Masifumanise ngqo ngomsebenzi wombane wentliziyo yakho? (Uphononongo lwe-Electrophysiology - Uphononongo lwe-EP)

Ngaba uziva into engaqhelekanga entliziyweni yakho, njengokubhabha? Ngamanye amaxesha oogqirha bathi kufuneka benze uvavanyo ukuze bajonge ngakumbi umsebenzi wombane wentliziyo yakho. Kulapho ke sithetha ngolu "Phando lwe-Electrophysiology"`, okanye njengoko silubiza ngokufutshane, "uPhando lwe-EP". Musa ukoyika, masithethe ngale nto ngokulula.

Yintoni uphando lwe-EP?

Ngamafutshane, uphando lwe-EP luvavanyo oluhlalutya ngokuchanekileyo umsebenzi wombane entliziyweni yakho. Khawuthelekelele, intliziyo yethu ifuna isignali encinci yombane ukuze ibethe. Xa ezi mpawu zisebenza kakuhle, intliziyo ibetha ngendlela ehlelekileyo. Ngamanye amaxesha kukho into engalunganga ngezi mpawu zombane, oko kuthetha ukubetha kwentliziyo okungahambelaniyo ( arrhythmia ) . Kulapho uphando lwe-EP lusetyenziswa khona ukufumanisa ukuba yintoni ingxaki kunye nokuba ingxaki iphi.

Oogqirha basebenzisa ii-catheter zentliziyo (iityhubhu ezincinci kakhulu) kunye neekhompyutha ukwenza oku. Ezi tyhubhu zifakwa entliziyweni yakho kwaye zilinganisa umsebenzi wombane wentliziyo yakho ukusuka apho. Kufana ne- EKG , kodwa ezi sensor, ezibekwe ngaphakathi entliziyweni yakho, zinokubonelela ngolwazi oluneenkcukacha ezininzi noluchanekileyo kunee sensor ezibekwe ngaphandle kwesifuba sakho.

Cinga ngayo njengebhasi ehamba ngendlela yayo eqhelekileyo, ngexesha elifanelekileyo, nangendlela ecwangcisiweyo. Kodwa ukubetha kwentliziyo okungahambelaniyo (i-arrhythmia) kufana nebhasi engahambi ngendlela yayo eqhelekileyo, mhlawumbi iqala kwindawo engafanelekanga, itsiba indawo yokuma, okanye ingahambi yonke indlela. Okanye ingahamba ngokukhawuleza kakhulu, okanye ingahamba kancinci kakhulu. Ezo ziimpawu ezingaqhelekanga ekufuneka oogqirha bazijonge. Kulapho kuphela apho banokugqiba khona ukuba le meko iyingozi kwaye bangayinyanga njani.

Uyibona njani le nto yombane yentliziyo?

Ilebhu apho kwenziwa khona olu `(Uphononongo lwe-EP)` ifana neofisi yomphenyi. Ugqirha oyingcali owenza oku yi-`( Electrophysiologist )` enolwazi oluhle ngeepateni zesingqisho sentliziyo. Uyakwazi ukubona indlela iindawo ezahlukeneyo zentliziyo ezisebenza ngayo kwiipateni ezahlukeneyo zamaza kwiteyiphu ye-`(EKG)`.

Aba gqirha bafunde amaza e-EKG, indlela afanele abonakale ngayo ngokuqhelekileyo, kunye nokuba kuthetha ukuthini ukuba amaza abonakala eyahlukileyo. Banika ingqalelo esondeleyo apho ukubetha kwentliziyo okungaqhelekanga kuqala khona kwaye kuphelela khona kwi-EKG.

Emva koko, bacinga, "Kulungile, yiloo nto inokuba yiyo." Emva koko bayayivavanya kwi-EP Lab.Banika amayeza (afana ne-Adenosine, i-Isoproterenol) ukukhawulezisa nokuthomalalisa intliziyo , baze bajonge indlela umsebenzi wombane wentliziyo otshintsha ngayo ngelo xesha. Oku kwenziwa ngokwesicwangciso esithile, kungekuphela nje ngokuqikelela. Ngokusekelwe kulwazi oluqokelelweyo, bacinga ngezizathu ezininzi ezinokubakho, baze emva koko benze uvavanyo de bafumanise ukuba yintoni kanye kanye ingxaki .

