Isifo se- sinus esigulayo senzeke lapho i- node ye-sinus iba nesifo ngokwanele ukudala i- bradycardia (izinga lentliziyo elincane) eliveza izimpawu. Abantu abanesifo se-sinus syndrome badinga ukwelashwa nge- pacemaker yokugcina ukukhulula izimpawu zabo.
Ngaphandle kwe-bradycardia ephawulekayo, i-sinus syndrome egulayo iphinde ihambisane neziqephu ze -fibrillation ye-atrial , okungadinga ukwelashwa okwengeziwe.
Isifo se-sinus syndrome yisiyaluyalu kubantu asebekhulile, futhi sivame ukubonakala kubantu abangaphezu kweminyaka engu-70 ubudala.
Yini Ebangelwa Isifo SaseSyus Syndrome?
Isizathu esivame kakhulu sesifo se-sinus syndrome i-fibrosis ehlobene neminyaka ethinta i-node yesusus (isakhiwo esincane esisezingeni elifanele elidala ukucindezela kagesi kagesi). "I-Fibrosis" isho ukuthi izicubu ezivamile zithatha indawo yesikhumba sesisindo. Uma i-fibrosis ithinta i-node yesusus, i-bradycardia ingabangela. Futhi uma i-bradycardia ibangelwa inkinga nge-node yesusus, ibizwa ngokuthi "i-sinus bradycardia."
Ngokufanayo, i-fibrosis ehlobene neminyaka ethinta i-node ye-sinus nayo ingathinta ubuhlungu be-atrial ngokwayo. Lokhu kuphefumula kwe-atrial fibrosis kuholela ekufubeni kwe-atrial okuvame ukuhamba nesifo se-sinus syndrome.
Ngaphezu kwalokho, le fibrosis nayo ingathinta i- AV node . Uma kunjalo, i-sinus bradycardia ingase ihambisane neziqephu ze- block block .
Ngakho-ke ngesifo se-sinus syndrome kungase kube khona ngempela izimbangela ezimbili ze-bradycardia - sinus bradycardia, ne-block heart.
Kwezinye izimo ezinye izimo zezokwelapha zingathinta i-node yesusus, ikhiqize i-sinus bradycardia. Lezi zimo zihlanganisa:
- amyloidosis
- sarcoidosis
- Isifo se-Chagas
- hypothyroidism
- ukuhlukunyezwa kwenhliziyo
Kodwa-ke, i-fibrosis ehlobene nokuguga yimbangela ejwayelekile kakhulu yesifo se-sinus syndrome.
Iziphi Izimpawu Ezihlobene NeSick Sinus Syndrome?
Izimpawu ezivelele zivame ukuthi lezo zibangelwa izinga lentliziyo elincane, futhi zifaka:
- kulula ukukhathala
- ikhanda elikhanyayo
- i-syncope
- i-dyspnea
- ukudideka
Kwezinye abantu abanesifo se-sinus syndrome, lezi zimpawu zizovele zenzeke uma zizama ukuzikhandla, futhi zizozizwa kahle ngenkathi ziphumula. Kulezi zimo inkinga enkulu ukuhluleka ukwandisa izinga lenhliziyo ngendlela efanele ngesikhathi somsebenzi, isimo esibizwa ngokuthi " ukungasebenzi kwekronotropic ."
I-Sick Sinus Syndrome ne-Fridaying Atrial
Abantu abanesifo se-sinus node futhi abaneziqephu ze-fibrillation e-atrial bazovame ukubhekana nezimpawu ezibangelwa yisus bradycardia, futhi ngaphezu kwalokho bangase babe nezimpawu ze-tachycardia (ukushaya kwenhliziyo okusheshayo), ikakhulukazi izilonda . Abantu abaneziqephu zombili zezinga lentliziyo ezisheshayo futhi eziphuthumayo kuthiwa bane-bradycardia-tachycardia syndrome, noma "i- brady-tachy syndrome ."
Isifo esibucayi kunazo zonke ezihlotshaniswa ne-brady-tachy syndrome yi-syncope. Ukulahlekelwa kokuqonda ngokuvamile kubonakala ngokushesha ngemva kokuba isiqephu se-fibrillation ye-atrial siphelile ngokuzumayo, okuholela ekumisekeni okwesikhashana ngenhliziyo.
Lokhu kuphumula okwesikhashana kwenzeka ngoba, uma i-node yesusus isivele "igula," isiqephu se-fibrillation ye-atrial sivame ukucindezela umsebenzi wayo.
Ngakho-ke, lapho i-fibrillation ye-atrial isuka ngokuzumayo, i-node ye-sinus ingadinga amasekhondi amaningana ukuba "avuke" futhi aqale ukudala imishanguzo kagesi futhi. Phakathi nalesi sikhathi, kungase kungabi khona inhlitiyo yenhliziyo yonke imizuzwana engu-10 noma ngaphezulu - eholele ekuhloleni okungapheli, noma i-syncope.
