I-defibrillators engenele (i-ICDs) iphumelela kakhulu ekuvimbeleni ukufa okungazelelwe komzimba kusuka ezigungwini zenhliziyo . Ngeshwa, iningi labangaphezu kuka-400,000 baseMelika abafa ngokuzumayo ngonyaka ngamunye abakaze bafunde ukuthi ingozi yabo iphezulu - ngakho-ke, abanaso ithuba lokubheka i-ICD.
Noma ubani onesifo senhliziyo esibalulekile, noma unamalungu omndeni oseduze oye wafa ngokuzumayo, kufanele akhulume nodokotela wabo mayelana nezingozi zabo zokufa okungazelelwe.
Uma ingozi yakho iphezulu, kufanele ube nengxoxo mayelana ne-ICD.
Ingabe Unengozi Ekhulayo Yokufa Okungazelelwe?
Abantu abasengozini enkulu yokufa ngokungazelelwe ngokuvamile bawela ezinhlokweni ezine:
1) Abantu abanesifo esibalulekile se- coronary artery (CAD) . Ama- plaque ahlobene ne-CAD angaphazamiseka ngokuzumayo, akhiqize umumo wezimo okuthiwa i- Acute Coronary Syndrome (i-ACS) .
Omunye wemiphumela emibi ye-ACS ukuboshwa komzimba. Lokhu kwenzeka ngoba ukuphuka kwamapayipi kungaphazamisa uhlelo lwegesi lomzimba, okhiqiza i -tachycardia ye-ventricular (VT ) noma i -fibrillation ye-ventricular (VF) . Kulinganiselwa ukuthi kubantu abangaba ngu-30% abane-CAD ebalulekile, ukufa okungazelelwe kuyisibonakaliso sokuqala sokuthi lesi sifo sikhona.
Ngokuvamile, noma kunjalo, abantu abane-CAD kodwa abangakabi ne- infarction ye-myocardial (ukushaya kwenhliziyo) akudingi ama-ICD. Esikhundleni salokho, laba bantu kudingeka benze izinyathelo ezinonya ekulawuleni izici eziyingozi eziyaziwa ukusheshisa i-CAD futhi okwenza kube lula ukuphuka kwamapayipi.
Ukunakekelwa okuhle kwezokwelapha nokuguqulwa kokuphila ngendlela ephumelelayo kunganciphisa kakhulu ingozi yokufa okungazelelwe, ukuhlaselwa yinhliziyo, kanye ne- angina .
2) Abantu asebevele baneziqephu ze-VT noma i-VF, ikakhulukazi uma i-arrhythmia ibangele ukubopha inhliziyo noma ukulahlekelwa ukwazi. Laba bantu banengozi enkulu yokuba nokuboshwa komzimba othile - mhlawumbe kube yithuba elilodwa ku-5 ngonyaka - futhi cishe bonke kufanele banikwe i-ICD.
3) Abantu abanokuhluleka kwenhliziyo ngokunciphisa kakhulu ingxenyana ye- ventricular ejection . Kulinganiselwa ukuthi cishe iziguli ezingu-50% ezinokuhluleka kwenhliziyo ekhululekile zigcina ziboshwa inhliziyo. Imikhombandlela yamanje iphakamisa ukuthi ama-ICD kufanele acatshangelwe abantu abafake amaqanda ejection anciphisa ama-35% noma aphansi.
Lesi yisinye sezizathu zokuthi kungani, uma unesifo senhliziyo cishe noma yiluphi uhlobo, kubalulekile ukwazi ingxenyana yakho ye-ejection.
4) Abantu abazuze njengeziphambeko zenhliziyo ezenza i-VT noma i-VF ibe khona. Izimo ezinjalo zihlanganisa i- QT syndrome ende , i- hypertrophic cardiomyopathy , ne- Brugada syndrome . Ama-ICD angavimbela ukufa okungazelelwe kulezi zimo ezizuze njengefa futhi kufanele acatshangwe ngokuqinile kubantu abaningi abathintekayo. Noma ubani onomlando oqinile womndeni wokufa okungazelelwe kufanele axoxe ngomlando wabo womndeni nodokotela wabo futhi abuze ukuthi ngabe kukhona ukuhlolwa okukhethekile okumelwe kwenziwe. Ezimweni eziningi, i- ECG elula futhi mhlawumbe i- echocardiogram yayiyokwanela ukulawula izifo ezibangelwa yizinhliziyo eziningi ezikhulisa ingozi yokufa kungazelelwe.
Uma ukholelwa noma yikuphi kulezi zigaba ezine kungase kusebenze kuwe, udinga ukuba nengxoxo ebalulekile nodokotela wakho mayelana nokuhlola ingozi yakho yokufa ngokuphazima kwenyama.
Ukuba ne-ICD Uma Ingozi Yakho Iphakanyisiwe
Ama-ICD awawona wonke umuntu. Kukhona izingozi ngala madivayisi kanye nezinzuzo. Kungakhathaliseki ukuthi unomunye - ngisho noma ingozi yakho iphakanyisiwe futhi une "isibonakaliso" esihlelekile se-ICD - isinqumo ngasinye. Kodwa-ke, ngaphambi kokuba uthole ngisho nethuba lokwenza lesi sinqumo, kudingeka uqaphele ukuthi ingozi yakho yokufa okungazelelwe iphakeme. Ngeshwa, odokotela abaningi (ngokuqondakalayo) banqika ukuxoxa ngalesi sihloko neziguli zabo. Ngakho-ke, uma ukhathazekile ukuthi ungase ube engozini eyengeziwe, qeda iqhwa ngokwakho - cela udokotela wakho akhulume nawe ngakho.
> Imithombo:
Russo AM, Stainback RF, Bailey SR, et al. I-ACCF / HRS / AHA / ASE / ASE / HFSA / SCAI / SCCT / SCMR 2013 indlela efanele yokusetshenziswa ye-cardioverter-defibrillators ne-cardiac resynchronization therapy: umbiko we-American College of Cardiology Foundation efanelekayo yokusebenza, iqembu le-Heart Rhythm Society, i-American Heart Umhlangano, i-American Society of Echocardiography, i-Heart Failure Society of America, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, kanye neNhlangano Yezinhliziyo Zomzimba I-Magnetic Resonance. J Am Coll Cardiol 2013; 61: 1318.