Uma unesigqi senhliziyo engavamile, isinyathelo sokuqala sokuthola ukuphathwa ngukuthi udokotela wakho abone ukuthi yikuphi uhlobo lokuhlelwa kwe-arrhythmia. Ukuqaphela ama- arrhythmiya enhliziyo kungaba lula kancane, kunzima kakhulu, noma kukhona phakathi. Ukwenza ukuxilongwa kulula uma une-arrhythmia engapheli noma eqhubekayo-ke kuyindaba nje yokurekhoda i- electrocardiogram (ECG) nokubhala ubukhona kanye nohlobo lwe-arrhythmia obhekene nalo.
Ngeshwa, ngokuvamile ama-arrhythmiya enhliziyo ayingxenye yemvelo-aya futhi ahambe ngaphandle kokuxwayisa. Kulezi zimo, izimpawu zakho zingase zivele njengeziqephu ezincane, ngokuvamile zihlala imizuzwana embalwa nje, ngakho-ke ukurekhoda i-ECG engama-12 yesibili engahleliwe kungabonakali ukuhlela, futhi ukuhlolwa okwengeziwe kuyadingeka. Kodwa isimiso esiyisisekelo sisafana: ukuhlolisisa i-arrhythmia yenhliziyo, i-arrhythmia ngokwayo idinga ukuba "ithunjiswe" kwenye uhlobo lokuqopha kwenhliziyo.
Ama-Labs nezivivinyo
Uma udokotela wakho ecabanga ukuthi ungaba ne-arrhythmias ye-cardiac, umbuzo wokuqala ukuthi ngabe lawo ma-arrhythmias kungenzeka abe esongela ukuphila. Uma uke waba nezinhlanzi zokungazichazi, ugozi olunzima, noma ube nesifo se- syncope (ukulahlekelwa kwengqondo)-ikakhulukazi uma une-heart disease epilisi-udokotela wakho cishe uzocabangela ukuthi kungenzeka ukuthi unesigamu esiyingozi, njenge-tricycardia ye-ventricular noma i- heart block .
Uma kunjalo, kufanele ubekwe esibhedlela ngesilonda senhliziyo kuze kube yilapho kutholakala ukuxilongwa okuqinile futhi, uma kunesidingo, ukwelashwa okuphumelelayo kuqaliswa.
Umlando Wezokwelapha kanye nokuhlolwa Kwemvelo
Uma udokotela wakho ebona ukuthi izimpawu zakho zingasongeli impilo, cishe uzoqala ngokuhlolwa ngokomzimba nokubuyekezwa kwezimpawu zakho kanye nemibandela engenzeka ukuthi ibangele i-arrhythmia.
Ngokwesibonelo, uma ecabanga ukuthi unesifo se- thyroid noma isifo senhliziyo esibangela ukuhlela kwakho, ungahlolwa ngalezi zimo. Ukwengeza, ungase ube nokuhlolwa kokuqapha inhliziyo njenge-electrocardiogram noma i-echocardiogram.
I-Electrocardiogram
Izimpawu ezengeziwe ezijwayelekile ze-arrhythmia ezinjenge- palpitations , ukukhathala okuncane, noma ukuzondeka okwesikhashana, akunakwenzeka ukuthi kubonise ukuguqulwa kokuphila okuphilayo futhi kusetshenziswe ukuhlolwa kwenhliziyo okuvamile. Ngokuvamile, lokhu kufezwa ngokuzama ukurekhoda i- electrocardiogram (ECG) ngesikhathi sesiqephu sezimpawu. Nge-ECG eyisisekelo, une-electrodes exhunyiwe esifubeni sakho okurekhoda umsebenzi wegesi wenhliziyo yakho, okufaka ukuthi nini futhi isikhathi eside kangakanani izinhliziyo zakho zenzeka. Kungadingeka ukusebenzisa i-ECG ephathekayo ongayigqoka ngenkathi uhamba mayelana nesimiso sakho sezinsuku zonke.
