Ke manaʻo nei ʻoe i kekahi manawa e wikiwiki ana kou puʻuwai, a i ʻole e lele ana kou puʻuwai, a i ʻole e kuʻi ana ma ke ʻano ʻē? I kekahi manawa hiki ke hele mai kēia me ka paʻa ʻana o ka umauma a me ka poniuniu. Ma nā ʻōlelo lapaʻau, ua kapa ʻia kēia ʻano haunaele o ka puʻuwai ʻo 'Arrhythmia'. ʻOiai me ka lāʻau lapaʻau, hiki ke paʻakikī ke kāohi i kēia kūlana i kekahi manawa. Akā, mai hopohopo, aia kahi lāʻau lapaʻau kūpono loa, ʻaʻole invasive no kēia. ʻO kēlā lāʻau lapaʻau, ʻo ia hoʻi, Cardiac Ablation, ka mea a mākou e kamaʻilio ai i kēia lā.
I ka ʻōlelo maʻalahi, he aha ka cardiac ablation?
E noʻonoʻo aia kahi uea liʻiliʻi 'pōkole' a hewa paha ma kekahi wahi o ka ʻōnaehana uila o kou home. A laila, ʻaʻole e mau ke kukui akā 'ʻālohilohi', a pio koke paha, ʻeā? ʻO ia ka mea e hana ʻia ana i loko o ko kākou puʻuwai. Kuʻi ko kākou puʻuwai me kahi ʻōnaehana palupalu o nā hōʻailona uila. Inā hoʻomaka kēia mau hōʻailona uila ma kahi kūpono ʻole, a inā hele lākou i ke ala kūpono ʻole, lilo ka puʻuwai i mea ʻano ʻē.
ʻO ka Cardiac Ablation (i kapa ʻia hoʻi ʻo Catheter Ablation) kahi lāʻau lapaʻau e ʻike ai i kahi ʻāpana liʻiliʻi loa o ka ʻiʻo i loko o ka puʻuwai e hoʻoulu ai i nā hōʻailona uila ʻē aʻe a hoʻopau iā ia. ʻAʻole kēia he hana nui. Hoʻokomo kahi kauka puʻuwai i kahi ʻōmole lahilahi a palupalu (ʻo kēia ka mea a mākou e kapa nei he catheter ) i loko o kou puʻuwai ma o kahi kīʻaha koko nui i loko o kou ʻūhā, lima, a i ʻole ka ʻāʻī.
A laila, me ka hoʻohana ʻana i nā mea hana ma ka hopena o kēia catheter, mālama ʻia ka ʻāpana o ka ʻiʻo puʻuwai me ka pilikia. Aia kekahi mau ala e hana ai i kēia:
- ʻO ka hoʻopau ʻana i ke alapine radio: Hoʻohana ʻia nā nalu alapine radio (wela) e hoʻomehana i ke kino, e hana ana i kahi ʻeha liʻiliʻi.
- Cryoablation: Ma ka hoʻohana ʻana i ke anu nui, ua paʻahau ʻia ke kino, e hana ana i kahi ʻeha.
- ʻO ka Pulsed Field Ablation: Hoʻohana kēia i nā nalu pōkole loa o ka ikehu uila e luku ai i nā ʻiʻo.
Ma muli o ka ʻeha liʻiliʻi i hana ʻia ma kēia ʻano, ʻaʻole hiki i ka hōʻailona uila hewa ke hele ma mua o kēlā wahi. Ua like ia me ke kau ʻana i ka lipine insulation ma luna o ke kaapuni pōkole i loko o kou hale. A laila hoʻi kou puʻuwai i ka maʻamau. ʻAʻole ʻoe e ʻeha i ka wā o kēia mālama ʻana. Hiki ke hāʻawi ʻia iā ʻoe ka hoʻomaha a i ʻole ka anesthesia laulā.
He aha nā ʻano maʻi puʻuwai e mālama ʻia e kēia lāʻau?
Hoʻohana nui ʻia ka cardiac ablation e mālama i nā arrhythmias puʻuwai wikiwiki. ʻO kēia ka hopena maikaʻi loa ke hiki ʻole ke kāohi ʻia me ka lāʻau lapaʻau a i ʻole he mea hoʻoweliweli i ke ola.
