He aha te AFib (Atrial Fibrillation)? Me mārama noa iho.
He whakarāpopototanga noa iho, ko te Atrial Fibrillation (AFib) he āhua ngakau koretake e tīmata ana i ngā rūma o runga o tō ngākau (e kiia ana ko te atria). Hei whakamārama, kāore te pūnaha hiko o te tangata whai AFib e mahi tika ana. Engari ko te tuku i ngā tohu hiko i runga i te tikanga tika, e tika ana, ka tīmata te tuku i ngā tohu rerekē maha i te wā kotahi. Whakaarohia he tira nui, engari kaua ko te kaiārahi matua e ārahi ana i te tira, he maha ngā tāngata i ia taha e tuku whakahau ana i te wā kotahi. Kātahi ka kore ngā kaiwaiata e mōhio ko wai hei whakarongo, me te aha hei purei. Ka pōhēhē te puoro katoa, ā, kāore i te tika te rangi, tika? Koinei te mea e pā ana ki ngā rūma o runga o ō tātou ngākau me te AFib. Nō reira, ka tīmata ngā rūma o runga o te ngākau (atria) ki te patu i roto i te tere, i te pōrearea. Nō reira, kāore e taea e ēnei rūma o runga te whakaheke tika, ā, kāore e taea te pupuhi toto ki ngā rūma o raro (e kiia ana ko ngā ventricles). Ko ngā rūma o raro, e mahi ana i runga i ngā tohu mai i ngā rūma o runga, ka tīmata hoki te whakaheke koretake. Koinei te take e rongo ai koe me te mea kei te tere, kei te koretake hoki tō ngākau. Ko te manawa o te ngakau e rongohia ana e koe, e ahu mai ana i te kōpiritanga o ēnei rūma o raro (ngā ventricles). Ka taea e te atrial fibrillation te arahi ki ngā raruraru nui pērā i te whiu, te ngoikore rānei o te ngakau. Koia te mea nui kia mōhio koe ki ōna tohu me te kōrero ki tō tākuta mō ō āhuatanga mōrearea whaiaro.He aha ngā tohu o te AFib? Tirohia mēnā kei a koe anō ēnei tohu?
Ehara i te mea ka pāngia te katoa e te AFib e ngā tohu. Heoi anō, kei reira ētahi tohu noa:- He kare ā-roto rerekē, pērā i te pūrerehua e rere ana i roto i tō uma, i te ika rānei e tohe ana. I ētahi wā, ka tere ake te pao o tō ngākau , me te mea kei te pao i roto i tō uma (koinei te mea e kiia nei e tātou ko ngā 'palpitations o te ngākau ').
- Tino ngenge. Kāore e taea te mahi i tetahi mea.
- Pōuriuri , māuiui rānei te mahunga.
- Te ngaronga o te māramatanga (syncope).
- Te uaua ki te manawa (dyspnea). Te āhua nei kei te whakamomori noa koe.
- Mamae o te umaangina `).
He pēhea te kino o te AFib?
Ahakoa he tohu kei a koe, kāore rānei, he mate kino te AFib me aro nui ki tēnei mate. Ko tōna tikanga he rerekē te tere o tō ngakau. Ki te kore tō ngakau e patu tika, ka nui ake te tūponotanga o te whakawhanake i ngā toto totoka kino i roto i tō ngakau. Ki te haere ēnei totoka ki ngā whekau nui pēnei i tō roro ka ārai i a rātou, ka taea e rātou te whakaputa i ngā mate kino pēnei i te whiu. Ka puta anō hoki ētahi atu raruraru.Mena kei a koe ngā tohu o te AFib, me toro atu ki tō tākuta tonu.
Āhea koe me rapu tohutohu hauora tonu?
I ētahi wā, me haere tonu pea koe ki te rūma whawhati tata. Kei roto i ēnei ko:- Mena he mamae nui tōu uma .
- Mena ka tino uaua ki te manawa .
