Ezinye iziguli ezinokuhluleka kwenhliziyo zingathola ukuthuthukiswa okuphawulekayo kwezibonakaliso, ukungenisa izihambi ezimbalwa, kanye nengozi enciphisa yokufa nehlobo lwe- pacemaker ekhethekile ebizwa ngokuthi ukwelashwa kabusha kwe-cardiac (CRT). Uma uthola ukuthi unesifo senhliziyo, kufanele ukhulume nodokotela wakho mayelana nokusebenzisa i-CRT.
Indlela i-CRT isebenza ngayo
I-CRT isebenzisa ubuchwepheshe be-heart pacing ukuze iqondise kabusha isenzo se- ventricle engakwesokudla nangakwesokunxele ezigulini ezikhethiwe ezinokuhluleka kwenhliziyo ngenxa ye- cardiomyopathy ehlanganisiwe .
Cishe umuntu oyedwa kubantu abathathu abanehluleka kwenhliziyo unokungajwayelekile esimisweni senhliziyo senhliziyo esibizwa ngokuthi i- block bundle block block (LBBB) (noma okuhlukile kwe-LBBB eyaziwa ngokuthi "ukuphuza ukuqhutshwa kwe-intraventricular conduction"). Kulaba bantu ngabanye, ukungajwayelekile kokuqhuba kubangela ilungelo futhi ngamabhayisikili ashiya ukuphuma ngaphandle kwe-synch. Ngamanye amazwi, esikhundleni sokushaya ngesikhathi esisodwa, ama-ventricles amabili ashaya kancane ngaphandle kwesigaba, omunye ngemva komunye. Lokhu njenge-asynchrony kuncipha kakhulu ukusebenza komsebenzi kuziguli ezinokuhluleka kwenhliziyo, futhi kwenza izimpawu zenhliziyo zihluleka kakhulu.
I-CRT isebenzisa i-pacemaker ekhethekile ekwazi ukuhamba ngokuzimela ngokubili. Lokhu kuhluke kuma-pacemaker ajwayelekile, okuhamba nge-ventricle kuphela.
Ngesikhathi esifanele ukuhamba kwayo kwe-ventricles ezimbili, i-CRT ikwazi ukuphinda ibenze kabusha ukushaya kwayo ukuze izakhi ze-ventricle zivumelane ngesikhathi esifanayo esikhundleni se-sequentially.
Lapho umsebenzi wezakhi ezimbili ze-ventricle ihlanganiswa ngale ndlela, ukusebenza kahle kwenhliziyo kuyanda, futhi inani lomsebenzi elithathayo ukuze inhliziyo iqhume igazi iyancipha.
Ukusebenza kwe-CRT
Izilingo eziningana zokuhlolwa komtholampilo ziye zahlola ukusebenza nokuphepha kwe-CRT kwiziguli ezinezinkinga zenhliziyo nesigatshana segatsha.
Ukuhlaziywa kwe-meta ekubhekeni kwezi-14 zalezi zivivinyo ezibhalisa iziguli ezingama-4420 ezinokuhluleka kwenhliziyo zaphetha ngokuthi, ezigulini ezikhethiwe kahle, i-CRT iqinisa izimpawu namandla okusebenza, inciphisa izinga lokubhedlela, futhi iyanciphisa ukufa.
Ucwaningo luye lwabonisa nokuthi i-CRT ingathuthukisa kokubili isisu nokusebenza kwenhliziyo, ehlose ukunciphisa ubukhulu be-ventricle ehlanjululwayo esele, ngaleyo ndlela ithuthukise ingxenyana ye- ventricular ejection .
Izinkinga ze-CRT
I-CRT iyi-pacemaker, ngakho-ke inengozi efanayo yezinkinga ongayibona nanoma iyiphi enye i-pacemaker, okufaka ingozi encane yokutheleleka, ukulimala enhliziyweni noma emithanjeni yegazi, nokuphuma kwegazi. Ngaphezu kwalokho, ingozi eyengeziwe ibandakanyeka ekubekeni umqhubi wokuhamba phambili okwazi ukuhamba nge-ventricle kwesokunxele. Kwesinye seziguli ezingama-20, ukuhamba nge-ventricular pacing akukwazi ukufezwa futhi i-CRT ayikwazi ukusetshenziswa.
Yikuphi Ukuhluleka Kwezinhliziyo Okumele Kucatshangelwe Ku-CRT?
Imikhombandlela evamile iphakamisa ukuthi i-CRT ingacatshangelwa iziguli ezinokwehluleka kwenhliziyo eziveza izimpawu ezibalulekile, ezinezinxenyana ezingezansi zangasese ze-ejection ye-0.35 noma ezansi, kanye nesigatshana segatsha lesokunxele.
Ngokuphawulekayo, iziguli eziningi ezihlangabezana nalezi zidingo ze-CRT zizophinde zihlangabezane nezilinganiso ze-defibrillator engasetshenziswa .
Ngakho uhlobo oluvame kakhulu lwedivayisi ye-CRT esetshenziselwa imithi yokwelapha kuyinhlanganisela yedivayisi ye-ICD-CRT.
Izwi elivela
Uma unesifo senhliziyo esikuvimbela ikhono lakho lokusebenza ngendlela evamile, futhi usuvele uthola ukwelashwa okunamandla ukwelashwa kwenhliziyo , kufanele uxoxe nge-CRT nodokotela wakho. Udokotela wakho uzokusiza ukuthi unqume ukuthi ungumuntu omele ukhetho lolu hlobo lwezokwelapha nokuthi ngabe i-CRT ikulungile yini.
> Imithombo:
> Burkhardt, JD, Wilkoff, BL. I-electrophysiology yangaphakathi kanye nokwelashwa kokuvuselela inhliziyo: ukuletha ukwelashwa kagesi ngenhloso yokuhluleka kwenhliziyo. Ukujikeleza kuka-2007; 115: 2208.
> McAlister FA, Ezekowitz J, Hooton N, et al. Ukwelapha ukuvuselelwa kwe-cardiac ngeziguli ezinezinkinga zokungasebenzi kwe-ventricular systolic: ukubuyekezwa okuhlelekile. I-JAMA 2007; 297: 2502.
> Yancy CW, Jessup M, Bozkurt B, et al. 2013 ACCF / AHA isiqondiso sokuphathwa kwehluleka kwenhliziyo: isifingqo somsebenzi: umbiko we-American College of Cardiology Foundation / i-American Heart Association Task Force emithethweni yokuziphatha. Ukujikeleza 2013; 128: 1810.