Puʻuwai kūpono ʻole? E aʻo kākou i nā mea āpau e pili ana i ka mālama ʻana i ka Pulmonary Vein Isolation (PVI)!

I kekahi manawa, manaʻo paha ʻoe ʻaʻole e kuʻi ana kou puʻuwai i kahi mele, i kekahi manawa ke kuʻi wikiwiki nei kou puʻuwai, me he mea lā e lele ana, a i ʻole ua hala kekahi mau kuʻi. ʻAʻole kēia ʻano puʻuwai kūpono ʻole he mea e lawe māmā ʻia. Ua kapa ʻia kēia ʻo Atrial Fibrillation (Afib) i ka ʻepekema lapaʻau. I kēia lā e kamaʻilio mākou e pili ana i kahi kaʻina hana kūikawā i hoʻohana ʻia ma ke ʻano he lāʻau lapaʻau no kēia ʻano.

I ka ʻōlelo maʻalahi, he aha ka Pulmonary Vein Isolation (PVI)?

ʻO ka Pulmonary Vein Isolation kahi hana kūikawā i hoʻohana ʻia e mālama i kahi puʻuwai puʻuwai kūpono ʻole i kapa ʻia ʻo Atrial Fibrillation (Afib). I nā huaʻōlelo maʻalahi, "hoʻokaʻawale" a hoʻokaʻawale paha ia i nā wahi kahi i hana ʻia ai nā hōʻailona uila e kāohi ana i ka mele o ka puʻuwai.

E noʻonoʻo i kēia ʻano. He ʻōkana kupaianaha ko kākou puʻuwai. Hoʻomalu ʻia kona kuʻi ʻana e kahi ʻōnaehana palupalu loa o nā hōʻailona uila. Akā i loko o ke kanaka me kēia maʻi i kapa ʻia ʻo Afib, hoʻomaka nā keʻena ʻelua o luna o ka puʻuwai (kapa mākou i kēia mau mea ʻo atria) e loaʻa nā hōʻailona uila hewa a ʻano ʻole. ʻO kēia mau hōʻailona hewa ke kumu o ka kuʻi wikiwiki ʻana o ka ʻaoʻao o luna o ka puʻuwai, me he mea lā e haʻalulu ana. Inā hoʻomau kēia, kiʻekiʻe loa ka pilikia o nā maʻi koʻikoʻi e like me ka hahau ʻana .

No laila, ua ʻike anei ʻoe i kahi e hoʻomaka pinepine ai kēia mau hōʻailona uila hewa? ʻEhā mau aa koko e lawe ana i ke koko maʻemaʻe a me ka oxygen mai ko mākou mau māmā a i ka atrium hema o ka puʻuwai. ʻO kēia nā mea a mākou e kapa nei ʻo Pulmonary Veins . Aia a puni kēlā mau aa koko ʻehā e hoʻomaka pinepine ai nā hōʻailona hewa e hoʻoulu ai iā Afib.

ʻO ka mālama ʻana i ka Pulmonary Vein Isolation (PVI) e pili ana i ka ʻike ʻana i kahi e hoʻomaka ai nā hōʻailona ʻē aʻe a me ka hana ʻana i kahi pale liʻiliʻi e pale ai iā lākou mai ka hiki ʻana i nā ʻāpana ʻē aʻe o ka puʻuwai. Hana ʻia kēia pale ma ka hoʻohana ʻana i ka wela mālie loa a i ʻole ke anu nui e hana i kahi liʻiliʻi o nā ʻiʻo ʻeha ma kēlā mau wahi. Pale kēia ʻiʻo ʻeha i nā hōʻailona uila ʻē aʻe mai ka hele ʻana ma mua o kēlā wahi. Ua like ia me ka pani ʻana i kahi ala hewa. A laila hoʻomaka hou ka puʻuwai e kuʻi maʻamau. Ua kapa ʻia kēia kaʻina hana ʻo Heart Ablation .

ʻO wai ka mea e pono maoli ai kēia lāʻau lapaʻau?

ʻAʻole no nā kānaka a pau kēia lāʻau lapaʻau. E noʻonoʻo kāu kauka i kekahi mau mea ma mua o ka hoʻoholo ʻana inā kūpono ia iā ʻoe. ʻOi aku ka maikaʻi o kēia lāʻau lapaʻau no kēia mau poʻe:

• No ka poʻe e loaʻa mau ana nā hōʻailona (piʻi ka puʻuwai, luhi, pōkole o ka hanu) ʻoiai ke lawe nei i nā lāʻau antiarrhythmic e kāohi i ko lākou maʻi Afib.
• Inā hoʻoulu kēia mau lāʻau i nā hopena ʻaoʻao a inā ʻaʻole hiki i ke kino ke ʻae i ka lāʻau.

Hiki ke hana i kēia lāʻau me ka ʻole o ka hoʻohana ʻana i ka lāʻau lapaʻau?

