Isihlonzi se-Cardioverter Defibrillator (ICD)

-Delile

• Yini i-defibrillator efakwe ngaphakathi?
• Kungani ngidinga i-cardioverter defibrillator engafakelwa?
• Isebenza kanjani i-cardioverter defibrillator efakiwe?
• Ngilungiselela kanjani inqubo?
• Kwenzekani ngesikhathi senqubo?
• Yiziphi izingozi ezihambisana nenqubo?
• Kwenzekani ngemuva kwenqubo?
• Uyini umbono wesikhathi eside?

Yini i-defibrillator efakwe ngaphakathi?

I-cardioverter defibrillator (i-ICD) efakwe ngaphakathi ithuluzi elincane udokotela wakho angalifaka esifubeni sakho ukusiza ukulawula isigqi senhliziyo esingajwayelekile, noma i-arrhythmia.

Yize incane kunendawo yokubeka amakhadi, i-ICD iqukethe ibhethri nekhompyutha encane eqapha ukushaya kwenhliziyo yakho. Ikhompyutha iletha ukushaqeka okuncane kukagesi enhliziyweni yakho ngezikhathi ezithile. Lokhu kusiza ukulawula ukushaya kwenhliziyo yakho.

Odokotela bavame ukufaka ama-ICD kubantu abane-arrhythmias esongela impilo futhi abasengozini yokuboshwa okungazelelwe kwenhliziyo, isimo lapho inhliziyo iyeka ukushaya. I-Arrhythmias ingaba yinto yokuzalwa (into owazalwa unayo) noma uphawu lwesifo senhliziyo.

Ama-ICD aziwa nangokuthi amadivayisi angafakwa inhliziyo noma ama-defibrillators.

Kungani ngidinga i-cardioverter defibrillator engafakelwa?

Inhliziyo yakho inama-atria amabili (amakamelo aphezulu kwesobunxele nangakwesokudla) nama-ventricles amabili (amakamelo aphansi kwesobunxele nangakwesokudla). Ama-ventricles akho adonsa igazi lisuke enhliziyweni yakho liye kuwo wonke umzimba wakho. Lawa magumbi amane enkontileka yenhliziyo yakho ngokulandelana kwesikhathi sokumpompa igazi emzimbeni wakho wonke. Lokhu kubizwa ngesigqi.

Ama-node amabili enhliziyweni yakho alawula isigqi senhliziyo yakho. I-node ngayinye ithumela umfutho kagesi ngokulandelana kwesikhathi. Lesi sifiso sibangela imisipha yenhliziyo yakho ukuba ingene. Okokuqala inkontileka ye-atria, bese kuba i-ventricles contract. Lokhu kudala ipompo.

Lapho isikhathi salezi zinkanuko sesicishiwe, inhliziyo yakho ayilifaki kahle igazi. Izinkinga zesigqi senhliziyo kuma-ventricles akho ziyingozi kakhulu ngoba inhliziyo yakho ingayeka ukupompa. Lokhu kungabulala uma ungatholi ukwelashwa ngokushesha.

Ungahlomula nge-ICD uma une:

• isigqi senhliziyo eshesha kakhulu futhi esiyingozi esibizwa nge-ventricular tachycardia
• ukudonsa okungahambi kahle, okubizwa ngokuthi yi-fibrillation eqhaqhazelayo noma ye-ventricular
• inhliziyo ebuthakathaka umlando wesifo senhliziyo noma isifo esedlule senhliziyo
• isicubu senhliziyo esikhulisiwe noma esijiyile, esibizwa ngokuthi yi-dilated, noma i-hypertrophic, cardiomyopathy
• ukukhubazeka kwenhliziyo okuzalwa, njenge-QT syndrome ende, ebangela ukuqhaqhazela kwenhliziyo
• ukuhluleka kwenhliziyo

Isebenza kanjani i-cardioverter defibrillator efakiwe?

I-ICD iyithuluzi elincane elifakwe esifubeni sakho. Ingxenye eyinhloko, ebizwa ngokuthi i-pulse generator, iphethe ibhethri nekhompyutha encane eqapha isigqi senhliziyo yakho. Uma inhliziyo yakho ishaya ngokukhulu ukushesha noma ngokungajwayelekile, ikhompyutha iletha ukushaya ngamandla kagesi ukulungisa inkinga.

