Uhlelo lomgogodla lwe-cardiac lubalulekile ngoba lulawula isigqi senhliziyo futhi ngenxa yokuthi ukungajwayelekile ohlelweni lwegesi kubhekene nezinhlelo eziningi ze-heart. Ucwaningo lwe-electrophysiology (ukufundwa kwe-EP) luhlolo olukhethekile lwe- catheterization lapho ama-catheter e-electrode (ama-flexible, ama-wire insulated nge-metal electrode tips) efakwa enhliziyweni ukuze atadishe uhlelo lwe-electrical cardiac.
Isifundo se-EP senziwe kanjani?
Uma udokotela wakho ekuthumelele ucwaningo lwe-EP, uzolethwa ku-laboratory ye-electrophysiology (i-laboratory ekhethekile ye-catheterization laboratory) futhi ulale etafuleni lokuhlola. Uzonikwa i-anesthesia yendawo, futhi mhlawumbe i-sedative, futhi ama-catheters we-electrode azofakwa emithinini eyodwa noma ngaphezulu yegazi. (I-Catheters ifakwa noma i-incision encane noma i-stick-stick, ngokuvamile ekhoneni, ehlathini noma entanyeni. Ngokuvamile kusetshenziselwa ama-catheter amabili noma amathathu, futhi angeniswa kwisayithi engaphezu kweyodwa.) Ukusebenzisa i-fluoroscopy (efana ne-x ray), ama-catheter athuthukile emithanjeni yegazi futhi ehlelwe ezindaweni ezithile ngaphakathi kwenhliziyo.
Uma sezibekwe kahle, ama-catheter ase-electrode asetshenziselwa ukwenza imisebenzi emibili eyinhloko: ukurekhoda izimpawu zombane ezenziwe yinhliziyo nokuhamba ngenhliziyo. (I-Pacing ifezwa ngokuthumela izimbonakaliso ezincane zamagesi ngokusebenzisa ikhamera ye-electrode.) Ngokurekhoda nokuhamba ngezindawo ezivela ngaphakathi kwenhliziyo, izinhlobo eziningi ze-arrhythmias zenhliziyo zingafundiswa ngokugcwele.
Uma inqubo isiphelile, i-catheter (ama) isusiwe. Ukwehla kwegazi kulawulwa ngokubeka ingcindezi kwisayithi ye-catheterization imizuzu engama-30 kuya kwangu-60.
Yiziphi izinhlobo ze-Arrhythmias Ingabe i-EP Study Evaluate?
Ucwaningo lwe-EP lungasiza ekuhloleni kokubili ama- bradycardias (izinhliziyo ezincane ezihamba kancane) kanye ne- tachycardias (i-heart arrhythmias esheshayo).
Uma ucwaningo lwe-EP lwembula ukubonakala okuphawulekayo kwe-bradycardia, kungadingeka i- pacemaker engapheli.
I-Tachycardias ihlolwe ngokusebenzisa amasu okuhleleka okuhlelwe ukuhlela (okungukuthi, ukuqala) i-tachycardia. Uma i-tachycardias ingadluliswa phakathi nokucwaninga kwe-EP, ke ngokutadisha izimpawu zikagesi eziqoshiwe ezivela kumakhemikhali e-electrode, imbangela eqondile ye-tachycardia ingase ibonakale. Uma lokhu sekufeziwe, ukwelashwa okufanelekayo kwe-tachycardia ngokuvamile kuvele kucace.
I-EP ifundela kanjani ukuphathwa ngokuqondile kwe-Arrhythmias?
Kunezindlela ezimbalwa ukufundwa kwe-EP kungakusiza wena nodokotela wakho wenze izinqumo zokwelashwa. Izinketho zokwelashwa ezingase zibhekwe ngokusekelwe emiphumeleni yocwaningo lwe-EP zifaka:
- Ukufakwa kwe-pacemaker: Uma isifundo se-EP siqinisekisa ukuthi kukhona i-bradycardia ebalulekile, i-pacemaker engapheli ingafakwa ngokushesha, ngesikhathi esifanayo.
- I-Ablation : Uma i-tachycardia engaphezulu (i-SVT) - nezinye izinhlobo ze-tricycardia ye-ventricular (VT) - zitholakala, ukukhishwa kwe-radiofrequency ngokuvamile kuyindlela yokwelashwa. Inqubo ye-ablation ivame ukuqhutshwa ngesikhathi esifanayo, ngokushesha emva kokufunda kwe-EP. Ungafunda kabanzi mayelana nokwelashwa kwe-ablation online.
- Ama-defibrillators angeniswa ngaphakathi : Uma izinhlobo eziphuthumayo ze-VT kanye / noma i -fibrillation ye-ventricular (VF) zikhonjiswe ngesikhathi sokutadisha kwe-EP, ngokuvamile ngokuvamile i-defibrillator engasetshenziselwa ukwelashwa yikhetho. Le divayisi manje isingeniswa njalo e-laboratories ye-EP, ngokushesha ngemva kokufunda kwe-EP. Eminyakeni eyadlula, ukuhlolwa kwe-EP kwasetshenziselwa ukuhlonza izidakamizwa "ezihle kakhulu" zokulwa neziguli ezine-VT noma i-VF, kodwa namuhla kwaziwa ukuthi akukho mshini wokulwa nomuthi osebenzayo osebenza kahle njenge- defibrillator engasetshenziselwa ukuvimbela ukufa okungazelelwe kusuka kulawa i-arrhythmias.
Yiziphi Izingozi Zokuba Nokufunda Kwe-EP?
Izingozi ezingase zibe khona zokuba nesifundo se-EP zifana nalokho okwenziwe nge- catheterization yomzimba .
Lezi zinqubo ziphephile, kepha ngoba ziyizinqubo ezingenayo ezihilela inhliziyo, izinkinga eziningana zingenzeka. Akufanele ube nesifundo se-EP ngaphandle uma kungenzeka ukuthi ulwazi olutholakala enkambisweni luyoba nenzuzo enkulu.
Izinkinga ezincane zibandakanya ukuphuma kwegazi esakhiweni sokufakwa kwe-catheter, ukuphazamiseka kwengqondo okwesikhashana okubangelwa i-catheter ecasula inhlitiyo yenhliziyo kanye nezinguquko zesikhashana egazini legazi.
Izinkinga ezibaluleke kakhulu zihlanganisa ukuguqulwa kwodonga lwenhliziyo (okubangela isimo esisongela ukuphila esibizwa ngokuthi " i-tamponade ye-cardiac "), ukuphuma kwegazi noma (ngenxa yokuthi ukukhishwa kwe-arrhythmias okungaba yingozi) kuboshwa inhliziyo . Ingozi yokufa ngesikhathi sokufunda i-EP ingaphansi kwe-1 kwangu-1 000.
Umthombo:
Rahimtoola, SH, Zipes, DP, Akhtar, M, et al. Isitatimende sokubambisana seNkomfa mayelana noMbuso Wezobuciko Zokuhlolwa Kwe-Electrophysiologic Ekuqaphelweni Nokuphathwa Kwezilwelwane Nge-Cardiac Arrhythmias. Ukujikeleza kuka-1987; 75: III3.