- Ki te ngaro tō māramatanga , ki te mea rānei kei te ngaro tō māramatanga.
He aha ngā mea ka puta ai te AFib?
Ko te nuinga o te wā, ko te Atrial Fibrillation e puta mai ana i ngā huringa o ngā kiko me te pūnaha hiko o tō ngākau. He maha ngā take pea o ēnei huringa:- Ētahi atu mate pūnaha manawa . Hei tauira, te mate uaua o te ngakau , te mate takirere, me te ngoikore o te ngakau .
- Ētahi atu āhuatanga hauora. Ngā mea pēnei i te toto toto tiketike, te momona, te hyperthyroidism, te mate tākihi mau tonu, me te apnea moe aukati .
- Ngā momo ira. Kua kitea e ngā rangahau tata nei he hononga ētahi momo ira ki te AFib. Koinei te take ka taea ai e ētahi rangatahi te pāngia e te AFib.
- Pokanga ngākau. Mena kua pokangahia tō ngākau mō tētahi atu take, ka taea te tīmata i te AFib i muri i taua pokanga. Ka taea hoki te puta te AFib i te wā e ora ana koe mai i ētahi atu pokanga kāore e pā ana ki te ngākau.
Ngā Take Tūpono e Whakanuia ai te Tūponotanga o te Whanaketanga o te AFib
Mena kei a koe tētahi o ngā mate hauora kua whakahuatia ake nei, he nui ake te tūponotanga ki te pāngia koe e te AFib. He maha atu anō ngā āhuatanga mōrearea:- Te pakeketanga. Ka piki ake tō tupono ki te pāngia e te AFib i a koe e pakeke haere ana, inā koa i muri i te 65 tau.
- Te nui rawa o te whakamahi waipiro.Mā te inu waipiro i te nui atu i ngā taumata kua tohua, inā koa te inu nui i te wā kotahi – e kiia ana e mātou ko te 'inu nui' – ka piki ake te mōrearea o te AFib.
- Mate kino. Ko ngā mate kino rawa atu e hiahiatia ana kia whakaurua ki te hōhipera (pēnei i te sepsis, te COVID-19 kino rānei) ka whakanui ake i te mōrearea o te AFib.
- Te kore o te korikori tinana. Ko te kore e nui te korikori tinana i te awatea ka taea hoki te waiho hei take o te AFib.
- Te whakangungu tinana tino kaha. He pai te whakakori tinana mō te ngākau, engari kāore e pai te nui rawa o te whakakori tinana. Ko te hunga e whakakori tinana ana mō te neke atu i te toru hāora i te rā mō ngā tau maha ka nui ake te mōrearea ki te pāngia e te AFib.
Me pēhea te tātaritanga tika a ngā tākuta i te AFib?
Ko te whakamātautau matua e whakamahia ana hei tātaritanga i te AFib he electrocardiogram, e mōhiotia ana ko te ECG (electrocardiogram) me te EKG rānei. Mā tēnei ka hangaia he kauwhata o ngā tohu hiko e haere ana i roto i tō ngākau. Ka taea e tēnei te āwhina i a koe ki te kite mēnā kei a koe te AFib, kei a koe rānei ētahi atu ngakau pākiki (arrhythmias). Hei tāpiri, ka mahi tō tākuta i ētahi atu mea:- Ka tirotirohia tō tinana, ā, ka pātaihia hoki mō tō hītori hauora.
- Ka whakahaua ngā whakamātautau toto hei tirotiro mō ētahi atu āhuatanga, inā koa ko ērā ka pā ki te mahere maimoatanga AFib.
- Tērā pea ka tonoa koe kia whai i tētahi echocardiogram (echo) hei tirotiro i te hanganga me te mahi a tō ngākau.
- Tērā pea ka tonoa koe kia mau i tētahi taputapu aroturuki (he 'Aroturuki Holter', he 'Aroturuki Ngā Mahi o te Ngākau' rānei) mō ngā hāora 24, neke atu rānei, hei hopu i ngā mahi hiko o tō ngākau i a koe e mahi ana i ngā mahi o ia rā.
