Uma uthola ukuthi une- arrhythmia yesifo senhliziyo , ukwelashwa kuzoxhomeke kuloluhlobo onalo nokuthi lubi kangakanani. Uma kungabangela izimpawu ezinkulu futhi awusengozini yokuthuthukisa i-arrhythmia noma ukuxilongwa okubi kakhulu, cishe ngeke udinga ukwelashwa. Kodwa-ke, uma izimpawu zakho zinzima futhi / noma udokotela wakho ukhathazekile ukuthi ukuhlela kwakho kungase kube yinto engathà sina, angancoma ukwelashwa okufanele izidingo zakho.
Imigomo
Ngokuvamile, kunezizathu ezimbili udokotela wakho angase afune ukukubeka emithonjeni ye-arrhythmia yenhliziyo. Okokuqala, i-arrhythmia ingase ibangele ukuthi ube nezimpawu, njenge- palpitations noma ikhanda elincane , futhi ukwelashwa kungase kubalulekile ukukhulula lezo zimpawu. Noma, okwesibini, i-arrhythmia ingase ibangele ukulimaza noma ukusongela ukwenza kanjalo.
Izidakamizwa Zama-antiarrhythmic
Izidakamizwa zokulwa ne-antiarrhythm yimithi eguqula izakhi zikagesi zezicubu zenhliziyo, futhi ngokwenza kanjalo, shintsha indlela isignali kagesi yenhliziyo yakho isakazeka ngayo yonke inhliziyo yakho. Njengoba i- tachycardias (i-arrhythmias ebangela ukushaya kwenhliziyo ngokushesha) ngokuvamile ihlotshaniswa nokungajwayelekile embonini kagesi, izidakamizwa ezishintsha isignali kagesi senhliziyo yakho zivame ukuthuthukisa lawo ma-arrhythmias. Izidakamizwa zokulwa nezifo zivame ukuphumelela, noma okungenani ziphumelele, ekuphatheni izinhlobo eziningi ze-tachycardias.
Ngeshwa, izidakamizwa ezithathelwanayo njengeqembu zivame ukuletha inani elihle lemiphumela yelinye uhlobo noma olunye, futhi ngenxa yalokho, kungaba nzima ukuthatha.
Isidakamizwa ngasinye sokulwa negciwane sinephrofayili yaso eyingqayizivele yobuthi, futhi ngaphambi kokumisela noma iyiphi yalezi zidakamizwa, kubalulekile ukuthi udokotela wakho uchaze ngokucophelela izinkinga ezingase zivele ngesidakamizwa esikhethiwe.
Kodwa-ke, kunenkinga eyodwa eyinhlekelele ejwayelekile kuzo zonke izidakamizwa ezihlukunyezwayo: Ngezinye izikhathi lezi zidakamizwa zenza ukukhubazeka kube nzima kunokuba kube ngcono.
Lesi sici semithi e-antiarrhythm-ebizwa ngokuthi i-proarrhythmia-ibuye ibe yindawo ephilayo yezidakamizwa ezishintsha isignali kagesi senhliziyo. Kalula nje, uma wenza noma yini ukuze ushintshe indlela isignali kagesi esakazeka ngayo yonke inhliziyo, kungenzeka ukuthi ushintsho luzokwenza i-tachycardia ibe ngcono, noma ingenza kube kubi nakakhulu.
Izidakamizwa ezisetshenziswa ngokuvamile ezibandakanya i-Cordarone noma iPacerone (amiodarone), iBapace (sotalol), iRhythmol (propafenone), ne-Multaq (i- dronedarone ). I-Amiodarone iyisidakamizwa esiwusizo kakhulu kunazo zonke futhi ingencane kakhulu yokwenza i-proarrhymia kunezinye izidakamizwa. Ngeshwa, ezinye izinhlobo zezinyosi ezibonwe nge-amiodarone , njengokulimala kwamaphaphu noma kwesibindi, zingaba zimbi kakhulu, futhi lesi sidakamizwa kufanele sisetshenziswe kuphela, njengezo zonke izidakamizwa zokulwa, uma kunesidingo.
Okubalulekile ukuthi odokotela bafanele-futhi kufanele babe-ukungabaza ukunikeza izidakamizwa zokulwa nezidakamizwa. Lezi zidakamizwa kufanele zisetshenziswe kuphela lapho i-arrhythmia ikhiqiza izimpawu eziphawulekayo noma ibeka usongo empilweni yakho yempilo.