Holter Monitor
Uma izimpawu zakho zenzeka nsuku zonke noma cishe nsuku zonke, okukhethwa kukho ukuhlonza imbangela kungase kube ukusebenzisa umlenze we-Holter, idivayisi ephathekayo ye-ECG egcina isigqi sakho senhliziyo isikhathi esingamahora angu-24-48. Ungacelwa ukuba ugcine idayari ngokucophelela, uqaphele izikhathi eziqondile iziqephu zezimpawu ezenzekayo. Idayari ingabe ihlotshaniswa nokurekhoda komculo ukukhombisa ukuthi izimpawu zihlobene yini nesifo senhliziyo.
I-Monitor Monitor
Uma izimpawu zakho zivela kaningi kangako kunsuku zonke noma zonke izinsuku ezimbalwa noma zenzeke ngokushesha kakhulu, okukhethwa kukho okungcono kungaba umqapha womcimbi, olunye uhlobo lwe-ECG ephathekayo. Uyifaka emzimbeni wakho uma unayo izimpawu bese ucindezela inkinobho ukurekhoda umsebenzi wegesi wenhliziyo yakho ngaleso sikhathi.
Izibukeli ze-Patch
Enye indlela uma izibonakaliso zakho zenzeka kaningi kangako ukuhlolwa kwe-patch njengesiqephu se-Zio, idivayisi yokurekhoda yesikhathi esigcwele engamathelisi engagcina amasonto amabili okuqoshwa okuqhubekayo kwenhliziyo yakho bese uthola futhi urekhode noma yikuphi ukuhlelwa kwe-cardiac you may have .
Kukhona futhi uhlelo lwe-SEEQ MT, olukwazi ukurekhoda nokuqapha izinsuku ezingu-30. Ukungalungi kwama-patch wokuhlola kungukuthi kungabi kubiza ngoba kungabuyiselwa futhi kungathatha isikhathi esengeziwe ukuthola imiphumela yakho, kodwa kulula, ukungabi namanzi, okulula ukuyisebenzisa, nokunethezeka.
I-Echocardiogram
I- echocardiogram uhlobo lwama-ultrasound olungenabuhlungu olusetshenziselwa ukubheka ubukhulu nesakhiwo senhliziyo yakho, kanye nendlela okushaya ngayo. Ungaba ne-echocardiogram ngenkathi usebenzisa umzimba noma ngenkathi uphumula.
I-Implantable Loop Recorder
Uma izibonakaliso zakho zingapheli kakhulu, kukhona amarekhoda ezincane ezinhliziyo ezincane ezingasetshenziswa ezingasetshenziswa kuze kube yiminyaka emithathu ukurekhoda njalo isigqi senhliziyo yakho bese uthatha ama-arrhythmias ukuthi abacubunguli bezinhliziyo ezincane abafinyelelekile. Le divayisi ifakwe ngaphansi kwesikhumba sakho esifubeni sakho futhi ingase ibe usizo ikakhulukazi uma unesihlungu sokukhomba ukuthi yini eyabangela.
Ukuhumusha i-ECG
Inhloso yokurekhoda isigqi senhliziyo yakho ngesikhathi sesiqephu sezimpawu ukuzama ukuqondanisa izimpawu zakho ngokurekhoda kwe-ECG yakho ngesikhathi izimpawu zenzeka. Okufanelekile, ukwenza ukuxilongwa, izimpawu zizoqala lapho i-arrhythmia yenza, bese uxazulula uma i-arrhythmia ima. Uma kubonakala sengathi iphethini elinjalo, kuqiniseke ukuthi i-arrhythmia ikhiqiza izimpawu.
Kodwa-ke, ngokuvamile, abantu bazobika izimpawu ngezikhathi lapho isigqi senhliziyo siphenduka sibe sesivamile; noma ngokuphambene, i-arrhythmia izorekhodwa ngesikhathi lapho kungekho khona izimpawu. Ngaphansi kwalezi zimo, kungenzeka ukuthi izimpawu ozibonayo azikho ngenxa yokuthi u-arrhythmia, futhi udokotela wakho kufanele aqale ukucabangela izincazelo ezihlukile zezimpawu zakho.
