Mena kei te raru tonu te manawa o tō ngākau, arā, ko te Atrial Fibrillation (Afib), he mate manawa o tō ngākau, ahakoa te tango rongoā me ētahi atu maimoatanga, tera pea ka whakaaro koe kāore he otinga tuturu mō tēnei? I ētahi wā ka tino āwangawanga koe i tēnei āhuatanga. Kaua e manukanuka, nā te whanaketanga o te pūtaiao hauora, he tino whai hua ngā maimoatanga mō ēnei āhuatanga. Mō ēnei tāngata tonu te kōrero nei mō tēnei tikanga maimoatanga hou i tēnei rā.
He aha tēnei Tukanga Whakakotahi?
He whakarāpopototanga tēnei, he huinga o ngā maimoatanga e rua. Arā, he pokanga tapahi iti me te maimoatanga e kiia nei ko te catheter ablation . Ka kiia hoki tēnei he maimoatanga ranu.
Whakaarohia, he pūnaha tohu hiko tō tō tātou ngākau. Koinei te mea e pupuri ana i te ngākau kia tika te pao. I roto i te Afib, ka pōhēhē ēnei tohu, ā, ka tukuna e ngā rūma o runga (atria) o te ngākau ngā tohu tere, pōturi. I roto i te tikanga whakakotahi, ka mahi tahi ngā taote pokanga me ngā tākuta ngakau ki te hanga i ngā tapahi iti rawa i roto, i waho hoki o tō ngākau i te wāhi e puta mai ai ēnei tohu pōturi. Ka aukatihia e ēnei tapahi ngā tohu hiko pōturi kei haere. He rite ki te kati i te huarahi hē, ka whakahokia ngā waka ki te huarahi tika.
Mā wai tēnei maimoatanga e tino tika?
Ehara tēnei maimoatanga i te mea mā te katoa. He mea tino taunaki mō:
- Mō te hunga he Afib pumau .
- Mō te hunga e pāngia ana e ngā wā Afib ahakoa te tango rongoā me te whiwhi maimoatanga tango catheter paerewa.
Mena he rite tō āhua, ka taea e koe te kōrero ki tō tākuta kia whakatau ai mēnā he tika tēnei maimoatanga māu.
Me pēhea te whakarite i mua i te pokanga?
Pērā i ngā mahi pokanga katoa, he iti noa te whakarite e hiahiatia ana.
- Ngā rongoā whakaiti toto (anticoagulants): Mena kei te tango koe i ēnei rongoā, me mutu te tango i ēnei i ētahi rā i mua i te pokanga. Mā tō tākuta koe e kī atu e hia ngā rā i mua i te pokanga me ēhea ngā rongoā hei whakamutu. Kaua rawa e mutu te tango i ō rongoā me te kore he tohutohu a tō tākuta.
- Nohopuku: I mua i te pokanga, ka tonoa koe kia mutu te kai me te inu mō tētahi wā motuhake (nohopuku). Mā tō tākuta koe e whakamōhio atu mō tēnei wā.
I ētahi wā ka mahia ngā wāhanga e rua o tēnei maimoatanga i te rā kotahi. I ētahi wā ka mahia kia whā wiki te tawhiti. Mā tō rōpū hauora tēnei e whakamārama ki a koe.
Me pēhea te mahi i te pokanga?
E rua ngā wāhanga matua o tēnei maimoatanga. Me titiro tātou ki ngā mea ka puta i ia wāhanga.
| Wāhanga o te maimoatanga | He māmā noa iho te mea ka tupu. |
|---|---|
| Wāhanga Tuatahi: Pokanga (Te Maimoatanga o te Ngākau mai i Waho) | Kia oti rawa te whakamoe, ka tapahia he tapahi iti e te taote ngakau, tata ki te 3-4 henimita i raro i tō wheua uma (sternum). Kātahi ka tapahia te kiri angiangi e karapoti ana i te ngakau (pericardium) ka whakauruhia he kāmera (endoscope). Kātahi ka whakamahia he ngongo kawe hiko motuhake (catheter) hei rongoā (tapahi) i ngā wāhi o waho o te ngakau e whakaputa ana i ngā tohu hiko rerekē. Tata ki te haora me te hawhe te roa o tēnei wāhanga. |
| Wāhanga Tuarua: Te Whakakore i te Catheter (Te Maimoatanga mai i Roto i te Ngākau) | Ko te tikanga ka mahia tēnei wāhanga i tētahi atu rā, arā, i muri i ētahi wiki. I konei, ka whakauruhia e te tohunga ngakau (electrophysiologist) he catheter ki roto i tō ngākau mā roto i tētahi uaua i roto i tō hope. Kātahi ka rongoatia e ia te roto o tō ngākau , i ngā wāhi i uaua ki te toro atu i te wā o te pokanga o mua. Ka hoatu he rongoā whakamoe māmā, he rongoā whakamoe whānui rānei ki a koe i tēnei mahi. |
He aha te Convergent Plus?
