I-Atrial Fibrillation: Amaqiniso, Izibalo, Nawe

-Delile

• Ukudlanga
• Izimbangela nezici zobungozi
• Izimpawu
• Izinkinga
• Ukuhlolwa nokuxilongwa
• Ukwelashwa
• Ukuvimbela
• Izindleko

I-Atrial fibrillation, eyaziwa nangokuthi i-AFib noma i-AF, ukushaya kwenhliziyo okungajwayelekile (arrhythmia) okungaholela ezinkingeni ezahlukahlukene ezihlobene nenhliziyo njengamahlule egazi, isifo sohlangothi nokuhluleka kwenhliziyo.

I-AFib yisimo esibi esingenzeka ngaphandle kwezimpawu noma izimpawu kepha kungaholela ezinkingeni ezisongela impilo uma sishiywa singalashwa.

Ukuncipha okujwayelekile kwemicu yemisipha yamakamelo aphezulu enhliziyo (i-atria) imvamisa kuvumela ukukhishwa kwegazi okuhlelekile nokuqediwe kusuka emakamelweni aphezulu enhliziyo kuya kulawa aphansi (ama-ventricles).

E-AFib, noma kunjalo, izimpawu ezingasebenzi kahle noma ezisheshayo zikagesi zidala ukuthi i-atria isebenze ngokushesha okukhulu nangokuphithizela (i-fibrillate).

Igazi elingakhishwa ngokuphelele ngaphandle kwe-atria lingahlala futhi lingahlangana lapho. Ukukhulisa ukusebenza kahle kwenhliziyo nokugwema izifo ezahlukahlukene, amagumbi aphezulu naphansi enhliziyo kufanele asebenze njengeqembu. Lokho akwenzeki ngesikhathi se-AFib.

I-AFib ingavela ngeziqephu ezimfushane, noma kungaba isimo saphakade. Kwesinye isikhathi, usizo oluphuthumayo lwezokwelapha luyadingeka. Nakhu okudingeka ukwazi:

Ukudlanga

I-AFib yi-arrhythmia ejwayelekile kunazo zonke etholakala emtholampilo.

Kulinganiselwa ukwanda kwe-AFib e-United States kusuka cishe. Leyo nombolo ilinganiselwa ukuthi inyukele ku.

Emhlabeni jikelele, inani elilinganisiwe labantu abane-AFib ngo-2010 laliyizigidi ezingama-33.5, ngokusho kocwaningo luka-2013. Lokho kungamaphesenti angama-0,5 omphakathi womhlaba.

Ngokusho kwe-, cishe amaphesenti ama-2 abantu abangaphansi kweminyaka engama-65 ubudala bane-AFib, kanti cishe amaphesenti ayi-9 wabantu abaneminyaka engama-65 nangaphezulu anayo.

Ngokusho kuka-a, abantu abangazikhombisi njengabamhlophe banesilinganiso esiphansi kanye nezigameko zokuba ne-AFib.

Izimbangela nezici zobungozi

Kunezinhlobo ezine eziyinhloko ze-AFib.

I-Paroxysmal atrial fibrillation kulapho i-AFib iqala ngaphandle kwesixwayiso bese iyeka ngokungazelelwe. Isikhathi esiningi, lolu hlobo lwe-AFib luzisula lodwa kungakapheli amahora angama-24, kepha kungathatha isonto.

Lapho i-AFib ihlala isikhathi esingaphezu kwesonto, ibizwa kanjalo ukuphikelela kwe-atrial fibrillation.

I-AFib ehlala isikhathi esingaphezu konyaka ngaphandle kokuhamba i-fibrillation ye-atrial ehlala isikhathi eside.

I-AFib eqhubekayo ngaphandle kokwelashwa ibizwa unomphela fibrillation atrial.

Ukungajwayelekile noma ukonakala kwesakhiwo senhliziyo yizimbangela ezivame kakhulu ze-atrial fibrillation. Kungenzeka ukuthi uthuthukise i-AFib uma une:

• umfutho wegazi ophakeme
• isifo senhliziyo, ukukhubazeka kwenhliziyo, noma ukwehluleka kwenhliziyo
• isifo senhliziyo i-rheumatic noma i-pericarditis
• i-hyperthyroidism
• ukukhuluphala ngokweqile
• isifo sikashukela noma i-metabolic syndrome
• isifo samaphaphu noma isifo sezinso
• ukulala ubuthongo
• umlando womndeni we-AFib

I-AFib iphinde ihlotshaniswe nokufa okwandayo kubantu abanezinye izimo zenhliziyo nezinqubo, kufaka phakathi ukwehluleka kwenhliziyo nokushaya uhlangothi.

Ukuziphatha kungakhuphula nobungozi be-AFib. Lokhu kufaka phakathi ukusetshenziswa kwe-caffeine nokusetshenziswa kabi kotshwala. Izinga lokucindezeleka okuphezulu noma izimo zempilo yengqondo nazo zingaba yingxenye ye-AFib.

