I-Atrial fibrillation okanye i-flutter

I-Atrial fibrillation okanye i-flutter yinto eqhelekileyo yokubetha kwentliziyo engaqhelekanga. Isingqisho sentliziyo siyakhawuleza kwaye sihlala singaqhelekanga.

Xa usebenza kakuhle, amagumbi amane esivumelwano sentliziyo (khama) ngendlela ehleliweyo.

Iimpawu zombane zalathisa intliziyo yakho ukuba impompe inani elifanelekileyo legazi kwiimfuno zomzimba wakho. Imiqondiso iqala kwindawo ebizwa ngokuba yi-sinoatrial node (ekwabizwa ngokuba yi-sinus node okanye i-SA node).

Kwi-fibrillation ye-atrial, ukunyanzeliswa kombane kwentliziyo akuqhelekanga. Kungenxa yokuba i-ninoatrial node ayisasilawuli isingqisho sentliziyo.

• Inxalenye yentliziyo ayinakho ukwenza isivumelwano ngendlela ehleliweyo.
• Ngenxa yoko, intliziyo ayinakupompa igazi elaneleyo ukuhlangabezana neemfuno zomzimba.

Kwi-atrial flutter, ii-ventricles (amagumbi entliziyo asezantsi) zinokubetha ngokukhawuleza okukhulu, kodwa kwipateni yesiqhelo.

Ezi ngxaki zinokuchaphazela amadoda nabafazi. Ziye ziqheleke ngakumbi ngokwanda kweminyaka.

Izizathu eziqhelekileyo ze-fibrillation ye-atrial ziquka:

• Ukusetyenziswa kotywala (ngakumbi ukuzinkcinkca ngotywala)
• Imithambo yegazi
• Ukuhlaselwa sisifo sentliziyo okanye ukugqitha kwentliziyo
• Ukusilela kwentliziyo okanye intliziyo eyandisiweyo
• Isifo se-valve senhliziyo (kaninzi i-mitral valve)
• Uxinzelelo lwegazi
• Amayeza
• Ukugqithisa kwe-thyroid gland (hyperthyroidism)
• Pericarditis
• Isifo sesinus

Usenokungazi ukuba intliziyo yakho ayibethi ngendlela eqhelekileyo.

Iimpawu zingaqala okanye zime ngokukhawuleza. Kungenxa yokuba i-fibrillation ye-atrial inokuma okanye iqale yodwa.

Iimpawu zingabandakanya:

• Pulse oziva ngokukhawuleza, ukubaleka, ukubetha, ukubetha, ukungaqhelekanga, okanye ukucotha
• Imvakalelo yokuziva ukubetha kwentliziyo (ukubetha kwentliziyo)
• Ukudideka
• Ukuba nesiyezi, ukuba nentloko elula
• Ukufa isiqaqa
• Ukudinwa
• Ukuphelelwa ngumthambo
• Ukuqhawukelwa ngumphefumlo

Umboneleli wezempilo unokuva ukubetha kwentliziyo ngokukhawuleza ngelixa umamele intliziyo yakho nge-stethoscope. Ukubetha kwakho kungaziva kukhawuleza, kungalingani, okanye zombini.

Inqanaba lentliziyo eliqhelekileyo li-60 ukuya kwi-100 beats ngomzuzu. Kwi-atrial fibrillation okanye i-flutter, izinga lentliziyo linokuba li-100 ukuya kwi-175 beats ngomzuzu. Uxinzelelo lwegazi lunokuba yinto eqhelekileyo okanye ephantsi.

Uvavanyo lwe-ECG (uvavanyo olurekhoda umsebenzi wombane wentliziyo) lunokubonisa i-atrial fibrillation okanye i-atrial flutter.

Ukuba isigqi senhliziyo esingaqhelekanga siza kwaye sihamba, unokufuna ukunxiba iliso elikhethekileyo ukufumanisa ingxaki. Imonitor irekhoda izingqisho zentliziyo kwithuba elithile.

• Ukujonga umcimbi (iiveki ezi-3 ukuya kwezi-4)
• Ukujonga iHolter (uvavanyo lweeyure ezingama-24)
• Ukurekhodwa kwerekhodi yeluphu

Uvavanyo lokufumana isifo sentliziyo lunokubandakanya:

• I-Echocardiogram (umfanekiso we-ultrasound yentliziyo)
• Uvavanyo lokuvavanya ukubonelelwa kwegazi kwezihlunu zentliziyo
• Uvavanyo lokufunda inkqubo yombane wentliziyo

Unyango lwe-Cardioversion lusetyenziselwa ukubuyisela intliziyo kwisingqisho esiqhelekileyo kwangoko. Zimbini iindlela onokukhetha kuzo kunyango:

• Ukutshitshiswa kombane entliziyweni yakho
• Iziyobisi ezinikezelwa ngomthambo

Olu nyango lunokwenziwa njengeendlela zongxamiseko, okanye kucwangciswe ngaphambi kwexesha.