He rerekē ngā wāhanga o te AFib?
Ae, he 'mate ahu whakamua' te AFib. Ko te tikanga ka taea e ia te haere i roto i ngā wāhanga rerekē, ā, ka kino haere i roto i te wā. Ka whakamahia e ngā tākuta ēnei wāhanga i te wā e tātaritanga ana, e rongoā ana hoki i te AFib:- Horopaki 1: Te hunga e mōrearea ana ki te AFib (`Kei te mōrearea ki te AFib`)
- Take 2: Pre-AFib (`Pre-AFib`)
- Take 3: AFib (`AFib`)
- Take 4: AFib Tuturu
Wāhanga 1: Kei te mōrearea mō te AFib
Ko te tikanga tēnei kei a koe ētahi āhuatanga mōrearea ka nui ake ai te tūponotanga ka pāngia koe e te AFib. Hei tauira:- toto toto tiketike
- Momonatanga
- Mate huka
- Te moe pōrearea
- Te nui rawa o te whakamahi waipiro
- Te mahi ngoikore o te pūnaha cardiovascular
- Neke atu i te 65 tau te pakeke
Wāhanga 2: Pre-AFib
I tēnei wā, tera pea ētahi huringa o te ngohe hiko, o te hanganga rānei o tō ngākau. Ka piki ake te tūponotanga o te whakawhanake i te AFib. Ko ngā tohu e rapuhia ana e ngā tākuta i tēnei wā ko:- Te tere o te ngakau (tachycardia atrial)
- Te wiri o te atrium
- Te whakanui ake i te atrium maui me/ranei matau
- Ngā manawa pāwera ectopic pinepine
- Te mate uaua koronari
- Te ngoikore o te ngākau
- Mate takirere ngakau
- Te mate taiaki toto nui
- Te uaua o te ngākau (hypertrophic cardiomyopathy)
- Ngā mate pūnaha io
Wāhanga 3: AFib
Ki te whakaūtia e te whakamātautau ECG kei a koe te Atrial Fibrillation, kei roto koe i tēnei wāhanga. Engari he rerekē ngā wāhanga iti o tēnei wāhanga. Tērā pea ka puta mai ngā tohumate ka haere noa iho. Tērā pea kei a koe te AFib tonu ahakoa te maimoatanga. Ahakoa ka ngaro ngā tohumate i muri i te maimoatanga, ka hoki mai anō pea i muri mai. Koia te take i wehea ai e ngā tākuta tēnei wāhanga kia whā ngā wāhanga iti:- Te Āpititanga o te Mate Pukupuku Ā-Wā ('Āpititanga Ā-Wāhanga'): Ka haere mai ngā tohu, ka haere. E kore e neke atu i te wiki te roa o ia wā, ā, he maha ngā wā ka memeha noa iho me te kore he maimoatanga. Tērā pea ka noho pōuri tonu koe i tēnei wā poto. He nui ake tō tūponotanga ki te pāngia e te whiu i te hunga kāore he Āpititanga.
- Te AFib pumau: Ka hoki mai anō ngā tohu, arā, ka hoki mai anō, ka hoki mai anō. Neke atu i te wiki te roa o ia wā. Me rongoā hei whakamutu i tēnei mate.
- Te roanga o te mate AFib: Ka roa te mau o ngā tohu mō te tau, neke atu rānei.
- I muri i te angitu o te tango i te AFib: Kua mutu te AFib i muri i te pokanga, i te tikanga rānei e whakamahi ana i te catheter.
Wāhanga 4: AFib Tuturu
Ko te tikanga o tēnei, kāore koe e whakamātau i ngā maimoatanga hei whakahaere i tō AFib, ā, ka noho tonu koe i roto i te AFib. Mā kōrua ko tō tākuta tēnei whakatau e whakatau, i runga i tō āhuatanga.He aha ngā maimoatanga mō te AFib?
