Inkqubo yombane yomzimba ibalulekile kuba ilawula isigqi senhliziyo kwaye ngenxa yokungaqhelekanga kwindlela yokusebenza yombane ijongene neninzi ye- arrhythmias yenhliziyo. Ucwaningo lwe-electrophysiology (uphando lwe-EP) luvavanyo oluthile lwe- catheterization apho i-electrode catheters (i-flexible, wire-insulated filas with metal electrode tips) ifakwe entliziyweni ukwenzela ukuba ifunde inkqubo yombane yomzimba.
Isifundo seP EP senziwa njani?
Ukuba ugqirha wakho ekubhekiselele ekufundeni kwe-EP, uza kufakwa kwi-laboratory ye-electrophysiology (i-laboratories eyodwa ye-catheterization) kwaye ulala phantsi kwetafile yeemviwo. Uya kunikelwa i-anesthesia yendawo, kwaye mhlawumbi unomdli ophantsi, kunye ne-electrode catheters iya kufakwa kwimitha eminye okanye ngaphezulu kwegazi. (I-Catheters ifakwe kwi-incati encinci okanye nge-stick-stick-stick, ngokuqhelekileyo kwingalo, ukuvuthwa okanye intamo. Amaninzi amaninzi okanye amathathu atyathelisiweyo asetyenziswa, kwaye angeniswa kwisayithi engaphezu kwesinye.) Ukusebenzisa i-fluoroscopy (efana ne-x-ray), i-catheters iqhutywe phambili kwimithambo yegazi kwaye ibekwe kwindawo ezithile kwiintliziyo.
Xa sele bebekwe ngokufanelekileyo, i-catheters ye-electrode isetyenziselwa ukwenza imisebenzi emibini ebalulekileyo: ukurekhoda iimpawu zombane eziveliswe ngentliziyo kwaye ziqhube intliziyo. (I-Pacing ifezekiswa ngokuthumela amashishini amancinci amancinci ngokusebenzisa i-catheter ye-electrode.) Ngokurekhoda nokuhamba kwiindawo ezicwangcisiweyo ngaphakathi kwentliziyo, ezininzi iintlobo ze-arrhythmias zenhliziyo zingakwazi ukufundiswa ngokupheleleyo.
Emva kokuba inkqubo igqityiwe, i-catheter (s) isuswe. Ukuhlamba kulawulwa ngokubeka uxinzelelo kwisiza sokungcebeleka imizuzu engama-30 ukuya kwangama-60.
Ziziphi iintlobo zeArrhythmias Ngaba i-EP Study Evaluation?
Uphononongo lwe-EP lunokukunceda ukuvavanya iibradycardias (i-slow heart arrhythmias) kunye ne- tachycardias (i-arrhythmias ye-heart fast).
Ukuba ukufundwa kwe-EP kubonisa into ebalulekileyo ye-bradycardia, kufuneka i- pacemaker esigxina.
I-Tachycardias ihlolwe ngokusebenzisa iindlela zokucwangcisa ukucwangcisa (oko kukuthi, ukuqala) i-tachycardia. Ukuba i-tachycardias inokunyuswa ngexesha lokufunda i-EP, ngoko ngokufunda izibonakaliso zombane ezirekhodiweyo kwi-catheters ye-electrode, isizathu esicacileyo se-tachycardia sinokuqatshelwa. Xa oko kufezekile, unyango olufanelekileyo lwe-tachycardia luvame ukucaca.
Uvavanyo lwe-EP lusinceda njani unyango ngokuthe ngqo kwiArrhythmias?
Kukho iindlela ezimbalwa uvavanyo lwe-EP lunokukunceda wena kunye nodokotela wakho wenze izigqibo zonyango. Iindlela zokonyango ezinokuqwalaselwa ngokusekelwe kwiziphumo zovavanyo lwe-EP ziquka:
- Ukufakwa kwe-pacemaker: Ukuba uphando lwe-EP luqinisekisa ubungqina bebradycardia ebalulekileyo, i-pacemaker engapheliyo inokufakwa ngokukhawuleza, ngexesha elifanayo.
- I-Ablation : Ukuba i-tachycardia ye-tachycardia (i-SVT) - kunye nezinye iindlela ze-tachycardia ye-ventricular (VT) - zifunyenwe, i-radiation frequency frequency often is therapy of choice. Inkqubo yokuphulukisa isetyenziswa rhoqo ngexesha elifanayo, ngokukhawuleza emva kokufunda kwe-EP. Unokufunda ngokubanzi malunga ne-inflation ye-ablation .
- Iimfibrillers ezifakekayo : Ukuba iifom ze-VT kunye / okanye i- fibrillation ye-ventricular (VF) zichongwa ngexesha lokufundwa kwe-EP, ngokuqhelekileyo i-defibrillator enokugxininiswa yonyango olukhethiweyo. Esi sixhobo singasoloko singeniswa kwi-laboratory ye-EP, ngokukhawuleza emva kokufunda kwe-EP. Kwiminyaka edlulileyo, isifundo se-EP sasetyenziselwa ukuchonga "isilwanyana" esilungileyo sokulwa nezigulane ezine-VT okanye i-VF, kodwa namhlanje kuyaziwa ukuba akukho nkunkuma echasene nesigqirha inokusebenza njengendlela yokukhusela i- defibrillator ekukhuseleni ukufa ngokukhawuleza kule izilungiso.
Ziziphi iingozi zokuba nokufunda kwe-EP?
Ubungozi obunokwenzeka bokuba nokufundwa kwe-EP kufana nalabo abanesifo senhliziyo .
Ezi nkqubo zikhuselekile, kodwa ngenxa yokuba ziyimigaqo echaphazela intliziyo, kukho iingxaki ezininzi. Akufanele ube novavanyo lwe-EP ngaphandle kokuba kunokwenzeka ukuba ulwazi olufunyenweyo kule nkqubo luya kuba luncedo olukhulu.
Iingxaki ezincinci ziquka ukuphuma kwamanzi kwisiza sokufakwa kwe-catheter, ukuphazamiseka kwintliziyo yesikhashana eyenziwa yintambo ephazamisayo intliziyo yesisu kunye noshintsho lwexeshana kwixinzelelo legazi.
Iingxaki ezibalulekileyo ziquka ukugqithiswa kwentonga yentliziyo (kubangela imeko ebungozi yobomi ebizwa ngokuthi "i- tamponade ye-cardiac "), ukuphuma kwamanzi okanye (ngenxa yokuba i-arrhythmias ebulalayo inokunyanzelwa). Umngcipheko wokufa ngexesha lokufunda i-EP ungaphantsi kwe-1 kwabangu-1,000.
Umthombo:
Rahimtoola, SH, Zipes, DP, Akhtar, M, et al. Ingxelo yomvumelwano yeNkomfa kwi-State of Art ye-Electrophysiologic Testing in the diagnosis and Treatment of patients with Cardiac Arrhythmias. Ukuhamba ngo-1987; 75: III3.