I ētahi wā, i te wā kotahi o tēnei pokanga, ka mahi ngā tākuta i tētahi atu mea hei whakaiti i te mōrearea o te whiu. Arā, ka katihia e rātou tētahi wāhanga iti o te atrium maui o te ngākau (te apiti atrial maui). Ina tāpirihia ēnei mahi tāpiri, ka kiia e mātou he tikanga "Convergent Plus".
He aha ngā painga o tēnei maimoatanga?
He maha ngā painga motuhake o tēnei tikanga maimoatanga:
- Te auau angitu teitei: He angitu ake tēnei i te maimoatanga tango catheter noa nā te mea ka rongoatia te roto me te waho o te ngākau.
- Mōrearea iti:I te wā o tēnei pokanga, ka kitea mārama e ngā tākuta te korokoro, kei muri i te ngākau, nō reira he iti rawa te mōrearea o te pakaru.
- Ehara i te pokanga ngākau tuwhera: Kāore e hiahiatia kia mutu tō ngākau ka hono atu ki te mīhini ngākau-pūkahukahu (cardiopulmonary bypass).
He tūponotanga, he raruraru rānei kei reira?
Pērā i ngā pokanga katoa, tera pea ētahi mōrearea me ngā raruraru ka pā mai. Heoi, he onge ēnei i te nuinga o te wā. Kei roto i ēnei:
- Maremare
- Ngenge
- Te uaua ki te manawa
- Whiu
- Te toto
- Te kohikohinga wai huri noa i te ngākau (te pupuhi pericardial)
- Te pakaru o te io
- Te whakaekenga ischemic poto (TIA)
Kāore he take e manukanuka ai koe mō tēnei. Mā tō tākuta koe e whakamārama katoa i ngā mea katoa i mua i te pokanga.
Kia pēhea te roa o te wā e ora ai?
I muri i te wāhanga tuatahi o te pokanga, me noho koe ki te hōhipera mō te rā kotahi, e rua rānei. Mēnā ka oti te wāhanga tuarua, ka oti pea i roto i te toru marama pea.
Ka whakaritea kia kite anō koe i tō tākuta i a koe e ora ana. Ko te tikanga, e 3 wiki tēnei i muri i te pokanga, ā, i te 3, 6, me te 12 marama anō. I taua wā, ka hoatu pea he mīhini iti (Holter monitor) ki a koe ka mau ki tō uma mō ētahi rā hei aroturuki i te tere o tō manawa.
Āhea koe e hiahia ana ki te kite anō i te tākuta?
Ki te pāngia koe e ēnei tohu e whai ake nei, me whakamōhio tonu atu ki tō tākuta.
- Ki te hoki mai anō ngā tohu o te Afib (te tere o te patu o te ngākau, te kikī o te uma, te ngenge).
- Mena he toto, he mate pāwera rānei (pupuhi, whero, pupuhi) i te wāhi i tapahia ai te pokanga.
Karere Tangohia ki te Kāinga
- He maimoatanga hou, tino whai hua te Tukanga Huinga mō te Atrial Fibrillation (Afib) roa, kāore nei e taea te whakahaere e ngā rongoā, e ngā maimoatanga tuku iho rānei.
- He huinga tēnei o te pokanga me te rongoā whakauru catheter, nō reira ka taea te whakatika i ngā raruraru o roto, o waho hoki o te ngākau.
- He tino teitei te angitu o tēnei maimoatanga, ā, he poto noa te wā whakaora.
- Ko tō tākuta ngakau te tangata pai hei mōhio mēnā he tika tēnei maimoatanga māu. Kōrerohia ki a ia mō tēnei mea me te kore wehi, kātahi ka whakatau.
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