Ukuthuthukisa Ukubikezelwa Kwakho Kwe-Atrial Fibrillation

-Delile

• Siyini isibikezelo somuntu one-AFib?
• Yiziphi izinkinga ezingenzeka nge-AFib?
• Iphathwa kanjani i-AFib?
• Imithi
• Ukuphefumula kwenhliziyo
• Izinqubo zokuhlinza
• Ungayivimba kanjani i-AFib?

Kuyini i-atrial fibrillation?

I-Atrial fibrillation (i-AFib) yisimo senhliziyo esibangela amakamelo aphezulu enhliziyo (awaziwa njenge-atria) aqhaqhazele.

Lokhu kuqhaqhazela kuvimbela inhliziyo ekuphepheni kahle. Ngokuvamile, igazi lihamba lisuka e-atrium liye ku-ventricle (ikamelo elingezansi lenhliziyo), lapho lifakwa khona emaphashini noma kuwo wonke umzimba.

Lapho i-atrium ikhala esikhundleni sokumpompa, umuntu angazizwa sengathi inhliziyo yakhe iye yaphaphalaza noma yeqa isigqi. Inhliziyo ingashaya ngokushesha okukhulu. Bangazizwa becanuzelelwa inhliziyo, baphefumuleke kancane futhi babuthakathaka.

Ngokungeziwe ekuzweleni kwenhliziyo nokushaywa okungafika ne-AFib, abantu basengozini enkulu yamahlule egazi. Lapho igazi lingampompi futhi, igazi eligxila enhliziyweni livame kakhulu ukujiya.

Amahlule ayingozi ngoba angadala unhlangothi. Ngokusho kwe-American Heart Association, abantu abalinganiselwa kumaphesenti angama-15 kuya kwangu-20 abanesifo sohlangothi nabo bane-AFib.

Imithi nokunye ukwelashwa kuyatholakala kulabo abane-AFib. Iningi lizolawula, hhayi ukwelapha, isimo. Ukuba ne-AFib nakho kungakhuphula ingozi yomuntu yokwehluleka kwenhliziyo. Udokotela wakho angancoma udokotela wenhliziyo uma ecabanga ukuthi ungaba ne-AFib.

Siyini isibikezelo somuntu one-AFib?

NgokukaJohns Hopkins Medicine, abantu abalinganiselwa ezigidini ezi-2.7 baseMelika bane-AFib. Abangaba yingxenye eyodwa kwezinhlanu zabo bonke abantu abanesifo sohlangothi nabo bane-AFib.

Iningi labantu abaneminyaka engama-65 nangaphezulu abane-AFib nabo bathatha imishanguzo yokunciphisa igazi ukunciphisa amathuba okuba nezinkinga ezinjenge-stroke. Lokhu kuthuthukisa ukubikezelwa okuphelele kubantu abane-AFib.

Ukufuna ukwelashwa nokugcina ukuvakashelwa njalo nodokotela wakho kungathuthukisa ukubikezela kwakho uma une-AFib. Ngokusho kwe-American Heart Association (AHA), amaphesenti angama-35 abantu abangatholi ukwelashwa kwe-AFib baqhubeka nokuhlaselwa yisifo sohlangothi.

I-AHA iphawula ukuthi isiqephu se-AFib asivamile ukubangela ukufa. Kodwa-ke, lezi ziqephu zingaba nomthelela kuwe ekubhekaneni nezinye izinkinga, njengokushaywa unhlangothi nokuhluleka kwenhliziyo, okungaholela ekufeni.

Ngamafuphi, kungenzeka ukuthi i-AFib ithinte isikhathi sakho sempilo. Imele ukungasebenzi enhliziyweni okufanele kubhekwane nakho. Kodwa-ke, kunezindlela zokwelashwa eziningi ezingakusiza ulawule izimpawu zakho futhi wehlise ubungozi bakho emicimbini emikhulu, njengokushaywa unhlangothi nokuhluleka kwenhliziyo.

Yiziphi izinkinga ezingenzeka nge-AFib?

