Ese umutima wawe usa n'aho umeze nabi cyane? Reka tuvuge kuri Atrial Fibrillation (AFib)!

Ese hari igihe wumva umutima wawe urimo gutera nk'ingoma, cyangwa urimo gutera nk'umusazi mu buryo butunguranye? Cyangwa wumva umeze nk'ikinyugunyugu kiri kuguruka mu gituza cyawe, cyangwa ifi irimo kurwana? Ibi bishobora kuba atari ibintu bikugaruka mu mutwe gusa. Bishobora kandi kuba ikimenyetso cy'indwara y'umutima yitwa 'Atrial Fibrillation' (AFib) . Rero, uyu munsi turaganira kuri iyi AFib mu buryo bworoshye ushobora gusobanukirwa.

Igisebe cyo mu mutwe (AFib) ni iki? Mu magambo make...

Mu magambo make, Atrial Fibrillation (AFib) ni ugutera k'umutima mu buryo budasanzwe biba mu byumba bibiri byo hejuru by'umutima wawe, byitwa atria . Imitima yacu ifite sisitemu y'amashanyarazi yohereza ibimenyetso ku mutima kugira ngo utere mu buryo busanzwe kandi buri ku murongo. Ariko mu mutima w'umuntu urwaye AFib, iyi sisitemu y'amashanyarazi ntikora neza. Aho kohereza ibimenyetso mu buryo buteguye, yohereza ibimenyetso byinshi bitandukanye icyarimwe.

Tekereza umutima wawe nk'itsinda ry'abaririmbyi. Ubusanzwe, hari umuyobozi umwe utanga ibimenyetso kandi agatuma imivugo icuranga neza. Ariko muri AFib, aho kuba umuyobozi umwe, hari abantu benshi batanga ibimenyetso mu byerekezo bitandukanye. Hanyuma abagize itsinda ry'abaririmbyi ntibasobanukiwe uwo bacuranga. Umuziki uragoye rwose, si byo se? Uko ni ko AFib ituma icyumba cyo hejuru cy'umutima, atria, gitangira gucuranga vuba cyane kandi mu buryo butunguranye.

Kubera ko atria idakora neza, ntishobora kohereza amaraso neza mu byumba biri hasi mu mutima, ari byo byitwa ventricles . Inkondo zisubiza ibimenyetso biva kuri atria, maze zigatangira gukora nabi mu buryo butunguranye. Umutima wumva uterwa no gukora nabi kw'izi nkondo. Rero, muri AFib, uku gutera kw'amaraso kuba kwihuta kandi kudasanzwe.

Wamenya ute ko ufite AFib? Ni ibihe bimenyetso?

Si abantu bose bafite AFib bafite ibimenyetso. Ariko, hari ibimenyetso bimwe na bimwe bisanzwe. Niba ufite kimwe muri ibi bimenyetso, ni byiza kujya kwa muganga.

• Bimeze nk'ikinyugunyugu kiri mu gituza cyawe, nk'ifi iri kurwana . Cyangwa se bikumva umutima wawe urimo gutera cyane kandi ukubita mu gituza cyawe. Mu buvuzi, ibi tubyita kandi "gutera umutima mu nda" .
• Kumva unaniwe cyane ni "umuruho ukabije" . Si ukunanirwa gusa, ahubwo ni ukunanirwa cyane ku buryo ntacyo ushobora gukora.
• Kuzungera cyangwa kugira umutwe ukeye .
• Hari igihe ushobora gucika intege (syncope).
• Guhumeka bigoranye (dyspnea) . Ushobora kumva umeze nk'aho ufite ikibazo cyo guhumeka nubwo waba ufite imbaraga nke.
• Kubabara mu gituza cyangwa gufungana (angina).

Niba ufite kimwe cyangwa byinshi muri ibi bimenyetso, ntukabirengagize.

Ese AFib ni indwara ikomeye?

Yego, AFib ni indwara ikomeye . Waba ufite ibimenyetso cyangwa udafite, kugira AFib bivuze ko umutima wawe utera mu buryo butari bwo. Iyo umutima wawe udatera neza, hari amahirwe menshi y'uko amaraso ashobora kuzura mu mutima wawe. Iyo ayo maraso acitse mu mutima wawe akajya mu gice cy'ingenzi nk'ubwonko bwawe, ashobora gutera indwara ikomeye yitwa stroke . Nanone, niba ufite AFib igihe kirekire, umutima wawe ushobora gucika intege ugacika intege, bigatera indwara yitwa umutima gucika intege .

