Ukuba une- fibrillation ye-agriyo , unyango olungileyo lunokuba yindlela e-ezintathu enokuthi izandile-intuitive-vumela i-fibrillation ye-atrial ukuba iqhubeke, ijolise unyango ekugcineni izinga lentliziyo yakho ngokukhawuleza (ukuze ulawule iimpawu zakho) kwaye uthathe amanyathelo okunciphisa umngcipheko wakho wesifo. Oku kubizwa ngokuba yindlela yokulawula izinga. Intuitively, enye indlela, indlela yokulawula isigqi , ejolise ekubuyiseleni nasekugcineni isandi sesiqhelo senhliziyo, izandi ngcono.
Kodwa kuninzi abantu abanokuphefumula okungapheliyo okanye okuqhubekayo (oko kukuthi, bebephethwe yi-fibrillation yonyango yonke okanye ixesha elininzi kwiiveki okanye kwiinyanga ezininzi), iziphumo ziba ngcono nakwizinga lokulawula izinga.
Kwimeko enkulu, oku kungenxa yokuba ulawulo lwesigqi luya kuba lukhuni, luyingozi, alusebenzi kwaye lubandakanya umngcipheko omkhulu wemiphumo emibi. Kwakhona, abaninzi abantu abaphathwa ngokulawulwa kwezinga benza kakuhle; Uphando lwezonyango lubonisa ukuba iziphumo zazo zincinci, nokuba kungengcono, kunokuba abo bazama ukulawula isigqi.
Indlela yokulawula isantya kwi-fibrillation ye-atrial ineenjongo ezimbini - ukulawula izinga lentliziyo kunye nokuthintela i-clots yegazi kunye ne-stroke.
Ukulawula i-Heart Rate
Kwinkoliso yabantu abanesifo se-agribriyo, iimpawu zibangelwa ngqo kwizinga lentliziyo elikhawulezayo eliqhelekileyo lihamba nale arhythmia.
Enyanisweni, ngokukhawuleza ukuba izinga lokulawula intliziyo lilawulwa, abaninzi abantu abane-fibrillation ye-atrial bangakhokelela ubomi obuqhelekileyo, naphezu kokuphikelela kwe-arrhythmia. Ngokuqhelekileyo, ukulawulwa kwentlawulo yenhliziyo kunokufezekiswa ngokunikezela ngezilwanyana ezinqanda i-beta , ngokuqhelekileyo kunye ne- block calcium . Ukongeza, i-digoxin isoloko iluncedo ekunciphiseni izinga lentliziyo kwi-fibrillation ye-atrial.
Zonke ezi zintathu zala machiza zisebenza ngokunciphisa ukuqhutyelwa kombane ngamandla kwi- AV node , eyanciphisa inani leempembelelo ezifikelela kuma-ventricle - ngaloo ndlela ukunciphisa izinga lentliziyo. Kwininzi enkulu yabantu abanefayibrillation ye-atrial, izinga lentliziyo lingalawulwa ngokwaneleyo kunye nokuhlanganiswa kwezi nkunkuma.
Kwezinye iimeko, ke, iqondo lentliziyo lihlala likhawuleza ngokwaneleyo ukudala iimpawu eziqhubekayo nangona unyango. Kule meko, izinga lokushaya intliziyo lingalawulwa ngokulula ngeprogram ekhethekileyo yokuphulukana nenjongo yokulimaza i-AV node. Kule nkqubo, i-catheter ekhethekileyo isusa i-node ngokucoca okanye ukuyiqandisa.
Ukuphelisa i-AV node kukuvimbela imiphumo ye-fibrillation ye-agrifi ekufikeleleni kwi-ventricles, ngoko iqondo lentliziyo liba lucotha kakhulu. Enyanisweni, ukuphulukiswa kwe-AV ye-AV ngokuvamile kukhokelela kwibhloko yeentliziyo , ezidla ngokukhokelela kwisantya senhliziyo esicothayo. Ngoko ukuphulukiswa kwe-AV ye-AV idinga ukufakwa kwe- pacemaker esigxina . Ngenxa yokuba abanokukhubaza abanamhlanje banokutshintsha isantya apho bahamba khona, kuxhomekeke kwinqanaba lomsebenzi wesigulane, inketho ye-AV ye-ablation-plus-pacemaker inikezela umntu ngeefayili zentliziyo ye-frill - kokubili ekuphumleni nakwixesha lokuzivocavoca-okufanisa ixabiso lentliziyo abantu abaneentsingiselo zentliziyo eziqhelekileyo.
Nangona i-AV nodal ablation ingabonakala yindlela elula yokulawula izinga lentliziyo, isoloko ibangela ukuba kuphuculwe ngokuphawulekayo kwiimpawu zezigulane ezine-fibrillation ye-agrifu eqhubekayo kunye naziphi ezinye iindlela eziye zahluleka.
Ukuthintela izambatho zegazi
Unyango lokuthintela ama-clots egazi ukususela kwi-atria yinyathelo elibalulekileyo kunoma ubani onobuncipheko be-agrification. Uninzi lwabantu abane-fibrillation ye-atrial kufuneka lubekwe unyango kunye neyeza-anti-coagulation (iziyobisi "ezincinci" igazi ukukhusela ama-blood clots) ukukhusela imivimbo. Kuze kube kutshanje u-Coumadin yinto ekhethekileyo kuphela ekhoyo, kodwa ukusebenzisa i-Coumadin ngokukhuselekileyo nangempumelelo kungaba yinto enzima ukuyifeza.
Ngethamsanqa, ukhetho olutsha kunye nolulula ukulusebenzisa lokulwa ne-coagulation olusebenzayo kwi-fibrillation ye-agrifu luza kufumaneka.
Isishwankathelo
Nangona kungenako kufikeleleka, indlela yokulawula isantya ekuphatheni i-fibrillation ye-atrial isoloko isebenzayo ekulawuleni iimpawu kwaye inciphise kakhulu umngcipheko wesifo. Kuze kubekho iindlela ezingcono eziphuhliswayo zokuphelisa i-fibrillation ye-atrial nokubuyisela isigqi senhliziyo eqhelekileyo, indlela yokulawulwa kwemilinganiselo yinto ekhethekileyo kuninzi lwabantu abanalo le-arrhythmia.
Imithombo:
Fuster, V, Ryden, LE, Cannom, DS, et al. I-ACC / AHA / ESC 2006 Izikhokelo zokuLawula izigulane ezine-Fibrillation ye-Atrial Ingxelo ye-American College of Cardiology / American Heart Association Umsebenzi wamaKhokelo kunye ne-European Society yeKomiti yeCardiology yokuSebenza ngeziKhokelo (iKomiti yokuBhala ukuHlola izikhokelo zika-2001 ukuLawula izigulane ezine-Fibrillation ze-Atrial). J Am Coll Cardiol 2006; 48: e149.
UWann LS, Curtis AB, uJanuwari CT, et al. Ingxelo ye-ACCF / AHA / HRS ejoliswe ngokugqithiseleyo kulawulo lwezigulane ezine-fibrillation ye-agriyoti (Ukuhlaziya i-Guideline ka-2006): ingxelo ye-American College of Cardiology Foundation / i-American Heart Association Task Force kwiZikhokelo zokuSebenza. J Am Coll Cardiol 2011; 57: 223.