Isifo sesifo se-sinus senzeka xa i- node ye-sinus iba nesifo esaneleyo ukwenza ibradycardia (izinga lentliziyo elincinci) elivelisa iimpawu. Abantu abane-syndrome ye-sinus yesifo badinga unyango nge- pacemaker ehlala njalo ukuze banciphise iimpawu zabo.
Ukongeza kwi-bradycardia ephawulekayo, i-sinus syndrome yesifo ihlala ihamba kunye neengqungquthela ze- fibrillation ye-atrial , enokufuna unyango olongezelelweyo.
Isifo sinus syndrome yintlungu yabantu abadala, kwaye ibonakala kakhulu kubantu abangaphezu kweminyaka engama-70 ubudala.
Yintoni Ebangelwa Izifo Ezigulayo zesifo?
Isizathu esiqhelekileyo sesifo sesifo se-sinus i-fibrosis ehlobene neminyaka echaphazela i-node yesusus (isakhiwo esincinane kwi-atrium efanelekileyo eyenza intliziyo ishukumisekile). "I-Fibrosis" ithetha ukuba izicubu eziqhelekileyo zithatyathwa yifom yeesundu. Xa i-fibrosis ithinta i-node ye-sinus, i-bradycardia ingabangela. Yaye xa i-bradycardia ibangelwa ingxaki ngesimo se sinus, kuthiwa "sinus bradycardia."
Ngokufanayo, i-fibrosis enxulumene neminyaka echaphazela i-node ye-sinus inokuchaphazela isifo se-atrial ngokwayo. Olu hlobo lwe-atrial fibrosis lukhokelela kwi-fibrillation ye-atrial evame ukuhamba nesifo se-sinus syndrome.
Ngaphezulu, le fibrosis inokuchaphazela ne- AV node . Ukuba kunjalo, i-sinus bradycardia inokuthi ihambisane neziqwenga zenhliziyo .
Ngoko kwisifo se-sinus syndrome kunokubakho izizathu ezibini ze-bradycardia-sinus bradycardia, kunye ne-block block.
Kwezinye iimeko ezinye iimeko zonyango zinokuchaphazela i-node yesusus, ukuvelisa i-sinus bradycardia. Ezi meko ziquka:
- amyloidosis
- sarcoidosis
- Isifo seChagas
- hypothyroidism
- ukukhathazeka kwenhliziyo
Nangona kunjalo, i-fibrosis ehambelana nokuguga yimiba ebangela kakhulu isifo se-sinus syndrome.
Ziziphi iimpawu ezidibaniswa nezifo zesifo seSinus?
Iimpawu ezibalaseleyo ziqhelekileyo ngenxa yezinga lentliziyo elincinci, kwaye zibandakanya:
Kwamanye abantu abane-syndrome ye-sickus yesifo, ezi zimpawu ziza kwenzeka xa zizama ukuzibhokoxa, kwaye ziya kuziva ziphelile xa ziphumla. Kule meko ingxaki enkulu ingakwazi ukunyusa izinga lentliziyo ngokufanelekileyo ngexesha lomsebenzi, imeko ebizwa ngokuthi " ukungabi nako kwekronotropic ."
Isifo sesifo seSinus kunye neFibrillation ye-Atrial
Abantu abanesifo sesifo se-sinus nabo baneziqulatho ze-fibrillation ye-agriyo baya kuba neempawu ezibangelwa yi-sinus bradycardia, kwaye ngaphezu koko bangenayo impawu ye-tachycardia Abantu abaneziqulatho zombini ezihamba ngokukhawuleza nangokukhawuleza kuthiwa bane-bradycardia-tachycardia syndrome, okanye "i- brady-tachy syndrome ".
Uphawu oluxakeke kakhulu olunxulumene ne-brady-tachy syndrome yi syncope. Ukulahleka kwengqondo ngokuqhelekileyo kwenzeka ngokukhawuleza emva kokuba isiqhelo se-fibrillation ye-atrial siphela ngokukhawuleza, ekhokelela ekuphumeni kwexesha elide kwizinga lentliziyo.
Le khefu elide liqhubeka ngenxa yokuba, xa i-sinus node isele "igula," isiqhelo se-fibrillation ye-atrial sithintela ngakumbi ukunyusa umsebenzi walo.