Uma udokotela wakho engatholi i-arrhythmia nhlobo ekuhlolweni kokuqapha inhliziyo, kodwa namanje usolwa ukuthi unawo, angase azame ukuqala eyodwa usebenzisa olunye lwalezi zivivinyo:
Ukucindezeleka kokucindezeleka
Njengoba amanye ama-arrhythmias ashukunyiswa noma enza okungalungile ngokuzivocavoca noma ngokuzikhandla, udokotela wakho angenza ukuhlolwa kokucindezeleka , aqaphele inhliziyo yakho ngenkathi usebenza ngebhayisikili esiteshini noma isitatimende sokuhamba. Uma kunesizathu sokuthi awukwazi ukuzivocavoca, ungase unikezwe isidakamizwa eshukumisa inhliziyo esikhundleni.
Ukuvivinya kwethebula le-Tilt
Uma uke wahlupha, udokotela wakho angase afune ukwenza ukuhlolwa kwetafula lokuthambekela . Ngesikhathi ulala phansi etafuleni, umsebenzi wakho wenhliziyo nokucindezelwa kwegazi kuhlolwa. Ungaphinde unikezwe umugqa wokugcoba (IV) uma udinga imithi. Itafula lishintshwa ukuze lime njengokungathi ume lapho udokotela wakho ehlola noma yikuphi ushintsho ekucindezelweni kwegazi kanye / noma umsebenzi wenhliziyo.
Ucwaningo lwe-Electrophysiology (EPS)
Uma i-arrhythmia yakho ingavamile noma idokotela wakho enenkinga enkulu ukuyithola noma ecabanga ukuthi ingasongela ukuphila, angase enze isifundo se-electrophysiology (EPS), uhlolo olukhethekile lokucwanitiza lapho ama-catheter e-electrode (ama-flexible, wireless insens with metal amathiphu e-electrode) afakwa enhliziyweni yakho ukuze afunde uhlelo lwegesi kagesi.
Okumele Ukulindele: Uma udokotela wakho ekuthumelele i-EPS, uzolethwa kwi-laboratory ye-electrophysiology (i-laboratory ekhethekile ye-catheterization laboratory) lapho uzolala khona etafuleni lokuhlola. Uzonikezwa i-anesthesia yendawo, futhi mhlawumbe i-sedative, futhi ama-catheters we-electrode azofakwa emithinini yakho yegazi eyodwa noma ngaphezulu. Ama-catheters afakwa noma ngokufaka isikhunta esincane noma nge-stick-stick, ngokuvamile ekhanda lakho, ekuguleni, noma entanyeni. Ngokuvamile kuvame ukusetshenziswa 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 yakho.
Uma sezibekwe kahle, ama-catheter ase-electrode asetshenziselwa ukwenza imisebenzi emibili eyinhloko: ukurekhoda izimpawu zikagesi ezenziwe yinhliziyo yakho nokuhamba ngenhliziyo yakho. I-Pacing ifezwa ngokuthumela izimbonakaliso ezincane zamagesi ku-catheter ye-electrode. Ngokurekhoda nokuhamba ngezindawo ezivela enhliziyweni yakho, izinhlobo eziningi ze-arrhythmiya zenhliziyo zingafundiswa ngokugcwele. Uma inqubo iphelele, i-catheter (s) isusiwe. Ukwehla kwegazi kulawulwa ngokubeka ingcindezi kwisayithi ye-catheterization imizuzu engama-30 kuya kwangu-60.
Lokho Okukwenzayo: I-EPS ingasiza ekuhloleni kokubili ama- bradycardias (izinhliziyo ezincane ezihamba kancane) kanye ne- tachycardias (i-heart arrhythmias esheshayo). I-Tachycardias ihlolwe ngokusebenzisa amasu okuhleleka okuhleliwe okwenza i-tachycardia. Uma i-tachycardias ingase ibangele ngesikhathi se-EPS, ke ngokutadisha izimpawu zikagesi ezirekhodiwe ezigumbini ze-electrode, imbangela eqondile ye-tachycardia ingase ibonakale. Uma lokhu sekufeziwe, ukwelashwa okufanele kuvame ukucaca.
