Ngokuvamile, kunezizathu ezimbili udokotela wakho angase afune ukukubeka emithonjeni ye- arrhythmia yenhliziyo . Okokuqala, i-arrhythmia ingase ibangele ukuthi ube nezimpawu, njenge- palpitations noma ikhanda elincane , futhi ukwelashwa kungase kubalulekile ukukhulula lezo zimpawu. Noma, okwesibini, i-arrhythmia ingase ibangele ukulimaza noma ukusongela ukwenza kanjalo. Ama-arrhythmias amaningi akwenzi lutho lwalezi zinto ezimbili futhi akadingi ukwelashwa okuhloswe ngokuqondile ku-arrhythmia uqobo.
Uma une-arrhythmia edinga ukwelashwa, kunezigaba ezintathu ezijwayelekile zemithi ezingase zibe usizo, kuye ngokuthi hlobo luni lwe-arrhythmia onalo. Iqembu lokuqala liqukethe izidakamizwa zokulwa nezidakamizwa-izidakamizwa ezihloswe ngokuqondile ekuqedeni izinhliziyo ezingavamile. Owesibini uqukethe izidakamizwa ezithinta i- AV node , esetshenziselwa ikakhulukazi ama -tachycardias angaphezulu (i-SVT). Iqembu lesithathu liqukethe izidakamizwa ezihlukahlukene eziye zaboniswa ukunciphisa ingozi yokufa okungazelelwe kusuka ekuhloleni komzimba.
Izidakamizwa Zama-antiarrhythmic
Izidakamizwa ze-antiarrhythm ziyimithi eguqula izakhi zikagesi zezicubu zenhliziyo, futhi ngokwenza kanjalo, shintsha indlela isignali kagesi yenhliziyo isakazeka ngayo yonke inhliziyo. Njengoba i- tachycardias (i-arrhythmias ebangela ukushaya kwenhliziyo ngokushesha) ngokuvamile ihlotshaniswa nokungajwayelekile embonini kagesi, izidakamizwa ezishintsha isignali kagesi senhliziyo zingase zithuthukise lezo zi-arrhythmias.
Izidakamizwa zokulwa nezifo zivame ukuphumelela, noma okungenani ziphumelele, ekuphatheni izinhlobo eziningi ze-tachycardias.
Ngeshwa, izidakamizwa ezithathelwanayo njengeqembu zivame ukudala inani eliyingozi lohlobo oludakayo lunye uhlobo noma olunye, futhi ngenxa yalokho, kungaba nzima ukuthatha. Isidakamizwa ngasinye sokulwa negciwane sinephrofayili yaso eyingqayizivele yobuthi, futhi ngaphambi kokumisela noma iyiphi yalezi zidakamizwa, kubalulekile ukuthi udokotela wakho uchaze ngokucophelela izinkinga ezingase zivele ngesidakamizwa esikhethiwe.
Kodwa-ke, kunenkinga eyodwa eyinhlekelele ejwayelekile kuzo zonke izidakamizwa ezihlukunyezwayo: Ngezinye izikhathi lezi zidakamizwa zenza ukukhubazeka kube nzima kunokuba kube ngcono.
Lesi sici semithi e-antiarrhythm-ebizwa ngokuthi "i-proarrhythmia" -iyaguquka ibe yindawo ehambisana nayo yezidakamizwa ezishintsha isignali kagesi senhliziyo. Kalula nje, uma wenza noma yini ukuze ushintshe indlela isignali kagesi esakazeka ngayo yonke inhliziyo, kungenzeka ukuthi ushintsho luzokwenza i-tachycardia ibe ngcono, noma ibe nzima nakakhulu.
Izidakamizwa ezisetshenziswa ngokuvamile ezibandakanya i-amiodarone (iCordarone, i-Pacerone), i-sotalol (i-Betapace), i-propafenone (i-Rhythmol), ne- dronedarone (i-Multaq).
