So wo koma te sɛ nea ɛrebɔ ntɛmntɛm dodo? Momma yensua A-fib a ɛwɔ RVR ho ade! (Atiridiinini a Wɔde RVR yɛ) .

So woate nka pɛn sɛ wo koma rebɔ te sɛ ɔbɔdamfo, anaasɛ wote nka sɛ wowɔ nkate bi a ɛyɛ nwonwa wɔ wo koko mu? Anaasɛ wote nka sɛ ɛyɛ den ma wo sɛ wobɛhome anaasɛ wo ho ayɛ wo yaw? Ebia eyinom nyɛ nneɛma afoforo ara kwa. Ɛnnɛ yɛrebɛka ɔhaw a ɛte sɛɛ a ɛba koma no mu ho asɛm, kyerɛ sɛ, tebea bi a koma no bɔ ntɛmntɛm na ɛyɛ ntɛmntɛm yiye, a wɔfrɛ no `(Atrial Fibrillation with Rapid Ventricular Rate)` anaa `(A-fib with RVR)` tiawa. Nsuro, ɛho hia paa sɛ wobɛhu eyi.

Dɛn ankasa ne A-fib a ɛwɔ RVR?

Sɛ yɛbɛka no tiawa a, `(A-fib with RVR)` yɛ tebea a ɛma wo koma bɔ, anaa sɛnea ɛbɔ no yɛ nea ɛnteɛ. Yɛwɔ atifi dan abien wɔ yɛn koma mu, na yɛfrɛ no atria. Saa `(atria)` yi ne baabi a anyinam ahoɔden nsɛnkyerɛnne a ɛkyerɛ sɛ koma no bɔ no fi ase. Nanso wɔ obi a ɔwɔ `(Atrial Fibrillation)` mu no, saa anyinam ahoɔden nsɛnkyerɛnne yi yɛ basabasa, ɛnyɛ adwuma, na atifi dan `(atria)` no fi ase twetwe ntɛmntɛm yiye. Ɛte sɛ nea obi rebɔ sanku te sɛ ɔkraman.

Afei anyinam ahoɔden nsɛnkyerɛnne a ɛyɛ basabasa yi kɔ koma no ase adan abien, ventricles no mu. Afei saa ventricles no bɔ bɛyɛ nea ɛnkɔ so daa na ɛyɛ ntɛmntɛm yiye . Ɛno ne nea wɔfrɛ no ``A-fib with RVR''. Ɛno kyerɛ sɛ koma no bɔ bɛboro mpɛn 100 simma biara.

Fa no sɛ ɛte sɛ nsu pɔmpɛ. Sɛ ɛnyɛ adwuma yiye a, entumi mfa mogya a ehia no nkɔ nipadua no mu. Ɛno na ɛba bere a wowɔ `(A-fib with RVR)`. Koma no nni bere a ɛdɔɔso a ɛbɛma mogya ahyɛ mu ma yiye, enti entumi mfa mogya a oxygen wom a ɛdɔɔso nkɔ nipadua no mu.

Saa tebea yi abu so dɛn?

Ebia wubesusuw sɛ eyi yɛ yare a ɛka nnipa kakraa bi pɛ. Nanso nokwarem no, ``Atrial Fibrillation`` ne tebea a ɛtaa ba wɔ koma a ɛnyɛ ne kwan so mu. Sɛ wohwɛ akontaabu a ɛwɔ ɔman te sɛ Amerika mu a, nnipa ɔpepem pii rehu amane wɔ saa tebea yi ho. Wohu tebea yi kɛse nso wɔ Sri Lanka.

Dɛn ne eyi ho sɛnkyerɛnne? Ɔkwan bɛn so na yebetumi ahu?

