Iinkqubo zokupheliswa kwentliziyo

Ukupheliswa kwentliziyo yinkqubo esetyenziswayo ukonakalisa iindawo ezincinci entliziyweni yakho ezinokuthi zibandakanyeke kwiingxaki zesingqisho sentliziyo yakho. Oku kunokuthintela imiqondiso yombane engaqhelekanga okanye isingqisho ukuba sihambe entliziyweni.

Ngexesha lenkqubo, iingcingo ezincinci ezibizwa ngokuba zii-electrode zibekwe ngaphakathi kwentliziyo yakho ukulinganisa umbane wentliziyo yakho. Xa umthombo wengxaki ufunyenwe, izicwili ezibangela ingxaki ziyatshatyalaliswa.

Zimbini iindlela zokwenza ukukhutshwa kwentliziyo:

• Ukurhoxiswa kweradiofrequency kusebenzisa amandla obushushu ukuphelisa indawo yengxaki.
• I-Cryoablation isebenzisa amaqondo obushushu abandayo kakhulu.

Uhlobo lwenkqubo onayo luya kuxhomekeka kuhlobo lwesingqisho sentliziyo esingaqhelekanga onaso.

Iinkqubo zokupheliswa kwentliziyo zenziwa kwilabhoratri yasesibhedlele ngabasebenzi abaqeqeshiweyo. Oku kubandakanya i-cardiologists (oogqirha bentliziyo), amagcisa, kunye nabongikazi. Ukuseta kukhuselekile kwaye kulawulwa ngoko umngcipheko usezantsi ngokusemandleni.

Uya kunikwa iyeza (ukuthambisa) ngaphambi kwenkqubo yokukunceda uphumle.

• Ulusu olusentanyeni yakho, ingalo, okanye i-groin luya kucocwa kakuhle kwaye lwenziwe lube ndindisholo nge-anesthetic.
• Emva koko, ugqirha uya kwenza ukusikwa okuncinci kulusu.
• Umbhobho omncinci oguqukayo (i-catheter) uya kufakwa ngale ndlela isikiweyo komnye wemithambo yegazi kuloo ndawo. Ugqirha uya kusebenzisa imifanekiso ye-x-ray ephilayo ukukhokela ngononophelo i-catheter ukuya entliziyweni yakho.
• Ngamanye amaxesha kuye kufuneke i-catheter engaphezulu kwesinye.

Nje ukuba i-catheter ibekhona, ugqirha wakho uya kubeka ii-electrode ezincinci kwiindawo ezahlukeneyo zentliziyo yakho.

• Ezi electrode zidityaniswe kwiimonitha ezivumela ugqirha wentliziyo ukuba axelele ukuba yeyiphi na indawo entliziyweni yakho ebangela iingxaki kwisingqi sentliziyo yakho. Kwiimeko ezininzi, kukho indawo enye okanye ezingakumbi.
• Nje ukuba umthombo wengxaki ufumaneke, omnye wemigca yecatheter usetyenziselwa ukuthumela amandla ombane (okanye ngamanye amaxesha abandayo) kwindawo yengxaki.
• Oku kudala inxeba elincinci elibangela ukuba ingxaki yesingqisho senhliziyo iyeke.

Ukucinywa kwe-catheter yinkqubo ende. Inokuhlala iiyure ezi-4 nangaphezulu. Ngexesha lenkqubo intliziyo yakho iya kubekwa esweni ngokusondeleyo.Umboneleli wezempilo unokukubuza ukuba ngaba uneempawu kumaxesha ahlukeneyo ngexesha lenkqubo. Iimpawu onokuziva ngathi zezi:

• Ukutshiswa okufutshane xa kufakwa amayeza
• Intliziyo ekhawulezayo okanye eyomeleleyo
• Ubumhlophe
• Ukutsha xa kusetyenziswa amandla ombane

Ukupheliswa kwentliziyo kusetyenziselwa ukunyanga iingxaki ezithile zesingqi sentliziyo ezingalawulwa ngamayeza. Ezi ngxaki zinokuba yingozi ukuba azinyangwa.

Iimpawu eziqhelekileyo zeengxaki zesingqisho senhliziyo zingabandakanya:

• Iintlungu zesifuba
• Ukufa isiqaqa
• Ukucotha okanye ukubetha kwentliziyo okukhawulezayo (ukubetha kwentliziyo)
• Ubukhaphukhaphu, isiyezi
• Ubumhlophe
• Ukuqhawukelwa ngumphefumlo
• Ukutsiba ukubetha - utshintsho kumzekelo wokubetha
• Ukubila

Ezinye iingxaki zesingqisho sentliziyo zezi:

• I-AV nodal reentrant tachycardia (AVNRT)
• Indlela yokufikelela, enjenge-Wolff-Parkinson-White syndrome
• I-fibrillation ye-Atriya
• Iflutter yeArial
• Tachycardia omoya

Ukucinywa kwe-catheter kukhuselekile ngokubanzi. Thetha nomboneleli wakho malunga nezi ngxaki zinqabileyo:

• Ukopha okanye ukudibanisa igazi apho kufakwa khona i-catheter
• Ihlwili legazi eliya kwimithambo emlenzeni wakho, entliziyweni, okanye kwingqondo
• Ukonakala kwimithambo apho kufakwa khona i-catheter
• Ukonakala kwezivalo zentliziyo
• Umonakalo kwimithambo yegazi (imithambo yegazi ehambisa igazi entliziyweni yakho)
• I-esophageal atrial fistula (unxibelelwano olwenzeka phakathi kwe-esophagus kunye nenxalenye yentliziyo yakho)
• Ulwelo olujikeleze intliziyo (itamponade yentliziyo)
• Ukuhlaselwa yintliziyo
• Vagal okanye phrenic luvo umonakalo

Soloko uxelela umboneleli wakho ukuba zeziphi iziyobisi ozithathayo, nditsho neziyobisi okanye amayeza owathengileyo ngaphandle kommiselo.

