Ua ʻike anei ʻoe i ka CRT (Cardiac Resynchronization Therapy), ka mea e hoʻoulu ai i nā keʻena o ka puʻuwai e kuʻi pū?

Ke luhi nei ʻoe i kekahi manawa me ke kumu ʻole, a i ʻole he paʻakikī ke hanu i ka piʻi ʻana i nā alapiʻi? Malia paha ua haʻi aku kāu kauka iā ʻoe ua nāwaliwali iki kou puʻuwai, ʻo ia hoʻi, he maʻi kou i kapa ʻia ʻo 'Heart Failure'. ʻO ka mea nui e hana ʻia i ia mau hihia, ʻaʻole e kuʻi nā keʻena o ka puʻuwai i ka manawa like a me ke ʻano like. Ma muli o kēia, ʻaʻole hiki i ka puʻuwai ke pamu pono i ke koko e pono ai ke kino. ʻO kēia ka hopena i kēia pilikia a mākou e kamaʻilio nei i kēia lā, ʻo kēia lāʻau lapaʻau kūikawā i kapa ʻia ʻo CRT.

I ka ʻōlelo maʻalahi, he aha kēia lāʻau CRT?

ʻO CRT kahi pōkole no 'Cardiac Resynchronization Therapy'. I ka pololei, he kaʻina hana kēia e hoʻokomo ʻia ai kahi pacemaker kūikawā i loko o ka puʻuwai ma o kahi kaʻina hana ʻoki liʻiliʻi. ʻO kekahi inoa no kēia ʻo 'biventricular pacing'.

E noʻonoʻo, aia i loko o ko kākou puʻuwai ʻelua mau keʻena haʻahaʻa, kahi a kākou e kapa nei ma ke ʻano lapaʻau he ventricles . I loko o ka puʻuwai olakino, pono e ʻaelike pū kēia mau keʻena ʻelua, i ka manawa like, e pamu i ke koko i ke kino. Akā i nā kūlana e like me ka hāʻule ʻana o ka puʻuwai, e ʻaelike kēia mau keʻena ʻelua i nā manawa like ʻole. Ua kapa ʻia kēia ʻo 'dyssynchrony.' I kēlā manawa, ʻo ka hana a kēia mea hana CRT, ʻo ia ka hoʻouna ʻana i nā hōʻailona uila liʻiliʻi e hoʻokuʻi i kēia mau keʻena ʻelua i ka manawa like, ma ke ʻano like. ʻO ia hoʻi, hoʻonohonoho hou ia i ka puʻuwai.

Pehea e hana ai kēia hāmeʻa CRT?

Ua lohe paha ʻoe i nā pacemakers maʻamau. Hoʻokahi a ʻelua paha mau alakaʻi ko lākou. Akā, ʻekolu mau alakaʻi ko kēia pacemaker CRT. ʻO kēia ka mea kūikawā.

E noʻonoʻo, ua pili kekahi o kēia mau uea ʻekolu i ka ventricle ʻākau o ka puʻuwai, a ʻo kekahi i ka ventricle hema. Ua pili ke uea ʻekolu i ka atrium ʻākau, ʻo ia hoʻi kahi keʻena ma luna o ka puʻuwai. No laila, ua nānā mau ʻia ke ʻano o ka puʻuwai ma o kēia mau uea ʻekolu. Inā ʻike ʻia kahi ʻano ʻē i ke ʻano, ʻo ia hoʻi, inā ʻaʻole e kuʻi pū ana nā keʻena, hoʻouna kēia mea hana i kahi hōʻailona uila liʻiliʻi i ka manawa kūpono a hana pū i kēlā mau keʻena. Ua like ia me ke alakaʻi o kahi hui mele, e hoʻomalu ana i nā mea āpau i hoʻokahi ʻano.

He aha ka ʻokoʻa ma waena o CRT a me ICD?

Ua lohe paha ʻoe i kahi mea i kapa ʻia he ICD. Mai huikau i nā mea ʻelua. Hana kēia mau mea ʻelua i ʻelua mau hana. E hoʻomaopopo kākou i kēia me kahi papa.