Ɛnyɛ obiara na onya yare no ho sɛnkyerɛnne koro. Ebia nnipa binom benya yare no a wonni sɛnkyerɛnne biara. Nanso, sɛnkyerɛnne ahorow bi wɔ hɔ a ɛtaa ba:

• Koma a ɛbɔ : Ebetumi ayɛ te sɛ nea wo koma rebɔ anaasɛ ɛrebɔ wɔ wo moma so.
• Adwene a ɛyɛ wo yaw : Ebetumi ayɛ te sɛ nea wo ti retwa, ɛtɔ mmere bi a ɛkɔ baabi a wuntumi nnyina.
• Ahomegye: Sɛ tebea yi mu yɛ den a, nnipa binom betumi ahwere wɔn adwene na wɔahwe ase.
• Koko mu yaw : Ebia koko no bɛte nka sɛ ɛreyɛ ayɛ mmerɛw anaasɛ ɛremia.
• Ahome tiaa : Ɛnyɛ bere a woabrɛ kakra nko, na mmom bere a wugyina hɔ ara kwa mpo no, ebia wobɛte nka sɛ wo home ayɛ wo yaw.
• Dadwen a ɛtaa ba`(Adwennwene)`: Ebia wobɛte ehu ne dadwen nka a ntease biara nnim.
• Ɔbrɛ : Ɛmfa ho sɛnea wobɛda no, ebia wobɛte nka sɛ woabrɛ na wunni nkwa.

Saa sɛnkyerɛnne ahorow yi betumi ayɛ nea emu nyɛ den koraa wɔ mmere bi mu, na ɛyɛ den yiye wɔ mmere foforo mu. Enti sɛ wuhyia biribi a ɛte sɛɛ a, ɛbɛyɛ papa sɛ wobɛkɔ oduruyɛfo nkyɛn .

Dɛn nti na eyi rekɔ so? Dɛn ne nea enti a ɛte saa?

Nneɛma pii wɔ hɔ a ebetumi ama `A-fib with RVR` aba. Wɔn titiriw ne:

• Coronary artery disease : Eyi kyerɛ sɛ ntini a ɛde mogya kɔ koma no mu no asiw.
• Mogya mmoroso : Yɛn nyinaa nim asɛmfua "mogya mmoroso".
• Koma a entumi nyɛ adwuma yiye : Koma no ntumi mfa mogya a ɛdɔɔso nkɔ nipadua no mu.
• Obstructive sleep apnea: Ɔhome a wogyae bere a woada bere a worebɔ ahurututu no.
• Koma oprehyɛn : Asiane yi betumi akɔ so nna anaa adapɛn pii wɔ koma oprehyɛn bi akyi.

Hena na ɔwɔ asiane kɛse ma eyi?

Ɛda adi sɛ nnipa binom benya saa tebea yi. Hwɛ sɛ wotɔ saa kuw yi mu anaa:

• Nnipa a wɔadi boro mfe 50 : Asiane yi kɔ soro bere a obi nyin no.
• Nnipa a wɔn nipadua mu duru (BMI) boro mfe 30 : Eyi kyerɛ sɛ wɔn mu duru boro so kɛse wɔ wɔn tenten ho.
• Nnipa a wɔwɔ nna mu ahomegye a esiw kwan.
• Nnipa a wɔnom nsa pii : Sɛ wonom nsa pii da biara anaa wotaa nom a, asiane no yɛ kɛse.
• Nnipa a wɔnom caffeine pii : Ɛnyɛ papa nso sɛ wobɛnom kɔfe anaa tii pii awiabere.
• Sɛ obi a ɔwɔ w'abusua mu anya ``A-fib'' a : Ebia awosu mu nkɛntɛnso nso wɔ hɔ.

Kae: Sɛ wowɔ saa asiane ahorow yi mu biako anaa nea ɛboro saa a, ɛnkyerɛ sɛ akyinnye biara nni ho sɛ wubenya ``A-fib with RVR''. Nanso, ɛho hia sɛ wohu eyinom.

Nsɛnnennen bɛn na eyi betumi de aba?

Sɛ wɔansa `A-fib a ɛwɔ RVR` no yiye a, nsɛnnennen bi a ɛyɛ hu betumi aba.

• Bere a mogya bɛhyɛ koma no fã a ɛwɔ fam no mu ma a ɛso tew .
• Koma ntini no hia mframa pa pii .
• Cardiomyopathy : Tebea a ɛma koma ntini no yɛ mmerɛw na ɛyɛ kɛse.
• Akisikuru : Sɛ mogya a ɛtɔ kɔ koma no mu na ɛkɔ amemene no mu, na esiw ntini bi ano a, obi betumi anya akisikuru. Eyi ne ɔhaw a asiane wom sen biara .
• Mogya mmoroso a ɛba fam .
• Koma a ɛyɛ den a ɛyɛ mmerɛw .