Ngexesha leentsuku ngaphambi kwenkqubo:

• Buza umboneleli wakho ukuba zeziphi iziyobisi omele uzithathe ngosuku lotyando.
• Xelela umboneleli wakho ukuba uthatha iaspirin, clopidogrel (Plavix), prasugrel (Effient), ticagrelor (Brilinta), warfarin (Coumadin), okanye elinye igazi elincinci njengeapixaban (Eliquis), rivaroxaban powder (Xarelto), dabigatran (Pradaxa) kunye edoxaban (Savaysa).
• Ukuba uyatshaya, yeka ngaphambi kwenkqubo. Cela uncedo kumboneleli wakho ukuba uyalufuna.
• Xelela umboneleli wakho ukuba unokubanda, umkhuhlane, umkhuhlane, ukuphuma kwe-herpes, okanye esinye isifo.

Ngomhla wenkqubo:

• Uya kuhlala ucelwa ukuba ungaseli okanye utye nantoni na emva kobusuku phakathi kobusuku ngaphambi kwenkqubo yakho.
• Thatha amayeza umboneleli wakho akuxelele ukuba uwathabathe ngesiphuzo esincinci samanzi.
• Uzakuxelelwa ukuba ufike nini esibhedlele.

Uxinzelelo lokunciphisa ukopha lubekwa kwindawo apho i-catheters yafakwa khona emzimbeni wakho. Uya kugcinwa ebhedini ubuncinci iyure. Kuya kufuneka uhlale ebhedini ukuya kuthi ga kwiiyure ezi-5 okanye ezi-6. Isingqisho sakho sentliziyo siya kujongwa ngeli xesha.

Ugqirha wakho uya kuthatha isigqibo sokuba ungagoduka kwangolo suku lunye, okanye ukuba kuya kufuneka uhlale esibhedlele ubusuku bonke ukuze ube nokujonga esweni kwentliziyo. Uya kudinga umntu oza kukuqhubela ekhaya emva kwenkqubo yakho.

Kwiintsuku ezi-2 okanye ezi-3 emva kwenkqubo yakho, unokuba nazo ezi mpawu:

• Ukudinwa
• Ukuziva Achy esifubeni sakho
• Tsiba ukubetha kwentliziyo, okanye amaxesha apho ukubetha kwentliziyo yakho kukhawuleza kakhulu okanye kungaqhelekanga.

Ugqirha wakho unokukugcina kumayeza akho, okanye akunike amatsha anokunceda ukulawula isingqi sentliziyo yakho.

Amanqanaba okuphumelela ahlukile ngokuxhomekeke ekubeni loluphi uhlobo lwengxaki yesingqisho yentliziyo ephathwayo.

Ukupheliswa kwephepha; Ukurhoxiswa kwe-catheter ye-Radiofrequency; Cryoablation - ukupheliswa kwentliziyo; I-AV nodal reentrant tachycardia-ablation yentliziyo; I-AVNRT-ukupheliswa kwentliziyo; I-Wolff-Parkinson-White Syndrome - ukupheliswa kwentliziyo; I-Atrial fibrillation -ukususwa kwentliziyo; I-atrial flutter - ukukhutshwa kwentliziyo; I-ventricular tachycardia - ukupheliswa kwentliziyo; VT - ukupheliswa kwentliziyo; Arrhythmia - ablation yentliziyo; Isingqisho sentliziyo esingaqhelekanga-ukupheliswa kwentliziyo

• Angina - ukubhobhoza
• UAngina - xa unentlungu esifubeni
• Iziyobisi Antiplatelet - P2Y12 inhibitors
• I-Aspirin kunye nesifo sentliziyo
• I-Atrial fibrillation - ukukhutshwa
• Ibhotolo, imajarini neeoli zokupheka
• Cholesterol kunye nendlela yokuphila
• Ukulawula uxinzelelo lwegazi oluphezulu
• Kuchazwe amafutha ezempilo
• Iingcebiso zokutya okukhawulezayo
• Ukuhlaselwa yintliziyo - ukukhutshwa
• Isifo sentliziyo - umngcipheko
• Ukungaphumeleli kwentliziyo - ukukhutshwa
• Intliziyo pacemaker - ukubhobhoza
• Ufunda njani iilebheli zokutya
• Ukutya okunetyuwa encinci
• Ukutya kweMeditera

UCalkins H, uHindricks G, uCappato R, et al. Ngo-2017 i-HRS / i-EHRA / i-ECAS / i-APHRS / i-SOLAECE isitatimende sokuvumelana malunga ne-catheter kunye ne-ablation ye-atrial fibrillation. Isingqi sentliziyo. Ngo-2017; 14 (10): e275-e444. IINKCUKACHA: 28506916 pubmed.ncbi.nlm.nih.gov/28506916/.

IFerreira SW, Mehdirad AA. Ilebhu ye-electrophysiology kunye nenkqubo ye-electrophysiologic. Ku: Sorajja P, Lim MJ, Kern MJ, ii-eds. Incwadi kaKern's Catheterization Handbook. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2020: isahluko 7.

UMiller JM, uTomaselli GF, uZipes DP. Unyango lwe-arrhythmias yentliziyo. 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 36.