I-AV Nodal Ukuvimbela Izidakamizwa
Imithi eyaziwa ngokuthi i-AV nodal blocking drugs- beta blockers , i- calcium channel blockers , kanye ne-digoxin-umsebenzi ngokunciphisa isignali kagesi senhliziyo yakho njengoba idlula ku- node ye - AV endleleni eya kusuka ku-atria kuya kwi-ventricles.
Lokhu kwenza izidakamizwa zokuvimbela i-AV nodal ikakhulukazi eziwusizo ekwelapheni ama -tachycardias angaphezulu (i-SVT). Ezinye izinhlobo ze-SVT, ikakhulukazi i- AV nodal reentrant tentycardia ne-tachycardias ebangelwa amapheshana, ifuna i-AV node ukuqhuba isignali kagesi ngendlela efanele, futhi uma i-AV node ingenziwa ukuqhuba isignali kagesi kancane kancane, i-SVT imane nje.
Ukuze i-SVT eyaziwa ngokuthi i-fibrillation ye-atrial , izidakamizwa zokuvimbela ama-AV azivimbeli i-arrhythmia, kodwa zinciphisa isilinganiso senhliziyo yakho ukusiza ukuqeda izimpawu. Eqinisweni, ukulawula izinga lenhliziyo yakho ngezidakamizwa zokuvimbela i-AV nodokotela ngokuvamile kuyindlela engcono kakhulu yokuphatha i-fibrillation ye-atrial .
Izibonelo ze-beta blockers zihlanganisa i-Sectral (acebutolol), i-Tenormin (i-atenolol), i-Zebeta (i-bisoprolol), i- Lopressor noma i-Toprol-XL (i-metoprolol), i-Corgard (nadolol), i-Bystolic (nebivolol), ne-Inderal LA noma i-InnoPran XL (i-propranolol). Lokhu kungabangela imiphumela emibi njengokucindezeleka, izinga lentliziyo elincane, ukukhathala, i-Raynaud's syndrome, ukungasebenzi komzimba ngokocansi, ukuphefumula okuphefumulayo, kanye nokuphefumula kwamabhayisikili.
Kuphela abavimbela isiteshi se-calcium abazuzisa ukuphatha ama-arrhythmias, kuhlanganise ne-Cardizem noma i-Tiazac (diltiazem), ne-Calan noma i-Verelan (i-verapamil). Imiphumela emibi engaba khona ihlanganisa izinyawo ezivuvukile, ukuqothulwa, isifo sohudo, nokucindezela kwegazi okuphansi.
Anticoagulants
Uma usengozini yokuthuthukisa ama-clots egazi, okungaholela ekushayweni, udokotela wakho angase anike i- anticoagulant (igazi elincane) . Le mithi igcina igazi lakho lingavali futhi liyeke ama-clots osuvele unayo ukusuka ekukhuleni, nakuba angakwazi ukunciphisa ubukhulu bezindwangu zegazi ezikhona. Uma usuke unesifo sokushaya isifo noma unesibindi se-atrial, kungenzeka ukuthi udokotela wakho uzokubeka ku-anticoagulant. Imiphumela emibi evamile ye-anticoagulants ihlanganisa ukubhuqa, igesi, isifo sohudo, isicanucanu, ukuhlanza, nokungazizwa ulambile.
Izidakamizwa Okunciphisa Inengozi Yokuboshwa Kwelinye Inhliziyo
Imithi embalwa icatshangwa ukuthi inganciphisa ingozi yokuboshwa komzimba ngokushesha, mhlawumbe ngokunciphisa ingozi ye- ventricular tachycardia noma i -fibrillation ye-ventricular , i-arrhythmias eveza ukuboshwa komzimba . Ucwaningo lubonisa ukuthi abakwa-beta blockers kubonakala sengathi bancishisa ingozi yokuboshwa komzimba ngokuzumayo ngokuvimbela umphumela we-adrenaline ezinsikeni zenhliziyo, ngaleyo ndlela ukunciphisa amathuba okuba i-arrhythmias ebulalayo. Zonke iziguli ezasinda ekuhlaselweni kwenhliziyo noma ezinokuhluleka kwenhliziyo kufanele zithathe ama-blocka blockers.
Ezinye izidakamizwa udokotela wakho angase azenze uma usengozini yokuboshwa komzimba ngokuzumayo zihlanganisa ama- angiotensin-aguqule i-enzyme (ACE) inhibitors , i-calcium channel blockers, kanye nama-amiodarone e-antiarrhythmic drug.