Ɛno nti na ɛho hia sɛ wuhu saa tebea yi na wohwehwɛ ayaresa ntɛm no.

Ɔkwan bɛn so na wohu eyi? Sɔhwɛ ahorow bɛn na wɔyɛ?

Sɛ wowɔ sɛnkyerɛnne ahorow a yɛaka ho asɛm wɔ atifi hɔ no a, sɛ wokɔ oduruyɛfo nkyɛn a, ɔbɛhwehwɛ wo mu, abisa w’ayaresa ho abakɔsɛm, na afei ahyɛ sɛ wɔnyɛ nhwehwɛmu pii mfa nkyerɛ sɛ tebea no te.

Sɔhwɛ ahorow a wɔtaa yɛ ne:

• Electrocardiogram (ECG anaa EKG) : Eyi kyerɛw anyinam ahoɔden dwumadi a ɛwɔ koma no mu. Ɛbɛtumi ahunu pefee sɛ `(A-fib a ɛwɔ RVR)` wɔ hɔ anaa.
• Echocardiogram : Eyi te sɛ koma no mu ultrasound scan. Ebetumi ahwɛ sɛ koma no mu adan ne ne ntini ahorow reyɛ adwuma yiye, ne sɛnea koma no kɛse te.
• Cardiac CT scan anaa MRI scan : Eyinom betumi ama wɔanya koma no nhyehyɛe ho nsɛm a ɛkɔ akyiri.
• Mogya mu nhwehwɛmu : Eyinom boa ma wohu nneɛma te sɛ thyroid haw ne nsakrae a ɛba electrolytes mu wɔ mogya no mu.

Dɛn ne ayaresa a wɔde sa eyi?

Asɛmpa no ne sɛ ayaresa a etu mpɔn wɔ hɔ ma A-fib a RVR ka ho. Wo duruyɛfo wɔ botae atitiriw abien: sɛ obedi wo yare no ho sɛnkyerɛnne ahorow so, ne sɛ obesiw nsɛnnennen a yɛaka ho asɛm wɔ atifi hɔ no ano.

Wɔde nea edidi so yi di dwuma titiriw sɛ ayaresa:

• Electrolytes a Ɛkari pɛ : Esiane sɛ electrolytes te sɛ potassium ne magnesium a ɛkɔ soro anaasɛ ɛso tew wɔ nipadua no mu no betumi aka koma no nnyigyei nti, wɔde ayaresa di dwuma de hwɛ ma ɛkɔ so yiye.
• Nnuru : Ayaresa titiriw a wɔde sa eyi ne nnuru.

Nnuru/ayaresa bɛn na wɔde di dwuma?

Nnuru ahorow pii wɔ hɔ a wɔde ma `A-fib with RVR`:

• Beta-blockers : Sɛ nhwɛso no, metoprolol (Lopressor® anaa Toprol®XL). Eyinom yɛ adwuma denam koma no a ɛbɔ brɛoo kakra na ɛtew nhyɛso a ɛba koma no so no so.
• Calcium akwan a esiw ano : Sɛ nhwɛso no, diltiazem (Diltzac® anaa Cardizem®). Saa aduru yi nso ma koma no bɔ brɛoo denam calcium a ɛhyɛn koma ntini mu nkwammoaa mu no so.
• Nneɛma a ɛko tia apɔw-mu-teɛteɛ : Sɛ nhwɛso no, amiodarone (Pacerone® anaa Cordarone®) anaa digoxin (Lanoxin® anaa Cardoxin®). Eyinom boa ma koma no nnyigyei a ɛnkɔ so daa no san ba.

Ade a ɛho hia sen biara! Sɛ wowɔ `(A-fib)` a, hokwan kɛse wɔ hɔ sɛ mogya a ɛbɛtɔ wɔ koma no mu. Sɛ mogya a ɛtɔ kɔ amemene no mu yi tu kwan kɔ amemene no mu a, `(Stroke)` betumi aba. Enti, ɛkame ayɛ sɛ wɔkyerɛw nnuru a ekum mogya a ɛtwetwe mogya , anaa nea yɛfrɛ no "mogya a ɛma mogya tu" ma bere nyinaa.