Ugula kanjani isifo se-sinus syndrome?
Ukubona i-sinus syndrome egulayo ngokuvamile akulula. Ukuxilongwa okunembile kuvame ukubonakala kahle lapho umuntu okhononda ngezibonakaliso ezivamile ezitholakala ukuthi une-sinus bradycardia ebalulekile kwi- electrocardiogram yabo (ECG) . Izinhlobonhlobo ze "sinous syndrome" ezigulayo ziyatholakala uma isiguli esinesifo se-sinus sitholakala futhi sibe neziqephu ze-fibrillation ye-atrial.
Ngenxa yokuthi i-fibrosis ebangela isifo se-sinus ngezinye izikhathi kuthinta i-node ye-AV, abantu abane-brady-tachy syndrome bangase babe ne-heart block block, ngakho-ke, isilinganiso senhliziyo esincane kakhulu uma se-fibrillation ye-atrial. Ngakho-ke, noma nini lapho umuntu enesifo sofuba esitholakala e-atrial esitholakalayo enesisindo senhliziyo esincane (lapho kungekho khona imithi ehlose ukunciphisa izinga lenhliziyo), lokho kufanele kunikeze udokotela ulwazi oluqinile ukuthi isifo se-sinus syndrome sikhona.
Odokotela bangenza ukuxilongwa kokungaqondakali kwe-chronotropic nje ngokubheka isilinganiso senhliziyo yesiguli ngesikhathi sokuvivinya umzimba - isibonelo, ngesikhathi sokuhlolwa kokucindezeleka . Ngenxa yokuthi ukungasebenzi kwe-chronotropic kuyinto ejwayelekile kubantu asebekhulile futhi kulula ukuphathwa (nge-pacemaker ene-rate-responsive), kubalulekile kubantu asebekhulile ababhekana nokukhathala ngokuzikhandla okuncane noma okulinganisela ukuqinisekisa ukuthi odokotela babo benza ukuhlolwa okufanele.
Isifo SaseSinus Siguliwe Kanjani?
Cishe bonke abantu abanesifo se-sinus syndrome kufanele baphathwe nge-pacemaker ehlala njalo.
I-pacemaker ibaluleke kakhulu kubantu abane-brady-tachy uhlobo lwesifo se-sinus syndrome, ngenxa yezizathu ezimbili. Okokuqala, laba bantu banengozi enkulu yokubhekana ne-syncope (kusuka kulawo maphakathi okwesikhathi eside uma i-fibrillation ye-atrial igxuma). Futhi okwesibili, izidakamizwa eziningi ezivame ukusetshenziselwa ukwelapha i-fiber fibrillation - i- beta blockers , i- block blockers ye- calcium , nezidakamizwa ezingavamile - zingenza isifo se-node se-sinus sibi nakakhulu. Ukufakela i-pacemaker kuzovimbela i-syncope, futhi kuzovumela udokotela ukuthi aphathe ukubhebhetheka kwe-atrial ngokuphepha ngokuphepha.
Izwi elivela
E-sinus syndrome egulayo, izifo ze-sinus node zidala i-bradycardia eyanele ukuholela ezimpawu - ikakhulukazi, ukuphoqa kalula noma ukukhanya okulula. Lesi simo singase sihambisane ne-fibrillation ye-atrial, ehambisana nesifo se-sinus, eyenza iziqephu ze-syncope kungenzeka. Isifo se-sinus esigulayo siphathwa nge-pacemaker ehlala njalo.
> Imithombo
> Epstein AE, DiMarco JP, Ellenbogen KA, et al. I-ACC / AHA / HRS 2008 Izinkombandlela zokwelashwa okusekelwe ngeDivaysi ye-Cardiac Rhythm Okungajwayelekile: Umbiko we-American College of Cardiology / American Heart Association Task Force on Guidelines Practice (Ikomidi Lokubhala Ukubuyekeza I-ACC / AHA / NASPE 2002 Isiqondiso Sokuqondisa Ukufakwa Kwentuthuko of Pacemakers Cardiac and Antiarrhythmia Devices): athuthukiswe ngokubambisana ne-American Association for Thoracic Surgery kanye neNhlangano Yezintatheli Zezintambo. Ukujikeleza ngo-2008; 117: e350.
> Fogoros RN, Mandrola JM. Ucwaningo lwe-Electrophysiology ekuhlolweni kweBradycardia: I-SA Node, i-AV Node, ne-His-Purkinje System. Ku: Ukuhlolwa kwe-Electrophysiologic kaFogoros, Ukushicilelwa Kwesithupha. UWiley Blackwell, ngo-2017.
> Josephson, ME. Umsebenzi weNode weNode. Ku: Clinical Cardiac Electrophysiology: Izindlela Nokuchazwa, 4, uLippincott, Williams, & Wilkins, Philadelphia 2008. p. 69-92.