Isifo se-Wolff-Parkinson-White (WPW)

I-Wolff-Parkinson-White (WPW) syndrome yisimo lapho kunendlela eyengeziwe kagesi enhliziyweni eholela ezikhathini zokushaya kwenhliziyo okusheshayo (tachycardia).

I-WPW syndrome ingenye yezimbangela ezivame kakhulu zezinkinga zokushaya kwenhliziyo ngokushesha ezinganeni nasezinganeni.

Ngokuvamile, izimpawu zikagesi zilandela indlela ethile enhliziyweni. Lokhu kusiza inhliziyo ishaye njalo. Lokhu kuvimbela inhliziyo ukuthi ingabi nokushaya okwengeziwe noma ukushaya okwengeziwe ngokushesha okukhulu.

Kubantu abane-WPW syndrome, ezinye zezimpawu zikagesi zenhliziyo zehla ngomgwaqo owengeziwe. Lokhu kungadala ukushaya kwenhliziyo okushesha kakhulu okubizwa nge-supraventricular tachycardia.

Iningi labantu abane-WPW syndrome abanazo ezinye izinkinga zenhliziyo. Kodwa-ke, lesi simo sixhunyaniswe nezinye izimo zenhliziyo, njenge-Ebstein anomaly. Ifomu lesimo lisebenza nasemindenini.

Ukushaya kwenhliziyo okusheshayo kwenzeka kaningi kangakanani kuyehluka kuye ngomuntu. Abanye abantu abane-WPW syndrome baneziqephu ezimbalwa kuphela zokushaya kwenhliziyo okusheshayo. Abanye bangaba nesilinganiso senhliziyo esisheshayo kanye noma kabili ngesonto noma ngaphezulu. Futhi, kungahle kungabikho zimpawu nhlobo, ngakho-ke leso simo siyatholakala lapho kwenziwa ukuhlolwa kwenhliziyo ngesinye isizathu.

Umuntu onale syndrome angaba:

• Ubuhlungu besifuba noma ukuqina kwesifuba
• Isiyezi
• Ubumhlophe
• Ukuquleka
• Ukushaya ngonyawo (umuzwa wokuzwa inhliziyo yakho ishaya, imvamisa ngokushesha noma ngokungajwayelekile)
• Ukuphelelwa umoya

Ukuhlolwa ngokomzimba okwenziwe ngesikhathi sesiqephu se-tachycardia kuzobonisa ukushaya kwenhliziyo ngokushesha ukwedlula ukushaya okungu-100 ngomzuzu. Ukushaya kwenhliziyo okuvamile ukushaya okungu-60 kuya kwayi-100 ngomzuzu kubantu abadala, nangaphansi kokushaya okungu-150 ngomzuzu ezinganeni ezisanda kuzalwa, ezinganeni, nasezinganeni ezincane. Umfutho wegazi uzoba ojwayelekile noma uphansi ezimweni eziningi.

Uma umuntu engenayo i-tachycardia ngesikhathi sokuhlolwa, imiphumela ingaba evamile. Isimo singatholakala ukuthi sine-ECG noma nge-ECG ehamba phambili yokuqapha, njenge-Monitor yeHolter.

Isivivinyo esibizwa nge-electrophysiologic Study (EPS) senziwa kusetshenziswa ama-catheters abekwe enhliziyweni. Lokhu kuhlolwa kungasiza ekuboneni indawo yendlela eyengeziwe kagesi.

Imithi, ikakhulukazi imishanguzo elwa nesigqi efana ne-procainamide noma i-amiodarone, ingasetshenziselwa ukulawula noma ukuvimbela ukushaya kwenhliziyo okusheshayo.

Uma izinga lokushaya kwenhliziyo lingabuyeli kwesejwayelekile ngokwelashwa, odokotela bangasebenzisa uhlobo lwezokwelapha olubizwa ngokuthi yi-electrical cardioversion (shock).

Ukwelashwa kwesikhathi eside kwe-WPW syndrome kuvame ukukhishwa kwe-catheter. Le nqubo ihilela ukufaka ishubhu (ipayipi) emthanjeni ngokusika okuncane eduze komgogodla kuya endaweni yenhliziyo. Lapho ithiphu ifinyelela enhliziyweni, indawo encane ebangela ukushaya kwenhliziyo okusheshayo iyabhidlika kusetshenziswa uhlobo oluthile lwamandla obizwa nge-radiofrequency noma ngokuyiqandisa (cryoablation). Lokhu kwenziwa njengengxenye yocwaningo lwe-electrophysiologic (EPS).

Ukuhlinzwa kwenhliziyo okuvulekile ukushisa noma ukubamba indlela eyengeziwe nakho kunganikeza ikhambi laphakade le-WPW syndrome. Ezimweni eziningi, le nqubo yenziwa kuphela uma udinga ukuhlinzwa kwenhliziyo ngezinye izizathu.

I-catheter ablation yelapha lesi sifo kubantu abaningi. Izinga lempumelelo lenqubo liphakathi kuka-85% kuya ku-95%. Izinga lempumelelo lizohluka ngokuya ngendawo nenombolo yemikhondo eyengeziwe.

Izinkinga zingafaka:

• Izinkinga zokuhlinzwa
• Ukwehluleka kwenhliziyo
• Umfutho wegazi owehlisiwe (obangelwa ukushaya kwenhliziyo okusheshayo)
• Imiphumela emibi yemithi

Isimo esibi kakhulu sokushaya kwenhliziyo esisheshayo yi-ventricular fibrillation (VF), engahle iholele ekushaqekeni noma ekufeni. Ngezinye izikhathi kungenzeka kubantu abane-WPW, ikakhulukazi uma futhi bane-atrial fibrillation (AF), nolunye uhlobo lwesigqi senhliziyo esingajwayelekile. Lolu hlobo lokushaya kwenhliziyo okusheshayo ludinga ukwelashwa okuphuthumayo kanye nenqubo ebizwa nge-cardioversion.

Shayela umhlinzeki wakho wezempilo uma:

• Unezimpawu zesifo se-WPW.
• Unale nkinga futhi izimpawu ziba zimbi kakhulu noma azithuthuki ngokwelashwa.

Khuluma nomhlinzeki wakho mayelana nokuthi amalungu omndeni wakho kufanele ahlolwe amafomu alesi simo.

Preexcitation syndrome; WPW; ITachycardia - Isifo seWolff-Parkinson-White; I-Arrhythmia - WPW; Isigqi senhliziyo esingajwayelekile - WPW; Ukushaya kwenhliziyo okusheshayo - WPW

• Okungahambi kahle kuka-Ebstein
• Ukuqapha kwenhliziyo kaHolter
• Uhlelo lokuqhuba kwenhliziyo

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UTomaselli GF, uZipes DP. Sondela esigulini ngama-arrhythmias enhliziyo. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ama-eds. Isifo Senhliziyo SikaBraunwald: Incwadi Yemithi Yezinhliziyo Nemithambo. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2019: isahluko 32.

I-Zimetbaum P. Supraventricular arrhythmias yenhliziyo. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 58.