Ngoko ke, xa i-fibrillation ye-atrial igxeka ngokukhawuleza, i-sinus node ingadinga imizuzwana emininzi ukuba "ivuke" kwaye iqalise ukudala iimpembelelo zombane kwakhona. Ngethuba leli xesha, kunokungabi nantliziyo yentsimbi kuyo yonke imizuzwana engama-10 okanye ngaphezulu - ekhokelela ekuziphatheni okuphezulu, okanye syncope.
Isifo seSinus Syndrome sifumana njani?
Ukufumanisa i-sinus syndrome yesifo ngokuqhelekileyo akunzima. Ukuxilongwa ngokuchanekileyo kudla ngokubonakalayo xa umntu okhalaza iimpawu ezibonakalisa ukuba nesinus bradycardia enkulu kwi- electrocardiogram (ECG) . Iindidi ezahlukeneyo zesifo se-sinus syndrome zifunyaniswa xa isigulane esinesifo se-node nesifo sifumana ukuba sibe neziqwenga ze-fibrillation ye-atrial.
Ngenxa yokuba i-fibrosis ebangela isifo sesifo se-sinus ngezinye izihlandlo sichaphazela i-AV node, abantu abane-brady-tachy syndrome banokuthi babe ne-heart block block, kwaye ngoko ke, isantya senhliziyo esicothayo xa i-fibrillation ye-atrial. Ngoko ke, naliphi na umntu ophethe i-friday frillation efunyenwe ukuba abe nenqanaba lentliziyo elincinci (ngokungabikho kwemithi ejolise ekunciphiseni intliziyo yesantya), oko kufuneka kunike ugqirha uncedo oluqinileyo olusenokuba lukhona nesifo se-sinus syndrome.
Oogqirha banokwenza i-diagnostic ye-chronotropic ingakwazi ukuthotyelwa ngokujonga isigxina senhliziyo yesigulane ngexesha lokuzivocavoca-umzekelo, ngexesha lovavanyo loxinzelelo . Ngenxa yokuba ukungabi nako kwexesha le-chronotropic kuyimeko eqhelekileyo kubantu abakhulileyo kwaye iyakhathazeka ngokukhawuleza (nge-pacemaker ene-rate-respondent response), kubalulekile kubantu abadala abakhathazekile ngokunyamezela okanye okulinganayo ukuqinisekisa ukuba oogqirha babo bavavanya uvavanyo olufanelekileyo.
Isifo seSinus Sifo sifumana njani?
Cishe bonke abantu abane-syndrome yesifo kufuneka baphathwe nge-pacemaker esigxina.
I-pacemaker ibaluleke ngokukhethekileyo kubantu abanesimo sengqondo esichukumisayo se-sinus syndrome, ngenxa yezizathu ezibini. Okokuqala, aba bantu banomngcipheko ophezulu wokufumana i-syncope (kulawo maxesha amade xa i-fibrillation ye-atrial iphela). Okwesibini, ezininzi iziyobisi eziqhelekileyo zisetyenziselwa ukhathaza i-fibrillation ye-atrial- blockers , i- calcium channel blockers , kunye neyeza-antiarrhymic - zingenza isifo se-node sinokubi kakhulu. Ukufakela i-pacemaker kuyakukhusela i-syncope, kwaye kuya kwenza ukuba ugqirha aphathe i-fibrillation ye-agriyo ngakumbi ngokukhuselekileyo.
ILizwi
Kwi-sinus syndrome egulayo, izifo ze-sinus node zibangela i-bradycardia eyaneleyo ukukhokelela kwiimpawu-ngokuqhelekileyo, ukunyaniseka okulula okanye ukukhanya okulula. Le meko inokuthi ihambisane ne-fibrillation ye-atrial, ehlangene nesifo se-sinus nesifo, yenza iipisodes ze syncope mhlawumbi. Isifo se-sinus esigulayo siphathwe nge-pacemaker esigxina.
> Imithombo
> 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.
> Fogoros RN, Mandrola JM. Ucwaningo lwe-Electrophysiology kuVavanyo lweBradycardia: I-Node yase-SA, i-AV Node kunye ne-His-Purkinje System. Ku: Uvavanyo lwe-Fogoros 'Electrophysiologic Testing, I-Sixth Edition. Wiley Blackwell, ngo-2017.
> Josephson, ME. Umsebenzi weNode weNode. Ku: I-Clinical Cardiac Electrophysiology: Iinkqubo kunye nokuchazwa, 4, uLippincott, Williams, & Wilkins, Philadelphia 2008. p.69-92.