Ukuguqulwa kweCardiac Ukuchithwa kweNyango (CRT) yeNtliziyo yokusilela

Ezinye izigulane ezinokukhubazeka kwentliziyo ziyakwazi ukuphucula ngokuphawulekayo kwiimpawu, izibhedlele ezimbalwa, kunye nomngcipheko wokunciphisa ukufa kunye nohlobo lwe- pacemaker olukhethekileyo olubizwa ngokuba yi-CRT). Ukuba ufumene unesifo senhliziyo, kufuneka uxoxe nodokotela wakho malunga nokusebenzisa i-CRT.

I-CRT isebenza njani

I-CRT isebenzisa iteknoloji ye-cardiac pacing ukuze ilungelelanise isenzo se- ventricles ezilungileyo kunye nezikhohlo ezikhethiweyo ezinokuphelelwa yintliziyo ngenxa ye- cardiomyopathy .

Phantse omnye kubantu abathathu abanesifo senhliziyo banokungaqhelekanga kwinkqubo yokuqhuba umbane ebizwa ngokuba yi- block bundle block block (LBBB) (okanye i-LBBB eyaziwa ngokuba yi-"intraventric conduction delayment"). kunye nama-ventricles asele ukuba ahlasele i-synch. Ngamanye amagama, endaweni yokubetha kanyekanye, i-ventricles ibetha kancane kwisigaba, enye emva kwesinye. iimpawu zesifo senhliziyo esibi nakakhulu.

I-CRT isebenzisa i-pacemaker ekhethekileyo enokukwazi ukuhamba ngokuzimela ngokuzimeleyo. Oku kwahluke kwi-pacemakers eziqhelekileyo, ezithatha i-ventricle efanelekileyo.

Ngokufanelekileyo ngokukhawuleza ukuhamba kwayo kwee-ventricles zombini, i-CRT inokukwazi ukuphinda ibenze ukubetha ukuze ama-ventricles athathwe ngokukodwa ngexesha lokulandelana.

Xa umsebenzi wee-ventricle zombini ulungelelaniswa ngale ndlela, ukusebenza kwentliziyo kwandisa, kwaye umlinganiselo womsebenzi uthatha ukuba intliziyo iphephe igazi.

Ukusebenza kwe-CRT

Izilingo ezininzi zonyango ziye zavavanya ukusebenza nokukhuseleko kwe-CRT kwizigulane ezinokukhubazeka kwentliziyo kunye ne-branch block block.

Uhlalutyo lwe-meta olubhekiselele kwi-14 yezi zilingo ezibhalise izigulane ezingama-4420 ezinokukhubazeka kwentliziyo zaphetha ukuba, kwizigulane ezikhethiweyo ngokufanelekileyo, i-CRT inokuphucula impawu kunye namandla okusebenza, ukunciphisa izinga lokubhedlele, nokunciphisa ukufa.

Ucwaningo luye lwabonisa ukuba i-CRT inokuphucula kokubili isisu kunye nomsebenzi wentliziyo, ukuzama ukunciphisa ubungakanani be-ventricle ehlanjulweyo eseleyo, ngaleyo ndlela iphucule iqhekeza le-ventricular ejection .

Iingxaki ze CRT

I-CRT iyi-pacemaker, ngoko inomngcipheko ofanayo oza kuwubona nangayiphi na enye i-pacemaker, kubandakanywa umngcipheko omncinci wokusuleleka, umonakalo entliziyweni okanye kwimithambo yegazi kunye nokuphuma kwamanzi. Ukongezelela, kubandakanywa ingozi eyongezelelweyo ekubekeni inkokheli ehamba phambili enokukwazi ukuhamba nge-ventricle ekhohlo. Kwi-izigulane ezingama-20, ukuhamba nge-ventricular pacing ayikwazi ukufezwa kwaye i-CRT ayikwazi ukusetyenziswa.

Yiyiphi Abantu abaneNyantliziyo Yokwehluleka Kufuneka Iqwalaselwe Kwi-CRT?

Izikhokelo eziqhelekileyo zincoma ukuba i-CRT ithathelwe ingqalelo kwizigulane ezinokukhubazeka kwentliziyo ezivelisa iimpawu ezibalulekileyo, ezineqhezu le-ventricular ejection ye-0.35 okanye ezantsi, kunye ne-block bundle branch block.

Ngokucacileyo, ezininzi izigulane ezidibana nale miqathango ye-CRT ziya kudibanisa imigaqo-nkqubo ye-defibrillator ( ICD ).

Ngoko uhlobo oluqhelekileyo lwesixhobo se-CRT esisetyenziswe kwiyeza lonyango ludibanisa isixhobo se-ICD-CRT.

ILizwi

Ukuba unentliziyo engaphumeleliyo ekunciphiseni amandla akho okusebenza ngokuqhelekileyo, kwaye sele sele ufumana unyango olunefuthe lokunyanga kwenhliziyo , kufuneka uxoxe nge-CRT kunye nogqirha wakho. Ugqirha wakho uya kukunceda ukuba unqume ukuba ngaba ungumviwa ofanelekileyo kule fayili yonyango kwaye ingaba i-CRT ikulungele.

> Imithombo:

> Burkhardt, JD, Wilkoff, BL. I-electrophysiology ye-intervention kunye ne-cardiac-up-up-treatment treatment: ukuhambisa izixhobo zombane ukwenzela ukuhluleka kwentliziyo. Ukuhamba ngo-2007; 115: 2208.

> McAlister FA, uEzekowitz J, Hooton N, et al. Ukuguqulwa kwamagciwane e-cardiac kwizigulane ezisebenzayo zokusweleka kwe-systolic ye-ventricular: ukuhlaziywa okucwangcisiweyo. JAMA 2007; 297: 2502.

> Yancy CW, Jessup M, Bozkurt B, et al. I-ACCF / i-AHA isikhokelo sokulawula ukusilela kwintliziyo: isishwankathelo esiphetheyo: ingxelo ye-American College of Cardiology Foundation / i-American Heart Association Task Force kwizikhokelo zokusebenza. Uhambo luka-2013; 128: 1810.