Wɔ nnipa binom a wontumi nkɔ so nnom nnuru a ɛma mogya yɛ mmerɛw yi fam no, wobetumi ayɛ ɔkwan titiriw bi a wɔfrɛ no left atrial appendage closure na wɔasiw mogya a ɛbɛtɔ.

Ɛtɔ mmere bi a, ɛyɛ den sɛ wɔde nnuru nkutoo bedi tebea yi so. Wɔ tebea horow a ɛtete saa mu no, ebia ɛho behia sɛ wɔfa akwan foforo a wɔfa so sa yare:

• Catheter ablation : Nea ɛka eyi ho ne sɛ wobehu koma no mmeae a anyinam ahoɔden nsɛnkyerɛnne a ɛnkɔ so pɛpɛɛpɛ no fi, na wɔde catheter ketewaa bi (tube a ɛyɛ tratraa) afa nan anaa basa no mu akɔ koma no mu, na ‘wɔama’ mmeae a nsɛnkyerɛnne a ɛnkɔ so no afi hɔ no ayɛ adwuma. Afei nsɛnkyerɛnne a ɛnkɔ so pɛpɛɛpɛ no gyae ba.
• Pacemaker : Nnipa binom de afiri ketewaa bi ahyɛ wɔn honam ani de hwɛ wɔn koma bɔ. Wɔfrɛ eyi sɛ pacemaker. Ɛde anyinam ahoɔden nsɛnkyerɛnne kɔ koma no mu, titiriw bere a koma no bɔ brɛoo no.
• Electrical cardioversion : Eyi hwehwɛ sɛ wɔde aduru tiawa bi a wɔde kum nipadua no ma na wɔde anyinam ahoɔden a ɛwɔ akyi a wɔhwɛ so kɔ koma no mu, na ɛma koma no san yɛ adwuma ntɛm ara.
• Maze procedure : Eyi yɛ adeyɛ a ɛyɛ den kakra. Wɔtwa ntini nketenkete wɔ koma no ntini mu de yɛ akwan a ɛfata a anyinam ahoɔden nsɛnkyerɛnne betumi afa so. Wɔtaa yɛ eyi bere a wɔreyɛ koma oprehyɛn foforo no.

So ayaresa no mu nsunsuanso bɔne bi wɔ hɔ?

Sɛnea ɛte wɔ aduruyɛ biara ho no, nsunsuanso bɔne anaa nsɛnnennen bi betumi aba wɔ saa `(A-fib with RVR)` ayaresa yi mu. Nanso, ɛnto obiara, na mpɛn pii no wɔyɛ nketewa.

• Efi nnuru mu : Nnipa binom betumi anya tiyɛ, mogya mmoroso, adwenemhaw, na wɔn yafunu ayɛ wɔn yaw.
• Akwan a wɔfa so yɛ te sɛ catheter ablation betumi ama koma no ayɛ basaa anaasɛ ɛntaa nsi koraa sɛ komayare.
• Ɛtɔ mmere bi a, pacemakers ntumi nyɛ adwuma yiye.
• Koma a ɛbɔ anaa ``A-fib'' betumi asan aba asram pii wɔ Maze adeyɛ no akyi .

Wo duruyɛfo bɛbɔ wo amanneɛ wɔ eyi ho. Ɛho nhia sɛ wohaw wo ho, efisɛ nnuruyɛfo bɔ mmɔden bere nyinaa sɛ wɔbɛtew asiane ahorow yi so.

Ɛrenkyɛ na me ho atɔ me wɔ ayaresa akyi?

Eyi gyina ayaresa a worenya no so ankasa. Nnuru bi te sɛ nnuru a wɔde fa ntini mu (IV) betumi aboa ma wo koma abɔ brɛoo na afi ase ate nka wɔ simma kakraa bi mu . Ebia ayaresa afoforo begye bere tenten ansa na ayɛ adwuma. Nea ɛho hia sen biara ne sɛ wubedi wo duruyɛfo akwankyerɛ akyi pɛpɛɛpɛ.

Mɛyɛ dɛn atumi atew asiane yi so?

