Ingaba umntu onentliziyo yebhokisi ufuna i-pacemaker incike kwiimeko ezininzi
"I-block block" yinkinga eqhelekileyo echaphazela inkqubo yombane wenhliziyo. I-block block-ebizwa ngokuba yi-atrioventric block, okanye i-AV block-yenye yezona zibini ezibangela i- bradycardia (izinga lentliziyo elincinci).
Sibanzi
Kwiibhloko zentliziyo, iimvakalelo zombane zentliziyo zincinci okanye zivaliwe ngokupheleleyo njengoko zizama ukuhamba ukusuka kumagumbi asemagqabini entliziyo kwiindawo zecala.
Ngenxa yokuba le migudu kagesi ivumela intliziyo ukuba ikwazi ukuba ibetha, ukuba i-heart block ibinzima ngokwaneleyo inganciphisa izinga lentliziyo kwizinga eliphantsi.
Ukuba unesibindi senhliziyo, nakhu iziganeko eziphambili eziza kugqiba ukuba ufuna i-pacemaker:
- Ukuba i-heart block yakho ibangelwe ukunyuka kwexesha elidlulileyo kwizwi le-vagal, i-pacemaker ayinakuze ifuneke.
- Ukuba unesibonda sokuqala senhliziyo, i-pacemaker ayiyomfuneko ngaphandle kokuba ibhloko ibonakala.
- Ukuba unesibini kwinqanaba lebhokisi lebhokisi elibonakalayo okanye libalahleka, kufuneka i-pacemaker. Iibhloko zecandelo lesibini elingazibonakalisi iimpawu kwaye lixhomekeka kakhulu alifunanga i-pacemaker.
- Ukuba unesibonda senhliziyo yesithathu, ngaphandle kokuba kungenxa yokwanda kwexesha elide kwithethini ye-vagal, i-pacemaker ifunwa rhoqo.
Izizathu
Iincwadana ezimfutshane zebhloko zentliziyo azihlali ziyingozi okanye zingavamile. Intsholongwane yentliziyo ibonakala rhoqo kubantu abancinci, abasempilweni abafumana ukwanda ngokukhawuleza kwetoni zabo.
Izwi le-vagal linyuka ngokukhawuleza lwenzeka nge-nausea, ukuhlanza, okanye ukuphendula intlungu, ukwesaba, okanye ukuxinezeleka ngokukhawuleza. Le fomu yebhokisi yenhliziyo ayiyikusongela ubomi kwaye ayibonakali nayiphi na ingxaki engundoqo kwinkqubo yamandla kagesi. Iyabonakala ngokukhawuleza xa isiganeko esichukumisayo siye sanciphisa kwaye phantse singalindelekanga ukungeniswa kwe-pacemaker.
Ngakolunye uhlangothi, iibhloko zeentliziyo zinokuthi zenzeke ngezifo ezahlukahlukeneyo zentliziyo, ngokubhekiselele kwizifo ze- coronary disease , ukuhluleka kwentliziyo , okanye i- myocarditis . Kukho iintlobo zeentsapho zebhokisi yentliziyo.
Ngokuqhelekileyo, xa ibhloko yenhliziyo iveliswa zizifo zentliziyo, kuthetha ukuba kukho ukuphazamiseka okusisigxina kwenkqubo yombane yomzimba. Olu hlobo lwesibindi senhliziyo luhlala luba lubi ngaphezu kwexesha, ngoko ke kufuneka bavuselele i-pacemakers.
Iimpawu
Ngokuxhomekeka kobunzima bayo, ibhloko yeentliziyo inokuvelisa uluhlu lweempawu, kungabikho nantoni ukuya kwidlozi , i- syncope (ukulahlekelwa kwengqondo), okanye nokufa. Ibloko yenhliziyo enzima ngokwaneleyo ukuvelisa iimpawu, okanye oko kusongela ukuba yinto enzima, inokuphathwa ngempumelelo nge- pacemaker . Ngoko ukuba unentliziyo yesibindi, ingxaki ebalulekileyo kuwe kunye nogqirha wakho iya kuba kukubona ukuba isithintelo senhliziyo yakho sinzulu ngokwaneleyo ukufuna i-pacemaker.
Ibloko yenhliziyo engenakuvelisa nayiphina impawu nayiphi na into ayifuni i-pacemaker, ngaphandle kokuba i-degree degree yesithathu ibambe iqhosha okanye i-distal heart block. Ukuba ibhloko yenhliziyo ivelisa iimpawu-ingakumbi utywala okanye i-synncope-ke ukuyiphatha nge-pacemaker idla ngokufunekayo. Imbango xa i-heart block ibonakala ukuba iyadlula-umzekelo, xa kuphuma ukwanda kwexeshana kwithethini ye-vagal.
Degree
Ibloko yenhliziyo ihlelwe ngoogqirha kwelinye labathathu "amadigri." Ugqirha wakho unokugqiba iqondo lebhodi yakho ye-heart nge- electrocardiogram (ECG) .
- I-block degree yokuqala ithetha ukuba isifo ngasinye senhliziyo siyakwenza ukuba sisuke kwi-atria ukuya kuma-ventricles, kodwa ukuqhuba umtsalane kuphuculwa.
- I-block degree yesibini ithetha ukuba ezinye zeempembelelo zenziwa ngempumelelo kwiipriricle, kodwa ezinye azikho.
