Kutheni i-LBBB ibalulekile?
Isibonda segatsha esisekhohlo sisisimo esingavamile esibonwe kwi- electrocardiogram (ECG) , ebonisa ukuba umgudu wombane we-cardiac ungasasazwa kuzo zonke iinjenge zentliziyo ngendlela eqhelekileyo.
Yintoni Ebangelwa Isibonda Sokushiya Isityiba?
Amagatsha amatye angacingwa ukuba yinxalenye yentliziyo "yombane". Ziyindlela yamandla eyenzelwe ukusasaza iinjongo zentliziyo ngokulinganayo ngokusebenzisa i-ventricles.
Oku kuqinisekisa ukuba ukuphambana kwee-ventricles ezimbini kulungelelaniswa.
I-block block yesigxina sekhohlo, isebe lesigqeba esasabalalisa umfutho wombane kwi-ventricle ekhohlo ivinjiwe okanye ivalwe ngokupheleleyo. Olu khuselo lulibazisa ukusetyenziswa kombane kwiphepha le-ventricle ekhohlo. Ngenxa yoko, i-ventricle efanelekileyo isebenze, kwaye iqalisa ukubambisana, ngaphambi kokuba i-ventricle ekhohlo isebenze.
Ukuze intliziyo ibethwe ngokukhawuleza njengoko kunokwenzeka, zombini ii-ventricle mazivunyelane ngokufanayo. Ngoko isakhelo segatsha esishiywe sisitye sinokunciphisa ukusebenza kakuhle kwentliziyo. Ukunciphisa ukusebenza komzimba kungabalulekanga kumntu onentliziyo engavamile, kodwa inokuchaphazela abantu abaneentlobo zesifo senhliziyo-ngokukodwa ukusilela intliziyo .
Ukuchonga i-Bundle ye-Bundle kwiBlue Block
I-block ye-bundle ye-bundle ekhohlo ivelisa utshintsho oluphawulekayo kwi-ECG, ngoko ke oogqirha banakho ukuxilonga le meko nje ngokuvavanya i-ECG.
Isiqendu se-ECG esibizwa ngokuba yi-QRS sakhiwo sichaza ukuqhutyelwa kombane kwi-ventricles. Ngokuqhelekileyo, kuba zombini ama-ventricles avuselelwa ngexesha elifanayo, i-QRS isakhiwo esincinci-ngokuqhelekileyo, phakathi kwe-0.08 kunye nemizuzwana eyi-0.1 ngexesha. Ngomgca wegatsha lekhohlo, i-QRS inkulu kakhulu, ngokuphindaphindiweyo ibe ngaphezu kwe-0.12 imizuzwana.
Ukongezelela, ukurekhoda kwe-ECG ehamba phambili kubonisa "iimbono" ezahlukeneyo ezi-12 (ezibizwa ngokuba "zikhokelo") zentsebenzo yombane wenhliziyo, kwaye oogqirha banokuzihlola ezi ntlobo ezahlukeneyo zikhokelela ekufumaneni ingcamango yendawo yeengxaki ezahlukahlukeneyo zentliziyo. Isithintelo segatsha lekhohlo esisekhohlo, ubunzima beQRS obubanzi bubonakala bukho tye kwiindlela ezithile, kwaye behla kwezinye. Ngokuhlolisisa ubude bexesha le-QRS, kunye nephethini yayo kwiintlobo ezahlukeneyo ze-ECG, ngokuqhelekileyo kulula ukufumanisa i-block bundle branch block xa ikhona.
Kutheni i-Left Bundle yeBluele Block ibalulekile?
Isibonda sesebe lesobunxele esisekhohlo kukufumana okubalulekileyo kwezizathu ezimbini ezahlukeneyo.
Okokuqala, i-block bundle branch block ngokuvamile ivela ngenxa yeengxaki ezithile zentliziyo. Ngoko xa kufunyanwe, kunokwenzeka ukuba kunesimo esithile esibalulekileyo senhliziyo.
Okwesibini, njengoko kuphawuliwe ngaphambili, i-block bundle branch block ngokwayo ingabangela ukuba intliziyo isebenze kangangoko kubantu abaneentlobo ezithile zesifo senhliziyo.
