I-Wolff-Parkinson-White syndrome (i-WPW) isimo sesifo senhliziyo esithinta inhliziyo esithinta isistimu kagesi kagesi. Abantu abazalwa nge-WPW bavame ukushintsha izinguquko kwi- electrocardiogram yabo (ECG) , futhi bavame ukuhlakulela i -tachycardia engaphezulu (i-SVT) , uhlobo lwe-symptomatic, i-cardiac arrhythmia . Ukwengeza, ngezinye izikhathi abantu abane-WPW bangaba nezinye izinhlobo eziyingozi kakhulu zokuhlelwa kwe-cardiac arrhythmias.
Kuyini i-WPW?
Abantu abane-WPW bazalwa ngokuxhumeka okungavamile kagesi okujoyina enye ye-atria (amakamelo aphezulu enhliziyo) ngeyodwa yama-ventricles (amakamelo aphansi enhliziyo). Lezi zixhumanisi ezingavamile kagesi zibizwa ngokuthi izindlela zokufinyelela. Izindlela zokufinyelela zidala izimo zenhliziyo lapho izilinganiso ezingavamile zenhliziyo zingenzeka khona.
Kungani Izindlela Zokufinyelela Zibalulekile
Izindlela zokufinyelela zibalulekile ngoba zinikeza isilungiselelo esidingekayo ukuthuthukisa uhlobo oluthile lwe-SVT - i-SVT eyaziwa ngokuthi i- trioyydiadia ye-atrioventricular reciprocating (AVRT) . I-AVRT uhlobo lwe- tachycardia ephindayo .
Indlela yokufinyelela idala uxhumano "olwengeziwe" kagesi phakathi kwe-atrium ne-ventricle, futhi ngokwenza kanjalo kuphelelisa isiteshi esingaba namandla kagesi. Lesi sesifunda esingavamile sivumela i-AVRT ukuba ithuthukise.
Nge-AVRT "evamile", ngesikhathi i-SVT ukuhamba kwegesi ukuhamba ukusuka ku-atrium kuya kwe-ventricle besebenzisa indlela evamile (okungukuthi, i- AV node ), bese ubuyela ku-atrium (okungukuthi, "ukubuyisela" i-atrium) ngokusebenzisa indlela yokufinyelela.
Umfutho wegesi ungase ujikeleze isifunda njalo, udale ukuhlelwa kwemithi. Ukuhamba ngeso lengqondo kuhamba ngaphesheya kwendlela yokufinyelela kusuka ku-ventricle kuya e-atrium ngoba, nge-AVRT evamile, yilapho kuphela indlela ekwazi ukuqhuba ngayo ugesi.
Kungani i-WPW ihlukile ku-AVRT ejwayelekile?
Umehluko phakathi kwaleli AVRT ejwayelekile ne-AVRT ebonwe nge-WPW yilokho, ku-WPW, indlela yokufinyelela ekwazi ukuqhuba umfutho kagesi kuzo zombili izinkomba - kusuka ku-atrium kuya kwe-ventricle kanye nase-ventricle kuya kwe-atrium.
Ngenxa yalokho, ngesikhathi i-tachycardia engenawo kabusha eWPW, umfutho wegesi ngokuvamile uhamba phansi endleleni yokufinyelela emigodini ye-ventricles, bese ubuyela e-atria ngokusebenzisa i-AV node, bese ibuyela emuva emgwaqweni wokufinyelela kuma-ventricles futhi-iphinda iphindaphinda efanayo isifunda. Lokhu kuyindlela ehlukile yokuhamba kuneziguli ezine-AVRT ejwayelekile.
Kungani i-WPW ibalulekile
Ikhono le-accessory pathway ku-WPW ukuqhuba izimpendulo zikagesi kusukela ku-atria kuya kwi-ventricles kubalulekile ngezizathu ezintathu.
Okokuqala, ngesikhathi sesigqi sesisindo esivamile , umfutho wegesi osabalala kuwo wonke ama-atria ufinyelela ema-ventricles kokubili nge-node ye-AV nangendlela yokufinyelela. Lokhu kuvuselela "okubili" kwe-ventricles kwakha iphethini ehlukanisayo ku-ECG - ngokukhethekile, "ukukhipha" okuyinkimbinkimbi ye- QRS okubizwa ngokuthi "i-delta wave". Ngokuqaphela ukuba khona kwe-delta wave kwi-ECG, udokotela angenza ukuthi ahlolwe i-WPW.
