Ukuthelekisa iindlela ezahlukeneyo
Ukuba une- fibrillation ye-atrial , unquma njani phakathi kweendlela ezimbini ezisisiseko zokuphatha i-arrhythmia (oko kukuthi, ukubuyisela nokugcina isigqi sesigqirha okanye ukulawula intlawulo yenhliziyo)? Kukho inani lezinto oza kugqirha wena kunye nogqirha wakho ekwenzeni esi sigqibo.
Ngabe I-Rhythm Control Approach Appropriate?
Ekubeni ubuso, indlela yokulawula isigqi - ukubuyisela nokugcina intliziyo yesiqhelo - iya kubonakala iyindlela efanelekileyo malunga nabani na.
Emva koko, ngubani ofuna ukuhlala kwi-fibrillation ye-atrial? Ingxaki, ukuba kunjalo, ukuba unyango olukhoyo ukuphumeza ukulawula isigqi kwi-fibrillation ye-atrial kubonakala kuwukusebenza okuthobekileyo kuphela, kwaye ukubonisa izigulane kwezinye izingozi ezinkulu.
Ngoko oogqirha baninzi bagcina isicwangciso sokulawula isigqirha kwizigulane zabo ezibonakala zifumana ithuba elihle lokuphumelela nalo, okanye ngubani owona mncinci okunyamezela ukuphefumula kwe-agriyo eqhubekayo nangona iqondo lentliziyo lilawulwa. Ezi zigulane ziza kuquka ezi zilandelayo:
- Abo bafakwe kwi-friday fibrillation kubonakala behambelana nesiganeko esipheleleyo, isizathu esiphendulwayo, okanye ingxaki yonyango engaphantsi. Ezi ziquka: hyperthyroidism ; pericarditis ; i-pulmonary embolus , i-pneumonia okanye enye ingxaki yomphunga emiphunga; inkqubo yo kutshintshwa kwangoko; ukungenisa utywala (" intliziyo yeholide "); ukuhluleka kwentliziyo ; okanye i- apnea yokulala engaphelelwanga. Emva kokuba unyango lwezi zizathu ezibangele ukufabiliswa kwe-agrifti luye lwalungiswa, isiguli sinethuba elingcono lokuhlala kwisigqi senhliziyo.
- Abantu abane "ventry" ezinokuthi zenze i-fibrillation ye-atrial zibekezeleleke, nangona xa ukulawulwa kwezinga elaneleyo kufezekisiwe. Iimeko ezinjalo ziquka i -cardiomyopathy ye-hypertrophic , isifo senhliziyo esixinzelelekileyo, ukungasebenzi kwe-diastolic , okanye i- aortic stenosis .
- Izigulane apho umlinganiselo wokulawula izinga uvivinywe, kwaye uhlulekile ukulawula iimpawu ngokufanelekileyo.
- Abadlali bezemidlalo kunye nabanye ababenemisebenzi yabo efuna ukuba bayisebenze ngenani le-cardiovascular function.
- Abantu abafuna ukusebenzisa indlela yokulawula isigqi emva kokuba baxelelwe ngokupheleleyo malunga nokulinganiselwa kwabo.
Ixesha lokuLawulwa kweNqanaba liLungelelani na?
Ngenxa yobunzima kunye neengozi ezinxulumene nendlela yokulawula isigqi kwi-fibrillation ye-atrial, ezininzi iingcali ziqwalasela indlela yokulawula izinga ukuba ibe "indlela engafanelekiyo" ininzi yezigulane ezine-arrhythmia.
Indlela yokulawula isantya kuphela kwaye iphumelele ngakumbi kunendlela yokulawula isigqi, kodwa iphinde iphumelele ekupheliseni iimpawu ze-fibrillation ye-arrivri kwininzi yabantu abano-arrhythmia. Ekubeni iphela ingqalelo ekuphatheni i-fibrillation ye-atrial kukukrazula iimpawu, indlela yokulawula isantya isebenza ngokubanzi ekuphumezeni injongo yonyango.
Ukongezelela koko, ngelixa kwakudlulileyo kwinto ecingelwe ukuba ukuba unokwenza ukuba i-fibrillation ye-atrial iphephe ingozi yokubethwa kwesibalo iya kunciphisa kakhulu, uphando lwezonyango aluphumelelanga ukubonisa le miphumo. Ngoko, nangona isicwangciso solawulo sesigqirha sisetyenziswe kwaye sibonakala siphumelele, izigulane zisadingeka ziphathwe ngeziyobisi ze-anticoagulant .
Ngaloo ndlela, inzuzo enkulu enkulu yokulawula indlela yokulawula isigqi ihlulekile (ubuncinci kude kube ngoku) ukubonakala.
Ngaba Ukugcina Isiqhelo Esiqhelekileyo Ngendlela Engcono Kunokuba Ulawulwe Kwemali?
Nangona kubonakala ngathi kuvela ngokucacileyo ukuba isicwangciso sokulawula isigqi siya kunika iziphumo ezingcono kuneqhinga lokulawula isantya kwi-fibrillation ye-arrivals, uphando lweekliniki aluphumelelanga ukubonisa ukuba oku kunjalo. Esikhundleni saloo ndlela, izilingo zeeklinikhi ezingenakulinganiswa nokuqhathaniswa nokulawulwa kwesigqi ukulinganisela ukulawulwa kwezigulane ezinefayili ye-acrivity zibonise umgangatho kwiziphumo ezingaphezulu kweekliniki (kuquka ukuhlaselwa okuphezulu kwesifo, ukusilela intliziyo , ukuphazamiseka nokuphuma kwegazi) ngendlela yokulawula isigqi.
Uninzi lweengcali zibonisa ukuba ezi ziphumo zibi kakhulu kwimiphumo emibi yezidakamizwa, kodwa oku akucaci.
Okukwintsusa
Okwangoku, iingcali ziyavuma ukuba indlela "yokungagqibekanga" yezigulane ezininzi ze-frilling (ikakhulukazi emva komnye okanye mhlawumbi imizamo emibili yokugcina isigqi esivamile). Nangona kunjalo, esi sigqibo soloko sifanele senziwe ngokubambisana phakathi kogqirha kunye nesigulane, nazo zonke iinkqubo kunye neendleko zendlela nganye ezithathwa kwi-akhawunti echanekileyo.
Imithombo:
Ikholeji yaseMelika yaseCardiology Foundation, i-American Heart Association, i-European Society of Cardiology, et al. Ukulawulwa kwezigulane ezine-fibrillation ye-agriyo (ukuhlanganiswa kuka-2006 ACCF / AHA / ESC kunye ne-2011 ACCF / AHA / HRS iingcebiso): ingxelo ye-American College of Cardiology / i-American Heart Association Task Force kwizikhokelo zokusebenza. Uhambo luka-2013; 127: 1916.
Wyse DG, Waldo AL, et al. Ukuthelekisa ukulawulwa kwezinga kunye nokulawula isigqi kwizigulane ezinefayibrillation. N Eng J Med 2002; 347 (23): 1825.
Van Gelder IC, Hagens VE, et al. Ukuthelekiswa kolawulo lwezinga kunye nokulawula isigqi kwezigulane ezinefayibriyo eziqhubekayo eziqhubekayo. N Eng J Med 2002; 347 (23): 1834.