Ko ngā maimoatanga mō te fibrillation atrial ka uru pea ki tētahi, neke atu rānei o ēnei e whai ake nei:- Ngā huringa āhua noho
- Ngā rongoā
- Te rongoā whakaweti
- Ētahi atu maimoatanga
Ngā huringa āhua noho
Koinei ngā mea ka taea e koe te mahi i ia rā hei āwhina i te ārai i te kino haere o te AFib. He mea nui ēnei huringa āhua noho i ngā wā katoa i te wā e pangia ana koe e te AFib — ahakoa kāore he tohu. Ka taea e tō tākuta te āwhina i a koe ki ēnei mea:- Kia mau tonu tō taumaha hauora.
- Whakawhāitihia te inu waipiro.
- Kaua e whakamahi i ngā hua tupeka.
- Whakamātauria te nui o te korikori tinana e taunakitia ana.
- Whakahaerehia ngā āhuatanga e whakanui ana i te mōrearea o te AFib, pērā i te toto toto tiketike, te momona, te apnea moe aukati, me te mate huka.
Rongoā
Tērā pea ka tohua e tō tākuta he rongoā hei whakahaere i tō tere o te ngakau me/ranei te tere o te ngakau. Ka taea e ēnei rongoā te āwhina i te ārai i te kino o tō ngakau me te whakaiti i ngā tohu e whakararuraru ana i a koe, e manukanuka ana rānei. Tērā pea ka tohua hoki e rātou he rongoā hei whakaiti i te mōrearea o te toto totoka ka puta ai te whiu. Ka rerekē pea ngā rongoā e hiahiatia ana e koe hei whakahaere i te AFib i roto i te wā. I te nuinga o te wā, ki te mea kei te mōrearea koe ki te pāngia e te whiu, me tango e koe he rongoā whakangawari toto (anticoagulants) . Ko te nuinga o te wā ka tohua e ngā tākuta he rongoā anticoagulants ā-waha (DOACs). Ngā tauira:- `Apixaban`
- `Rivaroxaban`
- `Dabigatran`
- `Edoxaban`
- `Carvedilol`
- `Digoxin`
- `Diltiazem`
- Metoprolol
- `Verapamil`
- `Amiodarone`
- `Dofetilide`
- `Dronedarone`
- `Flecainide`
- `Propafenone`
Te rongoā whakawete (Whakawete mō te AFib)
Ko te whakawātea i te kiri mō te AFib he kupu whānui mō tētahi rōpū maimoatanga e hanga ana i te kiko whara i roto i tō ngākau. Ahakoa e whakaarohia ana e tātou he mea kino te kiko whara, i tēnei wā, ka āwhina tēnei kiko whara i te pūnaha hiko o tō ngākau ki te mahi tika. Ka āraihia e tēnei kiko whara ngā tohu hiko rerekē, ā, ka āwhina i tō ngākau ki te patu i roto i te manawataki noa. Ko ngā maimoatanga motuhake ka tūtohu pea tō tākuta ngakau mō te AFib ko:- Te tango i ngā katitere: He maimoatanga iti noa te whakaekenga. Ka whakauruhia e te taote pokanga ngā ngongo angiangi (ngā katitere) mā roto i ō uaua toto ki roto i tō ngākau.Ko te tango i te uaua pūkahukahu (PVI) tētahi momo tango i te catheter e whakamahia whānuitia ana mō te AFib.
- Tukanga maze: E kiia ana hoki ko te tango pokanga, ko tēnei tikanga ka hangaia e te taote pokanga he tauira kiko kiri rite ki te maze e aukati ana i ngā tohu rerekē. Ko tēnei tango pokanga ka mahia i te wā kotahi me te pokanga ngākau mō tētahi atu take (pērā i te CABG, i te pokanga takirere rānei).
Ētahi atu maimoatanga
He maha atu anō ngā huarahi hei rongoā i te AFib:- Te Whakarerenga o te Kāti: Ka whakamahia e te tākuta he taputapu (defibrillator) he rongoā rānei hei whakahoki i te manawataki o tō ngakau kia noho noa.