E nānā i ka papa ma lalo nei e ʻike i nā kumu nui e hoʻohana ʻia ai kēia lāʻau lapaʻau.
| Ke Kūlana o ka Maʻi (ʻAno Arrhythmia) | I ka ʻōlelo maʻalahi, he aha ka mea e hana nei? |
|---|---|
| ʻO ka Atrial Fibrillation (AFib) a me ka Atrial Flutter (AF) | Ma kēia, kuʻi wikiwiki a kūlike ʻole nā keʻena ʻelua o luna o ka puʻuwai (atria). Me he mea lā e haʻalulu ana lākou. Hoʻoulu kēia i ke koko e hōʻiliʻili ma kahi hoʻokahi ma kahi o ka pamu pono ʻana, hiki ke alakaʻi i ka hoʻokumu ʻia ʻana o nā ʻōpū koko. Inā hele kēia mau ʻōpū koko i ka lolo, hiki iā lākou ke hana i kahi maʻi koʻikoʻi e like me ka hahau ʻana. |
| ʻO ka Tachycardia Supraventricular (SVT) | He puʻuwai koke kēia a wikiwiki loa (a hiki i 300 mau kuʻi i kēlā me kēia minuke). ʻOiai e hoʻopau pinepine ʻia kēia ma hope o kekahi manawa, inā hoʻomau a hana pinepine ʻia paha, hiki iā ia ke hōʻeha i ka puʻuwai. |
| ʻO ka Tachycardia Ventricular (VT) | He kūlana weliweli kēia. Hoʻomaka nā keʻena ʻelua o lalo o ka puʻuwai (ventricles) e kuʻi wikiwiki loa. Pale kēia i ka puʻuwai mai ka pamu ʻana i ke koko me ka pono. Hoʻonui kēia i ka pilikia o ka hopu koke ʻana o ka puʻuwai. |
Eia kekahi, hiki ke ʻōlelo ʻia kēia lāʻau lapaʻau no ka poʻe i loaʻa i ka pilikia nui o ka hopu koke ʻana o ka puʻuwai. I kekahi manawa, no ka ʻike pono ʻana i kahi e puka mai ai ka pilikia, hana nā kauka i kahi noiʻi electrophysiology (EP study) ma mua o kēia kaʻina hana ablation. Pili kēia i ka hoʻohana ʻana i kahi catheter e ana i nā hōʻailona uila i loko o ka puʻuwai.
Pehea e hoʻomākaukau ai ma mua o ka mālama ʻana?
Ke hoʻoholo kāu kauka e hana i kēia lāʻau lapaʻau, aia kekahi mau mea e pono ai ʻoe e hana. E wehewehe pono kāu kauka i kēia mau mea āpau iā ʻoe.
- Nā lāʻau hoʻokahe koko: Inā ʻoe e lawe ana i nā lāʻau hoʻokahe koko (e laʻa, apixaban, rivaroxaban, warfarin), e haʻi aku kāu kauka iā ʻoe i ka nui o nā lā ma mua o ka mālama ʻana e pono ai ʻoe e hoʻōki i ka lawe ʻana iā lākou. Mai hoʻōki i ka lawe ʻana i kēia mau lāʻau me ka ʻole o ke aʻo ʻana a kāu kauka.
- Meaʻai a me ka mea inu:E noi ʻia ʻoe e kāohi i ka ʻai ʻana a i ʻole ka inu ʻana no kekahi mau hola ma mua o ka mālama ʻana (mai ka manawa maʻamau mai ke aumoe).
- Kekahi e hoʻokele iā ʻoe i ka home: E hoʻonohonoho mua no kekahi e hoʻokele iā ʻoe i ka home ma hope o ka mālama ʻana.
- Nā lole a me nā mea pono: E ʻaʻahu i nā lole ʻoluʻolu ke hele mai ʻoe i ka haukapila. ʻOi aku ka maikaʻi o ka waiho ʻana i nā mea makamae e like me nā mea hoʻonani a me ke kālā ma ka home.
- Laina IV: Ma ka haukapila, hoʻokomo ʻia kahi ʻōmole liʻiliʻi (laina IV) i loko o kahi aa koko ma kou lima. Maanei e hāʻawi ʻia ai ʻoe i nā lāʻau lapaʻau e pono ai, ka saline, a me nā anesthetics.
He aha ka mea e hana ʻia i ka wā o ka mālama ʻana?
ʻAʻole kēia he mea weliweli e like me kou manaʻo. Penei ke kaʻina holoʻokoʻa:
1. Hoʻomākaukau: Ua kahi ʻia ka wahi e hoʻokomo ʻia ai ke catheter (ʻo ka ʻūhā maʻamau), hoʻomaʻemaʻe ʻia, a hoʻomānoʻo ʻia.