He pilikia kēia i loaʻa i nā poʻe he nui. Ke noiʻi nei nā kānaka noiʻi inā ʻoi aku ka maikaʻi o ka PVI no kekahi mau maʻi ma mua o ka lāʻau lapaʻau. Ua hōʻike kekahi mau noiʻi he ʻoi aku ka maikaʻi o ka PVI ma mua o ka lāʻau lapaʻau. Akā, ʻaʻole ia he lāʻau lapaʻau maʻamau. No laila, ʻo ke ʻano o kēia manawa, ʻo ia ka hoʻāʻo mua ʻana i ka lāʻau lapaʻau a laila e noʻonoʻo i ka PVI inā ʻaʻole ia e holo pono.

Pehea ʻoe e ʻike ai inā kūpono kēia lāʻau lapaʻau iā ʻoe?

ʻAʻole hiki ke ʻōlelo koke inā kūpono ʻoe no kēia. Pono ʻoe e hana i kahi hoʻokolokolo olakino piha. E nīnau mua ke kauka e pili ana i kou mōʻaukala olakino a hana i kahi hoʻokolokolo kino. A laila e kauoha ʻo ia i kekahi mau hoʻokolohua e pili ana i ka puʻuwai. ʻO kekahi o lākou:

• Echocardiogram: Hiki i kēia ke hāʻawi i kahi kiʻi maopopo o ka hana a me ke ʻano o ka puʻuwai.
• Electrocardiogram (EKG): He hoʻāʻo e hoʻopaʻa i ka hana uila o ka puʻuwai.
• Nānā Holter: He mīkini EKG liʻiliʻi kēia i hoʻopili ʻia i kou kino no 24 a i ʻole 48 mau hola. Hiki iā ia ke nānā i ke ʻano o ka loli ʻana o kou puʻuwai i ka lā a pau.

Na ke kauka e hoʻoholo hope loa inā kūpono ka mālama ʻana o ka PVI iā ʻoe ma muli o nā hopena o kēia mau hoʻokolohua.

Pehea e mālama ʻia ai ka PVI? He aha nā ʻano hana nui?

ʻO ka Pulmonary Vein Isolation kahi ʻano lapaʻau i kapa ʻia ʻo Catheter Ablation . ʻO ke ʻano kēia, ʻaʻole ia e hana ʻia ma ka hana ʻana i kahi ʻoki nui ma ka umauma e like me ke ʻoki ʻana. Akā, hana ʻia ia ma ke komo ʻana i kahi paipu lahilahi a lōʻihi (catheter) ma o kahi kīʻaha koko nui ma ka ʻāʻī a i ʻole ka ʻāʻī a i loko o ka puʻuwai.

ʻElua ala nui e hoʻoponopono ai i ka ʻiʻo palapū a mākou i ʻōlelo ai ma mua.

ʻO wai o kēia mau ʻano hana ʻelua ka mea maikaʻi loa?

ʻAʻohe ala e ʻōlelo ai he ʻoi aku ka maikaʻi o kekahi ʻano hana ma mua o kekahi. Loaʻa i nā mea ʻelua ko lākou mau pono a me nā hemahema. Ua hōʻike ʻia e ka noiʻi ʻaʻohe ʻokoʻa koʻikoʻi i nā hopena a me ka palekana o kēia mau ʻano hana ʻelua. E wehewehe kāu kauka iā ʻoe ma mua o ka mālama ʻana i ke ʻano hana kūpono loa iā ʻoe.

He aha ka mea e hana ʻia i ka wā o ka mālama ʻana? E ʻeha anei au?

ʻO ka maʻamau, i ka wā o kēia lāʻau lapaʻau, ua hoʻopau loa ʻia ʻoe (General Anesthesia) . ʻO ke ʻano kēia e hiamoe loa ʻoe. No laila, ʻaʻole ʻoe e ʻike i kekahi ʻeha a ʻoluʻolu ʻole paha i ka wā o ka lāʻau lapaʻau. Ke ala ʻoe, e pau nā mea āpau. I kekahi mau hihia kūikawā, hiki ke hana ʻia kēia ma ka hoʻomānoʻo wale ʻana i ka wahi kūpono (local anesthetic). E hoʻomaopopo ke kauka iā ʻoe e pili ana i kēia ma mua.

He aha ka mea e hana ʻia ana i kēlā me kēia ʻanuʻu

1. Hoʻomākaukau: ʻO ka mea mua, e hoʻomaʻemaʻe ʻia ʻoe. A laila, e hoʻomaʻemaʻe ʻia a hoʻomāʻū ʻia ka wahi ma kou ʻūhā a i ʻole ka ʻāʻī kahi e hoʻokomo ʻia ai ke catheter.

2. Hoʻokomo ʻana i ka catheter: E hoʻokomo ke kauka i ʻelua mau catheter lahilahi (nā paipu) mai ka wahi mae ma o kahi kīʻaha koko i loko o ka atrium hema o ka puʻuwai.