Akā aia kekahi mea ʻē aʻe. Loaʻa paha i kekahi mau maʻi kēia mau pilikia ʻelua. ʻO ia hoʻi, ʻaʻole e kuʻi pū nā keʻena puʻuwai, a loaʻa nā mele wikiwiki weliweli. No kēlā poʻe, paipai nā kauka e hoʻokomo i ka hui pū ʻana o kēia mau mea ʻelua (mea hana CRT-D) .

ʻO wai ka mea e pono ai kēia lāʻau lapaʻau?

ʻO ka maʻamau, pono i nā poʻe me nā ʻano puʻuwai kūpono ʻole (arrhythmias) kēia ʻano pacemaker. Eia nō naʻe, ua ʻōlelo kūikawā ʻia ka lāʻau lapaʻau CRT no ka poʻe e hoʻokō ana i kekahi mau kūlana. Aia kekahi mau kumu e nāwaliwali ai ka puʻuwai a i ʻole he ʻano puʻuwai kūpono ʻole.

• Ka Holo ʻole o ka Puʻuwai: ʻAʻole hiki i ka puʻuwai ke pamu i ke koko kūpono i ke kino.
• Ka hōʻeha ʻana o ka puʻuwai ma muli o kahi hāʻule puʻuwai ma mua .
• E emi ana ka hana o ka puʻuwai me ka makahiki.
• Ma muli o kekahi mau lāʻau lapaʻau.
• Maʻi puʻuwai hānau .
• Nā haunaele i ka hoʻoili ʻana o nā hōʻailona uila i loko o ka puʻuwai. No ka laʻana, kahi kūlana i kapa ʻia ʻo 'Bundle Branch Block' .

Pehea e hana ʻia ai ke ʻoki kino

He aha ka mea e hana ʻia ma mua o ke ʻoki kino?

I kekahi mau lā ma mua o ke ʻoki kino, e kauoha aku kāu kauka i kekahi mau hoʻokolohua e nānā i ka hana a me ke ʻano o kou puʻuwai. No ka laʻana, e noi ʻia paha ʻoe e hana i kahi MRI scan o ka puʻuwai a i ʻole kahi Transthoracic Echocardiogram (TTE) . E hāʻawi ʻia ʻoe i ka anesthesia e pale aku iā ʻoe mai ka ʻeha ʻana i ka wā o ke ʻoki kino. Hiki ke hoʻomoe ʻia ʻoe.

I ka wā o ke ʻoki kino...

1. ʻO ka mea mua, hoʻokomo ke kauka i ʻekolu mau kaula kūikawā i loko o nā wahi kikoʻī o kou puʻuwai, ma o kahi aʻa koko ma kou poʻohiwi a i ʻole kou ʻūhā paha.

2. A laila, hana ʻia kahi ʻoki liʻiliʻi ma ka ʻili ma lalo o ka poʻohiwi e hana i kahi ʻeke liʻiliʻi e paʻa ai ka mea hana pacemaker (kahi pahu liʻiliʻi e loaʻa ana ka pila a me ke kaapuni).

3. A laila ua hoʻopili ʻia nā uea i hoʻouna ʻia i ka puʻuwai i kēia hāmeʻa a nānā ʻia e ʻike inā e hana pono ana.

4. Inā maikaʻi nā mea a pau, hoʻokomo ʻia ka hāmeʻa i loko o ka ʻeke i hana ʻia, a pani ʻia ka ʻoki ʻili me nā humuhumu hiki ke hoʻoheheʻe ʻia.

He aha ka mea e hana ʻia ma hope o ke ʻoki kino?