2. Ke hoʻokomo ʻana i ka ʻūpā: Hoʻokomo ʻia kahi ʻōmole liʻiliʻi (ʻūpā) ma o ka ʻili i loko o ke kīʻaha koko e hana i kahi alahele.
3. Hoʻokomo ʻana i ka catheter: Hoʻokomo ʻia nā catheter maikaʻi me nā electrodes ma ke ala i hoʻomākaukau ʻia. Alakaʻi pono ʻia kēia mau mea i ka puʻuwai me ke alakaʻi ʻole ʻia e ka X-ray.
4. Ke palapala ʻāina ʻana i ka pilikia: Ke komo i loko o ka puʻuwai, nānā ʻia nā hōʻailona e puka mai ana mai ke catheter e ʻike i kahi kikoʻī o nā hōʻailona uila hewa (mapping).
5. Lapaʻau (Ablation): Ke loaʻa ka wahi kūpono, e like me ka mea i ʻōlelo ʻia ma mua, mālama ʻia a hoʻopau ʻia ka ʻiʻo me ka hoʻohana ʻana i ka wela, ke anu, a i ʻole ka ikehu ʻē aʻe.
6. Hoʻopau ʻana: Ma hope o ka pau ʻana o ka mālama ʻana, wehe pono ʻia ke catheter a me ka ʻūpā a kau ʻia kahi plug a i ʻole ka humuhumu e hoʻōki i ke kahe ʻana o ke koko.
ʻO ka maʻamau, ʻo ke kaʻina hana holoʻokoʻa ma waena o 2 a me 4 mau hola, akā i kekahi manawa hiki ke lōʻihi.
He aha ka mea e hana ʻia ma hope o ka lāʻau lapaʻau?
Ma hope o ka mālama ʻana, e lawe ʻia ʻoe i kahi lumi hoʻōla no kekahi mau hola. E hoʻomau ke kahu maʻi i ka nānā ʻana i kou kūlana. Ma muli o kou kūlana, hiki paha iā ʻoe ke hoʻi i ka home i ka lā hoʻokahi, a i ʻole pono paha ʻoe e noho i ka haukapila i ka pō.
Ke hoʻi ʻoe i ka home, e hāʻawi ʻia ʻoe i kekahi mau kuhikuhi e hahai ai ma ka home. Hiki ke noi ʻia ʻoe e lawe i nā lāʻau hoʻokahe koko e pale aku i nā ʻūpā koko. Ma muli o kou mōʻaukala olakino, pono paha ʻoe e lawe i kēia mau lāʻau no kekahi mau mahina a ʻoi aku paha.
E hoʻomanaʻo, i ka wā e ho'ōla ai ka ʻiʻo puʻuwai i nā mahina 3 mua ma hope o ka mālama ʻana, e hoʻi hou mai paha kekahi o kāu mau hōʻailona kahiko. He mea maʻamau kēia. Akā e hoʻomaopopo i kāu kauka e pili ana i ia mea.
He aha nā pōmaikaʻi a me nā pilikia o kēia lāʻau lapaʻau?
E like me nā lāʻau lapaʻau a pau, loaʻa i kēia nā pono a me nā pōʻino liʻiliʻi.
Nā Pōmaikaʻi
- ʻO kēiaʻAʻole ia he ʻoki kino nui. ʻAʻole pono ʻoe e kāʻei ʻia kou umauma. No laila hiki iā ʻoe ke ho'ōla koke.
- Hāʻawi ia i ka manawa kūpono e ho'ōla mau loa i nā maʻi o ka puʻuwai i hiki ʻole ke kāohi ʻia me ka lāʻau lapaʻau.
- Hiki i kekahi ke hoʻopakele i nā ola mai nā kūlana hoʻoweliweli i ke ola.
- Hiki iā ʻoe ke hoʻopau i nā hopena ʻaoʻao o nā lāʻau lapaʻau.
Nā Pōʻino
He haʻahaʻa loa nā pilikia o ka cardiac ablation. He kākaʻikahi nā pilikia, ʻoiai ma kahi haukapila akamai e hana pinepine ana i kēia lāʻau. Akā he mea maikaʻi ke makaʻala.
- Nā ʻūpā koko
- Ka hōʻino ʻana i ke kīʻaha koko kahi i hoʻokomo ʻia ai ke catheter
- Ka hōʻino ʻana i nā ʻiʻo puʻuwai a i ʻole nā kīwae
- Ka maʻi a i ʻole ke kahe ʻana o ke koko
- Hahau
- Pono no kahi pacemaker mau loa (kākaʻikahi loa)
Āhea wau e hoʻomaka hou ai e hana ma ke ʻano maʻamau?
