Ukuphucula iAntrial Fibrillation Prognosis yakho

Umxholo

• Sisiphi isibhengezo somntu one-AFib?
• Zeziphi iingxaki ezinokuthi zenzeke nge-AFib?
• Uphathwa njani i-AFib?
• Amayeza
• Intliziyo
• Iinkqubo zotyando
• Unokuthintela njani i-AFib?

Yintoni i-fibrillation ye-atrial?

I-Atrial fibrillation (i-AFib) yimeko yentliziyo ebangela ukuba amagumbi aphezulu entliziyo (aziwa njenge-atria) anyikime.

Ukungcangcazela kuthintela intliziyo ukuba impompe kakuhle. Ngokwesiqhelo, igazi lihamba lisuka kwi-atrium liye kwi-ventricle (kwigumbi elisezantsi lentliziyo), apho lifakwa khona kwimiphunga okanye kuwo wonke umzimba.

Xa i-atrium ikhala endaweni yokupompa, umntu unokuziva ngathi iintliziyo zabo ziye zabhabha okanye zatsiba ukubetha. Intliziyo inokubetha ngokukhawuleza okukhulu. Banokuziva benesicaphucaphu, baphefumla kancinci, kwaye babuthathaka.

Ukongeza kwiimvakalelo zentliziyo kunye nokubetha kwentliziyo okunokuza ne-AFib, abantu basemngciphekweni omkhulu wamagazi. Xa igazi lingampompo ngokunjalo, igazi eligcina entliziyweni lilungele ukubambeka.

Amahlwili ayingozi kuba anokubangela ukubetha kwamalungu omzimba. Ngokwe-American Heart Association, kuqikelelwa ukuba iipesenti ezili-15 ukuya kuma-20 ekhulwini zabantu abane-stroke nabo bane-AFib.

Amachiza kunye nolunye unyango luyafumaneka kwabo bane-AFib. Uninzi luya kulawula, hayi ukunyanga, imeko. Ukuba ne-AFib nako kunokunyusa umngcipheko womntu wokusilela kwentliziyo. Ugqirha wakho unokuncoma i-cardiologist ukuba ucinga ukuba unayo i-AFib.

Sisiphi isibhengezo somntu one-AFib?

Ngokuka-Johns Hopkins Medicine, kuqikelelwa ukuba izigidi ezi-2.7 zabantu baseMelika bane-AFib. Uninzi lwesihlanu kubo bonke abantu abane-stroke nabo bane-AFib.

Uninzi lwabantu abaneminyaka engama-65 nangaphezulu abane-AFib nabo bathabatha amayeza okunciphisa igazi ukunciphisa amathuba okuba neengxaki ezinjengokubetha. Oku kuphucula ukuxela kwangaphambili kubantu abane-AFib.

Ukufuna unyango kunye nokugcina ukutyelelwa rhoqo kunye nogqirha wakho kunokuphucula ukuxela kwakho xa une-AFib. Ngokwe-American Heart Association (AHA), iipesenti ezingama-35 zabantu abangafumani unyango lwe-AFib bayaqhubeka nokuhlaselwa yintlungu.

I-AHA iqaphela ukuba isiqephu se-AFib sinqabile ukubangela ukufa. Nangona kunjalo, ezi ziqendu zinokufaka isandla kuwe ekufumaneni ezinye iingxaki, ezinje ngokubetha kwentliziyo kunye nokusilela kwentliziyo, ezinokukhokelela ekufeni.

Ngamafutshane, kunokwenzeka ukuba i-AFib ichaphazele ixesha lokuphila kwakho. Imele ukungasebenzi kakuhle entliziyweni ekufuneka kulungisiwe. Nangona kunjalo, uninzi lonyango lukhona olunokukunceda ulawule iimpawu zakho kunye nokunciphisa umngcipheko weziganeko eziphambili, ezinje ngokubetha kwentliziyo kunye nokusilela kwentliziyo.

Zeziphi iingxaki ezinokuthi zenzeke nge-AFib?