• Pono ʻoe e noho ma ka haukapila no kekahi mau hola a i ʻole ka pō.
• No ka mea ua hoʻomoe ʻia kou ʻiʻo, mai hoʻi ʻoe i ka home. Pono ʻoe e hele pū me kekahi.
• Ke haʻi aku nei lākou iā ʻoe e mālama i kou lima hema mai ka neʻe nui ʻana no kahi o 12 mau hola ma hope o ke ʻoki ʻana a hiki i ka wā e hoʻopaʻa ai nā kaula i kahi.
• E hāʻawi ʻia ʻoe i kahi kāleka kūikawā. Aia i loko nā kikoʻī e pili ana i ka hāmeʻa i hoʻokomo ʻia i loko ou. He mea nui loa e mālama i kēia kāleka me ʻoe i nā manawa a pau . Pono kēia ma nā wahi e like me nā kahua mokulele.
• Pono paha ʻoe e lawe i kahi X-ray e hōʻoia i ka noho ʻana o nā kaula ma kahi kūpono, a i ʻole pono paha ʻoe e hana i kahi EKG (electrocardiogram) e nānā i ka manawa o kou puʻuwai.

Nā pono a me nā pilikia o ka mālama ʻana iā CRT

Nā pono o ka mālama ʻana

Inā holomua kēia lāʻau lapaʻau, hiki ke hoʻomaikaʻi nui i kou ola.

• Hoʻonui ʻia ka nui o ke koko i pamu ʻia e ka puʻuwai i ke kino.
• Hoʻonui ʻia ka pono o ka puʻuwai.
• Ua emi iho nā hōʻailona e like me ka pōkole o ka hanu a me ka luhi.
• Hoʻemi i ka pilikia o nā ʻano puʻuwai kūpono ʻole.
• Hiki ke hoʻonui ʻia ka manawa e ola ai.
• Hiki i nā kūlana e like me ka mitral regurgitation, kahi e kahe ai ke koko i hope ma o ka valve puʻuwai, ke hoʻomaikaʻi.
• Hoʻomaikaʻi ka hiki ke hoʻoikaika kino.

ʻAʻole anei he pilikia i loko o kēia?

• Ua haki a neʻe paha nā uaea i hoʻokomo ʻia mai ko lākou wahi aku.
• Ka maʻi ma kahi i hana ʻia ai ke ʻoki.
• Nā ʻūpā koko .
• nā maʻi alerika i nā anesthetics a i ʻole kekahi mea ʻē aʻe.
• Loaʻa kekahi pilikia puʻuwai ʻē aʻe, e like me ka hāʻule puʻuwai (kākaʻikahi loa).

Hoʻōla hou a me ka ʻimi ʻana i ka ʻōlelo aʻoaʻo lapaʻau

Hiki iā ʻoe ke hoʻi hou i nā hana maʻamau i loko o kekahi mau lā ma hope o ke ʻoki ʻana. Eia nō naʻe, ke aʻo aku nei nā kauka iā ʻoe ʻaʻole e hana i kekahi mea e like me ka hoʻokele kaʻa a i ʻole ka hāpai ʻana i nā mea kaumaha no hoʻokahi a ʻelua paha pule . ʻO ka pila i loko o kēia pacemaker i hoʻokomo ʻia e mau ana no kahi o 7-10 mau makahiki. Ke nāwaliwali ka pila, hiki ke hoʻololi ʻia me kahi ʻoki liʻiliʻi ʻē aʻe.

Āhea ʻoe e ʻike ai i ke kauka?

E loaʻa iā ʻoe kahi manawa hoʻopaʻa ma hope o hoʻokahi mahina ma hope o ke ʻoki ʻana. Ma hope o kēlā, pono ʻoe e ʻike i ke kauka i hoʻokahi a ʻelua paha i ka makahiki. E nānā lākou i ka hāmeʻa, ka pila, a me nā uea ma kahi kamepiula e hōʻoia i ka hana pono ʻana.

He mea nui loa: Inā loaʻa iā ʻoe ke kuni, a inā paha e ʻulaʻula, pehu, a ʻeha paha kahi i hoʻokomo ʻia ai ka hāmeʻa, i nā pule a i ʻole nā ​​mahina ma hope o ke ʻoki ʻana, e kāhea koke i kāu kauka. He hōʻailona paha kēia o kahi maʻi.