Amadivayisi afakiwe
Ezinye izinhlobo ze-arrhythmias zingadinga idivayisi efakwe ngaphakathi ukusiza ukulawula isigqi senhliziyo yakho.
I-Pacemaker
Uma ukushaya kwenhliziyo yakho kuhamba kancane noma kungavamile, udokotela wakho angase ancoma i- pacemaker , idivayisi eqhutshwa ngebhethri egcina inhliziyo yakho ibetha ngesivinini esifanayo, esivamile. Ubekwe ngaphansi kwesikhumba sakho eduze kwe-collarbone yakho, lapho uxhumeke khona ngecingo enhliziyweni yakho. I-pacemaker ikhiqiza imishanguzo kagesi esiza inhliziyo yakho ukuba ishaye ngokujwayelekile, ukuvimbela ama-arrhythmias.
I-Cardioverter Defibrillator (i-ICD) efakwe ngaphakathi
Uma uboshiwe ngokungazelelwe inhliziyo, utholakale ukuthi une-ventricular tachycardia noma i-fibrication ye-ventricular, noma usengozini yokuthuthukisa noma yimuphi walawa ma-arrhythmias, udokotela wakho angase ancoma i- cardioverter defibrillator (ICD) engasetshenziswa . Lawa madivaysi angavimbela ukufa okungazelelwe kusuka ekuboshiwe inhliziyo, okuyisisekelo esiyinhloko esetshenziswa ngazo. Njenge-pacemaker, i-ICD iphinde inikwe amandla ebhetri futhi iphinde ibe ngaphansi kwesikhumba sakho eduze kwe-collarbone yakho. Izintambo nge-electrode kulezi zeluleko zinamathele enhliziyweni yakho futhi ICD ihlola inhliziyo yakho njalo. Ngokungafani ne-pacemaker, i-ICD igxila kuphela uma ithola isigqi esingavamile, ukuthumela ukushaqeka noma ukwelashwa okuphambene nenhliziyo yakho ukuyibuyisela evamile. Njengoba ama-ICD awavimbeli ama-arrhythmias, cishe kuzodingeka uthathe imithi futhi.
Izindlela zokuhlinza kanye nezinqubo ezihamba phambili ezikhethekile
Kunezinqubo ezikhethekile noma ukuhlinza okungase kusetshenziselwe ukuphatha ukuhlelwa kwakho. Nakulokhu, lezi zelashwa zixhomeke kuhlobo kanye nobukhulu be-arrhythmia yakho.
Ablation
Amanye ama-arrhythmias abangelwa ukungalingani kwendawo ngaphakathi kwesistimu kagesi kagesi. Kulezi zimo, inqubo ye-ablation ingakwazi ukuphazamisa ukungavamile kwamandla kagesi. I- ablation ingasetshenziswa njengendlela yokwelashwa uma ungakwazi ukubekezelela imithi noma ayisebenzi. Umgomo wale nqubo uvame ukuqeda ukuhleleka kokuphelele.
Ngenkathi izinqubo zokuqeda izinyathelo zingenziwa ekamelweni lokusebenza ngesikhathi sokuhlinzwa kwenhliziyo evulekile , uhlobo oluvame kakhulu lwe-ablation lufezwa ngesikhathi esithile se- catheterization yomzimba ebizwa ngokuthi i-electrophysiology study (EPS).
Lezi zifundo zenziwa yi-electrophysiologists yenhliziyo-izazi ze-cardiologists ezinokuqeqeshwa okukhethekile ekwelapheni ama-arrhythmias enhliziyo. I-EPS ingenziwa njengendlela yokuxilonga uma kubalulekile ukukhipha kahle indlela ye-arrhythmia yakho futhi ngokuvamile ukunquma ukuthi inqubo yokuphumula ingase ibe nokuphulukisa ukuhlelwa komzimba. Namuhla, izifundo eziningi ze-electrophysiology zihlanganisa ukuhlolwa kokuhlola nge-ablation inqubo.
Ngesikhathi senqubo yokuphumula, ama-catheter akhethekile ane-electrode at the tip ahlelwe ezindaweni ezihlukahlukene ngaphakathi kwenhliziyo yakho, futhi yonke uhlelo lwegesi yocingo lufundwa futhi lihlolwe. Uma indawo engavamile ikhonjiswe ukuthi iyabangela ukukhiqiza i-arrhythmia yakho, iphuzu le-catheter liqondiswa kuleyo ndawo engavamile, futhi ukukhishwa kwe-ablation kwenziwa nge-catheter. I-ablation ifezwa ngokudlulisela uhlobo oluthile lwamandla ngokusebenzisa i-catheter (amandla okushisa, amandla okushisa, noma amandla we-radiofrequency) ukuze abonakalise (ablate) izicubu ekugcineni kwe-catheter. Lokhu kudala ibhuloho emgwaqweni kagesi okwenza u-arrhythmia wakho.