- Te katinga o te hononga atrial maui (LAA): Ki te kore e taea e koe te aro ki ngā rongoā whakaiti toto, tera pea ka tika koe ki te whakamahi i tētahi taputapu ārai hononga atrial maui hei whakaiti i tō tupono ki te whiu. Ka katia e tēnei tikanga tētahi pēke iti i roto i te ngākau ka taea te hanga ngāwari i ngā toto toto.
Ka hoki anō te ngākau ki te āhua noa i muri i te AFib? He rongoā katoa kei reira?
Ae, i ētahi wā ka taea e tō ngākau te hoki ki tōna auau noa. Koinei te mea ka pā ki te hunga whai `Paroxysmal AFib`. Mena kei a koe te `Persistent`, te `Long-standing AFib` rānei, me rongoā koe hei whakamutu i te mate.Engari he mea nui kia mōhio koe kāore he rongoā mō te AFib. Kia pāngia koe e tēnei mate, ka noho tonu tēnei mate mō te wā katoa.Ka taea e tō tākuta te āwhina i a koe ki te whakahaere i tēnei āhuatanga. Mā te maimoatanga ka whakaiti i tō tuponotanga ki te whiu me te whakaiti i te kino o ō tohu.
Kia pēhea te roa ka taea e koe te ora me te AFib?
I kitea i roto i tētahi rangahau i whakaputaina i te tau 2024 he poto ake te roa o te oranga o te hunga whai AFib i te hunga kāore he AFib. Ko te maha o ngā tau e ngaro ana mai i tō rātou roanga oranga e whakawhirinaki ana ki tō rātou tau i te wā i kitea ai te mate. Ko te iti ake o rātou i te wā i kitea ai te mate, ko te poto ake o ō rātou roanga oranga, ā, ko te maha atu o ngā tau e ngaro ana i a rātou ki te whakatauritea ki ō rātou hoa kāore he AFib. Engari kia mahara, ko ngā tatauranga anake e kōrero ana i tētahi taha o te kōrero. Mā te mahi tahi me tō rōpū hauora ki te whakahaere i te AFib me ētahi atu mate hauora, ka nui ake tō tupono ki te ora roa.Me pēhea taku tiaki i ahau anō?
Ko ngā tikanga e whakaiti ana i tō tupono ki te pāngia e te AFib ka āwhina i a koe kia noho hauora ahakoa kei a koe te AFib.- He tino pai mō tō ngākau te kai i ngā kai totika me te whakakorikori tinana mō te 30 meneti i ngā rā e rima o te wiki . Hei whakangāwari ake i te whakakorikori tinana māu, ka taea e koe te wehewehe i ngā wā kia 10 meneti te roa.
- He tino pai hoki te whakarērea o ngā hua tupeka me te waipiro mō te ngākau.
Āhea ahau me kite i te tākuta?
Kāore he wātaka kua whakaritea mō tēnei. Kei runga i ō tohumate, i tāu mahere maimoatanga, me te hiahia kia tirohia anō koe i muri i tētahi maimoatanga. Nō reira, he mea nui kia kōrero tahi koe ki tō tākuta, kia whakatakoto tahi hoki i tētahi mahere.- Haere mai ki ō wā whakarite katoa.
- Puritia he rārangi o ngā rongoā e tangohia ana e koe, ā, mauria ki ia wā tirotiro a te tākuta. He mea pai anō hoki kia puritia te rārangi i roto i tō pēke, he mea āwhina hoki i roto i ngā āhuatanga ohorere.
- Kōrerotia ki tō tākuta ngā tohu hou, ngā raruraru rānei e pā ana ki a koe (hei tauira, ngā pānga taha o ngā rongoā) i ia wā tirotiro.
- Me pātai atu ki tō tākuta i mua i te tango i ngā rongoā kore utu (OTC) – hei tauira, ngā rongoā makariri me te rewharewha – me ngā tāpiringa kai, nā te mea ka pā pea ēnei hua ki tō tere o te ngakau, ka taunekeneke rānei ki ngā rongoā e tangohia ana e koe.
