo sayo. Kuthiwa babe "idiopathic" fibrillation ye-atrial. Idiopathic fibrillation ye-atrial ngokuvamile yinkinga ehlobene nokuguga. Isibonelo, ngenkathi i-fibrillation ye-atrial ingavamile kwiziguli ezingaphansi kweminyaka engu-50, kuvamile kakhulu kubantu abaneminyaka engu-80 noma engu-90 ubudala.
Ucwaningo olusha luye lwabonisa ukuthi ezimweni eziningi, ukufucula kwama-atrial kuhlobene nokuphila . Isibonelo, abantu abakhuluphele ngokweqile futhi basondelene nabo banengozini enkulu kakhulu ye-fibrillation ye-atrial. Ngaphezu kwalokho, kubantu abano-fibriation e-atrial ehlobene nokukhetha kokuphila, uhlelo olujulile lokuguqula indlela yokuphila luye lwaboniswa ukusiza ukuqeda ukuhlelwa kwemithi.
Izimpawu Nge-Fibrillation Yase-Atrial
Iningi labantu abane-fibrillation ye-atrial libona izimpawu ezibalulekile. I-arrhythmia ivame ukubonakala kakhulu futhi iphazamise ngempela. Izimpawu ezivame ukwedlula zonke ziyizintambo, okuvame ukubonakala sengathi zizwa ukushaya kwenhliziyo okusheshayo, okungenasici, noma mhlawumbe njengokuthi "ukweqa".
Abantu abane-fibrillation ye-atrial nabo babhekana nokuphelelwa kalula, ukuphefumula, futhi (ngezikhathi ezithile) ikhanda elikhanyayo. Lezi zimpawu, ezihlobene ngokuqondile ne-fibrillation ye-atrial ngokwayo, zingase ziphazamise ngokukhethekile abantu abane- diastolic ukungasebenzi , noma i- hypertrophic cardiomyopathy .
Noma kunjalo, kuyacaca ukuthi ukuphefumula kwe-atrial kungenzeka ngaphandle kokuveza noma yiziphi izimpawu. Nakuba kungenayo impawu ngokuvamile, into enhle, ukuba "ukuthula" ekufubeni kwe-atrial kungaba yingozi-ngoba ngokuvamile kuvame izinkinga zezokwelapha noma ngabe i-arrhythmia ngokwayo ibangela izimpawu ezibalulekile.
Isibonelo, ukucubungula nge-atrial kungabangela ukuba angina kaningi noma ngaphezulu kunabantu abano-CAD. I-fibrillation ye-atrial ingabangela nokuwohloka okukhulu komsebenzi wenhliziyo kubantu abanesifo senhliziyo.
Eqinisweni, uma isilinganiso senhliziyo esisheshayo esibangelwa ukufiphaza kwe-atrial kuqhubeka isikhathi eside ngokwanele (okungenani izinyanga eziningana), imisipha yenhliziyo ingaqala ukwehlisa amandla, futhi ukuhluleka kwenhliziyo kungenzeka-ngisho nabantu abanezinhliziyo ezivamile.
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Funda Izingozi Zengozi Yokuthuthukisa A-Fib
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4 Izimpawu Ezibangelwa Ukulahlekelwa Kokuhlukana Kwe-Atrial Okuphumelelayo
Isizathu esibi kunazo zonke sokuthi i-fibrillation ye-atrial isifo se-atrial, kodwa kungenzeka ukuthi isifo sohlangothi. Ukungabonakali kwe-fibrillation e-atrial kuyandisa kakhulu ingozi yokushaywa yisifo. Kubonakala sengathi amaphesenti angu-15 azo zonke iziphazamiso abangwa yi-fibrillation ye-atrial. Ngaphezu kwalokho, abantu abaningi abaye bahlaselwa izibhamu ngenxa yeso sizathu esizwakalayo (okuthiwa yi- cryptogenic strokes ) bavele babe neziqephu zokuthi "zithule" ekufubeni kwe-atrial.
Izinhlobo zeFibrillation ye-Atrial
Odokotela bavame ukuhlukanisa izinhlobo ezinhlobonhlobo ze-atrial fibrillation, kanti empeleni izinhlelo eziningi zokudideka zokuhlukaniswa kwe-fibrillation ye-atrial zisetshenzisiwe. Kodwa ukukusiza ukuthi unqume ukuthi iyiphi indlela yokwelapha efanelekile, kuyasiza ukuqeda izinhlobo ze-fibrillation ye-atrial zibe izinhlobo ezimbili kuphela:
- Ukuqala okusha noma ukuphefumula kwama-atrial okuphakathi . Lapha, i-fibrillation ye-atrial ingabe inkinga entsha, noma inkinga eyenzeka kuphela ngokulandelanayo. I-fibrillation ye-atrial engapheli ivame ukubizwa ngokuthi "i-paroxysmal fibrillation ye-atrial." Abantu abakulesi sigaba banesilinganiso senhliziyo evamile isikhathi esiningi, futhi iziqephu zabo ze-fibrillation ye-atrial zivame ukuba zifushane futhi ngokuvamile zivame.
