Isixhobo seCardioverter Defibrillator (ICD)

Umxholo

• Yintoni i-Cardioverter defibrillator enokufakwa?
• Kutheni le nto ndifuna isixhobo se-Cardioverter defibrillator?
• Isebenza njani i-cardioverter defibrillator esebenzayo?
• Ndiyilungiselela njani inkqubo?
• Kwenzeka ntoni ngexesha lenkqubo?
• Yeyiphi imingcipheko enxulumene nenkqubo?
• Kwenzeka ntoni emva kwenkqubo?
• Ithini imbono yexesha elide?

Yintoni i-Cardioverter defibrillator enokufakwa?

Isixhobo se-Cardioverter defibrillator (ICD) sisixhobo esincinci esinokuthi sifakwe ngugqirha esifubeni sakho ukunceda ukulawula isingqisho sentliziyo esingaqhelekanga, okanye iarhythmia.

Nangona incinci kunendawo yamakhadi, i-ICD iqulethe ibhetri kunye nekhompyuter encinci ejonga ukubetha kwentliziyo yakho. Ikhompyuter ihambisa umothuko omncinci wombane entliziyweni yakho ngamaxesha athile. Oku kunceda ukulawula ukubetha kwentliziyo yakho.

Oogqirha bahlala befaka ii-ICD ebantwini abanesifo esisongela ubomi kwaye basemngciphekweni wokubanjwa kwentliziyo ngesiquphe, imeko apho intliziyo iyeka ukubetha. I-Arrhythmias inokuba yinto yokuzalwa (into owazalwa unayo) okanye uphawu lwesifo sentliziyo.

Ii-ICD zikwabizwa ngokuba zizixhobo ezinokufakwa kwentliziyo okanye izixhobo zokuzikhusela.

Kutheni le nto ndifuna isixhobo se-Cardioverter defibrillator?

Intliziyo yakho ine-atria ezimbini (amagumbi aphezulu asekhohlo nasekunene) kunye nee-ventricles ezimbini (amagumbi asekhohlo nasekunene asezantsi). Iimpembelelo zakho zimpompoza igazi lisuka entliziyweni yakho lisiya kuwo wonke umzimba wakho. La magumbi mane ekhontrakthi yentliziyo yakho ngokulandelelana okunamaxesha okupompa igazi emzimbeni wakho wonke. Oku kubizwa ngokuba yisingqisho.

Iindawo ezimbini entliziyweni yakho zilawula isingqisho sentliziyo yakho. I-node nganye ithumela impembelelo yombane ngokulandelelana kwexesha. Le ntshukumisa ibangela ukuba izihlunu zentliziyo yakho zenze isivumelwano. Kuqala isivumelwano se-atria, emva koko isivumelwano se-ventricles. Oku kudala impompo.

Xa ixesha lezi ntshukumisa liphelile, intliziyo yakho ayimpompi igazi ngokufanelekileyo. Iingxaki zesingqisho sentliziyo kwii-ventricle zakho ziyingozi kakhulu kuba intliziyo yakho ingayeka ukupompa. Oku kunokuba yingozi ukuba awufumani unyango ngokukhawuleza.

Unokufumana isibonelelo kwi-ICD ukuba:

• isingqisho sentliziyo esikhawulezayo nesiyingozi esibizwa ngokuba yi-ventricular tachycardia
• ukumpompa ngokungaqhelekanga, ekubhekiswa kuko njengokungcangcazela okanye ukubetha kwentsimbi kwangaphakathi
• intliziyo ebuthathaka yimbali yesifo senhliziyo okanye ukuhlaselwa kwentliziyo kwangaphambili
• imisipha yentliziyo eyandisiweyo okanye ejiyileyo, ebizwa ngokuba yi-dilated, okanye i-hypertrophic, i-cardiomyopathy
• Isiphene sentliziyo esibelekwe, njenge-QT syndrome ende, ebangela ukungcangcazela kwentliziyo
• ukumelwa yintliziyo

Isebenza njani i-cardioverter defibrillator esebenzayo?

I-ICD sisixhobo esincinci esifakwe esifubeni sakho. Elona candelo libalulekileyo, ekuthiwa yipulse generator, liphethe ibhetri kunye nekhompyuter encinci ejonga isingqi sentliziyo yakho. Ukuba intliziyo yakho ibetha ngokukhawuleza kakhulu okanye ngokungagungqiyo, ikhompyuter ihambisa ukubetha kombane ukulungisa ingxaki.