Kubwibyo, niba ufite ibimenyetso bya AFib, ni ngombwa cyane gushaka inama kwa muganga byihutirwa .

Muri iki gihe, hamagara 1990 ako kanya cyangwa ujye ku bitaro biri hafi yawe:

• Niba ufite ububabare bukomeye mu gituza .
• Niba ufite ikibazo gikomeye cyo guhumeka .
• Niba urimo guta umutwe cyangwa wumva ushaka guta umutwe .

Kuki AFib ibaho? Ni izihe mpamvu?

Impamvu nyamukuru itera AFib ni impinduka mu mitsi y'umutima n'imikorere y'amashanyarazi. Hari ibintu byinshi bishobora kugira ingaruka kuri izi mpinduka:

• Izindi ndwara z’umutima n’imitsi: Urugero, indwara nk’indwara y’imitsi ifata umutima, indwara y’imitsi ifungana, no kunanirwa k’umutima bishobora gutera AFib.
• Izindi ndwara: Umuvuduko ukabije w'amaraso, umubyibuho ukabije n'umubyibuho ukabije, hyperthyroidism, indwara zidakira z'impyiko, hamwe n'indwara yo guhumeka mu gihe cyo gusinzira.
• Ibintu bitera imiterere y’uturemangingo: Ubushakashatsi buherutse bwagaragaje ko itandukaniro ry’uturemangingo rimwe na rimwe rifitanye isano n’iterambere rya AFib. Izi ngaruka z’uturemangingo rimwe na rimwe zishobora kuba impamvu ituma AFib ikura ikiri nto.
• Kubagwa k'umutima: AFib ishobora no kubaho nyuma yo kubagwa umutima kubera izindi mpamvu. AFib ishobora no kubaho mu gihe cyo gukira nyuma yo kubagwa umutima.

Ni ibihe bintu bindi byongera ibyago byo kurwara AFib?

Uretse indwara zavuzwe haruguru, hari izindi mpamvu nyinshi zongera ibyago byo kurwara AFib:

• Imyaka igenda yiyongera: Ibyago byo kurwara AFib byiyongera uko umuntu akura, cyane cyane nyuma y'imyaka 65 .
• Kunywa inzoga nyinshi: Kunywa inzoga zirenze urugero rwategetswe, cyane cyane kunywa inzoga nyinshi, byongera ibyago byo kurwara AFib.
• Indwara zikomeye: Ingaruka zo kurwara AFib ziyongera iyo ufite indwara zikomeye ku buryo zisaba kujya mu bitaro (urugero: sepsis, kwandura COVID-19 gukabije).
• Kudakora imyitozo ngororamubiri:Kudakora imyitozo ngororamubiri ihagije ya buri munsi ni indi mpamvu itera AFib.
• Imyitozo ngororamubiri ikabije: Nubwo imyitozo ngororamubiri ari myiza ku mutima, ikintu cyose kirenze urugero si cyiza. Abantu bakora imyitozo ngororamubiri amasaha arenga atatu ku munsi, mu myaka myinshi, nabo bafite ibyago byinshi byo kurwara indwara ya AFib.

Ni gute abaganga basuzuma indwara ya AFib?

Ikizamini cy'ingenzi cyane kugira ngo umenye neza niba ufite AFib ni ECG cyangwa EKG (Electrocardiogram) .

• Ibi bikorwa ukoresheje uburyo umutima wawe ukora ku gishushanyo mbonera. Mu kureba iyo gishushanyo, muganga wawe ashobora kumenya neza niba ufite AFib cyangwa izindi ndwara z’umutima (arrhythmias).

