Uma une -fibrillation ye-atrial , ukwelashwa okufanele kungase kube indlela encane ebonakalayo ezwakalayo-enembile -vumela ukuphefumula kwama-atrial ukuze uqhubeke, uhlose ukwelapha ukugcina izinga lakho lenhliziyo lingasheshi (ukuze ulawule izimpawu zakho) futhi uthathe izinyathelo zokunciphisa ingozi yokushaya isifo. Lokhu kubizwa ngokuthi indlela yokulawula isilinganiso. Intuitively, enye indlela, indlela yokulawula isigqi , ehlose ukubuyiselwa nokugcina isigqi senhliziyo evamile, izwakala kangcono kakhulu.
Kodwa kubantu abaningi abanokuphefumula kwama-atrial okungapheli noma okuqhubekayo (okungukuthi, bebephethwe yi-fibrillation ye-atrial sonke isikhathi noma isikhathi esiningi samasonto amaningi noma izinyanga), imiphumela iba ngcono nakakhulu ngendlela yokulawula isilinganiso.
Ngokwezinga elikhulu, lokhu kungenxa yokuthi ukulawula isigqi kunzima kakhulu, kungonakali, kungasebenzi futhi kuhlanganisa ingozi ephezulu kakhulu yemiphumela emibi. Futhi, abantu abaningi abaphathwa ngezinga lokulawula benza kahle; Ucwaningo lwezokwelapha lubonisa ukuthi imiphumela yabo ingcono kakhulu, uma ingcono, kunelabo abazama ukulawula isigqi.
Indlela yokulawula izinga lokubhebhetheka kwe-atrial inezinhloso ezimbili - ukulawula izinga lenhliziyo nokuvimbela ama-clots wegazi kanye nesifo sohlangothi.
Ukulawula isilinganiso senhliziyo
Kubantu abaningi abane-fibrillation ye-atrial, izimpawu zibangelwa ngokuqondile ngesilinganiso senhliziyo esivamile esivame ukuhambisana nalesi sigamu.
Eqinisweni, uma nje izinga lokushaya kwenhliziyo lilawulwa, abantu abaningi abane-fibrillation ye-atrial bangase bahole ukuphila okuvamile, naphezu kokuphikelela kwe-arrhythmia yabo. Ngokujwayelekile, ukulawulwa kwenhliziyo kungatholakala ngokunikeza izidakamizwa zokuvimbela i-beta , ngokuvamile kanye nabavimbela isiteshi se-calcium . Ngaphezu kwalokho, i-digoxin ivame ukusiza ekunciphiseni izinga lokushaya kwenhliziyo ekufubeni kwe-atrial.
Yonke emithathu yalezi zidakamizwa isebenza ngokunciphisa ukuqhutshwa komshini kagesi ngokusebenzisa i- AV node , eyanciphisa inani lemifuziselo efinyelela ezingeni le-ventricles - ngaleyo ndlela ukunciphisa isilinganiso senhliziyo. Esikhathini esiningi sabantu abane-fibrillation ye-atrial, izinga lenhliziyo lingalawulwa ngokwanele ngenye inhlanganisela yalezi zidakamizwa.
Kwezinye izimo, izinga lokushaya kwenhliziyo lisho ngokushesha ngokwanele ukuze kubonakale izimpawu eziqhubekayo naphezu kokwelapha. Kulezi zimo, izinga lokushaya kwenhliziyo lingalawulwa kalula yizinqubo ezikhethekile zokuphumula okuhlose ukulimaza i-AV node. Kule nqubo, i-catheter ekhethekile igxilisa le node ngokuthi i-cauterizing noma iwuqede.
Ukuqeda isibhamu se-AV kuvimbela impulsation ye-atrial fibrillation ekufinyeleleni ama-ventricles, ngakho-ke izinga lokushaya kwenhliziyo lincane kakhulu. Eqinisweni, ukukhishwa kwe-AV ye-AV ngokuvamile kuholela enqenqenqenqenqenqenqenqenqenqenqenqenqeneni yehliziyo, okuvame ukuholela ekwenzeni kwenhliziyo ephuza kakhulu Ngakho ukukhishwa kwe-AV ye-AV njalo kudinga ukufakwa kwe- pacemaker ehlala njalo . Ngenxa yokuthi abahamba nge-pacemakers bangamanje bangashintsha izinga abahamba ngalo, kuye ngokuthi izinga lomsebenzi wesiguli, ukhetho lwe-AV node-plus-pacemaker lunikeza umuntu ngama-heart fibrillation rate rates - kokubili ngesikhathi sokuphumula nangesikhathi sokuzivocavoca - okulinganisa inani lezinhliziyo abantu abanezimiso zenhliziyo evamile.
Ngenkathi ukuvuthwa kwe-AV nodal kungase kubonakale kuyindlela eqondile yokulawula izinga lenhliziyo, cishe njalo kuholela ekuthuthukiseni okuphawulekayo kwezimpawu zeziguli ezinezintambo ezibhebhetheka emhlane futhi ezinye izinyathelo ziye zahluleka.
Ukuvimbela izambatho zegazi
Ukwelashwa ukuvimbela ama-clots egazi kusukela ekwenzeni i-atria kuyisinyathelo esibucayi kunoma ubani one-fibrillation ye-atrial. Iningi labantu abane-fibrillation ye-atrial kufanele libe ukwelapha ngesidakamizwa sokulwa ne-coagulation (izidakamizwa "ezincane" igazi ukuvimbela ama-blood clots) ukuvimbela imivimbo. Kuze kube yilapho nje u-Coumadin bekuwukuphela kokukhetha okukhona, kodwa ukusebenzisa i-Coumadin ngokuphepha nangokuphumelelayo kungaba yinto enzima ukuyifeza.
Ngenhlanhla, izinketho ezisha futhi ezilula zokuzisebenzisa zokulwa ne-coagulation esebenzayo ekufubeni kwe-atrial zivele zitholakale.
Isifingqo
Nakuba kungase kungabi yinkimbinkimbi, indlela yokulawula izinga lokuphatha i-fibrillation ye-atrial ngokuvamile isebenza kahle ekulawuleni izimpawu futhi inciphisa kakhulu ingozi yokushaywa yisifo. Kuze kube nezindlela ezingcono zokwakhiwa kwe-fibrillation ye-atrial nokubuyisela isigqi senhliziyo evamile, indlela yokulawula izinga kuyisinqumo esingcono kuningi labantu abanalo ukuhleleka.
Imithombo:
I-Fuster, V, Ryden, LE, i-Cannom, i-DS, ne-al. I-ACC / AHA / ESC 2006 Imihlahlandlela yokuphathwa kweziguli ezine-fridaying ye-Atrial Umbiko we-American College of Cardiology / American Heart Association Task Force on Guidelines Practice kanye ne-European Society of Cardiology Committee for Guiding Practice (Ikomiti Yokubhala Ukubuyekeza Iziqondiso Zika-2001 for the Management of Patients With Fibrillation Atrial). J Am Coll Cardiol 2006; 48: e149.
UWann LS, Curtis AB, uJanuwari CT, et al. Ukubuyekezwa okugxilwe ku-ACCF / AHA / HRS ekuqondiseni iziguli ezine-fibrillation ye-atrial (Ukubuyekeza Umhlahlandlela ka-2006): umbiko we-American College of Cardiology Foundation / i-American Heart Association Task Force on Guidelines Practice. J Am Coll Cardiol 2011; 57: 223.