Ezi ngxaki zimbini ziphambili ezinxulunyaniswa ne-AFib kukubetha kwentliziyo kunye nokusilela kwentliziyo. Umngcipheko okhulayo wokuqunjelwa kwegazi unokubangela ukuba iqhekeza liphume entliziyweni yakho kwaye uye kwingqondo yakho. Umngcipheko we-stroke uphezulu xa unezinto ezilandelayo:

• isifo seswekile
• ukumelwa yintliziyo
• igazi elonyukayo
• imbali yokubetha

Ukuba unayo i-AFib, thetha nogqirha wakho malunga nomngcipheko wakho wokubetha kunye nawaphi na amanyathelo onokuwathatha ukuthintela ukuba kungenzeki.

Ukusilela kwentliziyo yenye ingxaki eqhelekileyo enxulunyaniswa ne-AFib. Ukubetha kwentliziyo yakho okungcangcazelayo kunye nentliziyo yakho engabethanga kwisingqi sayo esiqhelekileyo esinexesha kunokubangela ukuba intliziyo yakho isebenze nzima ukumpompa igazi ngokufanelekileyo.

Ixesha elingaphezulu, oku kunokubangela ukusilela kwentliziyo. Oku kuthetha ukuba intliziyo yakho inobunzima bokujikeleza igazi eloneleyo ukuhlangabezana neemfuno zomzimba wakho.

Uphathwa njani i-AFib?

Unyango oluninzi luyafumaneka kwi-AFib, ukusuka kunyango lomlomo ukuya kutyando.

Okokuqala, kubalulekile ukumisela ukuba yintoni ebangela i-AFib yakho. Ngokomzekelo, iimeko ezinjenge-apnea yokulala okanye iingxaki ze-thyroid zingabangela i-AFib. Ukuba ugqirha wakho unokuyalela unyango ukulungisa ukungahambi kakuhle, i-AFib yakho inokuhamba njengesiphumo.

Amayeza

Ugqirha wakho unokukunika amayeza anceda intliziyo igcine ukubetha kwentliziyo yesiqhelo kunye nesingqisho. Imizekelo ibandakanya:

• amiodarone (eCordarone)
• idigoxin (Lanoxin)
• Ndiphiwe (Tikosyn)
• ipropafenone (Rythmol)
• I-sotalol (iBetapace)

Ugqirha wakho unokuyalela amayeza okucoca igazi ukunciphisa umngcipheko wokukhula kwehlwili kunokubangela ukubetha. Imizekelo yala mayeza ibandakanya:

• apixaban (uEliquis)
• dabigatran (iPradaxa)
• Rivaroxabanxabisa (Xarelto)
• edoxaban (Savaysa)
• iwarfarin (Coumadin, Jantoven)

Amayeza amane okuqala adweliswe ngasentla ayaziwa njenge-non-vitamin K yomlomo i-anticoagulants (NOACs). I-NOACs ngoku ziyacetyiswa ngaphezulu kwe-warfarin ngaphandle kokuba une-mitral stenosis okanye i-valve yentliziyo eyenziweyo.

Ugqirha unokuyalela amayeza ukuba afezekise intliziyo yakho (buyisela intliziyo yakho kwisingqisho esiqhelekileyo). Amanye ala mayeza afakwa ngaphakathi, ngelixa amanye ethathwa ngomlomo.

Ukuba intliziyo yakho iqala ukubetha ngokukhawuleza, ugqirha wakho unokukungenisa esibhedlele ade amayeza akwazi ukuzinzisa ukubetha kwentliziyo yakho.

Intliziyo

Isizathu se-AFib yakho sinokungaziwa okanye sinxulumene neemeko ezenza buthathaka ngokuthe ngqo intliziyo. Ukuba uphilile ngokwaneleyo, ugqirha wakho unokucebisa inkqubo ebizwa ngokuba yi-cardioversion yombane. Oku kubandakanya ukuhambisa umothuko wombane entliziyweni yakho ukuseta kwakhona isingqisho.