Amayeza emihla ngemihla athathwe ngomlomo asetyenziselwa:

• Nciphisa ukubetha kwentliziyo ngokungaqhelekanga- La machiza anokubandakanya i-beta-blockers, i-calcium channel blockers kunye ne-digoxin.
• Thintela i-fibrillation ye-atrial ekubuyeni -- La machiza asebenza kakuhle kubantu abaninzi, kodwa anokuba neziphumo ebezingalindelekanga ezibi. I-Atrial fibrillation ibuya kubantu abaninzi, nokuba bawathatha la mayeza.

Inkqubo ebizwa ngokuba yi-radiofrequency ablation ingasetyenziselwa ukubala kwiindawo entliziyweni yakho apho iingxaki zesingqisho sentliziyo zibangelwa khona. Oku kunokuthintela imiqondiso yombane engaqhelekanga ebangela ukuba i-atrial fibrillation okanye i-flutter ihambe entliziyweni yakho. Unokufuna i-pacemaker yentliziyo emva kwale nkqubo. Bonke abantu abane-fibrillation ye-atrial baya kufuneka bafunde indlela yokulawula le meko ekhaya.

Abantu abane-fibrillation ye-atrial baya kuhlala befuna ukuthatha amayeza amancinci egazi. La machiza asetyenziselwa ukunciphisa umngcipheko wokuphuhliswa kwegazi elihamba emzimbeni (kwaye oko kunokubangela ukubetha, umzekelo). Isingqisho sentliziyo esingaqhelekanga esenzeka nge-atrial fibrillation senza ukuba amahlule egazi enze ifom.

Amayeza amancinci egazi abandakanya i-heparin, warfarin (Coumadin), apixaban (Eliquis), rivaroxaban powder (Xarelto), edoxaban (Savaysa) kunye ne-dabigatran (Pradaxa). Amachiza e-antiplatelet anjenge-aspirin okanye i-clopidogrel anokumiselwa. Nangona kunjalo, abacoci gazi bonyusa ithuba lokopha, ke ayinguye wonke umntu onokuzisebenzisa.

Olunye ukhetho lokuthintela ukubetha kwabantu abangakwaziyo ukuthatha la mayeza ngokukhuselekileyo sisiXhobo seWatchman, esisandula ukuvunywa yi-FDA. Oku kufakelwa okwenziwe ngengobozi encinci ebekwe ngaphakathi entliziyweni ukuvimba indawo yentliziyo apho uninzi lwamahlwili enza khona. Oku kunciphisa amahlwili enza ifom.

Umboneleli wakho uya kuqaphela iminyaka yakho kunye nezinye iingxaki zonyango xa ethatha isigqibo sokuba zeziphi iindlela zokuthintela ukubetha okungcono kuwe.

Unyango lunokulawula esi sifo. Abantu abaninzi abane-fibrillation ye-atrial benza kakuhle kakhulu kunyango.

I-fibrillation ye-Atrial ihlala ibuya kwaye iye isiba mandundu. Inokubuyela kwabanye abantu, nokuba unyango.

Amahlwili aqhekezayo aze aye kwingqondo anokubangela ukubetha.

Fowunela umboneleli wakho ukuba uneempawu ze-atrial fibrillation okanye i-flutter.

Thetha nomboneleli wakho malunga namanyathelo okuphatha iimeko ezibangela i-atrial fibrillation kunye ne-flutter. Kuphephe ukuzinkcinkca ngotywala.

Ifayibha yentsimbi; Ifayibha; Afib

• I-Atrial fibrillation - ukukhutshwa
• Intliziyo pacemaker - ukubhobhoza
• Ukuthatha i-warfarin (Coumadin, Jantoven) -ukubuza ugqirha wakho

• Icandelo lentliziyo phakathi embindini
• Intliziyo - umbono wangaphambili
• Imithambo yentliziyo engasemva
• Imithambo yentliziyo engaphambili
• Inkqubo yokuqhuba kwentliziyo

NgoJanuwari CT, uWann LS, uCalkins H, et al. I-2019 AHA / ACC / i-HRS igxile kuhlaziyo lwe-2014 AHA / ACC / isikhokelo se-HRS kulawulo lwezigulana ezine-atrial fibrillation: ingxelo ye-American College of Cardiology / American Heart Association Task Force kwi-Clinical Practice Guidelines kunye ne-Rhythm Society ngokubambisana noMbutho woNyango lweTroacic. Ukujikeleza. 2019; 140 (6) e285. IINKCUKACHA: 30686041 pubmed.ncbi.nlm.nih.gov/30686041.

UMeschia JF, uBushnell C, uBoden-Albala B, et al. Izikhokelo zothintelo lokuqala lwe-stroke: ingxelo yabasebenzi bezempilo kwi-American Heart Association / American Association. Ukubetha. Ngo-2014; 45 (12): 3754-3832. IINKCUKACHA: 25355838 pubmed.ncbi.nlm.nih.gov/25355838.

UMorady F, uZipes DP. I-Atrial fibrillation: iimpawu zeklinikhi, iindlela kunye nolawulo. 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 38.

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.