Hiki ke ʻokoʻa kou hoʻōla ʻana mai kēlā kanaka a kēia kanaka.
- Ke hoʻi nei i ka hana: Inā ʻoe e hana i kahi hana luhi ʻole, e like me ka hāpai ʻana i nā mea kaumaha, hiki iā ʻoe ke hoʻi i ka hana i loko o hoʻokahi pule.
- Hāpai kaumaha: Mai hāpai i kekahi mea kaumaha ma mua o 10 paona (ma kahi o 4.5 kg) no hoʻokahi pule.
- Hoʻoikaika kino a me ka hoʻokele ʻana: E nīnau i kāu kauka e pili ana i ka manawa kūpono e hoʻomaka hou ai i ka hoʻoikaika kino a me ka hoʻokele ʻana.
He aha nā hōʻailona e pono ai iaʻu e ʻike i ke kauka?
Inā ʻike ʻoe i kekahi o nā hōʻailona ma lalo nei ke hoʻi ʻoe i ka home ma hope o ka mālama ʻana, pono ʻoe e kāhea koke i kāu kauka . Pono paha kekahi mau hihia i ka mālama koke ʻia ma ka ʻOihana Pilikia o ka haukapila (ETU).
| Hōʻailona | He aha e hana ai |
|---|---|
| Ke kahe ʻana o ke koko, ka pehu ʻana, ka ʻeha, a i ʻole ka manaʻo puʻupuʻu ma kahi i hoʻokomo ʻia ai ke catheter. | E kamaʻilio me kāu kauka. |
| ʻEha ka umauma, ka poniuniu, a i ʻole ke poʻo māmā. | E kamaʻilio me kāu kauka. |
| Ka luaʻi a i ʻole ka luaʻi ʻana. | E kamaʻilio me kāu kauka. |
| Inā ua hana ʻia ka lāʻau lapaʻau ma ka ʻūhā, he mae wale, ʻeha, a he ʻūlū paha ma ka wāwae. | E kamaʻilio me kāu kauka. |
| E hele koke i ka ʻOihana Pilikia (ETU)! (Nā hōʻailona o ka hahau ʻana) | |
| E kulou ana kekahi ʻaoʻao o ka maka, he lima make. | He mau hōʻailona paha kēia o ka hahau ʻana. E hele koke i ka haukapila. |
| ʻO nā hōʻailona koʻikoʻi e like me ka puʻuwai wikiwiki, ka poniuniu, ka pōkole o ka hanu, a i ʻole ka ʻeha o ka umauma e hana a mau paha no nā hola ʻekolu. | E hele koke i ka haukapila. |
ʻO ka mea hope loa, he mea maʻamau ke hopohopo iki a hopohopo paha e pili ana i ke ʻoki ʻana a i ʻole ka mālama ʻana no kou puʻuwai. Eia nō naʻe, ʻo Cardiac Ablation kahi hana palekana a haʻahaʻa ka pilikia i hoʻohana pono ʻia e mālama i nā poʻe he nui me nā pilikia o ka puʻuwai. Inā he mau nīnau kāu e pili ana i kēia, e ʻoluʻolu e nīnau i kāu kauka. Ke maopopo iā ʻoe ke kaʻina hana, e hōʻoluʻolu ʻia kou mau makaʻu.
Leka Lawe-Home
- ʻO ka Cardiac Ablation kahi lāʻau lapaʻau minimally invasive i hoʻohana ʻia e hoʻoponopono i nā puʻuwai puʻuwai kūpono ʻole (arrhythmias).
- ʻO kēia ka loaʻa ʻana o kahi wahi liʻiliʻi o ka ʻiʻo puʻuwai e hana ana i nā hōʻailona uila hewa, mālama ʻia, a hoʻopau iā ia.
- He lāʻau lapaʻau holomua a palekana loa kēia, a he haʻahaʻa loa ka pilikia o nā pilikia.
- He mau pule paha e ho'ōla piha ai ka puʻuwai ma hope o ka mālama ʻana, a hiki ke hoʻi hou mai kekahi mau hōʻailona i loko o ia manawa.
- E hahai pono i nā ʻōlelo a kāu kauka ma hope o ka mālama ʻana, ʻoiai e pili ana i ka lāʻau lapaʻau a me ka hoʻomaha.
- Inā loaʻa iā ʻoe kekahi mau hōʻailona ʻē (ʻoi aku ka ʻeha o ka umauma, ka poniuniu nui, nā hōʻailona o ka hahau ʻana), e ʻimi koke i ke kōkua lapaʻau.
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