Byongeye kandi, muganga azakora ibi bikurikira:

• Bazagusuzuma umubiri kandi bakubaze amateka y'ubuzima bwawe.
• Gupima amaraso bishobora gutegekwa. Ibi bishobora gufasha kumenya niba hari izindi ndwara cyangwa niba hari indwara ishobora kugira ingaruka kuri gahunda yo kuvura ya AFib.
• Hashyizweho ikizamini cya echocardiogram (echo) . Ibi bishobora gukoreshwa mu gusuzuma neza imiterere n'imikorere y'umutima.
• Ushobora guhabwa moniteri nto (Holter monitor cyangwa cardiac event monitor) ushobora kwambara iminsi mike cyangwa icyumweru. Iyi moniteri ishobora kwandika imikorere y'umutima wawe mu gihe ukora imirimo yawe ya buri munsi ndetse no mu gihe usinziriye.

Ese hari ibyiciro bitandukanye bya AFib?

Yego, AFib ni indwara "ikomeza" ("progressive"). Ni ukuvuga ko ishobora kunyura mu byiciro bitandukanye ikarushaho kuba mibi uko igihe kigenda gihita. Abaganga basuzuma ibi byiciro iyo basuzuma kandi bakavura AFib:

• Icyiciro cya 1: Hari ibyago byo kwandura AFib
• Icyiciro cya 2: Pre-AFib
• Icyiciro cya 3: AFib `(AFib)` (Iki kandi gifite ibice bito byinshi)
• Icyiciro cya 4: AFib ihoraho

Icyiciro cya 1: Hari ibyago byo kwandura AFib

Ibi bivuze ko ufite ibintu bishobora gutuma ibyago byo kurwara AFib byongera. Urugero:

• Umuvuduko ukabije w'amaraso
• Umubyibuho ukabije
• Diyabete
• Kugona no guhumeka nabi (Sleep apnea)
• Gukoresha inzoga nyinshi
• Indwara z'umutima n'imitsi
• Imyaka irenga 65

Niba ufite ibi bintu, ushobora kuba uri mu kaga ko kurwara AFib.

Icyiciro cya 2: Pre-AFib

Muri iki gihe, ushobora kubona impinduka zimwe na zimwe mu mikorere y'amashanyarazi cyangwa imiterere y'umutima wawe. Ibi byongera ibyago byo kurwara AFib. Abaganga bareba ibimenyetso nk'ibi:

• Tachycardia y'umutima
• Igitutu cy'umutima
• Atriamu yagutse ibumoso cyangwa iburyo
• Umutima ukunze gutera cyane mu nda

Nanone, abantu bafite indwara zibashyira mu kaga gakomeye ko kurwara AFib, nka `(Indwara y'imitsi itera amaraso mu mutima)`, `(Kunanirwa k'umutima)`, `(Indwara y'imitsi itera umutima)`, `(Hyperthyroidism)`, `(Hypertrophic cardiomyopathy)`, na `(Indwara z'imitsi)`, bashobora kugwa muri iki cyiciro cya kabiri.

Icyiciro cya 3: AFib (hari n'ibice byayo)

Iyo ECG yemeje ko ufite AFib, uba uri muri iki cyiciro. Ariko iki cyiciro gishobora gutandukana. Hari abantu bagira ibimenyetso biza bikanagenda, abandi bagakomeza kugira AFib nubwo bavuwe. Niyo mpamvu abaganga bagabanya iki cyiciro mo ibice bine:

• AFib yo mu bwoko bwa Paroxysmal: Muri ubu bwoko bwa AFib, AFib ibaho rimwe na rimwe kandi igakira ubwayo mu cyumweru kimwe, akenshi nta kuvurwa. Ariko, ushobora kugira ikibazo muri iki gihe gito. Ufite ibyago byinshi byo kurwara indwara yo mu bwonko kurusha abantu badafite AFib.
• AFib ihoraho: Iki ni igihe AFib ikomeza , bivuze ko imara icyumweru kirenga. Hakenewe kuvurwa kugira ngo ihagarare.
• AFib ihoraho igihe kirekire: Muri iki gihe, AFib ikomeza mu gihe cy'umwaka umwe cyangwa irenga.
• Nyuma yo kuvurwa neza: AFib yahagaze nyuma yo kubagwa cyangwa kuvurwa hakoreshejwe catheter (ablation).

Iyo umaze gupimwa indwara ya AFib, ushobora kugenda usubira inyuma hagati y’ibi byiciro. Urugero, nubwo wamaze gukuramo neza, AFib idakira ishobora kugaruka uko igihe kigenda gihita.