Amathuba okuthuthukisa i-AFib akhula ngeminyaka. Mayelana nabantu abane-AFib baphakathi kweminyaka yobudala engama-65 nengama-85. Ukwanda kwe-AFib kuphakeme emadodeni. Kodwa-ke, njengoba abesifazane bephila isikhathi eside kunamadoda, inani lamadoda nabesifazane abane-AFib licishe lilingane.

Yize abantu bozalo lwaseYurophu benesifo se-atrial fibrillation, ucwaningo luthole ukuthi eziningi zezinkinga zalo - kufaka phakathi isifo sohlangothi, isifo senhliziyo, nokwehluleka kwenhliziyo - zivame kakhulu kubantu base-Afrika baseMelika.

Izimpawu

Awuzizwa njalo izimpawu ze-AFib, kodwa ezinye izimpawu ezivamile zifaka ukushaya kwenhliziyo nokuphefumula okuncane.

Ezinye izimpawu zingabandakanya:

• ukushaya kwenhliziyo okungajwayelekile
• ikhanda elikhanyayo noma isiyezi
• ukuquleka noma ukudideka
• ukukhathala ngokweqile
• ukungaphatheki kahle kwesifuba noma ubuhlungu

Izinkinga

Kunokwanda okwandayo kokuthi i-atrial fibrillation ivame ukungaziwa kodwa kuyisimo esibi.

Kungakhathaliseki ukuthi unezimpawu noma cha, i-AFib ikubeka engcupheni enkulu yokushaywa unhlangothi. Ngokusho kwe-American Heart Association, uma une-AFib, unamathuba aphindwe ka-5 okuba nesifo sohlangothi kunomuntu ongenayo.

Uma inhliziyo yakho ishaya ngokushesha okukhulu, ingahle iholele nasekuhlulekeni kwenhliziyo. I-AFib ingadala ukuthi igazi ligcwale enhliziyweni yakho. Lawa mahlule angahamba egazini, ekugcineni abangele ukuvimba.

Ucwaningo lukhombisile ukuthi abesifazane abane-AFib basengozini enkulu yokushaywa unhlangothi nokufa kunabesilisa abane-AFib.

Ukuhlolwa nokuxilongwa

Ukuhlola kungaba yingxenye yokunakekelwa kwakho okuvamile uma uneminyaka engama-65 noma ngaphezulu, noma uma unezinye izinto ezinobungozi. Uma unezimpawu ze-AFib, bheka udokotela wakho.

Ukuhlola okuxilongayo kungafaka i-electrocardiogram (EKG noma i-ECG) ukuze uhlole umsebenzi kagesi wenhliziyo yakho. Olunye uvivinyo olungasiza ukuqapha kweHolter, i-ECG ephathekayo ekwazi ukuqapha isigqi senhliziyo yakho izinsuku ezimbalwa.

I-echocardiogram olunye uvivinyo olungenasidingo olungaveza izithombe zenhliziyo yakho, ngakho-ke udokotela wakho angabheka okungajwayelekile.

Udokotela wakho angaphinde ahlele ukuhlolwa kwegazi ukuze abheke izimo ezingaphansi ezingadala izimpawu zakho, njengezinkinga ze-thyroid. I-X-ray yesifuba inganikeza udokotela wakho ukubheka kangcono inhliziyo yakho namaphaphu ukuze abone ukuthi asikho yini isizathu esisobala sezimpawu zakho.

Ukwelashwa

I-AFib iphathwa ngezinguquko zendlela yokuphila, imithi, izinqubo, nokuhlinzwa ukusiza ukuvimbela amahlule egazi, ukubamba ukushaya kwenhliziyo, noma ukubuyisa isigqi esijwayelekile senhliziyo.

Uma une-fibrillation ye-atrial, udokotela wakho uzophinde afune noma yisiphi isifo esingase sisibangele futhi ahlole ubungozi bakho bokuthola amahlule egazi ayingozi.

Ukwelashwa kwe-AFib kungafaka:

• imithi yokulawula isigqi nenhliziyo
• imithi yokwehlisa igazi ukuvimbela amahlule egazi ekwakheni nasekunciphiseni ubungozi bohlangothi
• ukuhlinzwa
• izinguquko zokuphila ngendlela enempilo ukuphatha izingcuphe

Eminye imishanguzo ingasiza ekulinganiseni izinga lokushaya kwenhliziyo yakho. Lokhu kufaka phakathi i-beta blockers (i-metoprolol, i-atenolol), i-calcium channel blockers (diltiazem, verapamil), ne-digitalis (digoxin).