3. Ka ʻike ʻana i nā hōʻailona: Hoʻolālā pololei kahi catheter i kahi e puka mai ai nā hōʻailona uila hewa.

4. Ablation: Hāʻawi ka catheter ʻē aʻe i ka wela (Radiofrequency) a i ʻole ke anu (Cryoablation) a mākou i kamaʻilio ai, e luku ana i nā ʻiʻo pili a hana i ka ʻeha.

5. Hoʻopau ʻana: Ma hope o ka hoʻopau pono ʻana o ka lāʻau lapaʻau, wehe pono ke kauka i nā catheters ʻelua a kau i kahi kāʻei liʻiliʻi ma luna o nā wahi i hoʻokomo ʻia.

Pehea e nānā ʻia ai koʻu puʻuwai i ka wā o ka mālama ʻana?

E hoʻomau ka hui lapaʻau i ka nānā ʻana i kou puʻuwai a me kāu hana kino i ka manawa a pau āu e noho ana ma lalo o ka anesthesia, me ka hoʻohana ʻana i kekahi mau mea hana.

Hiki i ke kaʻina hana holoʻokoʻa ke hala ma waena o ʻehā a ʻeono hola , no laila he manaʻo maikaʻi e hoʻomaopopo mua i kou ʻohana. Pono paha ʻoe e noho i ka haukapila i ka pō ma hope o ka mālama ʻana.

He aha ka mea e hana ʻia ma hope o ka lāʻau lapaʻau?

Ma hope o ka pau ʻana o ka lāʻau lapaʻau, e kamaʻilio ke kauka me ʻoe a me kou ʻohana e pili ana i nā hopena. Pono ʻoe e hoʻomaha ma kahi moe no kahi o ʻehā a ʻewalu hola. E nānā nā kahu maʻi i kou helu puʻuwai a me kou mele i ka pō a pau. I ka hapanui o nā hihia, hiki iā ʻoe ke hoʻi i ka home i ke kakahiaka aʻe. Ma mua o kou hoʻi ʻana i ka home, e nānā nā kahu maʻi i nā wahi catheter a wehe i nā kāʻei a hoʻomaʻemaʻe iā lākou.

He aha nā pilikia e hiki mai ana?

He lāʻau palekana loa ka PVI ma ke ʻano laulā. Eia nō naʻe, e like me nā kaʻina hana lapaʻau āpau, aia kahi pilikia liʻiliʻi. ʻAʻole pinepine loa ia mau mea.

• He maʻi alerika i ka dye hoʻohālikelike i hoʻohana ʻia no nā kukuna X.
• Ka maʻi ma kahi i hoʻokomo ʻia ai ke catheter.
• Ka hōʻino ʻana i ka paia o ka puʻuwai (ma kahi o 1% ka pilikia).
• Ka hōʻino ʻia ʻana o nā aʻa pulmonary (ma kahi o 1% ka pilikia).
• Hahau (ʻo ka pilikia ma kahi o 0.5%).

Mai makaʻu i kēia mau pilikia. E hana kāu hui lapaʻau i kā lākou mea maikaʻi loa e pale aku i kēia mai ka hana ʻana. E wehewehe kāu kauka i kēia mau mea āpau iā ʻoe ma mua o ka mālama ʻana.

Ka manawa ho'ōla a me ka mālama ma hope

I loko o nā lā ʻelua mua (48 mau hola) ma hope o ka mālama ʻana, hiki iā ʻoe ke manaʻo i kahi ʻeha iki, luhi, a i ʻole ka ʻeha o ka umauma. He mea maʻamau kēia. Ma hope o kēlā, hiki iā ʻoe ke hoʻi mālie i kāu mau hana maʻamau. Eia nō naʻe , hiki ke hala kekahi mau pule ma mua o kou hiki ke hoʻi hou i nā hana ikaika, e like me ka hoʻoikaika kino.

E kuhikuhi ʻia ʻoe i kekahi mau lāʻau lapaʻau no kekahi mau mahina ma hope o ka mālama ʻana:

• Nā lāʻau antiarrhythmic: E kāohi i ka ʻōʻō o ka puʻuwai a hiki i ka loaʻa ʻana o nā hopena o ka ablation.
• Nā Anticoagulants (nā mea hoʻokahe koko): E hōʻemi i ka pilikia o ka hahau ʻana. Pono paha ʻoe e hoʻomau i ka lawe ʻana i kēia mau lāʻau lapaʻau.

E loaʻa iā ʻoe kāu manawa hoʻokolokolo mua ma hope o ʻekolu a ʻehā mahina ma hope o ka lāʻau lapaʻau, a ʻo ka mea aʻe ma kahi o hoʻokahi makahiki ma hope. I loko o kēia mau manawa hoʻokolokolo, hiki i kāu kauka ke hana hou i nā hoʻokolohua e like me ka CT scan, echocardiogram, a i ʻole EKG e nānā i ke kūlana o kou puʻuwai.