Okwesibili, ngesikhathi i-AVRT ibonwe nge-WPW, umfutho wegesi uvuselela ama-ventricle kuphela ngokusebenzisa indlela yokufinyelela (kunokuba uhambe ngendlela evamile, indlela ye-AV nodal). Ngenxa yalokho, i-QRS eyinkimbinkimbi phakathi ne-tachycardia ithatha isimo esingavamile kakhulu, okusikisela kwe- tricycardia ye- ventricular (VT) esikhundleni se-SVT.
Ukubhekana ne-AVRT ebangelwa i-WPW ye-VT kungadala ukudideka okukhulu kanye ne-alamu engadingekile kwabasebenzi bezokwelapha, futhi kungaholela ekwelapheni okungalungile.
Okwesithathu, uma isiguli esine-WPW kufanele sithuthukise ukucubungula kwe-atrial - i-arrhythmia lapho i-atria idala khona umfutho kagesi ngesilinganiso esisheshayo kakhulu - lezo zimpembezo zingakwazi ukuhamba phansi indlela yokufinyelela futhi zivuselele ama-ventricle ngezinga eliphezulu kakhulu, okuholela ukushaya kwenhliziyo ngokuyingozi. (Ngokuvamile, i-AV node ivikela ama-ventricles ukuba avuselelwe ngokushesha ngesikhathi se-frictional atrial.) Ngakho ezigulini ezine-WPW, i-fibrillation ye-atrial ingaba yinkinga esongela ukuphila.
Izimpawu Nge-WPW
Izimpawu ze-SVT ezibangelwa i-WPW zifana nanoma yikuphi i-SVT. Zifaka amapulpitations , ikhanda elikhanyayo , nesiyezi . Iziqephu ngokuvamile zihlala emaminithini ambalwa kuya emahoreni amaningana.
Uma ukufabulisa kwe-atrial kufanele kwenzeke, noma kunjalo, izinga lokushaya kwenhliziyo eliphuthumayo lingase liholele ekulahlekelweni kolwazi, noma ngisho nokuboshwa komzimba .
Ukwelapha i-WPW
Isifunda sokuvuselela esenza i-SVT ku-WPW ifaka i-AV node, isakhiwo esinikezwa ngokucebile yi- vagus nererve . Ngakho iziguli ezine-WPW zivame ukuyeka iziqephu zazo ze-SVT ngokuthatha izinyathelo zokwandisa ithoni lezinzwa zabo, njenge- Valsalva , noma ukufaka ubuso babo emanzini e-ice imizuzwana embalwa. Kwabanye abantu abaneziqephu ezingavamile kuphela ze-SVT, lokhu ukwelashwa kungase kwanele.
Ukusebenzisa izidakamizwa ezivimbela ukuvimbela ama-arrhythmias aphindaphindiwe ku-WPW kusebenza ngempumelelo kuphela, futhi le ndlela ayisebenzisi kaningi namuhla.
Kodwa-ke, indlela yokufinyelela eWPW ingasetshenziswa (okungaphezu kuka-95% wesikhathi) isuswe ngokuphelele nge- ablation therapy , lapho indlela yokufinyelela ihlolwe ngokucophelela futhi igxiliwe. Ukwelashwa kwe-Ablation cishe njalo kuyindlela engcono kunazo zonke umuntu ophethe i-WPW oye waba ne-arrhythmias.
Ngaphezu kwalokho, ngoba ukuqala kwe-fibrillation e-atrial ku-WPW kungaholela ezingeni lezinhliziyo zengozi eziyingozi, futhi ngenxa yokuthi i-fibrillation ye-atrial iyinto evamile (futhi ingase ivame kakhulu kubantu abane-WPW kunabantu abaningi), ochwepheshe abaningi bayakhuthaza cishe noma ubani onamandla we-WPW cabanga nge-ablation therapy.
> Imithombo:
> Izingane kanye ne-Congenital Electrophysiology Society (PACES), i-Heart Rhythm Society (i-HRS), i-American College of Cardiology Foundation (ACCF), et al. I-PACES / HRS Isaziso Sokubambisana mayelana Nokuphathwa Kwesineke Esineziguli Ezincane Ne-Wolff-Parkinson-White (I-WPW, I-Ventricular Preexcitation) I-Electrocardiographic Pattern: Kuthuthukiswe Ngokubambisana Phakathi kwezingane kanye ne-Congenital Electrophysiology Society (PACES) ne-Heart Rhythm Society (HRS) ). Ukuvunyelwa yizinhlangano ezibusayo ze-PACES, i-HRS, i-American College of Cardiology Foundation (i-ACCF), i-American Heart Association (AHA), i-American Academy of Pediatrics (AAP), neCanada Heart Rhythm Society (CHRS). I-Heart Rhythm 2012; 9: 1006.