Uma leyo mithi ingaphumeleli, ezinye izidakamizwa zingasiza ukugcina isigqi senhliziyo esijwayelekile. Le mithi idinga ukulinganisa nokuqapha ngokucophelela:

• i-amiodarone (Cordarone, Pacerone)
• Siphokuhle (Tikosyn)
• i-flecainide (iTambocor)
• ibutilide (Corvert)
• ipropafenone (Rythmol)
• i-sotalol (Betapace, Sorine)
• i-disopyramide (i-Norpace)
• i-procainamide (i-Procan, i-Procapan, i-Pronestyl)

Isigqi senhliziyo esijwayelekile singabuyiselwa futhi ngokusebenzisa ukushaqeka kwamandla amancane kunqubo ebizwa ngogesi kagesi. Uma lokho kungasebenzi, udokotela wakho angazama okuthile okubizwa ngokuthi yi-ablation, esebenza ngokuqhekeza noma ngokucekela phansi izicubu enhliziyweni yakho ukuphazamisa amasiginali kagesi angalungile enza i-arrhythmia.

Ukuchithwa kwe-node ye-Atrioventricular kungenye indlela. Kule nqubo, ama-radiowave frequency asetshenziselwa ukonakalisa ingxenye yezicubu. Ngokwenza kanjalo, i-atria ayisakwazi ukuthumela imizwa kagesi.

I-pacemaker igcina ama-ventricles eshaya ngokujwayelekile. Ukuhlinzwa kweMaze kuyindlela evame ukubekelwa abantu asebevele badinga uhlobo oluthile lokuhlinzwa kwenhliziyo. Ukusikwa okuncane kwenziwa e-atria ukuze amasignali kagesi axakile angakwazi ukudlula.

Njengengxenye yokwelashwa kwakho, uzokwaziswa ukuthi ugcine ukudla okunempilo enhliziyweni. Ukuvivinya umzimba njalo kuyingxenye ebalulekile yempilo yenhliziyo, ngakho-ke cela udokotela wakho ukuthi ukuzivocavoca kukufanele kangakanani.

Bheka udokotela wakho njalo ukuze uthole ukunakekelwa okulandelayo. Kufanele futhi ugweme ukubhema.

Ukuvimbela

Awukwazi ukuvimbela i-AFib ngokuphelele, kepha kunezinto ongazenza ukugcina inhliziyo yakho iphilile.

Lwela ukugcina umfutho wegazi lakho, amazinga e-cholesterol, amazinga we-triglyceride, nesisindo ngaphakathi kwebanga elijwayelekile.

Idatha iphakamisa ukuthi abantu abakhuluphele ngokweqile nabakhuluphele kakhulu abane-dalili ye-AFib abakhethe ukwehlisa isisindo kanye nabaphathi abanobungozi bokulawulwa kwezinhlekelele babenezibhedlela ezimbalwa, ukuphefumula, kanye nezinqubo zokuncipha kunabalingani babo abenqabile ukubhaliswa.

Olunye ushintsho lwendlela yokuphila ongayenza lubandakanya:

• ukugcina ukudla okuphansi ku-cholesterol, amafutha agcwele, namafutha we-trans
• ukudla imifino eningi, izithelo, nezinhlamvu ezigcwele
• ukuzivocavoca nsuku zonke
• ukuyeka ukubhema
• ukuphuza utshwala ngokulinganisela
• ukugwema i-caffeine uma kubangela i-AFib yakho
• uthatha yonke imithi yakho ngokwelebula noma ngemiyalo kadokotela wakho
• ukubuza udokotela wakho ngaphambi kokungeza noma yimiphi imishanguzo yokuthenga noma izengezo kuhlobo lwakho lwemithi
• ukuhlela ukuvakashelwa njalo nodokotela wakho
• ukubika ubuhlungu besifuba, ubunzima bokuphefumula, noma ezinye izimpawu kudokotela wakho ngokushesha
• ukuqapha nokwelapha ezinye izimo zezempilo

Izindleko

I-AFib yisimo esibizayo. Izindleko eziphelele ze-AFib e-United States zifike cishe ku- $ 26 billion dollars ngonyaka.

Iphukile, lokhu bekungama-dollar ayizigidi eziyizinkulungwane eziyisithupha (6 billion) ukunakekelwa okuhloselwe ukwelapha i-AFib, ama- $ 9.9 billion ukwelapha ezinye izifo zenhliziyo nemithambo eyingozi, kanye ne- $ 10.1 billion yokwelapha izinkinga zempilo ezingezona eziphathelene nemithambo yegazi.

, izibhedlela ezingaphezu kuka-750,000 zenzeka minyaka yonke ngenxa ye-AFib. Lesi simo sinomthelela ekufeni kwabantu ababalelwa ku-130,000 unyaka nonyaka.

I-CDC ibika ukuthi inani lokufa elivela ku-AFib njengesizathu esiyinhloko noma esinegalelo ekufeni likhuphuke isikhathi esingaphezu kwamashumi amabili eminyaka.

Ucwaningo lwakamuva lweziguli zeMedicare phakathi kuka-1998 kuya ku-2014 luthole ukuthi abantu abane-fibrillation ye-atrial basengozini enkulu yokulaliswa esibhedlela (amaphesenti angama-37.5 uma kuqhathaniswa namaphesenti ayi-17.5) futhi maningi amathuba okufa ngesikhathi sokulaliswa (amaphesenti angu-2.1 uma kuqhathaniswa namaphesenti ayi-0.1) abantu abangenayo i-AFib.