Iingcingo ezibizwa ngokuba ziiselfowuni zibaleka zivelise ukubetha kweendawo ezithile zentliziyo yakho. Ezi zikhokelela ekuhambiseni iimpembelelo zombane ezithunyelwe ngumvelisi wombane.

Kuxhomekeke kwisifo sakho, ugqirha unokucebisa enye yezi ndlela zilandelayo ze-ICD:

• Igumbi elinye le-ICD lithumela imiqondiso yombane kwi-ventricle elungileyo.
• I-ICD enamagumbi amabini ithumela imiqondiso yombane kwi-atrium yasekunene nakwi-ventricle yasekunene.
• Isixhobo se-biventricular sithumela imiqondiso yombane kwi-atrium yasekunene nakwii-ventricles zombini. Oogqirha bayisebenzisela abantu abanesifo sentliziyo.

I-ICD inokuhambisa ukuya kuthi ga kwiindidi ezine zeempawu zombane entliziyweni yakho:

1. Intliziyo. I-Cardioversion inika umqondiso wombane owomeleleyo onokuziva ngathi ubambekile esifubeni sakho. Iseta kwakhona izingqisho zentliziyo ziye kwimo yesiqhelo xa ifumana ukubetha kwentliziyo ngokukhawuleza.
2. Ukuchazwa kwegama. I-Defibrillation ithumela umqondiso wombane onamandla ohlaziya kwakhona intliziyo yakho. Uvakalelo lubuhlungu kwaye lunokukhupha ezinyaweni zakho kodwa luhlala kuphela umzuzwana.
3. Antitachycardia. I-Antitachycardia pacing ibonelela ngamandla asezantsi ekubetheni ukubetha kwentliziyo ngokukhawuleza. Ngokwesiqhelo, awuva nto xa ukubetha kwenzeka. Nangona kunjalo, unokuva ukubetha okuncinci esifubeni sakho.
4. Bradycardia. I-Bradycardia pacing ibuyisela kwisantya esiqhelekileyo ukubetha kwentliziyo okucothayo. Kule meko, i-ICD isebenza njenge-pacemaker. Abantu abane-ICD bahlala baneentliziyo ezibetha ngokukhawuleza okukhulu. Nangona kunjalo, ukuphucuka komzimba ngamanye amaxesha kunokubangela ukuba intliziyo icothe ukuya kwinqanaba eliyingozi. I-Bradycardia pacing ibuyisela isingqisho kwinto yesiqhelo.

Ndiyilungiselela njani inkqubo?

Akufanele utye okanye usele nantoni na emva kobusuku phakathi komhla ngaphambi kwenkqubo yakho. Ugqirha wakho usenokukucela ukuba uyeke ukuthatha amayeza athile, njengeasprini okanye lawo aphazamisa ukujija kwegazi. Ngaphambi kwenkqubo, qiniseka ukuxelela ugqirha wakho malunga namayeza, amayeza e-counter-counter, kunye nezongezelelo ozithathayo.

Akufanele uyeke ukuthatha amayeza ngaphandle kokuthetha nogqirha wakho kuqala.

Kwenzeka ntoni ngexesha lenkqubo?

Inkqubo yokumiliselwa kwe-ICD incinci. Ngokwesiqhelo uya kuba kwilabhoratri ye-electrophysiology xa ugqirha we-electrophysiologist efaka isixhobo. Kwiimeko ezininzi, uya kuba uvukile ngexesha lenkqubo. Nangona kunjalo, uyakufumana ukuthomalalisa ukuze ukozele kunye ne-anesthetic yendawo ukuze ubethe isifuba sakho.

Emva kokwenza ukusikwa okuncinci, ugqirha ukhokela isikhokelo ngokusebenzisa umthambo kwaye ubambelele kwiindawo ezithile zentliziyo yakho yemisipha. Isixhobo sokujonga i-X-ray esibizwa ngokuba yi-fluoroscope sinokunceda ukukhokela ugqirha wakho entliziyweni yakho.

Emva koko ke bancamathisela kwelinye icala lezinto ezikhokelela kumvelisi wenkunkuma. Ugqirha wenza usiko oluncinci kwaye ubeka isixhobo epokothweni yesikhumba esifubeni sakho, amaxesha amaninzi phantsi kwegxalaba lakho lasekhohlo.

