I-tachycardia yemithambo emininzi

I-tachycardia ye-multifocal atrial (MAT) sisantya sentliziyo esikhawulezayo. Kwenzeka xa imiqondiso emininzi kakhulu (iimpembelelo zombane) zithunyelwa zisuka kwintliziyo ephezulu (atria) zisiya kwintliziyo esezantsi (ii-ventricles).

Intliziyo yomntu ikhupha amandla ombane, okanye imiqondiso, ethi mayibethe. Ngokwesiqhelo, le miqondiso iqala kwindawo yegumbi lasekunene elibizwa ngokuba yi-sinoatrial node (sinus node or SA node). Le node ithathwa njenge "pacemaker yendalo" yentliziyo. Inceda ukulawula ukubetha kwentliziyo. Xa intliziyo ifumanisa umqondiso, iyanikezela (okanye ibethe).

Inqanaba lentliziyo eliqhelekileyo kubantu abadala limalunga ne-60 ukuya kwi-100 beats ngomzuzu. Inqanaba lentliziyo eliqhelekileyo liyakhawuleza ebantwaneni.

Kwi-MAT, indawo ezininzi kwiimpawu zomlilo ze-atria ngaxeshanye. Iimpawu ezininzi zikhokelela kwinqanaba lentliziyo elikhawulezayo. Ihlala iphakathi kwe-100 ukuya kwi-130 beats ngomzuzu okanye nangaphezulu kubantu abadala. Isantya sentliziyo esikhawulezayo senza ukuba intliziyo isebenze nzima kakhulu kwaye ingahambisi igazi ngokufanelekileyo. Ukuba ukubetha kwentliziyo kuyakhawuleza, alikho ixesha elincinci lokuba igumbi lentliziyo ligcwalise igazi phakathi kokubetha. Ke ngoko, alonelanga igazi elimpontshelwa kwingqondo kunye nawo wonke umzimba ngokuncipha ngakunye.

I-MAT ixhaphake kakhulu kubantu abaneminyaka engama-50 nangaphezulu. Ihlala ibonakala kubantu abaneemeko ezithoba isixa seoksijini egazini. Ezi meko zibandakanya:

• I-pneumonia yentsholongwane
• Isifo esinganyangekiyo semiphunga (COPD)
• Ukusilela kwentliziyo
• Umhlaza wemiphunga
• Ukungaphumeleli kwemiphunga
• Ukudibanisa iipulmonary

Unokuba semngciphekweni omkhulu weMAT ukuba:

• Isifo sentliziyo
• Seswekile
• Ngaba utyando lwenziwe kwiiveki ezi-6 ezidlulileyo
• Ukugqithisa kwiyeza le-theophylline
• Sepsis

Xa izinga lokubetha kwentliziyo lingaphantsi kwe-100 beats ngomzuzu, i-arrhythmia ibizwa ngokuba "kukujikeleza kwe-atem pacemaker."

Abanye abantu banokungabikho mpawu. Xa iimpawu zenzeka, zinokubandakanya:

• Ukuqina kwesifuba
• Ubumhlophe
• Ukufa isiqaqa
• Imvakalelo yokuziva intliziyo ibetha ngokungaqhelekanga okanye ngokukhawuleza kakhulu (ukubetha)
• Ukuqhawukelwa ngumphefumlo
• Ukwehla kobunzima kunye nokusilela ukukhula kwiintsana

Ezinye iimpawu ezinokubakho nesi sifo:

• Ukuphefumla ubunzima xa ulala phantsi
• Ukuba nesiyezi

Uvavanyo lomzimba lubonisa ukubetha kwentliziyo okungahambelaniyo okungaphezulu kwe-100 beats ngomzuzu. Uxinzelelo lwegazi luqhelekile okanye luphantsi. Kukho iimpawu zokuhamba kakubi.

Uvavanyo lokufumanisa i-MAT lubandakanya:

• ECG
• Isifundo se-Electrophysiologic (EPS)

Isilumkiso sentliziyo sisetyenziselwa ukurekhoda ukubetha kwentliziyo okukhawulezayo. Oku kubandakanya:

• Ukubeka iliso kwiiyure ezingama-24
• I-Portable, ixesha elide ukurekhoda okuvumela ukuba uqale ukurekhoda ukuba iimpawu zenzeka

Ukuba usesibhedlele, isingqi sentliziyo yakho siya kubekwa esweni iiyure ezingama-24 ngosuku, ubuncinci kuqala.

Ukuba unemeko enokukhokelela kwi-MAT, loo meko kufuneka inyangwe kuqala.

Unyango lweMAT lubandakanya:

• Ukuphucula amanqanaba eoksijini egazini
• Ukunika i-magnesium okanye i-potassium ngomthambo
• Ukuyeka amayeza, anjenge theophylline, anokunyusa izinga lokubetha kwentliziyo
• Ukuthatha amayeza ukunciphisa isantya sentliziyo (ukuba isantya sentliziyo sikhawuleze kakhulu), njenge-calcium channel blockers (verapamil, diltiazem) okanye i-beta-blockers

I-MAT inokulawulwa ukuba imeko ebangela ukubetha kwentliziyo okukhawulezayo inyangwa kwaye ilawulwa.

Iingxaki zinokubandakanya:

• Cardiomyopathy
• Ukusilela kwentliziyo
• Ukuncipha kwempompo yesenzo sentliziyo

Fowunela umboneleli wakho wezempilo ukuba:

• Unentliziyo ekhawulezayo okanye engaqhelekanga kunye nezinye iimpawu zeMAT
• UnemAT kwaye iimpawu zakho ziya zisiba mbi, ungaphucuki kunyango, okanye uvelise iimpawu ezintsha

Ukunciphisa umngcipheko wokuphuhlisa iMAT, nyanga ukuphazamiseka okubangela oko kwangoko.

Isiphithiphithi se-tachycardia

• Icandelo lentliziyo phakathi embindini
• Intliziyo - umbono wangaphambili
• Inkqubo yokuqhuba kwentliziyo

I-Olgin JE, iZipes DP. I-supraventricular 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 37.

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.