I-tachycardia ene-ventricular eyeka yodwa ngaphakathi kwamasekhondi angu-30 ibizwa ngokuthi i-tricycardia engeyona engapheli (NSVT). Njengoba okungenani i-tachycardia ye-ventricular ingaba yingozi ye- cardiac arrhythmia , isikhathi eside siqhubeka sibi kakhulu. Ngakho i-NSVT ayingozi kakhulu kune-tachycardia ye-ventricular ephikelela isikhathi eside. Noma kunjalo, kungabangela izimpawu ezibalulekile, futhi ngokuqinisekile kungabonisa ingozi yenhliziyo eyandayo.
Sibutsetelo
Incazelo ehlelekile ye-NSVT iyisiqephu se-tachycardia ye-ventricular enesisindo senhliziyo okungenani ukushaya okungu-120 ngomzuzu, okuhlala okungenani izintambo ezintathu nokuphikelela ngaphansi kwamasekhondi angu-30.
Ngokuvamile, i-NSVT ayibangeli noma yiziphi izimpawu, noma ingase ibangele amaphupho . Nokho, ngezikhathi ezithile, i-NSVT ingaveza ukukhanya okulula , isizungu , noma, ngokungajwayelekile, i- syncope (ukulahlekelwa kokuqonda).
Ngenxa yokuthi i-NSVT ayifuni izimpawu ezivusa amadlingozi, ngokuvamile itholakele ngengozi, kuyilapho iqopha i-electrocardiogram (ECG) noma ngenye indlela yokuqapha inhliziyo.
Kungani i-NSVT ibalulekile?
Kunezizathu ezintathu ze-NSVT ebalulekile. Okokuqala, i-NSVT ngokwayo ingabonisa izimpawu ezinzima. Okwesibili, kungabonisa ukuba khona kwesifo senhliziyo esingaziwa ngaphambili. Okokugcina, ukuba khona kwe-NSVT kungase kubonise ukuthi ukungazinzi kagesi kungasongela nakakhulu, mhlawumbe kuholele emigqumeni eyingozi nakakhulu njenge- fibrication ye-ventricular .
Ukuxilongwa
Uma kuthiwa unesifo se-NSVT, kubaluleke kakhulu ukuthi udokotela wakho enze ukuhlolwa kwenhliziyo ukuze afune isifo senhliziyo esingaphansi.
Izinhlobo zesifo senhliziyo esivame ukuhlotshaniswa ne-NSVT ziyi- coronary artery disease (CAD) nokuhluleka kwenhliziyo ngenxa ye-cardiomyopathy eguqulekile. I-NSVT ibonakala futhi nge- hypertrophic cardiomyopathy nesifo se-valve senhliziyo (ikakhulukazi i-aortic stenosis ne- mitral regurgitation ).
Iningi lalezi zimo zingenziwa ngaphandle kwe-echocardiogram, kodwa ukuhlolwa kokucindezeleka kwe-thallium kungase kube usizo uma unengozi yemiphumela ye-CAD.
Ngezinye izikhathi, i-NSVT ibangelwa izimo zenhliziyo ezingahlotshaniswa nesifo senhliziyo (okungukuthi, isifo senhliziyo esingashintshi isimo senhliziyo). Okuvamile kulezi zimo kuphindaphinda i-monomorphic ventricular tachycardia (RMVT) . I-RMVT yinkinga engavamile yokuzalwa engenawo ohlelweni lwegesi lwenhliziyo, elingenalo izinguquko zesakhiwo ezitholakala nge-echocardiogram. Izinkinga ezinjengalezi ezikhiqiza i-NSVT zivame ukutholakala lapho udokotela ebona izici ezithile ze-arrhythmia ku-ECG.
Ukwelapha
Ezimweni eziningi, i-NSVT ibaluleke ngokuyinhloko njengesibonakaliso esingase sibe khona. Uma isifo senhliziyo sitholakala kamuva, ukwelashwa kufanele kuqondiswe kulokho. Uma kungekho isifo senhliziyo esitholakalayo, ngokuvamile, i-NSVT ayikwenyusi ngokulingana ingozi yokuboshwa komzimba, futhi ngokombono oqinile wezokwelapha, ngokuvamile kuvame ukuthi akukho ukwelashwa okudingekayo.
