Isifo seWolff-Parkinson-White (WPW)

I-Wolff-Parkinson-White (WPW) syndrome yimeko apho kukho enye indlela yombane entliziyweni ekhokelela kumaxesha esantya sentliziyo (tachycardia).

I-WPW syndrome sesinye sezona zinto zixhaphakileyo ezibangela iingxaki zokukhawuleza kwentliziyo kwiintsana nabantwana.

Ngokwesiqhelo, imiqondiso yombane ilandela indlela ethile edlula entliziyweni. Oku kunceda intliziyo ibethe rhoqo. Oku kuthintela intliziyo ukuba ingabinamabhithi okanye ii-beats ezongezelelweyo ezenzeka msinyane.

Kubantu abane-WPW syndrome, ezinye zeempawu zombane zentliziyo zihla ngomgaqo owongezelelweyo. Oku kunokubangela ukuba izinga lentliziyo elikhawulezayo libizwe ngokuba yi-supraventricular tachycardia.

Uninzi lwabantu abane-WPW syndrome abanazo ezinye iingxaki zentliziyo. Nangona kunjalo, le meko inxulunyaniswe nezinye iimeko zentliziyo, ezinje nge-Ebstein anomaly. Ifom yesimo ikwaqhuba nakwiintsapho.

Kukangaphi ukubetha kwentliziyo ngokukhawuleza kwenzeka kuyahluka ngokuxhomekeke emntwini. Abanye abantu abane-WPW syndrome baneziqendu ezimbalwa zokukhawuleza kwentliziyo. Abanye banokubetha ngokukhawuleza kwentliziyo kanye okanye kabini ngeveki okanye nangaphezulu. Kananjalo, akunakubakho zimpawu konke konke, ukuze imeko ifumaneke xa kuvavanywa intliziyo kwenziwa esinye isizathu.

Umntu onale syndrome unokuba:

• Intlungu yesifuba okanye ukuqina kwesifuba
• Ukuba nesiyezi
• Ubumhlophe
• Ukufa isiqaqa
• Iipalpitations (imvakalelo yokuziva ukubetha kwentliziyo yakho, ihlala ikhawuleza okanye ingaqhelekanga)
• Ukuqhawukelwa ngumphefumlo

Uvavanyo lomzimba olwenziwe ngexesha lesigcawu se-tachycardia luya kubonisa ukubetha kwentliziyo ngokukhawuleza kune-100 beats ngomzuzu. Inqanaba lentliziyo eliqhelekileyo li-60 ukuya kwi-100 beats ngomzuzu kubantu abadala, nangaphantsi kwe-150 beats ngomzuzu kwiintsana, kwiintsana nakubantwana abancinci. Uxinzelelo lwegazi luya kuba yinto eqhelekileyo okanye ephantsi kwiimeko ezininzi.

Ukuba umntu akanayo i-tachycardia ngexesha loviwo, iziphumo zinokuqheleka. Imeko inokuthi ifumaneke ine-ECG okanye ijonge ukubekwa esweni kwe-ECG, njenge-esweni iHolter.

Uvavanyo olubizwa ngokuba yi-electrophysiologic Study (EPS) lwenziwa kusetyenziswa iicatheters ezibekwe entliziyweni. Olu vavanyo lunokunceda ekuchongeni indawo yendlela yombane eyongezelelweyo.

Amayeza, ngakumbi amachiza anqabileyo afana ne-procainamide okanye i-amiodarone, anokusetyenziselwa ukulawula okanye ukuthintela ukubetha kwentliziyo okukhawulezayo.

Ukuba isantya sentliziyo asibuyeli esiqhelekileyo kunyango, oogqirha banokusebenzisa uhlobo lonyango olubizwa ngokuba yi-cardioversion yombane (ukothuka).

Unyango lwexesha elide lwe-WPW syndrome luhlala luphelisa i-catheter ablation. Le nkqubo ibandakanya ukufaka ityhubhu (i-catheter) emthanjeni ngokusika okuncinci kufutshane nomqala ukuya kwindawo yentliziyo. Xa incam ifikelela entliziyweni, indawo encinci ebangela ukubetha kwentliziyo okukhawulezayo iyatshatyalaliswa kusetyenziswa uhlobo oluthile lwamandla abizwa ngokuba yi-radiofrequency okanye ngokuyiqanda (cryoablation). Oku kwenziwa njengenxalenye yesifundo se-electrophysiologic (EPS).

Utyando lwentliziyo oluvulekileyo ukutshisa okanye ukukhenkceza indlela eyongezelelweyo inokubonelela ngonyango olusisigxina kwi-WPW syndrome. Kwiimeko ezininzi, le nkqubo yenziwa kuphela ukuba ufuna uqhaqho lwentliziyo ngezinye izizathu.

Ukucinywa kwe-catheter kunyanga oku kuphazamiseka kuninzi lwabantu. Izinga lokuphumelela kwenkqubo liphakathi kwe-85% ukuya kwi-95%. Amanqanaba empumelelo aya kwahluka ngokuxhomekeka kwindawo kunye nenani leendlela ezongezelelweyo.

Iingxaki zinokubandakanya:

• Iingxaki zotyando
• Ukumelwa yintliziyo
• Ukunciphisa uxinzelelo lwegazi (kubangelwa kukukhawuleza kwentliziyo)
• Iziphumo ebezingalindelekanga zamayeza

Eyona ndlela ibaluleke kakhulu yokubetha kwentliziyo ngokukhawuleza yi-ventricular fibrillation (VF), enokuthi ikhokelele kukothuka okanye ekufeni ngokukhawuleza. Ngamanye amaxesha kunokwenzeka kubantu abane-WPW, ngakumbi ukuba banayo i-fibrillation ye-atrial (AF), nolunye uhlobo lwesingqisho sentliziyo esingaqhelekanga. Olu hlobo lokubetha kwentliziyo ngokukhawuleza lufuna unyango olungxamisekileyo kunye nenkqubo ebizwa ngokuba yi-cardioversion.

Fowunela umboneleli wakho wezempilo ukuba:

• Unempawu zesifo seWPW.
• Unale ngxaki kwaye iimpawu ziba mandundu okanye zingaphucuki kunyango.

Thetha nomboneleli wakho malunga nokuba amalungu osapho lwakho kufuneka ahlolwe kusini na kwiifom zale meko.

Preexcitation syndrome; WPW; I-Tachycardia - isifo seWolff-Parkinson-White; Arrhythmia - WPW; Isingqisho sentliziyo esingaqhelekanga -WPW; Ukubetha kwentliziyo okukhawulezileyo-WPW

• Isiphene sika-Ebstein
• Imonitha yentliziyo kaHolter
• Inkqubo yokuqhuba kwentliziyo

UDalal AS, uVan Hare GF. Ukuphazamiseka kwenqanaba kunye nesingqisho sentliziyo. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, ii-eds. Incwadi kaNelson yeNcwadi yePediatrics. Umhla wama-21. IPhiladelphia, PA: Elsevier; 2020: isahluko 462.

UTomaselli GF, uZipes DP. Indlela eya kwisigulana esine-cardiac arrhythmias. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ii-eds. Isifo sentliziyo seBraunwald: Incwadi yesifundo seMpilo yeNtliziyo. Ngomhla we-11. IPhiladelphia, PA: Elsevier; I-2019: isahluko 32.

I-Zimetbaum P. Supraventricular arrhythmias yentliziyo. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 58.