Ukuqhathanisa izindlela ezahlukene
Uma une -fibrillation ye-atrial , unquma kanjani phakathi kwezindlela ezimbili eziyisisekelo zokwelapha i-arrhythmia (okungukuthi, ukubuyisela nokugcina isigqi esivamile noma ukulawula isilinganiso senhliziyo)? Kunezici ezimbalwa wena nodokotela wakho okumele nicabangele ekwenzeni lesi sinqumo.
Ngabe i-Rhythm Control Approach ifanelekile?
Ebusweni bayo, indlela yokulawula isigqi - ukubuyiselwa nokugcina isigqi senhliziyo evamile - kubonakala sengathi kuyindlela efanele mayelana nanoma ubani.
Phela, ngubani ofuna ukuhlala e-fibrillation ye-atrial? Inkinga, yilokho ukuthi izindlela zokwelapha ezitholakalayo ukuze zifinyelele ukulawula isigqi ekufubeni kwe-atrial zivame ukusebenza kahle kakhulu, futhi ziveze iziguli kwezinye izingozi ezinkulu.
Ngakho odokotela bavame ukugcina isu lokulawula isigqi iziguli zabo ezibonakala zinekhono elihle lokuphumelela nalo, noma ngubani okungenani okumele abhekane nokubhebhetheka kwesifo se-atrial ngisho nalapho izinga lokushaya kwenhliziyo lilawulwa. Iziguli ezinjalo zizofaka izigaba ezilandelayo:
- Labo abanobuchopho babo be-atrial kubonakala sengathi bahlobene nesenzakalo esithatha isikhathi eside, imbangela eguquguqukayo, noma inkinga yezokwelapha engaphansi okungaphathwa kangcono. Lokhu kungafaka: i- hyperthyroidism ; i-pericarditis ; i-pulmonary embolus , i-pneumonia noma enye inkinga yamaphaphu acute; inqubo yokuhlinzwa yakamuva; ukufaka utshwala (" inhliziyo yeholide "); ukuhluleka kwenhliziyo okulawulwa kahle; noma i- apnea yokulala engalashwa. Uma ukwelashwa kwalezi zimbangela eziyinhloko zokufibisa kwe-atrial kuye kwalungiswa, isiguli sinethuba elingcono kakhulu lokuhlala ngesigqi senhliziyo evamile.
- Abantu abanama-ventricle "abanzi" abajwayele ukwenza i-atrial fibrillation engavumi ukubekezelela, ngisho nalapho kutholakala ukulawulwa kwezinga elifanele. Imibandela enjalo ihlanganisa hypertrophic cardiomyopathy , isifo se-hypertensive heart, ukungasebenzi kwe-diastolic , noma i- aortic stenosis .
- Iziguli okuye kwahlolwa indlela yokulawula izinga, futhi yehlulekile ukulawula izimpawu ngokwanele.
- Abagijimi kanye nabanye ababenemisebenzi abadinga ukuba benze ngenani lezinhliziyo zempilo.
- Abantu abafuna ukusebenzisa indlela yokulawula isigqi uma bekwaziswa ngokugcwele mayelana nokulinganiselwa okungenzeka.
Ngabe Isilinganiso Sokulawula Ukulinganiswa Sifaneleka?
Ngenxa yobunzima kanye nezingozi ezihambisana nendlela yokulawula isigqi ku-fibrillation ye-atrial, ochwepheshe abaningi bacabangela indlela yokulawula izinga ukuthi ibe "indlela yokuzenzakalela" yeziningi zeziguli ezine-arrhythmia.
Akuyona nje indlela yokulawula izinga okuphephile futhi ephumelela kakhulu kunendlela yokulawula isigqi, kodwa futhi iphumelela ekuqedeni izimpawu ze-fibrillation ye-atrial kubantu abaningi abane-arrhythmia. Njengoba iphuzu elilodwa ekukhipheni i-fibrillation ye-atrial ukukhipha izimpawu, indlela yokulawula izinga livame ukusebenza kahle ekufinyeleleni umgomo wokwelapha.
Ngaphezu kwalokho, nakuba esikhathini esidlule kwakucatshangwa ukuthi uma ungenza ukuthi i-fibrillation ye-atrial igweme ingozi yokushaywa yisisu inganciphisa kakhulu, izifundo zokwelashwa zihlulekile ukubonisa lokhu. Ngakho-ke, ngisho noma isu lokulawula isigqi sisetshenziswa futhi kubonakala sengathi siphumelele, iziguli zidinga ukuphathwa ngezidakamizwa ze-anticoagulant .
Ngakho-ke, inzuzo enkulu engaba yindlela yokulawula isigqi ihlulekile (okungenani kuze kube manje) ukuba igcwalise.
Ingabe Ukugcina Isimiso Esingavamile Kungcono Kunokulawulwa Kwezinga?
Yize kubonakala sengathi i-intuitively isu lokulawula izinga lingaba nemiphumela engcono kuneqhinga lokulawula izinga lokubhebhetheka kwe-atrial, izifundo zokwelashwa zihlulekile ukubonisa ukuthi yilokho okwenzekayo. Esikhundleni salokho, ukuhlolwa komtholampilo okungahleliwe ngokuqhathanisa ukulawula isigqi ukukala ukulawulwa kweziguli ezine-fibrillation ye-atrial kubonise umkhuba wemiphumela emibi kakhulu emitholampilo (kufaka phakathi isifo esiphakeme sokufa, ukuhluleka kwenhliziyo , ukushaya isisu nokugaya) ngendlela yokulawula isigqi.
Ochwepheshe abaningi bathi lezi ziphumo ezimbi emiphumeleni emibi yezidakamizwa, kodwa lokhu akucacile.
Ngaphansi
Okwamanje, ochwepheshe bayavuma ukuthi indlela "yokuzenzakalelayo" yokuthola iziguli eziningi izifo ze-inrial fibrillation (ikakhulukazi ngemva kokuzama komunye noma mhlawumbe kwemizamo emibili yokugcina isigqi esivamile ehlulekile) kuyindlela yokulawula isilinganiso. Kodwa-ke, lesi sinqumo ngaso sonke isikhathi sidinga ukuhlanganiswa phakathi kukadokotela kanye nesiguli, ngazo zonke izinzuzo nezingozi zendlela ngayinye ethathwa ku-akhawunti ngokucophelela.
Imithombo:
I-American College of Cardiology Foundation, i-American Heart Association, i-European Society of Cardiology, et al. Ukuphathwa kweziguli ezine-fibrillation ye-atrial (ukuhlanganiswa kuka-2006 ACCF / AHA / ESC kanye no-2011 kwe-ACCF / AHA / HRS izincomo): umbiko we-American College of Cardiology / American Heart Association Task Force emithethweni yokuziphatha. Ukujikeleza 2013; 127: 1916.
I-Wyse DG, Waldo AL, et al. Ukuqhathaniswa kokulawulwa kwesilinganiso nokulawula isigqi kuziguli ezine-fibrillation ye-atrial. N Eng J Med 2002; 347 (23): 1825.
UVan Gelder IC, uHagens VE, et al. Ukuqhathaniswa kokulawulwa kwesilinganiso nokulawula isigqi kuziguli ezinezinhlamvu eziqhubekayo zokuphefumula kwama-atrial. N Eng J Med 2002; 347 (23): 1834.