- Ukuphefumula okungapheli noma okuqhubekayo kwe-atrial . Lapha, i-fibrillation ye-inrial ingaboniswa ngaso sonke isikhathi, noma kwenzeka kaningi-njengokuthi izinkathi zesigamu senhliziyo evamile zihamba kancane noma ziphilile.
Ukuthola Ukufiphaza Kwemvelo
Ukuxilongwa kwe-fibrillation ye-atrial ngokuvamile kuvamile. Kumane kudinga ukurekhoda i- electrocardiogram (ECG) ngesikhathi sesiqephu se-fibrillation ye-atrial. Le mfuneko ayikho inkinga kubantu abanokuphefumula okungapheli noma okuphikisanayo okuphethwe yi-atrial fibriation, okungahle kutholakale ukuthi i-arrhythmia ibonwe noma nini lapho i-ECG ithathwa.
Kodwa-ke, kubantu abanobuchopho obususwe nge-atrial kwenzeka ngokulandelanayo, ukuqapha kwe-ECG yokugcina isikhathi eside kungadingeka ukuba kutholakale ukuxilongwa. Ukuqapha kwe-ECG yesikhathi eside kungasiza kakhulu kubantu abaye bahlaselwa yi-cryptogenic, ngoba ukwelapha i-fibrillation ye-atrial (uma ikhona) kungasiza ekuvimbeleni isifo esivamile.
Ukwelapha I-Fibrillation Ye-Atrial
Uma kwakulula kakhulu futhi ephephile kakhulu ukwenza kanjalo, kubonakala sengathi ukuphathwa kahle kwe-fridaying fibrillation kungaba ukubuyisela nokugcina isigqi senhliziyo evamile. Ngeshwa, ezimweni eziningi akuphephile ikakhulukazi noma kulula kakhulu.
Ezimweni eziningi, ikakhulukazi uma i-fibrillation ye-atrial ibe khona amasonto noma izinyanga, kunzima kakhulu ukugcina isigqi esivamile esingaphezu kwamahora ambalwa noma izinsuku. Leli qiniso elibi liye lafuna izindlela ezimbili zokwelashwa ezijwayelekile zokuphefumula kwe-atrial. Owokuqala kuyindlela "yokulawula isigqi", kanti eyesibili yiyona "indlela yokulawula isilinganiso".
Indlela "yokulawula isigqi" izama ukubuyisela nokugcina isigqi senhliziyo evamile. Ngesikhathi ukubuka kuqala lokhu ngokuqinisekile kuyobonakala kuwumphumela omuhle kunayo yonke, kunezinkinga eziningi kuwo. Indlela yokulawula isigqi ivame ukuba nzima, ingabonakali, ingasebenzi kahle futhi ngokuvamile ihlanganisa ingozi ephakeme kakhulu yemiphumela emibi. Kungenzeka ukuthi kusebenze kubantu abane-friction noma i-frictional atrial fibrillation yamuva nje, futhi cishe kuncane kakhulu ukuba abantu basebenze ngendlela abahlala ngayo noma abangapheliyo. Noma kunjalo, kubantu abaningi abane-fibrillation ye-atrial lena indlela yokuhamba.
Indlela yokulawula isigqi ngokuvamile idinga ukuthi ukusetshenziswa kwezidakamizwa ezithathelwanayo , ukwelashwa kwe-ablation , noma kokubili.
Indlela "yokulawula izinga" ekufubeni kwe-atriyria ilahla umzamo wokubuyisela nokugcina isifiso senhliziyo evamile. I-fibrillation ye-atrial iyamukelwa njengengoma entsha "evamile", futhi ukwelashwa kuhloswe ukulawula izinga lenhliziyo ukuze kuncishiswe noma yiziphi izimpawu ezibangelwa ukufabula kwe-atrial. Inzuzo yendlela yokulawula izinga ukuthi cishe njalo kungenzeka ukulawula ukuphumelela kwenhliziyo ngenhliziyo kubantu abane-fibrillation ye-atrial, futhi kanjalo ngokuvamile kuncishisa kakhulu izimpawu ezibangelwa yi-arrhythmia ngokwayo. Kanti futhi, ukwelashwa okusetshenziselwa ukulawula izinga kuyabonakala kuphephile futhi kuvunyelwe kahle. Ngaphezu kwalokho, izifundo zesikhathi eside ziye zabonisa ukuthi imiphumela yomtholampilo kanye nendlela yokulawula isilinganiso isenani elihle njengoba (futhi mhlawumbe lihle kakhulu kunendlela yokulawula isigqi).