Kutheni usenza olu phando lwe-EP?

Uphononongo lwe-EP lunokuxelela ugqirha wakho okuninzi malunga nokubetha kwentliziyo yakho okungaqhelekanga . Umzekelo:

• Loluphi uhlobo lwesifo sentliziyo (arrhythmia) onaso?
• Yintoni unobangela wale nto ingaqhelekanga?
• Le ngxaki iqala phi kanye entliziyweni?
• Yintoni ebangela ukuba uzive unesizungu kwaye ube nengxaki yokuphupha ?
• Gqiba ukuba loluphi unyango olungcono koku.
• Jonga ukuba amayeza owasebenzisayo ngoku asebenza kakuhle na .
• Fumanisa ukuba usemngciphekweni wokufa ngesiquphe kwentliziyo .

Ugqirha ugqiba ekubeni enze i-EP Study xa engakwazi ukufumana ulwazi olwaneleyo kwiimvavanyo ezifana ne-ECG, i -Holter monitor (isixhobo esijonga isingqisho sentliziyo ngelixa usebhedini malunga nosuku okanye ezimbini), i -event recorder , uvavanyo loxinzelelo (olujonga intliziyo ngexesha lokuzilolonga), i-echocardiogram (i-ultrasound scan yentliziyo), okanye i-angiogram (ejonga imithambo yegazi entliziyweni).

Ngamanye amaxesha, kuxhomekeke kwimeko yakho kunye nolwazi olufunyenwe kwi-EP Study, unyango olubizwa ngokuba yi-Catheter Ablation lunokwenziwa ngaxeshanye . Oku kuthetha ukuba iindawo ezincinci entliziyweni ezibangela imiqondiso yombane engahambelaniyo ziyacinywa nge-catheter (ityhubhu) efakwe entliziyweni.

Ufanele ulungiselele njani isifundo se-EP?

Kukho amalungiselelo amancinci ambalwa ekufuneka uwenze ngaphambi kolu vavanyo. Ungakhathazeki, ezi zizinto eziqhelekileyo.

• Lungiselela ukuba kubekho umntu oza kukuhamba nawe ukuya nokubuya esibhedlele. Awuyi kukwazi ukuqhuba iiyure ezingama-24 emva kovavanyo.
• Ukuba unemibuzo okanye iinkxalabo malunga nolu vavanyo, nceda uxoxe ngayo nogqirha.
• Sixelele ukuba une-allergy kwi-latex okanye ukhe waba neengxaki ze -anesthesia ngaphambili .
• Iimpahla ezikhululekileyoYiza unxibe.
• Susa zonke izinto zokuthambisa kunye nepeyinti yeenzipho ngaphambi kokuba uye esibhedlele.
• Shiya zonke izinto zokuhombisa ezixabisekileyo ezifana nemisesane, imigexo, kunye neewotshi ekhaya. Zisa iiglasi zakho kunye nezixhobo zokuva, ukuba unazo.

Masijonge amayeza nokutya:

• Xelela ugqirha wakho ngazo zonke iziyobisi ozisebenzisayo (ezibhalwe ngugqirha, ezithengiswa ngaphandle kwemvume kagqirha, ezifumaneka kwizityalo, iivithamini) .
• Zisa amayeza akho aneleyo usuku olunye. Kodwa ungawasebenzisi ude uthethe nogqirha wakho.
• Buza ugqirha wakho ukuba zeziphi amayeza omele uwathathe ngaphambi kovavanyo, zeziphi amayeza omele uwayeke, nini na, kwaye nini na omele uwaqale kwakhona . Musa ukuyeka naliphi na iyeza ngaphandle kwengcebiso kagqirha wakho.
• Ukuba unesifo seswekile, buza ukuba ungayilungisa njani amayeza akho eswekile .
• Yitya ngokuqhelekileyo ngobusuku bangaphambi kovavanyo.
• Musa ukutya, ukusela, okanye ukuhlafuna nantoni na emva kweentsuku ezinzulwini zobusuku ngaphambi kovavanyo. Ungatyi netshungama, iminti, okanye amanzi. Oku kubaluleke kakhulu kukhuseleko lwakho.
• Ukuba kufuneka usele iyeza, lisele nentwana yamanzi okanye amabini.
• Musa ukuginya amanzi ngelixa uhlamba amazinyo akho.

