Tachycardia omoya

I-Ventricular tachycardia (VT) yintliziyo ekhawulezayo eqala kumagumbi asezantsi entliziyo (ii-ventricles).

I-VT yireyithi yokubetha engaphezulu kwe-100 beats ngomzuzu, ubuncinci ukubetha kwentliziyo okungaqhelekanga ngokulandelelana.

Imeko inokukhula njengobunzima bokuqala okanye kade bokuhlaselwa sisifo sentliziyo. Inokwenzeka kwakhona kubantu abane:

• Cardiomyopathy
• Ukumelwa yintliziyo
• Utyando lwentliziyo
• Isifo esinganyangekiyo
• Isifo sentliziyo seValvular

I-VT inokwenzeka ngaphandle kwesifo sentliziyo.

Izicubu ezinqabileyo zingenzeka kwimisipha yee-ventricles iintsuku, iinyanga, okanye iminyaka emva kokuhlaselwa sisifo sentliziyo. Oku kunokukhokelela kwi-tachycardia ye-ventricular.

I-VT inokubangelwa ngu:

• Iziyobisi ezichasayo (ezisetyenziselwa ukunyanga isigqi sentliziyo esingaqhelekanga)
• Utshintsho kwikhemistry yegazi (njengeqondo eliphantsi le potassium)
• Utshintsho kwi-pH (isiseko seasidi)
• Ukungabikho kwe-oxygen eyaneleyo

"I-Torsade de pointes" luhlobo oluthile lwe-VT. Amaxesha amaninzi kubangelwa sisifo sentliziyo okanye ukusetyenziswa kwamayeza athile.

Unokuba neempawu ukuba inqanaba lentliziyo ngexesha le-VT isiqendu likhawuleza kakhulu okanye lihlala ixesha elide kunemizuzwana embalwa. Iimpawu zingabandakanya:

• Ukungonwabi kwesifuba (angina)
• Ukuphelelwa amandla (syncope)
• Ubumhlophe obukhanyayo okanye isiyezi
• Imvakalelo yokuziva ukubetha kwentliziyo (ukubetha kwentliziyo)
• Ukuqhawukelwa ngumphefumlo

Iimpawu zingaqala kwaye zime ngokukhawuleza. Ngamanye amaxesha, akukho zimpawu.

Umboneleli wezempilo uya kukhangela:

• Ukubetha okungabikho
• Ukuphulukana nokuqonda
• Uxinzelelo lwegazi oluqhelekileyo okanye oluphantsi
• Ukubetha ngokukhawuleza

Uvavanyo olunokusetyenziselwa ukufumanisa i-tachycardia ye-ventricular ibandakanya:

• Ukubeka iliso kwiHolter
• ECG
• Isifundo se-Intracardiac electrophysiology (EPS)
• Ukujonga isingqisho ngesishicileli sokuloba okanye isixhobo

Unokuba neekhemistri zegazi kunye nolunye uvavanyo.

Unyango luxhomekeke kwiimpawu, kunye nohlobo lwesifo sentliziyo.

Ukuba umntu one-VT uxinzelelo, banokufuna:

• CPR
• I-Cardioversion (ukothuka kombane)
• Amayeza (afana ne-lidocaine, i-procainamide, i-sotalol, okanye i-amiodarone) enikezwe ngomthambo

Emva kwesiqendu se-VT, kuthathwa amanyathelo okuqhubela phambili iziqendu.

• Amayeza athathwe ngomlomo anokufuneka kunyango lwexesha elide. Nangona kunjalo, la mayeza anokuba neziphumo ebezingalindelekanga ezibi. Zisetyenziswa ngokufuthi njengoko ezinye iindlela zonyango zisenziwa.
• Inkqubo yokutshabalalisa izicubu zentliziyo ezibangela ukubetha kwentliziyo okungaqhelekanga (okubizwa ngokuba yi-ablation) kunokwenziwa.
• Isixhobo se-cardioverter defibrillator (ICD) esinokufakwa sinokucetyiswa. Sisisixhobo esimiliselweyo esibhaqa nasiphi na isoyikiso sobomi, ukubetha kwentliziyo okukhawulezayo. Ukubetha kwentliziyo okungaqhelekanga kuthiwa yi-arrhythmia. Ukuba iyenzeka, i-ICD ikhawuleza ithumele umothuko wombane entliziyweni ukutshintsha isingqisho sibuyele esiqhelweni. Oku kubizwa ngokuba kukusasaza.

Isiphumo sixhomekeke kwimeko yentliziyo kunye neempawu.

I-ventricular tachycardia ayinakubangela iimpawu kwabanye abantu. Nangona kunjalo, inokubulala. Ngoyena nobangela uphambili wokufa kwentliziyo ngequbuliso.

Yiya kwigumbi likaxakeka okanye fowunela inombolo yongxamiseko yendawo (enje nge-911) ukuba une-pulse ekhawulezileyo, engaqhelekanga, utyhafile, okanye unentlungu esifubeni. Zonke ezi zinto zinokuba ziimpawu ze-tachycardia ye-ventricular.

Ngamanye amaxesha, ukuphazamiseka akunakuthintelwa. Ngamanye amaxesha, inokuthintelwa ngokunyanga iingxaki zentliziyo kunye nokuphepha amayeza athile.

Ububanzi be-tachycardia; V tach; Tachycardia - ventricular

• Isixhobo se-Cardioverter defibrillator esinokufakwa

• Isixhobo se-Cardioverter-defibrillator esinokufakwa
• Isixhobo se-cardiac defibrillator esinokufakwa

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U-Olgin JE, uTomaselli GF, uZipes DP. I-Arrhythmias yeVentricular. 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 39.