Isibonda esisekhohlo Isithintelo kunye neengcinezelo zezifo zentliziyo
Ibhloko lekhohlo lesekhohlo lichaphazela kakhulu abadala abadala. Itholakala ngaphantsi kwe-1 ekhulwini labantu abangaphantsi kweminyaka eyi-50; Ngokwahlukileyo, malunga nama-6 ekhulwini aneminyaka engama-80 ubudala baye bashiya ibloko lebhunga.
Uninzi lwabantu abanebloko yesigqeba esisekhohlo banesimo esithile sesifo senhliziyo. Kwisifundo se-Framingham, izifundo eziye zaphuhlisa i-block bundle branch block yayineminyaka eliphakathi kweminyaka engama-62 ubudala, kwaye yayineziganeko ezininzi zengcinezelo yegazi , i-cardiomyopathy , okanye i- coronary disease (CAD) . Enyanisweni, ngexesha lokufunda kukaFramingham, iipesenti ezingama-89 zabantu abaye bahlakulela i-block bundle block block baye bafumanisa ukuba banesifo esithile senhliziyo.
Oko kuthetha ukuthini na ukuba nabani na, nawuphi na umdala, ofunyenweyo ukushiya isitishi segatsha kufuneka abe nokuhlolwa kwenhliziyo ukujonga isifo senhliziyo esisisiseko.
Olu vavanyo lufanele lubandakanye ubuncinane i- echocardiogram , kwaye ukuba kukho imingcipheko ekhoyo kwi-CAD, isifundo soxinzelelo / i-thallium kufuneka siqwalaselwe ngamandla. Izifo eziqhelekileyo zeengqondo ezinokufumaneka kwimeko ye-LBBB ziquka ukuxinzelela kwegazi, i-CAD, ukuhluleka kwentliziyo, i -cardiomyopathy ye-hypertrophic , okanye isifo senhliziyo .
Ukuba akukho sifo senhliziyo sithotyelwa emva kokuvavanya kwentsholongwane yomzimba kumntu oselunxwemeni yesigqeba, ngokukodwa kubantu abangaphantsi kwe-50, ukuxela kwangaphambili kubonakala kukuhle. Kule meko, ibhloko yesigxina sekhohlo libhekiselele kwi-ECG yokufumana.
Isibonda sasekhohlo esivimbayo kunye neCandelo leNtliziyo
Kwinqanaba lefestile yesigxina sasekhohlo, iintliziyo ezimbini zentliziyo ziyashukunyiswa yi-cardiac electrical impulse ngokulandelelana, endaweni yexeshanye. Okokuthi, i-ventricle yekhohlo ivuselelwe kuphela emva kokuba i-ventricle efanelekileyo ivuselelwe. Ngaloo ndlela, i-block bundle block block ibangela ukulahlekelwa koqhelaniso oluqhelekileyo phakathi kwee-ventricle ezimbini, ezinciphisa ukusebenza kakuhle kwentliziyo. Intliziyo kufuneka isebenze nzima ukufezekisa amandla okupompa.
Kubantu abancinci, abantu abaneempilo abanesibonda sesebe esisekhohlo, kwaye nakubantu asebekhulile abanesibonda sesebe esisekhohlo esingaba nesifo senhliziyo esifanelekileyo, ukuchithwa kwendlela yokusebenza komzimba kubonakala kukuhle kakhulu, kwaye ubungqina bokuba bubonisa ukuba i-block bundle block block ngokwayo ayifaki ingxaki kula bantu.
Nangona kunjalo, kubantu abanesifo senhliziyo kunye neqhekeza le-ventricular ejection elincinci elinciphisa libe ngaphantsi kweepesenti ezingama-35, i-block bundle branch block ingavelisa ukuphahlaka okukhulu kwi-cardiaac efficiency. Oku kuphuculwa kwempumelelo kunokukhawulezisa ukutshabalalisa kwenhliziyo, kwaye kwenza iimpawu zibe zibi kakhulu.
Ukusetyenziswa kwonyango yokuguqulwa kwenhliziyo (CRT) kufuneka kuqwalaselwe ngamandla kubantu abanjengale. I-CRT luhlobo lwe-pacemaker oluphinda lulungelelanise ukubethelwa kwee-ventricles, kwaye lunokuphucula ukuphumelela kwenhliziyo kubantu abanomgca wesigqeba sekhohlo kunye nokungaphumeleli kwintliziyo.