Izintambo ezibizwa ngokuthi imikhondo zigijima zisuka ku-pulse generator ziye ezindaweni ezithile zenhliziyo yakho. Lokhu kuhola kuletha imizwa kagesi ethunyelwa i-pulse generator.

Ngokuya ngokuxilongwa kwakho, udokotela wakho angancoma enye yezinhlobo zama-ICD ezilandelayo:

• Igumbi elilodwa le-ICD lithumela amasiginali kagesi ku-ventricle efanele.
• I-ICD enamagumbi amabili ithumela amasiginali kagesi ku-atrium engakwesokudla naku-ventricle engakwesokudla.
• Umshini we-biventricular uthumela amasiginali kagesi e-atrium elungile nakuwo womabili ama-ventricles. Odokotela bayisebenzisela abantu abanesifo senhliziyo.

I-ICD nayo ingaletha izinhlobo ezine zamasignali kagesi enhliziyweni yakho:

1. Ukuphefumula kwenhliziyo. I-Cardioversion inikeza isignali enamandla kagesi engazizwa njengokushaywa esifubeni sakho. Isetha kabusha isigqi senhliziyo siye kokujwayelekile lapho ithola ukushaya kwenhliziyo okushesha kakhulu.
2. Ukwehliswa kwesibindi. I-defibrillation ithumela isignali enamandla kakhulu kagesi evuselela inhliziyo yakho. Ukuzwa kubuhlungu futhi kungakususa ezinyaweni zakho kepha kuhlala umzuzwana kuphela.
3. I-Antitachycardia. I-Antitachycardia pacing inikeza ukushaya ngamandla okuphansi okuhlose ukusetha kabusha ukushaya kwenhliziyo okusheshayo. Imvamisa, awuzwa lutho lapho kushaya kwenhliziyo. Noma kunjalo, ungahle uzwe i-flutter encane esifubeni sakho.
4. I-Bradycardia. I-Bradycardia pacing ibuyisela kusivinini esivamile ukushaya kwenhliziyo okuhamba kancane kakhulu. Kulesi simo, i-ICD isebenza njenge-pacemaker. Abantu abane-ICDs bavame ukuba nezinhliziyo ezishaya ngokushesha okukhulu. Kodwa-ke, i-defibrillation kwesinye isikhathi ingadala ukuthi inhliziyo yehle iye ezingeni eliyingozi. I-Bradycardia pacing ibuyisela isigqi kokujwayelekile.

Ngilungiselela kanjani inqubo?

Akufanele udle noma uphuze noma yini ngemuva kwamabili ngosuku olwandulela inqubo yakho. Udokotela wakho futhi angakucela ukuthi uyeke ukuthatha imithi ethile, njenge-aspirin noma leyo ephazamisa ukujiya kwegazi. Ngaphambi kwenqubo, qiniseka ukuthi utshela udokotela wakho ngemithi, izidakamizwa ezingekho emthethweni, kanye nezithako ozithathayo.

Akufanele uyeke ukuthatha umuthi ngaphandle kokukhuluma nodokotela wakho kuqala.

Kwenzekani ngesikhathi senqubo?

Inqubo yokufakwa kwe-ICD iyahlasela kancane. Imvamisa uzoba kwilabhorethri ye-electrophysiology lapho udokotela we-electrophysiologist efakela le divayisi. Ezimweni eziningi, uzobe uphapheme ngesikhathi senqubo. Kodwa-ke, uzothola umuthi wokuthomalalisa umzimba ukuze ukwenze wozele futhi ube nomuthi wokubulala izinzwa wendawo ukuze undikindize indawo yesifuba sakho.

Ngemuva kokwenza ukusikeka okuncane, udokotela uqondisa ukuhola ngomthambo bese ekunamathisela ezingxenyeni ezithile zenhliziyo yakho. Ithuluzi lokuqapha le-X-ray elibizwa nge-fluoroscope lingasiza ekuqondiseni udokotela wakho enhliziyweni yakho.

Bese banamathisela komunye umkhawulo wemikhombandlela ku-generator yenhliziyo. Udokotela wenza ukusikeka okuncane bese ebeka okokufaka ephaketheni lesikhumba esifubeni sakho, imvamisa ngaphansi kwehlombe lakho lesobunxele.