Nneɛma pii wɔ hɔ a wubetumi ayɛ de atew asiane a ɛwɔ hɔ sɛ wubenya `(A-fib with RVR)` no so. Ɛnyɛ sɛ eyinom ye ma tebea no nko, na mmom eye ma w’akwahosan nyinaa nso:

• Apɔw-mu-teɛteɛ a ɛkɔ fam anyɛ yiye koraa no simma 150 dapɛn biara : nantew, sakre, anaa asuguare ye.
• Di nnuan a ɛma koma nya ahoɔden: Fa nhabannuru, nnuaba, atoko, aburow a wɔayam, ne mpataa ka w’aduan ho. Tew ngo, nkyene, ne asikre so.
• To nsa a wobɛnom ano hye : Ɛyɛ papa sɛ wobɛtew so sɛnea wubetumi biara.
• Kwati tawa ho nneɛma koraa : Sɛ wonom sigaret a, gyae.
• Sɛ wowɔ ayaresa mu tebea afoforo te sɛ mogya mmoroso, srade a ɛdɔɔso, nna mu ahomegye, anaa asikreyare a, di so yiye.

Sɛ mewɔ `(A-fib a RVR ka ho)` a, dɛn na ɛsɛ sɛ mehwɛ kwan?

Sɛ wuhu sɛ wowɔ `(A-fib with RVR)` a, ebetumi ayɛ ahodwiriw kakra. Nanso kae sɛ eyi yɛ tebea a wubetumi adi ho dwuma na wubetumi abɔ bra pa . Ade a ɛho hia ne sɛ wode suban pa a yɛadi kan aka ho asɛm no besi hɔ, anom nnuru a wo duruyɛfo akyerɛw ama wo no pɛpɛɛpɛ, na sɛ ɛho hia a, hwehwɛ ayaresa titiriw bi.

Sɛ wɔansa a, ebetumi de tebea horow a emu yɛ den te sɛ komayare, komayare, anaa akisikuru aba. Wɔada no adi sɛ ayaresa te sɛ catheter ablation di yiye wɔ nnipa pii mu. Maze dwumadie no wɔ nkonimdie 80% kɔsi 90%, na ɛtumi ma ahotɔ a ɛkyɛ firi yareɛ no ho.

Tebea yi bɛkɔ so akosi bere bɛn?

``(A-fib with RVR)`` yɛ tebea a ɛtɔ da bi a ebetumi atra hɔ mfe pii. Wɔ nnipa binom fam no, mpɛn dodow a tebea yi ba ne bere tenten a ɛkyɛ no betumi akɔ soro bere a bere kɔ so no. Ɛno nti na ɛho hia sɛ wokɔ so di wo duruyɛfo afotu akyi na wokɔhwɛ wo daa no.

Mɛyɛ dɛn ahwɛ me ho?

W’akwahosan wɔ wo nsam. Kae eyi:

• Nom nnuru a wo duruyɛfo akyerɛ wo nyinaa pɛpɛɛpɛ na fa bere ano. Mma da koro mpo nmpa wo ti so.
• Hwɛ wo duruyɛfo wɔ bere a wɔahyɛ sɛ wobɛkɔ akɔhwɛ wo no mu. Ɛho hia paa sɛ wuhu sɛnea wo ho te.
• Yɛ apɔw-mu-teɛteɛ daa. Biribi a ɛyɛ mmerɛw te sɛ da biara da nantew mpo betumi ama w’asetra atu mpɔn na aboa wo ma woayɛ da biara da nnwuma ntɛmntɛm.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Sɛ wosan nya saa sɛnkyerɛnne yi bi bio, anaasɛ wosan nya foforo a, kɔ oduruyɛfo nkyɛn ntɛm ara:

• Koko mu yaw.
• Sɛ wo koma bɔ boro 100 simma biara bere a woagye w’ahome a.
• Adwene a ɛyɛ basaa.
• Ɔhome a ɛyɛ den.

Bere bɛn na ɛsɛ sɛ mekɔ Emergency Treatment Unit (ETU) ?