Icyiciro cya 4: AFib ihoraho

Ibi bivuze ko wowe na muganga wawe mwafashe icyemezo hamwe cy'uko utazongera kuvurwa ngo ugenzure AFib yawe, kandi ko uzakomeza kuba muri AFib burundu. Iki cyemezo gifatwa hashingiwe ku mimerere yawe bwite.

Ni ubuhe buryo bwo kuvura AFib?

AFib ishobora kuvurwa na kimwe cyangwa byinshi muri ibi bikurikira:

• Impinduka mu mibereho
• Imiti
• Uburyo bwo kuvura indwara yo kubura amaraso
• Ubundi buryo bwo kuvura

Impinduka mu mibereho

Ibi ni ibintu ushobora gukora buri munsi kugira ngo ufashe kwirinda ko AFib irushaho kuba mbi. Izi mpinduka mu mibereho yawe ni ingenzi na mbere yuko utangira kugira ibimenyetso. Muganga wawe ashobora kugufasha muri ibi bintu:

• Bigufasha kugumana ibiro byiza .
• Kugabanya ikoreshwa ry'inzoga.
• Kureka burundu gukoresha ibikomoka ku itabi (nk'itabi).
• Kubona imyitozo ngororamubiri isabwa buri munsi.
• Gucunga neza indwara zishobora kongera ibyago byo kurwara AFib, nko kurwara umuvuduko ukabije w'amaraso, umubyibuho ukabije, ubumuga bwo kubura ibitotsi, na diyabete.

Imiti

Muganga wawe ashobora kuguha imiti yo kugenzura umuvuduko w'umutima wawe cyangwa umuvuduko w'umutima wawe. Iyi miti ishobora kugufasha kwirinda kwangirika k'umutima wawe no kugabanya ububabare n'imihangayiko ushobora kumva. Muganga wawe ashobora kandi kuguha imiti yo kugabanya ibyago byo kubyimba kw'amaraso no gucika intege mu bwonko.

Ubwoko bw'imiti ikenewe mu kugenzura AFib bushobora guhinduka uko igihe kigenda gihita. Ubusanzwe, niba uri mu kaga ko kurwara indwara yo mu bwonko, uzakenera gufata imiti igabanya amaraso (anticoagulants) . Abaganga bakunze gutanga imiti igabanya amaraso mu kanwa (DOACs - Direct Oral Anticoagulants). Ingero:

• `Apixaban`
• Rivaroxaban
• `Dabigatran`
• `Edoxaban`

Mu bihe bimwe na bimwe, umuti witwa "Warfarin" utangwa aho kuba "DOACs".

Imiti yo gucunga umuvuduko w'umutima wawe:

• 'Carvedilol'
• 'Digoxin'
• `Diltiazem`
• 'Metoprolol'
• 'Verapamil'

Imiti ifasha umutima wawe gutera mu buryo busanzwe:

• 'Amiodarone'
• 'Dofetilide'
• 'Dronedarone'
• 'Flecainide'
• 'Propafenone'

Uburyo bwo kuvura indwara yo mu nda (Ablation for AFib)

Gukoresha AFib mu kuvura indwara ziterwa no kuvura indwara (Ablation) ni ijambo rusange risobanura ubwoko bw'imiti itera udukoko duto tw'inkovu mu bice bimwe na bimwe by'umutima. Nubwo dusanzwe dutekereza ko udukoko tw'inkovu ari ikintu kibi, muri iki gihe, iyi nkovu ifasha imikorere y'amashanyarazi y'umutima gukora neza. Iyi nkovu ibuza ibimenyetso by'amashanyarazi bidasanzwe kunyura mu mutima. Ibi bifasha umutima gusubira mu buryo busanzwe.

