Kulezi zindlela ezimbili ezijwayelekile ezisebenzisela ukwelashwa kwe-atrial fibrillation , indlela ehlose ukubuyisela nokugcina isigqi senhliziyo evamile (indlela yokulawula isigqi) ebusweni bayo ibonakala iyadingeka kakhulu. Kodwa-ke, ngoba le ndlela ingathwala ingozi enkulu futhi kaningi ayisebenzisi ngokuphelele. Akulungile wonke umuntu.
Indlela yokulawula isigqi ihlanganisa izinyathelo ezimbili ezijwayelekile: ukubuyisela nokugcina isigqi senhliziyo evamile.
Ukuphefumula: Ukubuyiselwa kweRhythm Heart Rhythm
Uma unesibindi se-atrial, udokotela wakho angazama ukubuyisela isigqi senhliziyo yakho evamile ngokusebenzisa izidakamizwa eziphikisanayo noma ukuphefumula kagesi.
Izidakamizwa eziningana zokulwa nomzimba zinganikezwa nge-intravenously ukuzama ukuyeka ukucubungula kwe-atrial nokubuyisela isigqi esivamile. Lezi zihlanganisa iTambocor (flecainide), Corvert (ibutilide), iRhythmol (propafenone), ne-Tikosyn (i-dotiflide). Noma kunjalo, lezi zidakamizwa zizobuyisela ngempumelelo isigqi esivamile kuphela amaphesenti angu-50 kuya ku-60 amaphesenti wesikhathi, futhi kungaba nemiphumela emibi.
Iningi lezinzwa ze-cardiologists likhetha ukuvutha komzimba kagesi esikhundleni salokho. Ngomsindo we-cardioversion kagesi, uzobekwa ekulaleni okukhanyayo, okwenzelwe i-anesthesia imizuzu embalwa. Udokotela uzokhipha uketshezi kagesi esifubeni sakho usebenzisa isethi yamadada. Le nqubo ayibuhlungu, iyashesha, iphephile futhi isebenza njalo.
I-complication enkulu ye-cardioversion ayikho enkambweni ngokwayo, kodwa kunomphumela wokuphefumula kwe-cardioversion.
Uma ama-clots ahlanzekile egazi ekhona e-atria lapho inhliziyo iqala ukushaya ngokujwayelekile futhi, ama-clots angawayeka futhi abange isifo . (Lokhu kungenzeka nganoma isiphi isikhathi nge-fibrillation ye-atrial kodwa cishe kungenzeka ukuthi kwenzeke ngemuva kokuba isigqi senhliziyo esiphenduliwe siphinde sabuyiselwe.) Lo mcimbi awuvamile ngemva kokuvutha kwe-cardioversion, kodwa uma kwenzeka kungenzeka kube yinkimbinkimbi.
Ingozi yokushaywa yi-post-cardioversion ingancishiswa kakhulu ngokuphatha nge-antiticoagulant (i-blood thinner) amasonto ambalwa ngaphambi kokwenza i-cardioversion noma ngokubhala ukuthi ayikho ama-cloth engxenyeni yesokunxele ngokwenza i- echocardiogram ye-transesophageal ngaphambi kwe-cardioversion. Ngaphezu kwalokho, uma kuqinisekiswe ukuthi ukutholakala kwe-atrial fibrillation kube khona emahoreni angaphansi kwama-24, i-cardioversion ingenziwa ngokuphepha okuhlobene.
Lesi sinyathelo sokuqala sokulawula isigqi-ukubuyisela isigqi senhliziyo evamile-siphumelele ngaphezu kuka-98% wesikhathi.
Ukugcina isigqi esivamile
Iqhinga langempela ekulawuleni isigqi ligcina isigqi senhliziyo evamile uma siphinde sibuyiselwe. Ngokuvamile, nge-episode yokuqala ye-fibrillation ye-atrial, odokotela abaningi bazovele bavuselele isigqi esivamile futhi bathumele ekhaya lesiguli bengenalo ikhambi elithile lomzimba wesiguli (ngaphandle kokwelashwa, noma kunjalo, kunoma yikuphi ukusola okubangelwa yi-fibrillation ye-atrial). Abantu abaningi bazogcina isigqi esijwayelekile ezinyangeni noma ngisho neminyaka ngaphandle kokwelashwa kwezidakamizwa.