- I-block degree yesithathu ithetha ukuba zonke iimpembelelo zivaliwe. Isiqendu sesithathu intliziyo yebhokisi ibhekiswe "njengebhokisi lenhliziyo epheleleyo."
Kwimeko yomntu onesithathu kwisigxina senhliziyo, ukusinda kuxhomekeke ekubeni kukho iiseli ze-pacemaker ezincinci ngaphantsi kwesiza kwibloko.
Oko kukuthi, iiseli ezenza iimpembelelo zazo zombane ezivumela intliziyo ukuba iqhubeke ibetha.
Intliziyo yesigqi eveliswa yii-cell cell pacemaker kuthiwa "isigqi sokusinda." Ngokuqhelekileyo, ezi ziqhamo zendlela yokuphepha ziyaziwayo kwaye zithembeke. Ngamanye amaxesha ubukho beengqungquthela zokuphepha zibhekwa njengengxamisekileyo yonyango.
Ngokuqhelekileyo, ukuphakama kwezinga lebhokisi leentliziyo, kusenokwenzeka ukuba kunesidingo sokwenza i-pacemaker. I-Pacemakers zihlala zifunwa rhoqo nge-block degree yesithathu, ngokuphindaphindiweyo nge-block degree yesibini, kodwa ngokungafanekiyo kunye ne-grade degrees block.
Indawo
Ngexesha lentliziyo yesiqhelo, intliziyo yefuthe yombane kufuneka idlule ngaphesheya komda phakathi kwe-atria kunye ne-ventricles (AV coup). Le ngqungquthela ye-AV inamalungu amabini:
- I- AV node
- Umthwalo wakhe (ucinga nje nge-"compact" ye-fiber ehambelana neendlela zokuqhuba umbane ukusuka kwi-AV node ukuya kuma-ventricle)
Ekuqaliseni ubunzima bebhokisi leentliziyo, kubalulekile ukwazi ukuba kukuphi i-AV junction ibhloko eqhubekayo. Oko kukuthi, ibhloko ngaphakathi kwe-AV node okanye ingayimpahla yakhe (okanye amasebe enqwaba ephuma kwinqutyana yakhe)?
Kwiimeko ezininzi, ugqirha unokukwazi ukubona indawo yebhokisi yenhliziyo nje ngokuhlolisisa i-ECG. Ngamanye amaxesha, nangona kunjalo, kufundwa uphando lwe-electrophysiology .
Ibloko yenhliziyo eyenzeka ngaphakathi kwe-AV node ("incximal" ibhloko yenhliziyo) ngokuqhelekileyo ixhomekeka kwaye kaninzi ayifuni i-pacemaker engunaphakade. Oku kungenxa yokuba xa ibhloko ibonakala kwi-node ye-AV, iiseli ze-pacemaker zesebe kwi-AV node ngaphaya kwesayithi yebhloko zidla ngokuthatha isigqi sentliziyo. Oku kubizwa ngokuthi "isigqirha sokuphepha esinqununu" sihlala sizinzile kwaye asisongela ubomi.
Ngakolunye uhlangothi, kunye ne-"distal" yebhokisi yenhliziyo, apho ibloko inokwenzeka khona okanye ngaphantsi kwesigxina sakhe, nayiphi na iiseli ze-pacemaker ezincinci zifumaneka kuphela kumasebe okanye kwi-ventricles. Isiphumo senhliziyo esiphumelayo sibizwa ngokuba "sesigxina sokuphunyuka." Ngenxa yokuba iiseli ze-pacemaker ezincedayo ziyaziwayo zingathembekanga kwaye zithandelwa ukuyeka ngokukhawuleza, isigqi sokuphunyuka kwesantya sithathwa njengesimo esiyingozi.
I-heart block distal ikhula ngakumbi kwixesha. Ngoko nakwiimeko apho okwangoku kubangela kuphela ibhloko yokuqala yesibini okanye yesibini, i-blockal heart block ibonwa njengengozi kwaye ihlala ifuna unyango nge-pacemaker.
ILizwi
Ukuba uxelelwe ukuba unobhloko bentliziyo okanye i-AV block, wena kunye nogqirha wakho kuya kufuneka ukuba uqwalasele zonke ezi zinto ukuze ubone ukuba ufuna i-pacemaker. Ngethamsanqa, ukuqokelela ulwazi oluyimfuneko ngokuqhelekileyo luyinkqubo ngokukhawuleza kwaye ecacileyo kwaye ngezinye iinkqubo kufuna i-invrove study electrophysiology.
> Umthombo:
> Epstein AE, DiMarco JP, Ellenbogen KA, et al. I-ACC / AHA / HRS 2008 Izikhokelo zonyango olusekelwe kwiCandelo le-Cardiac Rhythm Ukungavumelekanga: Ingxelo ye-American College of Cardiology / i-American Heart Association Task Force kwiZikhokelo zokuSebenza (iKomidi yokuBhala yokuHlola i-ACC / AHA / NASPE 2002 Isikhokelo sokuHlaziya ukuFakelwa I-Cardiac Pacemakers kunye nee-Antiarrhythmia Devices): ziphuhliswe ngokubambisana ne-American Association ye-Thoracic Surgery kunye ne-Society of Thoracic Surgeons. Uhambo luka-2008; 117: e350.