Yintoni onokuyilindela ngomhla wophando lwe-EP?

Uvavanyo lwakho luza kwenziwa kwigumbi elikhethekileyo elibizwa ngokuba yi-Electrophysiology Lab (EP Lab) okanye i-Catheterization Lab .

Emva kokuba ulele ebhedini, ugqirha kunye neqela lakho baya kwenza oku kulandelayo:

• Umgca we-intravenous (IV) (ofana nomgca we-saline) uza kufakwa engalweni okanye esandleni sakho. Kulapho uza kunikwa khona amayeza kunye nolwelo ngexesha lovavanyo.
• Ukuba kuyimfuneko, amakhwapha akho, iingalo, okanye intamo yakho iya kuchetywa ize icocwe ngesisombululo sokubulala iintsholongwane.
• Uza kugutyungelwa ngelaphu elicocekileyo ukususela entanyeni ukuya ezinzwaneni.
• Ukuze izandla zakho zingachukumisi iindawo ezingenwanga ntsholongwane, faka ibhanti esinqeni sakho uze uphakamise iingalo zakho.

Kwenzeka ntoni ngexesha lesifundo se-EP?

Eli lelona xesha libalulekileyo. Nazi izinto eziza kwenziwa ngugqirha:

• Imbombo yakho, intamo, okanye ingalo (apho kufakwa khona i-catheter) iya kuba ne-numbness ngeyeza elikhethekileyo.
• Emva koko, uninzi lwezi catheters (iityhubhu ezincinci) zifakwa kumthambo omkhulu kwimiphunga yakho, entanyeni, okanye engalweni.
• Ukusebenzisa i-'Fluoroscopy' (oku kufana nevidiyo ye-'X-ray') kunye nomatshini we-'Ultrasound', ezi catheters zikhokelwa ngqo entliziyweni yakho, kwiigumbi zayo. Ezi catheters zisetyenziselwa ukubona nokurekhoda umsebenzi wombane wentliziyo. Oku kukuvumela ukuba uqonde ngcono 'iNkqubo yoKuqhuba', inkqubo apho imiqondiso yombane ihamba khona entliziyweni yakho.
• Nge-catheter enye,Isixhobo esibizwa ngokuba yi-pacemaker sithumela imiqondiso emincinci yombane ukukhawulezisa isantya sentliziyo yakho. Ngeli xesha, ungaziva intliziyo yakho ibetha ngokukhawuleza nangakumbi.
• Ngokuxhomekeke kwimeko yakho, ukuba kukho uqhagamshelo oluneengxaki olubangela imiqondiso yombane engahambelaniyo, lunokuvalwa ngokusebenzisa inkqubo ebizwa ngokuba yi-'Catheter Ablation' .

Eyona nto ibalulekileyo kukuba ukuba uziva into engathandekiyo okanye engaqhelekanga ngexesha le-EP Study, xelela ugqirha okanye umongikazi apho.

Ukuba ukubetha kwentliziyo yakho akuhambelani kakuhle, ugqirha wakho uza kukunika amayeza nge-IV yakho ukuze abone ukuba bayayilawula njani. Ukuba kuyimfuneko, banokukunika nombane omncinci ohamba nge-patch esifubeni sakho ukunceda ukubuyisela isigqi sentliziyo yakho.

Kulo lonke olu vavanyo, iqela lakho lezonyango liza kusebenzisa izixhobo ezahlukeneyo:

