I-Atrial fibrillation noma i-flutter

I-Atrial fibrillation noma i-flutter uhlobo oluvamile lokushaya kwenhliziyo okungavamile. Isigqi senhliziyo siyashesha futhi imvamisa asijwayelekile.

Lapho kusebenza kahle, amakamelo amane enkontileka yenhliziyo (khama) ngendlela ehlelekile.

Izimpawu zikagesi ziqondisa inhliziyo yakho ukuthi ipompe inani elifanele legazi ngezidingo zomzimba wakho. Izimpawu ziqala endaweni ebizwa nge-sinoatrial node (ebizwa nangokuthi i-sinus node noma i-SA node).

Ku-fibrillation ye-atrial, umfutho kagesi wenhliziyo awuvamile. Lokhu kungenxa yokuthi i-node sinoatrial ayisasilawuli isigqi senhliziyo.

• Izingxenye zenhliziyo azikwazi ukwenza iphethini ehlelekile.
• Ngenxa yalokho, inhliziyo ayikwazi ukumpompa igazi elanele ukuhlangabezana nezidingo zomzimba.

E-atrial flutter, ama-ventricles (amakamelo enhliziyo aphansi) angashaya ngokushesha okukhulu, kepha ngendlela ejwayelekile.

Lezi zinkinga zingathinta abesilisa nabesifazane. Zivame kakhulu ngokwanda kweminyaka.

Izimbangela ezivamile ze-fibrillation ye-atrial zifaka:

• Ukusetshenziswa kotshwala (ikakhulukazi ukuphuza ngokweqile)
• Isifo semithambo yegazi
• Ukuhlaselwa yinhliziyo noma ukuhlinzwa kwenhliziyo ngokudlula
• Ukwehluleka kwenhliziyo noma inhliziyo ekhulisiwe
• Isifo se-valve senhliziyo (imvamisa i-mitral valve)
• Umfutho wegazi ophezulu
• Imithi
• Indlala yegilo eyeqile (hyperthyroidism)
• I-Pericarditis
• Isifo se-sinus syndrome

Ungahle ungazi ukuthi inhliziyo yakho ayishayi ngendlela ejwayelekile.

Izimpawu zingaqala noma zime ngokungazelelwe. Lokhu kungenxa yokuthi i-atrial fibrillation ingama noma iqale yodwa.

Izimpawu zingafaka:

• I-Pulse ezizwa ishesha, igijima, ishaya ngamandla, ishaya, ingajwayelekile, noma ihamba kancane
• Ukuzwa kokuzwa ukushaya kwenhliziyo (ukushaya kwenhliziyo)
• Ukudideka
• Isiyezi, ikhanda elikhanyayo
• Ukuquleka
• Ukukhathala
• Ukulahlekelwa amandla okuzivocavoca umzimba
• Ukuphelelwa umoya

Umhlinzeki wezokunakekelwa kwempilo angakuzwa ukushaya kwenhliziyo okusheshayo ngenkathi elalele inhliziyo yakho nge-stethoscope. I-pulse yakho ingazizwa ishesha, ingalingani, noma yomibili.

Ukushaya kwenhliziyo okujwayelekile kushaya okungu-60 kuye kwayi-100 ngomzuzu. Ku-fibrillation ye-atrial noma i-flutter, ukushaya kwenhliziyo kungaba ukushaya okungu-100 kuya ku-175 ngomzuzu. Umfutho wegazi ungajwayelekile noma uphansi.

I-ECG (isivivinyo esiqopha umsebenzi kagesi wenhliziyo) ingakhombisa i-atrr fibrillation noma i-atrial flutter.

Uma isigqi senhliziyo sakho esingajwayelekile sifika futhi sidlule, kungadingeka ukuthi ugqoke umqapha okhethekile wokuthola inkinga. Ukuqapha kuqopha isigqi senhliziyo isikhathi esithile.

• Ukuqapha umcimbi (amasonto amathathu kuya kwayi-4)
• Ukuqapha kweHolter (ukuhlolwa kwamahora angama-24)
• I-loop recorder efakiwe (ukuqapha okunwetshiwe)

Ukuhlolwa kokuthola isifo senhliziyo kungafaka:

• I-Echocardiogram (isithombe se-ultrasound senhliziyo)
• Ukuhlolwa kokuhlola ukunikezwa kwegazi kwemisipha yenhliziyo
• Ukuhlolwa kokufunda uhlelo lukagesi lwenhliziyo

Ukwelashwa kwe-Cardioversion kusetshenziselwa ukubuyisela inhliziyo kwisigqi esijwayelekile zisuka nje. Kunezinketho ezimbili zokwelashwa:

• Ukushaqeka kukagesi enhliziyweni yakho
• Izidakamizwa ezinikezwa ngomthambo

Lokhu kwelashwa kungenziwa njengezindlela eziphuthumayo, noma kuhlelwe ngaphambi kwesikhathi.