Hari uburyo butandukanye bwo kuvura indwara z'umutima abaganga b'indwara z'umutima bashobora kukugira inama kuri AFib:

• Gukuramo katheteri: Ubu ni uburyo bwo kuvura budakoresha cyane. Umuganga ubaga ashyira umuyoboro muto (catheteri) mu mutima wawe binyuze mu mitsi imwe y'amaraso. Gukuramo imitsi y'ibihaha (PVI ablation) ni nabwo buryo bukunze gukoreshwa cyane bwo gukuramo katheteri kuri AFib.
• Uburyo bwo kubaga Maze: Ibi kandi byitwa kubaga. Umuganga ubaga akora ishusho ya "maze" y'inkovu mu mutima kugira ngo ahagarike ibimenyetso bidasobanutse neza. Ibi bikunze gukorwa icyarimwe n'ubundi buryo bwo kubaga umutima (nk'uburyo bwo kubaga imitsi y'umutima cyangwa kubaga valve).

Ubundi buryo bwo kuvura

Ubundi buryo bwo kuvura AFib:

• Indwara y'umutima:Muri ibi, muganga azakoresha igikoresho cy'ikoranabuhanga (defibrillator) cyangwa aguhe imiti yo gusubiza umutima wawe ku murongo usanzwe.
• Gufunga igice cy'ibumoso cy'umutima (LAA): Niba udashobora kwihanganira imiti igabanya amaraso, igikoresho gito gishobora gushyirwa mu mutima wawe kugira ngo kigabanye ibyago byo kurwara indwara yo gucika imitsi. Ibi bikora mu gufunga igice cy'ibumoso cy'umutima , igice gito cy'umutima gisa n'agafuka gashobora gutuma amaraso afungana byoroshye.

Ese umutima usubira ku murongo nyuma ya AFib?

Yego, hari igihe umutima wawe usubira ku murongo usanzwe ubwawo. Ibi nibyo bibaho muri ``Paroxysmal AFib``. Niba ufite ``udacika`` cyangwa ``igihe kirekire``, uzakenera kuvurwa kugira ngo uhagarike umutima utari umeze neza.

Ariko icy'ingenzi ni uko AFib idashobora gukira. Ni indwara y'ubuzima bwose. Muganga wawe ashobora kugufasha kuyifata. Kuyivura bishobora kugabanya ibyago byo kurwara indwara yo mu bwonko no kugabanya ibimenyetso by'indwara.

Ushobora kumarana igihe kingana iki na AFib?

Ubushakashatsi bwasohotse mu 2024 bwagaragaje ko abantu barwaye AFib bashobora kubaho igihe gito ugereranyije n'abadafite AFib. Ibi biratandukanye bitewe n'imyaka basanzwe barwaye.

Ariko ibuka ko imibare igaragaza uruhande rumwe gusa rw'inkuru. Niba ukorana n'itsinda ry'abaganga bawe kugira ngo ucunge neza AFib yawe n'izindi ndwara, ufite amahirwe menshi yo kubaho ubuzima burambye kandi buzira umuze .

Nitwara nte?

Ingeso zimwe zigabanya ibyago byo kurwara AFib zizagufasha kuguma umeze neza nubwo waba ufite AFib.

• Kurya ibiryo bifite intungamubiri .
• Gukora imyitozo ngororamubiri iminota 30 ku munsi, nibura iminsi 5 mu cyumweru, ni byiza cyane ku mutima. Niba bigoye gukora imyitozo ngororamubiri buri gihe, ushobora no kuyigabanyamo iminota 10.
• Kureka itabi n'inzoga nabyo ni ingirakamaro cyane ku mutima.

Ni ryari ngomba kubonana na muganga?

Nta gahunda imwe ijyanye n'ibi byose. Biterwa n'ibimenyetso byawe, gahunda yo kuvurwa, n'ikurikirana ry'uko wakorewe ubuvuzi. Rero, ni ngombwa kuvugana na muganga wawe ukagena gahunda ikubereye.

• Shaka muganga ku gihe nta gahunda iyo ari yo yose usibye.
• Buri gihe andika urutonde rw'imiti ufata, kandi uyijyane iyo ugiye kwa muganga. Ni byiza kandi kubika uru rutonde mu gikapu cyawe mu gihe cy'impanuka.
• Kuri buri gahunda, bwira muganga wawe ibimenyetso bishya ufite hamwe n'ingaruka mbi zishobora guterwa n'imiti yawe.
• Buri gihe banza ubaze muganga wawe mbere yo gufata imiti igurishwa ku giciro cya muganga (OTC) (urugero: imiti y'ibicurane n'inkorora) hamwe n'inyongeramusaruro z'imirire.Hari igihe ibi bishobora kugira ingaruka ku muvuduko w'umutima wawe cyangwa bigatera ingaruka ku yindi miti ufata.