Kodwa-ke, ngokuhamba kwesikhathi i-fibrillation ye-atrial ingase ibuye. Uma lokho kwenzeka isigaba "sokugcinwa" kwendlela yokulawula isigqi kuba nzima nakakhulu.
Okuvamile, uma isigqi esivamile sibuyiselwa udokotela uzokuncoma enye yezidakamizwa ezithintekayo ukusiza ukuvimbela ukuphindaphinda kwe-fibrillation ye-atrial. Ngeshwa, izidakamizwa ezithathelwanayo, ngaphandle kokuba phakathi kwezidakamizwa ezinobuthi kakhulu ezisetshenziselwa ukwelashwa, zisebenza ngokulinganisela kuphela ekugcineni ukubhebhetheka kwe-atrial ukubuyela emuva. Ngenxa yalokho, ukufeza umgomo wokulawula isigqi ngokuvamile kudinga "izilingo" eziningana nalezi zidakamizwa, zibheke eyodwa zombili ezigcina isigqi esivamile futhi zibekezeleleke ngokwanele.
Ngisho nangendlela yokwenza ubuvivinyo-yephutha, i-antiarrhythmic drug ephumelela ekulawuleni okuhle kwe-fibrillation ye-atrial ngaphandle kokubangela imiphumela engavumelekile yomsindo izotholakala cishe isigamu sesikhathi.
Lolu hlobo lwezinga lokuphumelela ngezidakamizwa ezithathelwanayo ngokusobala lishiya okufisa kakhulu. Ngenxa yalesi sizathu, odokotela nabacwaningi baye bakhula kanzima emsebenzini iminyaka engaphezu kweyishumi ukuze bathuthukise izindlela eziphephile zokusebenza "zokuphulukisa" ukuphefumula kwe-atrial-okuwukuthi, ukugcina isigqi senhliziyo evamile-besebenzisa izinqubo zokubheja ezisekelwe ekhaleni . Nakuba kwenziwa inqubekela phambili eningi, ukwelashwa kwe-ablation ye-fibrification ye-atrial kusasebenza kuphela kodwa kusenomthelela omkhulu wezinkinga ezinkulu. I-Ablation iyindlela enhle yezinye iziguli ezine-fibrillation ye-atrial, kodwa akuyona yonke into.
Okokugcina, ezigulini eziphumelelayo ukulawula isigqi ngomuthi noma ukuphumula, ubufakazi kuze kube manje bubonisa ukuthi ingozi yabo yokushaya isifo ihlala iphakanyisiwe. Ngakho-ke, ochwepheshe abaningi batusa lezi ziguli ukuthi zihlale zikhona emithwalweni engapheliyo ye-antiticoagulation naphezu kokuba isigqi esivamile.
Isifingqo
Uma indlela yokulawula isigqi yokwelapha i-fibrillation ye-atrial yayiphephile futhi iphephile, ingasetshenziswa cishe kuwo wonke umuntu onalesi sigamu. Ngeshwa, ngenkathi ukulawula isigqi kuyindlela engcono kakhulu kubantu abaningi, kushiya okuningi okudingekayo. Yingakho enye indlela yokulawula ukukala- isetshenziselwa esikhundleni seziguli eziningi kangaka. Futhi yingakho udinga ukufunda okuningi ngangokunokwenzeka ngakho konke okunye ngaphambi kokuba unqume ukwelashwa okufaneleko kwe-friday fibrillation kuwe.
Imithombo:
I-Fuster, V, Ryden, LE, i-Cannom, i-DS, ne-al. I-ACC / AHA / ESC 2006 Imihlahlandlela yokuphathwa kweziguli ezine-fridaying ye-Atrial Umbiko we-American College of Cardiology / American Heart Association Task Force on Guidelines Practice kanye ne-European Society of Cardiology Committee for Guiding Practice (Ikomiti Yokubhala Ukubuyekeza Iziqondiso Zika-2001 for the Management of Patients With Fibrillation Atrial). J Am Coll Cardiol 2006; 48: e149.