He aha ngā pātai me pātai atu koe ki te tākuta?
Anei ētahi pātai ka taea e koe te pātai atu ki tō tākuta:- Me pēhea taku whakaiti i aku āhuatanga mōrearea?
- Ka taea e koe te āwhina i ahau ki te whakapā atu ki tētahi tohunga kai?
- Ka taea e koe te tūtohu i ētahi kaupapa hauora me te whakapakari tinana i tēnei wāhanga?
- Kei tēhea taumata taku AFib?
- Ko ēhea ngā maimoatanga e pai ana mōku?
- He aha ngā pānga taha ka puta mai i te maimoatanga?
Ka taea e koe te tirotiro mō te AFib i te kāinga?
Ki te whakaaro koe kei a koe ngā tohu o te AFib, he mea nui kia kōrero tonu atu koe ki tō tākuta, me te kōrero atu ki a rātou mō ō kare ā-roto. Tērā pea ka tono atu tō tākuta kia tirohia e koe tō manawa. Mēnā he āhua rerekē, he ngoikore rānei, he tohu pea tēnā kei a koe te AFib. Engari i ētahi wā, kāore pea koe e kite i ngā huringa o tō manawa, inā koa mēnā kāore tō AFib i te kino. Engari, tērā pea ka ngenge noa koe, ka poto rānei te manawa. Kāore pea koe e mōhio mēnā nā te AFib, nā tētahi atu mea rānei ō tohu. Koia te mea nui kia kōrero koe ki tō tākuta. Kāore e taea e koe te tautuhi i a koe anō me te AFib.He pēhea te noa o te AFib?
Neke atu i te 33 miriona tāngata neke atu i te 55 tau te pakeke puta noa i te ao kua tātaritatia kei te mate AFib. I te United States anake, e matapaetia ana ka mate te 12 miriona tāngata i te AFib i te tau 2030. Tata ki te haurua miriona ngā tāngata e noho hōhipera ana i te United States i te AFib, ā, kei te piki haere te maha o ngā mate mai i tēnei mate i ia tau. He mea whakamataku, he mea whakapoauau, he mea taumaha rānei te mōhio kei te mate koe i te AFib. Engari ehara koe i te mea ko koe anake. Ko koe tētahi o ngā miriona tāngata e ako ana i ngā huarahi hou ki te whakahaere i te AFib me te noho harikoa tonu. Ka taea e tō tākuta te kōrero atu ki a koe mō ngā kōwhiringa maimoatanga, ngā rauemi, me ngā hapori tautoko.Hei whakarāpopototanga (Karere hei tango ki te kāinga)
Āe, ko tāku tumanako kua mārama ake tō whakaaro mō te AFib i kōrerohia e tātou.He pākia te ngakau o te ngakau e te AFib. Tērā pea he kino rawa atu, engari ki te tika te whakahaere, ka taea e koe te noho ora.
- Kia tūpato ki ngā tohu. Ki te pāngia koe e te mamae o te uma i ngā wā katoa, te ngenge rawa, te whanoke rānei, me toro atu ki te tākuta.
- Whakaitihia ngā āhuatanga mōrearea. Kia ora te noho.
- Me whai i te maimoatanga kia rite ki tā te tākuta i kī ai. Tangohia tō rongoā i te wā tika, ā, me haere ki ngā whakamātautau kua whakaritea.
- Kāore koe i te mokemoke. He tokomaha te hunga e noho ana me tēnei mate. Inoi atu ki te āwhina mēnā e hiahia ana koe.
Te tere o te manawa, te tere o te manawa kāore i te rite, te Atrial Fibrillation, te AFib, te mate manawa, te mōrearea o te whiu, te whakaeke ngakau, ngā tohu o te AFib, te maimoatanga o te AFib, te tere o te manawa











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