I-Patient Chronicle ye-Pacemaker kunye neCandelo leNqunqwa leSiza laseBaleni
I- pacemaker eqhelekileyo isenza intliziyo ivela kwindlela ehamba phambili ekhompyutheni elungileyo. Ngenxa yokuba umbane (okwenzeka kulo mzekelo uvela kwi-pacemaker) uvuselela i-ventricle efanelekileyo phambi kwe-ventricle engasekhohlo, abantu abaneemilenze ezinomsolo ngokusisigxina bane-block-leftduced bundle block block.
Kwiminyaka yakutshanje, obunye ubungqina bucebise ukuba abantu abanokunciphisa amaqhezu e-ventricular ejection, abano-pacemakers abanelungelo lokuhlala ngokusisigxina eqinisweni okanye baninzi ixesha, banokuba neengozi yokwanda kwenhliziyo ngenxa yokushiya kwe-pacemaker ibloko lebhunga. Ngenxa yoko, ezinye iingcali zihlala zisebenzisa i-CRT pacemakers (ekhusela i-block-leftduced bundle block block) kubantu abanamaqhezu e-ejection ayancitshitshiswa abaxhomekeke ngokupheleleyo kwi-pacemakers ezihlala zihlala.
Ngaba i-Left Bundle Isango leBloko lifuna i-Pacemaker engunaphakade?
Ngaphandle kokuba kukho isizathu sokufaka i-CRM pacemaker ukulungelelanisa umsebenzi wee-ventricles, abaninzi abantu abanebloko yesigqeba esisekhohlo asifuni ukuba i-pacemaker.
Nangona kunjalo, ngamanye amaxesha ubukho bebloko besebe esisele kwintsimbi kubonisa ukukhathazeka ngokubanzi kwenkqubo yokuqhuba umbane. Kubantu abanjalo, isibonakaliso sombane senhliziyo sinokuphazanyiswa ngeendlela ezininzi, kwaye i-bradycardia ebalulekileyo (izinga lentliziyo elincinci) lingagcina liphuhlise, kunye ne-pacemaker engapheliyo ingadingeka. Ngenxa yesi sizathu sodwa, abantu abanesibonda sesebe lesekhohlo kufuneka baqinisekise ukuba bahlolwa rhoqo kwizonyango.
ILizwi
Isibonda sesebe esisekhohlo siyi-disorder yesimo senkqubo yokuqhuba umbane. Nabani na ofunyanwe nesitishi segatsha lesokunxele kufuneka abe nokuhlola kwenhliziyo ukujonga isifo senhliziyo esiluncedo sokwenza unyango. Kwaye kwezinye iimeko-ingakumbi kubantu abanentliziyo engaphumeleli kwongezwa kwisibonda sesebe esisekhohlo-i-block block yona ngokwayo ifuna unyango nge-CRT pacemaker.
Nangona kunjalo, ukuba uhlolo olupheleleyo lwe-cardiac alubonakali sisifo sesifo senhliziyo, i-block bundle branch block ingaqhelekanga ithathwa njengesimo esibuhlungu.
> Imithombo:
> Badheka AO, Singh V, Patel NJ, et al. I-QRS Ubude be-Electrocardiography kunye nokufa kwe-Cardiovascular (ukusuka kwi-National Health and Nutrition Examination Survey-III). InguJ Cardiol 2013; 112: 671.
> Curtis AB, Worley SJ, Adamson PB, et al. I-Biventricular Pacing ye-Atrioventricular Block kunye ne-Systolic Dysfunction. N Engl J Med 2013; 368: 1585.
> Imanishi R, Seto S, Ichimaru S, et al. Ukubaluleka kweSiganeko esigqibeleleyo Isibonda segatsha Ukukhutshwa kwegatsha eligcinwe kwixesha eli-40 leminyaka. Ngaba uJ Cardiol 2006; 98: 644.
> Schneider JF, Thomas HE Jr, Kreger BE, et al. Isithintelo esitsha esisisigxina esisekhohlo-Isango lokuvimba: isifundo seFramingham. U-Ann Intern Med 1979; 90: 303.