• I-Fluoroscopy: Umatshini omkhulu we-X-ray ongaphezulu kwakho. Oku kuvumela ugqirha ukuba aqhubeke ejonga i-catheter engaphakathi entliziyweni yakho kwisikrini se-X-ray.
• `I-Defibrillator / I-Pacemaker / I-Cardioverter`: Le iqhagamshelwe kwi-patch emqolo wakho kunye ne-patch esifubeni sakho. Inganika ii-electrical pulses ukukhawulezisa ukubetha kwentliziyo okucothayo okanye umise isigqi esiyingozi.
• I-Electrocardiogram (EKG): Le iqhagamshelwe kwiindawo ezininzi ezinamathelayo esifubeni sakho, kunye nee-catheter ezingaphakathi entliziyweni yakho. Ivelisa umfanekiso wemiqondiso yombane edlula entliziyweni yakho.
• I-Intracardiac Echocardiogram: Le yi-ultrasound encinci. Inceda ukukhokela ngokuchanekileyo i-catheter ngexesha lovavanyo.
• Isixhobo sokuJonga uxinzelelo lwegazi: Esi sincamatheliswe kwi-cuff engalweni yakho kwaye sijonga uxinzelelo lwegazi lakho kulo lonke uvavanyo.
• I-Oximeter Monitor: Le yi-clip encinci oyifaka emnweni wakho. Ilinganisa inqanaba le-oksijini egazini lakho.

Yintoni onokuyilindela emva kovavanyo?

Emva kokuba uPhononongo lwe-EP lugqityiwe, ugqirha uza kususa i-catheter kwi-groin yakho, engalweni, okanye entanyeni aze afake uxinzelelo kwindawo leyo okwethutyana ukuze ayeke ukopha. Emva koko:

• Kuya kufuneka uhlale ebhedini malunga neyure enye ukuya kwezine . Ukuba i-catheter ifakwe ngaphakathi kwesisu, kufuneka ugcine umlenze wakho uthe tye kangangoko kwaye ungawushukumisi.
• Ngokuxhomekeke kwiziphumo zokuqala zovavanyo lwakho, kunokufuneka uhlale esibhedlele ukuba kuyimfuneko .
• Ibhandeji elincinci elingenazintsholongwane (ibhandeji) lifakwa phezu kwe-catheter. Lingasuswa ngosuku olulandelayo. Kwiimeko ezininzi, akukho mfuneko yokuthungwa.
• Indawo eyonzakeleyo mayigcinwe icocekile kwaye yomile .
• Emva kovavanyo, ungatya uze uthathe amayeza.
• Ungaqhubeka nemisebenzi yakho yesiqhelo ngosuku olulandela uvavanyo.Kodwa kuya kufuneka unciphise izinto ezifana nokuphakamisa iintsimbi kangangeveki.

Ngaba kukho naziphi na iingozi koku?

Uphononongo lwe-EP luvavanyo olukhuselekileyo kakhulu. Nangona kunjalo, njengayo nayiphi na inkqubo yezonyango, kukho iingozi ezithile. Ezi ziquka:

• Ukosuleleka okanye ukopha kwindawo efakwe kuyo i-catheter.
• Ukubetha kwentliziyo okungaqhelekanga (i-Arrhythmia) .
• Ihlwili legazi lenzeka kwi-catheter lize libambeke kwimithambo yegazi.
• Ukulimala komthambo wegazi, ivalvu yentliziyo, okanye igumbi lentliziyo.
• Uhlaselo lwentliziyo.
• Istroke.

Kodwa ungakhathazeki, oogqirha bakho benza olu phononongo lwe-EP kwindawo elawulwa kakuhle. Kwaye bathatha amanyathelo akhethekileyo okunciphisa iingozi kuwe. Ukuba unemibuzo malunga neengozi kunye neenzuzo zolu vavanyo, thetha nogqirha wakho.

Zithini iingenelo zophando lwe-EP?

Ungafumana ezi zibonelelo zilandelayo kwi-`(EP Study)`:

• Uza kufumana iimpendulo kwimibuzo yakho malunga nokuba yintoni engalunganga ngesingqisho sentliziyo yakho.
• Mhlawumbi ukuba ingxaki ingasonjululwa nge-"Catheter Ablation", sisenokunganyanzelekanga ukuba siqhubeke nokusebenzisa amayeza athile.
• Umgangatho wobomi bakho uya kuphucuka.
• Kwezinye iingxaki zesingqisho sentliziyo, ukunyanga nge-"Catheter Ablation" kusenokuba lolona khetho lungabizi kakhulu kunotyando lwe-"Arrhythmia".