Izinkinga ezimbili eziyinhloko ezihambisana ne-AFib isifo sohlangothi nokuhluleka kwenhliziyo. Ingozi eyengeziwe yokujiya kwegazi ingaholela ekuqhekekeni kwegazi lisuke enhliziyweni yakho liye ebuchosheni bakho. Ingozi yokushaywa unhlangothi iphakeme uma unalezi zinto eziyingozi ezilandelayo:

• isifo sikashukela
• ukuhluleka kwenhliziyo
• umfutho wegazi ophakeme
• umlando wesifo sohlangothi

Uma une-AFib, khuluma nodokotela wakho ngengozi yakho yokushaywa unhlangothi kanye nanoma yiziphi izinyathelo ongazithatha ukuvimbela eyodwa ukuthi ingenzeki.

Ukwehluleka kwenhliziyo kungenye inkinga ejwayelekile ehambisana ne-AFib. Ukushaya kwenhliziyo yakho okuqhaqhazelayo nenhliziyo yakho engashayi ngesigqi sayo esijwayelekile esibekiwe kungadala ukuthi inhliziyo yakho isebenze kanzima ukumpompa igazi ngempumelelo enkulu.

Ngokuhamba kwesikhathi, lokhu kungaholela ekuhlulekeni kwenhliziyo. Lokhu kusho ukuthi inhliziyo yakho inobunzima bokujikeleza igazi elanele ukuhlangabezana nezidingo zomzimba wakho.

Iphathwa kanjani i-AFib?

Izindlela zokwelapha eziningi ziyatholakala ku-AFib, kusuka emithini yokwelashwa kuya ekuhlinzweni.

Okokuqala, kubalulekile ukunquma ukuthi yini ebangela i-AFib yakho. Isibonelo, izimo ezinjenge-apnea yokulala noma izifo ze-thyroid zingabangela i-AFib. Uma udokotela wakho engakunika izindlela zokwelapha ukulungisa lesi sifo, i-AFib yakho ingahle ihambe ngenxa yalokho.

Imithi

Udokotela wakho angakunikeza imithi esiza inhliziyo ukuthi igcine isilinganiso sokushaya kwenhliziyo nesigqi. Izibonelo zifaka:

• i-amiodarone (i-Cordarone)
• i-digoxin (Lanoxin)
• Siphokuhle (Tikosyn)
• ipropafenone (Rythmol)
• i-sotalol (Betapace)

Udokotela wakho angaphinde anikeze imishanguzo yokuncipha igazi ukunciphisa ubungozi bokuba nehlwili elingadala unhlangothi. Izibonelo zale mithi zifaka:

• i-apixaban (Eliquis)
• i-dabigatran (Pradaxa)
• i-Rivaroxaban powder (i-Xarelto)
• i-edoxaban (Savaysa)
• i-warfarin (Coumadin, Jantoven)

Imithi yokuqala emine ebhalwe ngenhla yaziwa nangokuthi ama-anticoagulants (NOACs) angenawo uvithamini K. Ama-NOAC manje anconywe ngaphezu kwe-warfarin ngaphandle kokuthi une-mitral stenosis noma i-valve yenhliziyo yokufakelwa.

Wena dokotela unganikeza imishanguzo yokuguqula inhliziyo yakho (buyisela inhliziyo yakho esigqini esijwayelekile). Eminye yale mithi ifakwa ngemithambo, kanti eminye ithathwa ngomlomo.

Uma inhliziyo yakho iqala ukushaya ngokushesha okukhulu, udokotela wakho angakwamukela esibhedlela kuze kube yilapho imithi ikwazi ukuzinzisa izinga lokushaya kwenhliziyo yakho.

Ukuphefumula kwenhliziyo

Isizathu se-AFib yakho kungenzeka singaziwa noma sihlobane nezimo ezenza buthaka inhliziyo ngqo. Uma uphilile ngokwanele, udokotela wakho angancoma inqubo ebizwa ngogesi kagesi. Lokhu kubandakanya ukuletha ukwethuka kagesi enhliziyweni yakho ukusetha kabusha isigqi sayo.