Imithi yansuku zonke ethathwa ngomlomo isetshenziselwa:

• Yehlisa ukushaya kwenhliziyo okungajwayelekile - Le mithi ingafaka i-beta-blockers, i-calcium channel blockers, ne-digoxin.
• Vimbela i-fibrillation ye-atrial ekubuyeni -- Le mithi isebenza kahle kubantu abaningi, kepha ingaba nemiphumela emibi kakhulu. I-atrial fibrillation ibuya kubantu abaningi, noma ngabe bathatha le mithi.

Inqubo ebizwa ngokuthi yi-radiofrequency ablation ingasetshenziselwa ukwengeza izindawo enhliziyweni yakho lapho kubangelwa khona izinkinga zesigqi senhliziyo. Lokhu kungavimbela amasiginali kagesi angajwayelekile adala i-atrial fibrillation noma i-flutter ekuhambeni enhliziyweni yakho. Ungadinga i-pacemaker yenhliziyo ngemuva kwale nqubo. Bonke abantu abane-fibrillation ye-atrial bazodinga ukuthi bafunde ukuphatha lesi simo ekhaya.

Abantu abane-fibrillation ye-atrial kuzodingeka kakhulu ukuthi bathathe imithi emincane yegazi. Le mithi isetshenziselwa ukunciphisa ubungozi bokuba negazi elihamba emzimbeni (futhi lokho kungadala isifo sohlangothi, isibonelo). Isigqi senhliziyo esingajwayelekile esenzeka nge-atrial fibrillation senza amahlule egazi abe sengozini yokwakheka.

Imithi emincane yegazi ifaka phakathi i-heparin, i-warfarin (i-Coumadin), i-apixaban (i-Eliquis), i-rivaroxaban powder (i-Xarelto), i-edoxaban (i-Savaysa) ne-dabigatran (i-Pradaxa). Izidakamizwa ze-antiplatelet ezifana ne-aspirin noma i-clopidogrel nazo zingabekwa. Kodwa-ke, izinciphisi zegazi zandisa amathuba okuphuma kwegazi, ngakho-ke akubona bonke abantu abangazisebenzisa.

Enye indlela yokuvikela unhlangothi yabantu abangakwazi ukuthatha le mithi ngokuphepha yiWatchman Device, esanda kuvunywa yi-FDA. Lokhu kufakelwa okuncane okwenziwe ngobhasikidi okufakwa ngaphakathi enhliziyweni ukuvimba indawo yenhliziyo lapho iningi lamahlule lakha khona. Lokhu kukhawulela amahlule enza ifomu.

Umhlinzeki wakho uzobheka iminyaka yakho nezinye izinkinga zezokwelapha lapho ethatha isinqumo sokuthi yiziphi izindlela zokuvimbela unhlangothi ezingcono kuwe.

Ukwelashwa kuvame ukulawula lesi sifo. Abantu abaningi abane-fibrillation ye-atrial benza kahle kakhulu ngokwelashwa.

I-Atrial fibrillation ivame ukubuya futhi ibe yimbi kakhulu. Kungabuya kubanye abantu, noma ngabe kwelashwa.

Amahlule aqhekeka aye ebuchosheni angadala isifo sohlangothi.

Shayela umhlinzeki wakho uma unezimpawu ze-atrial fibrillation noma i-flutter.

Khuluma nomhlinzeki wakho ngezinyathelo zokwelapha izimo ezibangela i-atrial fibrillation ne-flutter. Gwema ukuphuza ngokweqile.

I-fibrillation yendlebe; A-fib; I-Afib

• I-Atrial fibrillation - ukukhishwa
• Inhliziyo pacemaker - ukukhipha
• Ukuthatha i-warfarin (Coumadin, Jantoven) - okufanele ubuze udokotela wakho

• Inhliziyo - isigaba phakathi nendawo
• Inhliziyo - ukubuka kwangaphambili
• Imithambo yenhliziyo engemuva
• Imithambo yenhliziyo yangaphakathi
• Uhlelo lokuqhuba kwenhliziyo

UJanuwari CT, uWann LS, uCalkins H, et al. Ukubuyekezwa okugxile kwe-2019 AHA / ACC / HRS komhlahlandlela we-2014 AHA / ACC / HRS wokuphathwa kweziguli ezine-fibrillation ye-atrial: umbiko we-American College of Cardiology / American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society in ngokubambisana neNhlangano Yabahlinzayo Besihluku. Ukujikeleza. 2019; 140 (6) e285. I-PMID: 30686041 pubmed.ncbi.nlm.nih.gov/30686041.

UMeschia JF, uBushnell C, uBoden-Albala B, et al. Imihlahlandlela yokuvimbela okuyinhloko ukushaywa unhlangothi: isitatimende sabasebenzi bezempilo abavela e-American Heart Association / American Stroke Association. Unhlangothi. 2014; 45 (12): 3754-3832. I-PMID: 25355838 pubmed.ncbi.nlm.nih.gov/25355838.

UMorady F, uZipes DP. I-Atrial fibrillation: izici zomtholampilo, izindlela, nokuphathwa. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ama-eds. Izifo Zenhliziyo zeBraunwald: Incwadi Yemithi Yezinhliziyo. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2019: isahluko 38.

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.