Sɛ wowɔ saa sɛnkyerɛnne yi a, ɛsɛ sɛ wokɔ Emergency Treatment Unit (ETU) a wontwentwɛn wo nan ase :

• Nsɛnkyerɛnne a ɛkyerɛ sɛ obi anya akisikuru : Tiyɛ a emu yɛ den mpofirim, n’aniwa nhu ade yiye, ɛyɛ den sɛ ɔbɛkasa, ɛyɛ den sɛ ɔbɛnantew, na n’anim fã biako ahwe ase.
• Mogya a ɛtɔ dodo esiane nnuru a ɛma mogya yɛ mmerɛw nti: Ɔfe kɔkɔɔ, nsuo kɔkɔɔ anaa tuntum a ɛtwam, nsuo kɔkɔɔ a ɛtwam.
• Koko mu yaw anaa komayare anaa komayare ho sɛnkyerɛnne afoforo : Ɔhome a ɛyɛ tiaa, yafunu mu yaw kɛse, ne fifiri.

Nsɛm bɛn na ɛsɛ sɛ mibisa me duruyɛfo?

Sɛ wokɔ wo duruyɛfo nkyɛn a, wubetumi abisa nsɛm yi na ama woate wo tebea no ase yiye:

• Mpɛn ahe na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn (follow-up)?
• Bere tenten ahe na egye ansa na wɔahu nea efi asetra mu nsakrae mu ba?
• Aduru bɛn na wokamfo kyerɛ me? Dɛn nti na ɛte saa?
• So ɛsɛ sɛ meyɛ ayaresa te sɛ cardioversion, ablation, anaa maze procedure?

Sɛ wote nka sɛ koma bɔ a ɛnteɛ a, ebetumi ahaw wo. Nanso, ayaresa a etu mpɔn wɔ hɔ ma saa tebea yi a wɔfrɛ no ``A-fib with RVR''. Wo duruyɛfo betumi aboa wo ma woapaw ayaresa a ɛfata ama wo. Sɛ wokɔ wo duruyɛfo nkyɛn bere ano na wonom nnuru a wɔakyerɛw ama wo no sɛnea wɔakyerɛw ama wo no pɛpɛɛpɛ a, wubetumi aboa ma woabɔ w’akwahosan ho ban.

Nkrasɛm a Wɔde Kɔ Fie: Nneɛma a ɛho hia sen biara a ɛsɛ sɛ wokae

Okay, enti momma yɛnbɔ nneɛma bi a ɛsɛ sɛ wokae fi nea yɛaka ho asɛm no mu no mua:

• ``(A-fib with RVR)`` yɛ tebea a ɛma koma no nnyigyei nyɛ pɛpɛɛpɛ na ɛbɔ ntɛmntɛm yiye.
• Sɛ wuhu sɛnkyerɛnne ahorow te sɛ wo koko a ɛyɛ wo yaw, wo ti a ɛyɛ wo yaw, anaasɛ ɛyɛ den sɛ wobɛhome a , hwɛ hu sɛ wobɛhwehwɛ aduruyɛfo afotu.
• Eyi betumi afi nneɛma ahorow bi mu aba, a mogya mmoroso ne komayare ka ho.
• Akisikuru yɛ eyi mu nsɛnnennen a ɛyɛ hu sen biara no mu biako, enti ɛho hia yiye sɛ wobɛnom nnuru a ɛma mogya yɛ mmerɛw.
• Akwan ahorow wɔ hɔ a wɔfa so sa yare, te sɛ nnuru ne catheter ablation.
• Asetra mu nsakrae a ɛma apɔwmuden (adidi pa, apɔw-mu-teɛteɛ, ne sigaretnom a wogyae) boa kɛse ma wodi tebea yi so.
• Fa aduru no sɛnea oduruyɛfo no akyerɛ no pɛpɛɛpɛ. Wo ne oduruyɛfo no di akyi wɔ nna a wɔahyɛ ato hɔ no mu.
• Sɛ wuhu kɔkɔbɔ nsɛnkyerɛnne a egye ntɛmpɛ (akisikuru ho sɛnkyerɛnne, mogya a ɛtɔ kɛse, wo koko mu yaw kɛse) , kɔ ayaresabea ntɛm ara.

Ɛnyɛ wo nko ara. Nnipa pii wɔ hɔ a wɔte saa tebea yi mu. Sɛ wonya ayaresa ne asetra kwan a ɛfata a, wo nso wubetumi abɔ bra pa. Nsuro sɛ wo ne wo nnuruyɛfo bɛkasa na woadi wo haw ahorow ho dwuma.

` Koma a ɛbɔ, komayare, A-fib, RVR, koma a ɛbɔ ntɛmntɛm, koko mu yaw, akisikuru