Ni ibihe bibazo ugomba kubaza muganga?

Ibibazo bimwe na bimwe ushobora kubaza muganga wawe:

• Ni gute nagabanya ibintu bishobora gutera ibyago?
• Ushobora kunsubiza inzobere mu mirire?
• Ese ushobora gutanga inama kuri gahunda z'ubuzima n'imyitozo ngororamubiri ziri hafi aho?

Ese ushobora gusuzuma AFib uri mu rugo?

Niba ubona ko ufite ibimenyetso bya AFib, icy'ingenzi ni uguhamagara muganga wawe ako kanya ukamubwira uko wumva. Birashoboka ko bazakubwira kugenzura uko umutima wawe uhagaze. Niba utari umeze neza cyangwa ufite intege nke, bishobora kuba ikimenyetso cya AFib.

Ariko rimwe na rimwe, ushobora kutagira impinduka mu mitsi yawe, cyane cyane niba AFib yawe idakabije cyane. Ahubwo, ushobora kumva unaniwe cyangwa uhumeka nabi. Ushobora kudashobora kumenya niba ibimenyetso byawe biterwa na AFib cyangwa ikindi kintu. Niyo mpamvu ari ngombwa kuvugana na muganga wawe. Ntushobora kwihitiramo ko ufite AFib.

AFib ikunze kugaragara gute?

Abantu barenga miliyoni 33 barengeje imyaka 55 ku isi yose basanzwe barwaye AFib. Muri Leta Zunze Ubumwe za Amerika honyine, bivugwa ko abantu miliyoni 12 bazaba bafite AFib mu 2030. AFib itera abantu bagera kuri kimwe cya kabiri cya miliyoni kujya mu bitaro muri Leta Zunze Ubumwe za Amerika buri mwaka, kandi umubare w'abapfa bayirwaye ugenda wiyongera buri mwaka.

Kumenya ko ufite AFib bishobora gutera ubwoba, kurengerwa, no gutera urujijo. Ariko ntabwo uri wenyine. Abantu babarirwa muri za miriyoni ku isi barimo kwiga uburyo bushya bwo kwifata no kubaho ubuzima bwiza. Muganga wawe ashobora kukubwira byinshi ku bijyanye n'uburyo bwo kuvura, ibikoresho, n'imiryango itanga ubufasha.

None se, ni ibihe bintu by'ingenzi tugomba kwibuka muri iyi nkuru?

Sawa, dore ibintu bimwe na bimwe ugomba kuzirikana mu byo twavuze:

- AFib ni indwara aho umuvuduko w'umutima udakora neza, kandi ishobora kuba ikomeye, nubwo nta bimenyetso by'indwara. Hari ibyago byo kugira ingorane, cyane cyane indwara yo mu bwonko.

- Menya ibimenyetso nko gufungana mu gituza, umunaniro, isereri, no kugorwa no guhumeka. Niba uhuye na kimwe muri ibi, menya neza ko wagiye kwa muganga.

- AFib ni indwara ivurwa neza. Ishobora kugenzurwa neza hakoreshejwe impinduka mu mibereho, imiti, ndetse rimwe na rimwe, uburyo bwo kuvura nko "kugabanya ububabare".

- Ubuzima bwiza (indyo nziza, imyitozo ngororamubiri ihoraho)Kugumana ubuzima bwiza (imyitozo ngororamubiri, kunywa itabi, no kwirinda inzoga) ni ingenzi cyane mu kugenzura AFib no ku buzima bw'umutima.

- Ntabwo uri wenyine muri uru rugendo. Vugana na muganga wawe kugira ngo bagutezeho gahunda yo kuvura n'ingamba zo kugufasha. Ntutinye kubaza ibibazo no gusangira amarangamutima yawe.

Wibuke ko kumenya ibintu ari yo ntambwe ya mbere igana ku buzima bwiza!

` Atrial Fibrillation, AFib, umuvuduko w'umutima, umutima utera nabi, guhagarara k'umutima, indwara z'umutima, ububabare mu gituza, umuvuduko w'umutima, ubuzima bw'umutima