Eminyakeni yamuva, izinqubo zokuqeda izinkampani ziye zithuthuka kakhulu, futhi zivame ukusebenzisa ama-mapping systems asebenza ngokucophelela asebenzisa i-3D-imaging kanye nemephu yamandla kagesi ukukhomba indawo efanelekile yokuthola imali. Ngokuvamile kuthatha amahora ambalwa futhi udinga usuku noma ezimbili zokuphumula ngesikhathi esibhedlela.
I-Ablation isebenza ngamaphesenti angama-60 kuya kwangu-80 engxenyeni yesikhathi sokuba abantu abanezibalo ezinzima kakhulu ezifana ne-fibrillation ye-atrial, i-atrial tachycardia, ne-tricycardia ye-ventricular. Kubantu abanama-tachycardias angaphezulu, izinga lokuphumelela lingamaphesenti angama-90 kuya kuma-95%.
I-cardioversion
Kwezinye izinhlobo ze-arrhythmias njenge-fibrillation ye-atrial kanye ne-fibrication ye-ventricular, i- cardioversion ingase ibe ukhetho lwezokwelapha. Kule nqubo, inhliziyo yakho ishukunyiswa ngogesi ngamadada noma ama-patches esifubeni sakho kusuka ku-defibrillator. Ukwethuka kungaphoqa inhliziyo yakho ukuba ibuyele kwisigqi esivamile.
Inkambiso ye-Maze
Uma ungaphenduli kwezinye izimo zokwelapha noma ukuhlinzwa kwenhliziyo ngesinye isizathu, udokotela wakho angancoma inqubo ye-Maze . Lokhu kuhilela ukwenza ukucatshangelwa engxenyeni engenhla yenhliziyo yakho (i-atria) elwalayo futhi ivimbele impembelelo kagesi ekudaleni i-arrhythmia ngoba imizwa ayikwazi ukuhamba ngezicubu ezibomvu.
I-Coronary Bypass
Ezimweni zesifo se-coronary artery esiyingozi esibangela ukuba u-arrhythmia wakho, udokotela wakho angase ancoma i- passpass coronary , engayithuthukisa ukunikezwa kwegazi enhliziyweni yakho.
Amakhambi asekhaya kanye nendlela yokuphila
Ukwenza izinguquko ezithile zokuphila kungasiza ukugcina inhliziyo yakho iphilile futhi unciphise ingozi yokuthola isifo senhliziyo.
Yidla ukudla okunempilo enhle
Qinisekisa ukuthi ukudla kwakho kugcwele izinhlobo ezihlukahlukene zezinhlamvu, izithelo, nemifino nokuthi kuncane usawoti, i-cholesterol, namafutha. Shintshela ekamelweni eliphansi lamafutha noma elinamafutha futhi udle inyama enomzimba, izinkukhu nezinhlanzi.
Hlala Uhamba
Ukuzivocavoca kugcina inhliziyo yakho iphilile. Zama ukuthola usuku nosuku noma usethe umgomo wokwandisa umsebenzi wakho futhi usebenze kuwo.
Buka isisindo sakho
Ukweqisa ngokweqile noma ukukhuluphele kunandisa ingozi yesifo senhliziyo ngoba usebenza ngenhliziyo yakho kanzima. Ukudla ukudla okunempilo nokwandisa ukuzivocavoca kwakho kungakusiza ukuba ufike futhi ugcine isisindo esinempilo.
Phula Indlela Yokubhema
Uma uphethile, sebenzela ukuyeka. Lesi sinqumo esingcono kunayo yonke ongayenza ngomzimba wakho wonke, ungasho ngenhliziyo yakho.
Gcina Ukucindezeleka Kwegazi Nezinga Le-Cholesterol
Sisebenzise izinguquko ezingenhla zendlela yokuphila futhi uqiniseke ukuthi uthatha noma yimiphi imithi oyinikezwe ukucindezelwa kwegazi kanye / noma i-cholesterol.
Lawula Ukucindezeleka Kwenu
Ukucindezeleka kungasiza ekwenzeni ama-arrhythmias, Qinisekisa ukuthi uthatha isikhathi sokwenza imisebenzi oyithandayo. Funda amasu okuphumula. Yenza ukukhungatheka kwakho ngokuzivocavoca.