Uphononongo lwe-EP lukhuselekile ngokubanzi. Umngcipheko wokufa ngenxa yoku uphantsi kakhulu, malunga nomntu omnye kwabayi-5,000.

Ndizifumana njani iziphumo? Ndenza ntoni emva koko?

Emva kovavanyo, ugqirha uza kukuxelela iziphumo zokuqala . Ngokusekelwe kwezo ziphumo, uza kugqiba ukuba ungaya ekhaya okanye kufuneka uhlale esibhedlele. Ugqirha angakucela ukuba ubuye ngenye imini ukuze sixoxe ngeziphumo zoPhando lwe-EP kunye nonyango lwakho ngakumbi.

Ukuba iziphumo zibonisa into engaqhelekanga, ugqirha wakho unokukwazi ukuyinyanga ngoko nangoko nge-"Catheter Ablation". Ukuba akunjalo, banokufuna ukucwangcisa ezinye iindlela zonyango okanye bakunike amayeza. Abanye abantu banokufuna ezinye iindlela zonyango, ezifana ne- "Pacemaker" , nokuba emva kwe-"Catheter Ablation".

Linini ixesha ekufuneka ubone ugqirha ngalo?

Xa ubuyela ekhaya emva kovavanyo, ngokuqinisekileyo kufuneka ufowunele ugqirha wakho ukuba ufumana naziphi na kwezi mpawu:

• Ukuba indawo ye-catheter ibomvu, idumbile, okanye kukho naluphi na ulwelo oluphuma kuyo.
• Ukuba ufumana ukungaziva okanye naluphi na uvakalelo olungaqhelekanga engalweni okanye emlenzeni apho kufakwe khona i-catheter.
• Nokuba kusengaloni okanye emlenzeni apho kufakwe khona i-catheterUkuba iminwe yakho iyabanda, ayiva buhlungu, okanye itshintsha umbala.
• Ukuba uza kuhlanza.
• Ukuba unentlungu esifubeni .

Fowunela u-1990 ukuze ufumane unyango olungxamisekileyo, okanye uye kwisibhedlele esikufutshane, ukuba ufumana nayiphi na kwezi zilandelayo:

• Ukuba ukopha akuyeki nokuba sele ucinezele kwaye ubambe indawo ye-catheter.
• Ukuba ukudumba okujikeleze inxeba kuyanda ngequbuliso.

Eminye imibuzo embalwa kuwe.

Ngaba sivukile xa senza uphando lwe-EP?

Ewe. Unikwa amayeza nge-IV ukuze uthomalalise umsindo kwaye uzive ulele kancinci. Kodwa awulele ngokupheleleyo.

Kuthatha ixesha elingakanani ukufunda nge-EP?

Idla ngokuthatha malunga neyure enye ukuya kwezine .

Ngaba uphando lwe-EP lubuhlungu?

Uza kunikwa iyeza lokuthomalalisa ukuze ungabi nantlungu. Nangona kunjalo, ungaziva uxinezelekile kancinci eluswini apho kufakwe khona i-catheter.

Izinto ezibaluleke kakhulu ekufuneka uzikhumbule

Xa uceliwe ukuba wenze uphando lwe-EP, kunokubonakala ngathi yinto enkulu kunalo naluphi na olunye uvavanyo lwentliziyo owakha walwenza ngaphambili. Kodwa ugqirha wakho uyayiyalela ngesizathu. Ukwenza oku ukuze afumanise ukuba kwenzeka ntoni entliziyweni yakho aze akuncede . Uphononongo lwe-EP lubandakanya ukufaka izixhobo entliziyweni yakho, kodwa luvavanyo olukhuselekileyo. Lunika ugqirha wakho ulwazi aludingayo ukunyanga ukubetha kwentliziyo yakho okungaqhelekanga.

Khumbula, iqela lezonyango liza kwenza konke okusemandleni alo ukukwenza uzive ukhululekile ngexesha lovavanyo. Thetha nabo ngayo nayiphi na imibuzo okanye iinkxalabo onokuba nazo. Oku kuya kukunceda uzive ukhululekile ngakumbi.

Isantya sentliziyo , uphando lwe-EP, isifo sentliziyo, i-catheter, umsebenzi wombane wentliziyo, i-arrhythmia, uvavanyo lwentliziyo