Inqubo ngokuvamile ithatha phakathi kwehora elilodwa kuya kwamathathu. Ngemuva kwalokho, uzohlala esibhedlela okungenani amahora angama-24 ukuthola nokuqapha. Kufanele uzizwe usuthole ngokugcwele kungakapheli amasonto amane kuya kwayisithupha.

Udokotela angafaka futhi i-ICD ngokuhlinzwa ngaphansi kwe-anesthesia ejwayelekile. Kulokhu, isikhathi sakho sokululama esibhedlela singahlala izinsuku ezinhlanu.

Yiziphi izingozi ezihambisana nenqubo?

Njenganoma yikuphi ukuhlinzwa, inqubo yokufaka i-ICD ingadala ukopha, ubuhlungu nokutheleleka esizeni sokusikwa. Kungenzeka futhi ukuba ne-allergen reaction kumithi oyithola ngesikhathi senqubo.

Izinkinga ezinkulu kakhulu eziqondene nale nqubo azivamile. Noma kunjalo, zingabandakanya:

• amahlule egazi
• ukulimala enhliziyweni yakho, kuma-valve, noma emithanjeni yegazi
• uketshezi oluzungeze inhliziyo
• isifo senhliziyo
• wawa amaphaphu

Kungenzeka futhi ukuthi idivayisi yakho ngezikhathi ezithile izokwethusa inhliziyo yakho ngokungadingekile. Yize lokhu kushaqeka kufushane futhi kungalimazi, kungenzeka ukuthi uzizwe. Uma kunenkinga nge-ICD, i-electrophysiologist yakho ingadinga ukuyiphinda uyihlele kabusha.

Kwenzekani ngemuva kwenqubo?

Ngokuya ngesimo sakho, ukululama kungathatha noma kuphi kusukela ezinsukwini ezimbalwa kuye emavikini ambalwa. Gwema imisebenzi enomthelela omkhulu nokuphakamisa okunzima okungenani inyanga ngemuva kwenqubo yakho.

I-American Heart Association ayikukhuthazi ukushayela okungenani izinyanga eziyisithupha ngemuva kwenqubo yokufakwa kwe-ICD. Lokhu kukunika ithuba lokuhlola ukuthi ukushaqeka enhliziyweni yakho kungakwenza uquleke. Ungakucabanga ukushayela uma uhamba isikhathi eside ngaphandle kokushaqeka (izinyanga eziyisithupha kuya kweziyi-12) noma uma ungapheli amandla uma uthukile.

Uyini umbono wesikhathi eside?

Ukuba ne-ICD ukuzibophezela kwempilo yonke.

Ngemuva kokululama, udokotela wakho uzohlangana nawe ukuhlela uhlelo lwakho. Kufanele uqhubeke nokuhlangana nodokotela wakho njalo ezinyangeni ezintathu kuya kweziyisithupha. Qiniseka ukuthi uthatha noma imiphi imithi enqunyiwe futhi wamukele indlela yokuphila kanye nezinguquko zokudla okunconyelwa udokotela wakho.

Amabhethri akule divayisi ahlala iminyaka emihlanu kuya kweyisikhombisa. Uzodinga enye inqubo yokushintsha amabhethri. Kodwa-ke, le nqubo incanyana uma iqhathaniswa neyokuqala.

Izinto ezithile zingaphazamisa ukusebenza kwedivayisi yakho, ngakho-ke uzodinga ukuzigwema. Lokhu kufaka phakathi:

• izinhlelo zokuphepha
• imishini ethile yezokwelapha, njengemishini ye-MRI
• ugesi ophehla ugesi

Ungahle uthande ukuphatha ikhadi esikhwameni sakho noma ufake isongo lobunikazi elisho uhlobo lwe-ICD onalo.

Kufanele futhi uzame ukugcina omakhalekhukhwini namanye amadivayisi eselula okungenani amasentimitha ayisithupha ukusuka ku-ICD yakho.

Tshela udokotela wakho uma uhlangabezana nezinkinga ngedivayisi yakho, bese ushayela udokotela wakho ngokushesha uma i-defibrillator yakho ikwethusa ukuqala kabusha inhliziyo yakho.