Utshwala olinganiselwe
Udokotela wakho angase angafuni ukuthi uphuze utshwala ngoba kungenza inhliziyo yakho ishaye ngokushesha, kodwa uma wenza, qiniseka ukuthi uyayenza ngokulinganisela. Ukudla okunomsoco okuphuza kuya kwesinye isiphuzo ngosuku ngabesifazane nabesilisa abaneminyaka engaphezu kwengu-65 futhi kuze kube yiziphuzo ezimbili ngosuku ngabasilisa abaneminyaka engaphansi kwengu-65.
Gcina Izinqunto Zakho
Ngisho noma uzwa kahle, qiniseka ukuthi ugcina izikhundla zakho zezokwelapha kanye nazo zonke ezinye izinsizakalo zakho zokulandelela. Thatha imithi yakho njengoba iqondiswe futhi uvumele udokotela wakho wazi ukuthi unayo yini izimpawu noma imiphumela emibi yecala.
Imithi yokwelapha ehambisanayo (i-CAM)
Kunezinye izindlela zokwelapha ezingasiza ukuphatha ama-arrhythmias noma ukucindezeleka okungabenza kube kubi nakakhulu. Lokhu kufaka:
Ama-Vagal Maneuvers
Uma une-tachycardia ephakeme, izivivinyo ezilula ezibizwa ngokuthi i-vagal maneuvers zingasiza ukunciphisa noma ngisho nokuyeka. Lezi zindlela zisebenza ngokuthinta i-vagus nerve, elawula ukushaya kwenhliziyo yakho, futhi ihlanganisa:
- Ukugubha
- Ukushaya
- Ukubheka ubuso bakho emanzini e-ice
- Ukubamba umoya wakho ngenkathi uzama ukuphoqa ngamandla
- Ukubeka iminwe yakho kumajwabu amehlo akho bese ucindezela ngobumnene
Khuluma nodokotela wakho mayelana nokusebenzisa ama-vagal ukuhamba kusukela kungase kungabi yindlela yokwelashwa okuhle kuwe.
I-Acupuncture
Nakuba kudingeke ucwaningo olwengeziwe, ucwaningo luye lwabonisa ukuthi ukukhishwa kwesikhumba kungase kube ukwelashwa okuphephile futhi okuwusizo ama-arrhythmias athile, ikakhulukazi i-tachycardia ephezulu ye-paroxysmal, beat beat premature, tachycardia yesinus, kanye ne-fibrillation ye-atrial. Ukwengeza, ukukhishwa kwesikhumba kunezingozi ezimbalwa, ngakho lokhu kungafaneleka.
Ukucindezeleka Ukunciphisa Imithi
Njengoba ukucindezeleka kuyisici esingenza isimo sakho sibi nakakhulu, kungenzeka ukuthi uzama ukunciphisa inani lokucindezeleka ozizwayo. Nazi ezinye izindlela zokusiza:
- Yoga
- Ukuzindla
- Izindlela zokuphumula ezifana nokuphefumula okujulile, ukuphumula kwemisipha okuqhubekayo, nokubukeka
> Imithombo:
> American Heart Association. Imithi ye-Arrhythmia. Kubuyekezwe ngo-September 2016.
> Bohnen M, Stevenson WG, Tedrow UB, et al. Ukukhubazeka Nokuziqaphelisa Kwezinkinga Ezinkulu Ezivela Emthonjeni Wenkathi Yesikhathi Esizayo Ukwelapha I-Cardiac Arrhythmias. I-Heart Rhythm . Novemba 2011; 8 (11): 1661-6. doi: 10.1016 / j.hrthm.2011.05.017.
> Li Y, Barajas-Martinez H, Li B, et al. Ukuqhathanisa Ukuqhathaniswa Kwe-Acupuncture ne-Antiarrhythmic Izidakamizwa Zokuvimbela I-Cardiac Arrhythmias: Ukubuyekezwa Okuhlelekile Nokuhlaziywa Kwezinguquko Zemizamo Elawulwa Ngamaphutha. Imingcele e-Physiology . 2017; 8: 358. doi: 10.3389 / fphys.2017.00358.
> Abasebenzi beMayo Clinic. I-Heart Arrhythmia. I-Mayo Clinic. Kubuyekezwe i-Disemba 27, 2017.
> Mitchell LB. Sibutsetelo samazwi angavamile wezinhliziyo. I-Merck Manual: I-Consumer Version.