Inkqubo ithatha phakathi kweyure enye neyure ezintathu. Emva koko, uya kuhlala esibhedlele ubuncinci iiyure ezingama-24 zokufumana kwakhona kunye nokubeka iliso. Kuya kufuneka uzive uchache ngokupheleleyo kwiiveki ezine ukuya kwezintandathu.

Ugqirha unokufaka i-ICD ngotyando phantsi kwe-anesthesia ngokubanzi. Kule meko, ixesha lakho lokubuyisela esibhedlele linokufikelela kwiintsuku ezintlanu.

Yeyiphi imingcipheko enxulumene nenkqubo?

Njengalo naluphi na utyando, inkqubo yokumiliselwa kwe-ICD inokubangela ukopha, iintlungu, kunye nosulelo kwindawo yokucheba. Kwakhona kunokwenzeka ukuba ube nempendulo yokunyanga kumayeza owafumanayo ngexesha lenkqubo.

Iingxaki ezinzulu ngakumbi kule nkqubo zinqabile. Nangona kunjalo, banokubandakanya:

• amahlwili egazi
• umonakalo entliziyweni yakho, iivalves, okanye imithambo
• ulwelo olwakha malunga nentliziyo
• ukuhlaselwa yintliziyo
• umphunga owileyo

Kuyenzeka ukuba isixhobo sakho ngamanye amaxesha sothuse intliziyo yakho ngokungeyomfuneko. Nangona oku kothuka kufutshane kwaye kungenabungozi, kunokwenzeka ukuba uya kuziva. Ukuba kukho ingxaki nge-ICD, i-electrophysiologist yakho inokufuna ukuyilungisa kwakhona.

Kwenzeka ntoni emva kwenkqubo?

Kuxhomekeke kwimeko yakho, ukuchacha kunokuthatha naphina ukusuka kwiintsuku ezimbalwa ukuya kwiiveki ezimbalwa. Gwema imisebenzi enefuthe eliphezulu kunye nokuphakamisa okunzima ubuncinci kwinyanga emva kwenkqubo yakho.

Umbutho weAmerican Heart Association awukhuthazi ukuqhuba iinyanga ezintandathu ubuncinci emva kwenkqubo yokufakwa kwe-ICD. Oku kukunika ithuba lokuvavanya ukuba ukothuka kwentliziyo yakho kungakubangela ukuba ufe isiqaqa. Ungakuthathela ingqalelo ukuqhuba ukuba uhamba ixesha elide ngaphandle kothukiso (iinyanga ezi-6 ukuya kwezi-12) okanye ukuba awuphelelwa ngamandla xa wothukile.

Ithini imbono yexesha elide?

Ukuba ne-ICD kukuzinikela ubomi bakho bonke.

Emva kokuba uphinde wachacha, ugqirha wakho uya kudibana nawe ukwenza isixhobo sakho. Kuya kufuneka uqhubeke nokudibana nogqirha wakho rhoqo malunga neenyanga ezintathu ukuya kwezintandathu. Qiniseka ukuba uthatha nawaphi na amayeza amiselweyo kwaye wamkele indlela yokuphila kunye notshintsho olwenziwe ngugqirha.

Iibhetri kwifowuni zihlala iminyaka emihlanu ukuya kwesixhenxe. Uya kudinga enye inkqubo yokutshintsha iibhetri. Nangona kunjalo, le nkqubo inzima kancinci kuneyokuqala.

Izinto ezithile zinokuphazamisa ukusebenza kwesixhobo sakho, ke kuya kufuneka uziphephe. Oku kubandakanya:

• iinkqubo zokhuseleko
• izixhobo ezithile zonyango, njengoomatshini beMRI
• umbane

Unokufuna ukuphatha ikhadi kwisipaji sakho okanye unxibe isacholo sonyango esichaza uhlobo lwe-ICD onayo.

Kuya kufuneka uzame ukugcina iiselfowuni kunye nezinye izixhobo eziphathwayo ezi-intshi ezintandathu ubuncinci ukusuka kwi-ICD yakho.

Tshela ugqirha wakho ukuba ufumana naziphi na iingxaki ngesixhobo sakho, kwaye ubize ugqirha ngokukhawuleza ukuba i-defibrillator yakho ihambisa umothuko ukuqala kwakhona intliziyo yakho.