Ngexesha lale nkqubo, unikwa amayeza okuthomalalisa, ke ngekhe ungazi malunga nokothuka.

Kwiimeko ezithile, ugqirha wakho uya kukuyalela amayeza okucoca igazi okanye enze inkqubo ebizwa ngokuba yi-transesophageal echocardiogram (TEE) ngaphambi kokuba uphefumle umzimba ukuze uqiniseke ukuba akukho gazi entliziyweni yakho elinokuthi likhokelele ekubethweni.

Iinkqubo zotyando

Ukuba i-cardioversion okanye ukuthatha amayeza akulawuli i-AFib yakho, ugqirha unokucebisa ezinye iinkqubo. Banokubandakanya ukucinywa kwe-catheter, apho i-catheter ifakwa ngomthambo esihlahleni okanye kwi-groin.

I-catheter inokujoliswa kwiindawo zentliziyo yakho eziphazamisa umbane. Ugqirha wakho unokutshabalalisa, okanye atshabalalise, indawo encinci yethishu ebangela imiqondiso engaqhelekanga.

Enye inkqubo ebizwa ngokuba yinkqubo ye-maze inokwenziwa ngokubambisana nokuhlinzwa kwentliziyo evulekileyo, njengokugqithisa kwentliziyo okanye ukutshintshwa kwe-valve. Le nkqubo ibandakanya ukudala izicwili ezibomvu entliziyweni ukuze iimpembelelo zombane ezingaqhelekanga zingakwazi ukuhambisa.

Unokufuna kwakhona i-pacemaker ukunceda intliziyo yakho ihlale kwisigqi. Oogqirha bakho banokufaka i-pacemaker emva kwe-AV node ablation.

I-AV node yintloko ye-pacemaker yentliziyo, kodwa iyakwazi ukuhambisa imiqondiso engaqhelekanga xa une-AFib.

Ugqirha wakho uya kudala izicwili ezibomvu apho indawo ye-AV ikhoyo ukukhusela imiqondiso engaqhelekanga ekuhanjisweni. Uya kuthi emva koko afake i-pacemaker ukuba idlulise imiqondiso yesingqisho yentliziyo echanekileyo.

Unokuthintela njani i-AFib?

Ukuziqhelanisa nendlela yokuphila esempilweni ngentliziyo kubalulekile xa une-AFib. Iimeko ezinje ngoxinzelelo oluphezulu lwegazi kunye nesifo sentliziyo kunokunyusa umngcipheko wakho we-AFib. Ngokukhusela intliziyo yakho, unokukhusela imeko ukuba ingenzeki.

Imizekelo yamanyathelo onokuwathatha ukuthintela i-AFib ibandakanya:

• Ukuyeka ukutshaya.
• Ukutya ukutya okunesifo sentliziyo okunamafutha amaninzi, ityuwa, icholesterol, kunye namafutha.
• Ukutya ukutya okuphezulu kwizakhamzimba, kubandakanya ukutya okuziinkozo, imifuno, iziqhamo, kunye nobisi olunamafutha asezantsi kunye nemithombo yeeproteni.
• Ukuzibandakanya kwimisebenzi eqhelekileyo yomzimba ekunceda ugcine ubunzima obunempilo kubungakanani bakho kunye nesakhelo.
• Ukunciphisa umzimba kuyacetyiswa ukuba ukhuluphele ngoku.
• Ukufumana uxinzelelo lwegazi rhoqo kwaye ubone ugqirha ukuba ingaphezulu kwe-140/90.
• Ukuphepha ukutya kunye nemisebenzi eyaziwayo ukuba ibangele i-AFib yakho. Imizekelo ibandakanya ukusela utywala kunye necaffeine, ukutya ukutya okune-monosodium glutamate (MSG), kunye nokwenza umthambo kakhulu.

Kuyenzeka ukuba ulandele onke la manyathelo kwaye ungakhuseli i-AFib. Nangona kunjalo, indlela yokuphila esempilweni iya kuphucula impilo yakho kunye nokuxela kwangaphambili ukuba une-AFib.