Ngokuvamile, isifo senhliziyo esisodwa ngokwayo sibeka ingozi enkulu ekufeni okuphazima kweso kusuka e-arrhythmias yenhliziyo.
Lokhu kuyiqiniso ikakhulukazi kwe-CAD nokuhluleka kwenhliziyo. Kulezi zimo, ingozi yokuboshwa komzimba ihlotshaniswa kakhulu nengxenyana ye-ventricular ejection engakwesokunxele kunokuba khona noma ukungabikho kwe-NSVT. Ukuze kuncishiswe leyo ngozi, uma ingxenyana ye-ejection iyancishiswa kakhulu, i- defibrillator engasungulwa kufanele icatshangwe ngokujulile.
Kubantu abanesifo se-hypertrophic cardiomyopathy, ukuba khona kwe-NSVT kubonisa ingozi ephakeme kakhulu yokufa okungazelelwe. Ngakho kulaba bantu abanesifo se-NSVT bangenza i-cardiologist ixhomeke ekuqondeni kwe-defibrillator engasetshenziswa, ikakhulukazi uma kukhona umlando wokufa okungazelelwe kusuka enhlobonhlobo ye-cardiomyopathy emndenini.
Ukuba ne-NSVT ayishintshi ukubikezelwa kwesifo senhliziyo se-valvular, kufaka phakathi i- mitral valve prolapse , futhi kulezi zimo akufanele kube yisici ekwenzeni izinqumo zokwelashwa.
Intsha enenqwaba ye-NSVT futhi ayikho isifo senhliziyo isetshenziswe ku-electrophysiologist yenhliziyo (isazi sezinhliziyo zenhliziyo) ukuze ihlolwe i-RMVT nezinye izimo zokubeletha ezingakhipha lokhu ku-arrhythmia. Lezi zinhlobo ze-arrhythmias zivame ukwelashwa nge- ablation therapy .
Imithi
Uma kwakulula futhi / noma ephephile ukuqeda i-NSVT ngemithi yokwelapha, lokhu ngeke kube umbuzo onzima. Ngeshwa, izidakamizwa ezithathelwanayo ezingasetshenziswa ukuphatha i-NSVT kaningi aziphumelelanga futhi zivame ukukhiqiza imiphumela emibi kakhulu embi kakhulu.
Uma ngabe ukwelashwa kwezidakamizwa kusetshenziswa, odokotela abaningi bazoqala ngokusebenzisa amabhethra blockers , bese kuthiwa abavimba be-calcium , ngoba lezi zidakamizwa zinganciphisa ngezikhathi ezithile izimpawu, futhi ziphephile. Kodwa-ke, uma izidakamizwa zangempela zokulwa nezidakamizwa zicatshangelwa, ukusetshenziswa kwazo kufanele kuhlale kuqondiswa yi-electrophysiologist yomzimba.
Okubalulekile ukuthi ukubaluleka kwe-NSVT kaningi akukhona nge-NSVT ngokwayo. Esikhundleni salokho, ngokuvamile kuvame ukuthi i-NSVT ingaba yinkinga yenkinga yenhliziyo engaphansi okudingeka ihlolwe futhi iphathwe.
> Imithombo:
> Marine JE, Shetty V, Chow GV, et al. > Ukubaluleka nokubaluleka kokubikezelwa kwe-Tachycardia engenawo amandla e-Ventricular engaxilongwa ngokuzivocavoca emaVolontiya angenasifo >: BLSA (i-Baltimore Longitudinal Study of Aging). J Am Coll Cardiol 2013; 62: 595.
> Zipes, DP, Camm, AJ, Borggrefe, M, et al. > I-ACC / AHA / ESC 2006 Imihlahlandlela yokuPhatha kweziguli ezine-Arrhythmias ezinamandla kanye nokuvimbela ukufa kwegazi okuphazamiseka ngokuzenzekelayo Umbiko we-American College of Cardiology / American Heart Association Task Force kanye ne-European Society of Cardiology Committee for Practice Guidelines ( Ikomidi lokubhala ukuthuthukisa iziqondiso zokuphathwa kweziguli ezine-arrhythmias ezinamandla kanye nokuvinjelwa kokufa kwegazi lomphefumulo . J Am Coll Cardiol 2006; 48: 1064.