Ukunquma Ukwelashwa: Kunezindlela ezimbalwa i-EPS ingakusiza wena nodokotela wakho wenze izinqumo zokwelapha. Izinketho zokwelashwa ezingase zibhekwe ngokusekelwe kwimiphumela ye-EPS zifaka:
- Ukufakwa kwe-pacemaker: Uma i-EPS iqinisekisa ukuthi kukhona i-bradycardia ebalulekile, i- pacemaker engapheli ingafakwa ngokushesha, ngesikhathi esifanayo.
- I-Ablation: Uma i -tachycardia engaphezulu (i-SVT) -nezinye izinhlobo ze-tachycardia ye-ventricular (VT) -yatholakala, ukukhishwa kwe-radiofrequency ngokuvamile kuyindlela yokwelashwa. Inqubo ye-ablation ivame ukuqhutshwa ngesikhathi esifanayo, ngokushesha emva kwe-EPS.
- Ukufakwa kwe-defibrillator engasetshenziswa: Uma izinhlobo eziphuthumayo ze-VT kanye / noma i -fibrillation ye-ventricular (VF) zikhonjiswe ngesikhathi se-EPS, ngokuvamile ngokuvamile i- defibrillator engasetshenziselwa yindlela yokwelapha. Le divayisi manje ingeniswa kaningi e-laboratory EP, ngokushesha ilandela i-EPS. Eminyakeni eyadlula, i-EPS yasetshenziselwa ukukhomba isidakamizwa esingcono kakhulu sokulwa neziguli ngeziguli ezine-VT noma i-VF, kodwa namuhla kuyaziwa ukuthi akukho mshini wokulwa nomuthi osebenzayo osebenza kahle njengendlela yokuhlenga isisindo sokuvimbela ukufa okungazelelwe kusuka kulezi zi-arrhythmias.
Izingozi: Izingozi ezingase zibe khona zokuba ne-EPS zifana nalabo abanokwelashwa kwenhliziyo. Lezi zinqubo ziphephile, kepha ngoba ziyizinqubo ezingenayo ezihilela inhliziyo, izinkinga eziningana zingenzeka. Akufanele ube ne-EPS ngaphandle kokuthi kunethuba elihle lokuthi imininingwane etholakale kusukela enkambisweni izoba nenzuzo enkulu.
Izinkinga ezincane zibandakanya ukuphuma kwegazi esakhiweni sokufakwa kwe-catheter, ukuphazamiseka kwengqondo okwesikhashana okubangelwa i-catheter ecasula isisu senhliziyo, nezinguquko zesikhashana egazini legazi. Izinkinga ezibaluleke kakhulu zihlanganisa ukuguqulwa kwodonga lwenhliziyo okubangela isimo esongela ukuphila esibizwa ngokuthi i-tamponade ye-cardia , ukuphuma kwamanzi amaningi, noma, ngoba ukukhishwa kwamakhemikhali okubulala, okuboshwa inhliziyo. Ingozi yokufa ngesikhathi se-EPS ingaphansi kwe-1 ku-1,000.
> Imithombo:
> American Heart Association. Izivivinyo ezivamile ze-Arrhythmia. Kubuyekezwe ngomhla ka-21 Disemba, 2016.
> Fung E, Jarvelin MR, uDoshi RN, et al. Amadivayisi we-Patch Electrocardiographic ne-Contemporary Wireless Cardiac Monitoring. Imingcele e-Physiology . 2015; 6: 149. doi: 10.3389 / fphys.2015.00149.
> Levy S. Arrhythmia Management for the Clinic Care Clinic. Kusesikhathini. Kubuyekezwe ngo-Ephreli 17, 2017.
> Abasebenzi beMayo Clinic. I-Heart Arrhythmias. I-Mayo Clinic. Kubuyekezwe i-Disemba 27, 2017.