Noma ngabe iyiphi indlela yokwelashwa ekhethiwe, isici esibalulekile esengeziwe sokwelapha i-frictional atrial is ukuthatha izinyathelo ezidingekayo ukuze unciphise ingozi yokushaywa yisifo. Lokhu ngokuvamile kudinga ukuthatha izidakamizwa ze-anticoagulant , kodwa kunezinye izindlela zokwelashwa kanye.
Uma Usanda Kubonwa Nge-Fibrillation Yase-Atrial
Kukhona izinto eziningana okudingeka uzigcine engqondweni njengoba wena nodokotela wakho sinquma ngendlela efanele. Lokhu kufaka:
- Kungani une-fibrillation ye-atrial? Ingabe kukhona noma wena noma udokotela wakho ongakwenza (njengokuphatha ukwelashwa komfutho wegazi, ukugwema utshwala, noma ukwenza izinguquko ezibalulekile zokuphila) ezingasiza ekuqedeni inkinga?
- Uma i-fibrillation yakho ye-atrial ingelapheki noma iphikelela, iziqephu zakho zenzeka kangaki, zihlala isikhathi esingakanani, futhi ziziphi izimpawu ezibangela?
- Ingabe unesifo esiwumgogodla we-cardiac esenza ukuthi i-fibrillation ye-atrial ingase iphinde iphinde iphinde ibuyele, noma yenza i-fibrillation ye-atrial ibe neminye amathuba yokukhiqiza ezinye izinkinga, njenge-angina noma ukuhluleka kwenhliziyo?
- Ziqine kangakanani izimpawu ezenziwa yi-fibrillation yakho ye-atrial?
- Ingabe unenkinga yokubekezelela ukuphathwa kwezidakamizwa?
- Uzizwa kanjani ngezinqubo ezihlaselayo ezihlose ukwelapha i-arrhythmia?
Ukukhetha ukuthi yiziphi izindlela ezimbili zokwelashwa ezijwayelekile- "ukulawula isigqi" noma "ukulawula isilinganiso" -ngokufanele kuwe kuzoxhomeka kuzo zonke lezi zici.
Ukunquma ukwelashwa okufanele kuyindaba ebaluleke kakhulu nge-fibrillation ye-atrial. Kungaba ukhetho oluyinkimbinkimbi, futhi yilo olufanele lufane nomuntu ngamunye. Uma uqonda ngokwengeziwe ngakho, nakakhulu uzokwazi ukusiza udokotela wakho enze izinqumo zokwelapha okulungile kuwe.
Izwi elivela
Khumbula ukuthi izigidi zabantu ziphila ngokuphila okujwayelekile naphezu kokuba ne-fibrillation ye-atrial. Lokho kufanele kube umgomo wakho, futhi. Lapho kufika isinqumo esifanele sokwelashwa kungaba inselele, kanti ngenkathi ukhipha ukwelashwa kungathatha isikhathi nokuzikhandla, uma ukwelashwa kwakho kuxazululwe kuwe kufanele ubuyele ekuphile impilo yakho evamile (mhlawumbe ngezinguquko ezithandekayo zokuphila). Lokhu kufanele kube ukulindela kwakho. Futhi njengoba uxoxa ngezinketho zakho zokwelashwa nodokotela wakho, qiniseka ukuthi unalindelekile okufanayo nawe.
Imithombo:
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Meier B, Blaauw Y, Khattab AA, et al. Isitatimende sobudlelwano be-EHRA / EAPCI esivumelwaneni esisekelwe e-catheter esekelwe ekungeneni kwezinto ezingekho emthethweni. I-Europace . 2014; 16: 1397.
Pathak RK, Middeldorp ME, Lau DH, et al. Ucwaningo lokunciphisa izinkinga ezikhungethe izinyathelo zokunciphisa i-atrial kanye nemiphumela yomphumela we-ablation: Ucwaningo lwe-ARREST-AF. J Am Coll Cardiol . 2014; 64: 2222-2231.
UWann LS, Curtis AB, uJanuwari CT, et al. Ukubuyekezwa okugxilwe ku-ACCF / AHA / HRS ekuqondiseni iziguli ezine-fibrillation ye-atrial (Ukubuyekeza Umhlahlandlela ka-2006): umbiko we-American College of Cardiology Foundation / i-American Heart Association Task Force on Guidelines Practice. J Am Coll Cardiol . 2011; 57: 223.