I-Amiodarone yiyona imithi ehluleka kakhulu yokulwa ne-antiarrhythmic futhi iphinde ibe nomthelela omncane wokubangela i-proarrhythm kunezinye izidakamizwa. Ngeshwa, ezinye izinhlobo ze- toxicities ezibonwe nge-amiodarone zingaba zimbi kakhulu, futhi lesi sidakamizwa kufanele sisetshenziswe kuphela (njengezo zonke izidakamizwa ezithintekayo) lapho kudingekile.
Okubalulekile ukuthi odokotela bafanele-futhi kufanele babe-ukungabaza ukunikeza izidakamizwa zokulwa nezidakamizwa. Lezi zidakamizwa kufanele zisetshenziswe kuphela uma i-arrhythmia ikhiqiza izimpawu eziphawulekayo noma ibeka ingozi emzimbeni we-cardiovascular.
I-AV Nodal Ukuvimbela Izidakamizwa
Imithi eyaziwa ngokuthi yi-AV nodal blocking drugs- beta blockers , i- calcium channel blockers , kanye ne-digoxin-umsebenzi ngokunciphisa isignali kagesi senhliziyo njengoba idlula i-AV node endleleni eya kusuka ku-atria kuya kwi-ventricles.
Lokhu kwenza ukuthi izidakamizwa zokuvimbela ama-AV ziwusizo ekuphatheni i-SVT. Ezinye izinhlobo ze-SVT (ngokuqondile, i- AV nodal reentrant tachycardia kanye ne-tachycardias ebangelwa amapheshana amancane), zidinga i-AV node ukuqhuba isignali kagesi ngendlela efanele, futhi uma i-AV node ingenziwa ukuqhuba isignali kagesi kancane kancane, i-SVT imane nje uyayeka.
Ukuze i-SVT eyaziwa ngokuthi i-fibrillation ye-atrial , izidakamizwa zokuvimbela ama-AV azivimbeli i-arrhythmia, kodwa zinciphisa isilinganiso senhliziyo ukusiza ukuqeda izimpawu. Eqinisweni, ukulawula izinga lenhliziyo ngezidakamizwa zokuvimbela i-AV nodokotela ngokuvamile kuyindlela engcono kakhulu yokuphatha i-fibrillation ye-atrial .
Izidakamizwa Okunciphisa Ingozi Yokufa Okungazelelwe
Imithi embalwa kucatshangwa ukuthi inganciphisa ingozi yokufa okungazelelwe, mhlawumbe ngokunciphisa ingozi ye- ventricular tachycardia noma i -fibrillation ye-ventricular , ama-arrhythmias enza ukuboshwa komzimba .
Ukucwaninga kubonisa ukuthi ukuvimbela i-beta cishe kuncishisa ingozi yokufa okungazelelwe ngokuvimbela umphumela we-adrenaline emzimbeni wenhliziyo, ngaleyo ndlela ukunciphisa amathuba okuba i-arrhythmias ebulalayo. Zonke iziguli ezasinda ekuhlaselweni kwenhliziyo noma ezinokuhluleka kwenhliziyo kufanele zithathe ama-blocka blockers.
Ukulula okulula ukuchaza ukunciphisa ukufa okungazelelwe kubikwe ezigulini ezithatha izidakamizwa, noma ezidla ama-fatty acids ama-omega-3, kodwa lezi zonyango zibonakala zizosiza.
> Imithombo:
> Banika i-AO. Iziteshi ze-Caronac Ion. I-Circ Arrythm Electrophysiol 2009; 2: 185.
> I-Gambit yeSicilian. Indlela Entsha Yokuqokwa Kwezidakamizwa Zama-Antiarrhythmic Ehlulwa Ngezenzo Zabo Ngezinqubo Ze-Arrhythmogenic. Umsebenzi Weqembu Elisebenzayo E-Arrhythmias ye-European Society of Cardiology. Ukujikeleza kuka-1991; 84: 1831.