Ngesikhathi sale nqubo, unikezwa imishanguzo yokuthambisa, ngakho-ke kungenzeka ukuthi ngeke ukwazi ukwethuka.

Ezimweni ezithile, udokotela wakho uzokunika imishanguzo yokuncipha igazi noma enze inqubo ebizwa nge-transesophageal echocardiogram (TEE) ngaphambi kwe-cardioversion ukuqinisekisa ukuthi awekho amahlule egazi enhliziyweni yakho angaholela ekushayweni unhlangothi.

Izinqubo zokuhlinza

Uma i-cardioversion noma ukuthatha imishanguzo kungalawuli i-AFib yakho, udokotela wakho angancoma ezinye izinqubo. Kungabandakanya ukukhishwa kwe-catheter ablation, lapho i-catheter ifakwe ngomthambo esihlakaleni noma emgodini.

I-catheter ingaqondiswa ezindaweni zenhliziyo yakho eziphazamisa umsebenzi kagesi. Udokotela wakho angabhidliza, noma abhubhise, indawo encane yezicubu edala izimpawu ezingajwayelekile.

Enye inqubo ebizwa ngokuthi inqubo ye-maze ingenziwa ngokubambisana nokuhlinzwa kwenhliziyo evulekile, njengokudlula kwenhliziyo noma ukufaka i-valve esikhundleni. Le nqubo ifaka ukudala izicubu ezibomvu enhliziyweni ukuze imizwa kagesi engajwayelekile ingakwazi ukudlulisa.

Ungadinga futhi i-pacemaker ukusiza inhliziyo yakho ukuthi ihlale ngesigqi. Odokotela bakho bangafaka i-pacemaker ngemuva kwe-AV node ablation.

I-AV node ingumenzi wenhliziyo ohamba phambili wenhliziyo, kepha ingadlulisa amasiginali angajwayelekile uma une-AFib.

Udokotela wakho uzokwakha izicubu ezibomvu lapho kutholakala khona i-AV node ukuvimbela amasiginali angajwayelekile ukuthi adluliswe. Uyobe esefaka umshini wenhliziyo ukuze udlulise amasiginali afanele esigqi senhliziyo.

Ungayivimba kanjani i-AFib?

Ukuqhuba impilo enempilo yenhliziyo kubalulekile uma une-AFib. Izimo ezifana nomfutho wegazi ophakeme nesifo senhliziyo zingakhuphula ubungozi bakho be-AFib. Ngokuvikela inhliziyo yakho, ungakwazi ukuvimbela lesi simo ukuthi singenzeki.

Izibonelo zezinyathelo ongazithatha ukuvimbela i-AFib zifaka:

• Ukuyeka ukubhema.
• Ukudla ukudla okunempilo kwenhliziyo okunamafutha agcwele, usawoti, i-cholesterol, namafutha we-trans.
• Ukudla ukudla okunomsoco omningi, kubandakanya okusanhlamvu okuphelele, imifino, izithelo, nemithombo yobisi ephansi nama-protein.
• Ukwenza umsebenzi ojwayelekile womzimba okusiza ukuthi ugcine isisindo esinempilo sosayizi nohlaka lwakho.
• Ukwehlisa isisindo kuyanconywa uma ukhuluphele njengamanje.
• Ukuhlolelwa umfutho wegazi njalo nokubona udokotela uma kungaphezulu kuka-140/90.
• Ukugwema ukudla nemisebenzi okwaziwayo ukuqala i-AFib yakho. Izibonelo zifaka ukuphuza utshwala ne-caffeine, ukudla ukudla okune-monosodium glutamate (MSG), nokuzivocavoca umzimba kakhulu.

Kungenzeka ukulandela zonke lezi zinyathelo futhi ungavimbi i-AFib. Kodwa-ke, indlela yokuphila enempilo izothuthukisa impilo yakho yonke nokubikezela uma une-AFib.