Ngaba intliziyo yakho ivakalelwa ngathi ibetha ngokukhawuleza kakhulu? Masifunde nge-A-fib ene-RVR! (I-Atrial Fibrillation ene-RVR)

Ngaba wakha waziva ngathi intliziyo yakho ibetha ngokungathi uyaphambana, okanye uziva ngathi unemvakalelo engaqhelekanga esifubeni sakho? Okanye uziva ngathi unengxaki yokuphefumla okanye uyadinwa? Ezi zisenokungabi zezinye izinto nje. Namhlanje siza kuthetha ngolu hlobo lwengxaki eyenzeka entliziyweni, oko kukuthi, imeko apho intliziyo ibetha ngokungacwangciswanga nangokukhawuleza kakhulu, ebizwa ngokuba yi-`(Atrial Fibrillation with Rapid Ventricular Rate)` okanye `(A-fib with RVR)` ngamafutshane. Musa ukoyika, kubaluleke kakhulu ukuqaphela oku.

Yintoni kanye kanye i-A-fib ene-RVR?

Ngamafutshane, `(A-fib ene-RVR)` yimeko apho isingqisho sentliziyo yakho, okanye indlela yokubetha, iba yinto engaqhelekanga. Sineendawo ezimbini eziphezulu entliziyweni yethu, esizibiza ngokuba yi-atria. Ezi `(atria)` kulapho kuqala khona iimpawu zombane ezixelela intliziyo ukuba ibethe. Kodwa kumntu one-`(Atrial Fibrillation)`, ezi zimpawu zombane azilungelelananga, azilungelelananga, kwaye iindawo eziphezulu `(atria)` ziqala ukufinyela ngokukhawuleza. Kufana nomntu obetha idrama ngokungathi uyaphambana.

Ngoku ezi mpawu zombane zingalawulekiyo ziya kumagumbi amabini asezantsi entliziyo, iiventricles. Emva koko ukubetha kwezo ventricles kuba yinto engahambelaniyo kwaye ngokukhawuleza kakhulu . Yiloo nto ibizwa ngokuba yi-"A-fib ene-RVR". Oko kuthetha ukuba intliziyo ibetha ngaphezu kwe-100 amaxesha ngomzuzu.

Cinga ngayo njengepompo yamanzi. Ukuba ayisebenzi kakuhle, ayikwazi ukupompa igazi eliyidingayo emzimbeni. Yiloo nto eyenzekayo xa une-`(A-fib ene-RVR)`. Intliziyo ayinalo ixesha elaneleyo lokuzalisa igazi ngokufanelekileyo, ngoko ke ayinakupompa igazi elineoksijini eyaneleyo emzimbeni.

Ixhaphake kangakanani le meko?

Usenokucinga ukuba esi sisifo esichaphazela abantu abambalwa kakhulu. Kodwa eneneni, i-"Atrial Fibrillation" yeyona meko ixhaphakileyo phakathi kokuphazamiseka kwesantya sentliziyo. Ukuba ujonga izibalo kwilizwe elifana neMelika, izigidi zabantu zihlushwa yile meko. Le meko ikwabonakala ngakumbi eSri Lanka.

Zithini iimpawu zoku? Ungazibona njani?

Ayingabo bonke abantu abafumana iimpawu ezifanayo. Abanye abantu banokuba nale meko ngaphandle kweempawu. Nangona kunjalo, kukho ezinye iimpawu eziqhelekileyo:

• Ukubetha kwentliziyo : Kungavakala ngathi intliziyo yakho iyabetha okanye ibetha ngaphakathi esifubeni sakho.
• Isiyezi : Kungathi intloko yakho iyajikeleza, ngamanye amaxesha ide ingakwazi ukuma.
• Ukuquleka: Abanye abantu banokulahlekelwa zingqondo baze bawe ukuba le meko imbi kakhulu.
• Intlungu yesifuba : Kunokubakho intlungu evakala ngathi isifuba siyancitshiswa okanye siyacinezelwa.
• Ukuphefumla kancinci: Akupheleli nje xa udiniwe kancinci, kodwa nokuba umile nje, usenokuziva uphelelwa ngumphefumlo.
• Ukuxhalaba rhoqo`(Ukuxhalaba)`: Usenokuziva uloyiko kunye nexhala ngaphandle kwesizathu.
• Ukudinwa : Nokuba ulala kangakanani na, usenokuziva udiniwe kwaye ungenabomi.

Ezi mpawu zinokuba buthathaka kakhulu ngamanye amaxesha, kwaye zibe buhlungu kakhulu ngamanye amaxesha. Ngoko ke ukuba ufumana into efana nale, kungcono ukubona ugqirha .

Kutheni oku kusenzeka? Zithini izizathu?

Kukho izinto ezininzi ezinokubangela i-'A-fib ene-RVR'. Ezona ziphambili zezi:

• Isifo semithambo yegazi yentliziyo: Oku kuthetha ukuvaleka kwemithambo yegazi ehambisa igazi entliziyweni.
• Uxinzelelo lwegazi oluphezulu : Sonke siyayazi igama elithi "uxinzelelo lwegazi oluphezulu".
• Ukusilela kwentliziyo : Intliziyo ayikwazi ukupompa igazi elaneleyo emzimbeni.
• I-Obstructive sleep apnea: Ukuyeka ukuphefumla ngexesha lokulala ngelixa urhona.
• Utyando lwentliziyo: Le ngozi isenokuqhubeka iintsuku okanye iiveki emva kotyando lwentliziyo.

Ngubani osengozini enkulu yoku?

Abanye abantu banamathuba amaninzi okuba nale meko. Jonga ukuba uwela kolu luhlu:

• Abantu abangaphezu kweminyaka engama-50 ubudala : Le ngozi iyanda xa abantu bekhula.
• Abantu abane-body mass index (BMI) engaphezulu kwama-30 : Oku kuthetha ukuba batyebe kakhulu xa kuthelekiswa nobude babo.
• Abantu abane-obstructive sleep apnea.
• Abantu abasela utywala obuninzi : Umngcipheko uphezulu ukuba usela utywala obuninzi imihla ngemihla okanye rhoqo.
• Abantu abasebenzisa i-caffeine eninzi : Akulunganga nokusela ikofu okanye iti eninzi emini.
• Ukuba kukho umntu kusapho lwakho okhe waba ne-"A-fib" : Kusenokubakho nefuthe lemfuza.

Khumbula: Ukuba nenye okanye ezingaphezulu kwezi zinto zomngcipheko akuthethi ukuba ngokuqinisekileyo uza kuba ne-"A-fib ene-RVR". Nangona kunjalo, kubalulekile ukuzazi ezi zinto.

Zeziphi iingxaki ezinokubangela oku?

Ukuba i-`A-fib ene-RVR` ayinyangwanga kakuhle, kukho iingxaki ezinobungozi ezinokubakho.

• Ixesha elinciphileyo lokuba amagumbi asezantsi entliziyo azaliswe ligazi.
• Izihlunu zentliziyo zifuna ioksijini engaphezulu .
• I-Cardiomyopathy : Imeko apho izihlunu zentliziyo ziba buthathaka kwaye zande.
• Istroke : Istroke sinokwenzeka ukuba igazi liqhekeka entliziyweni lize liye engqondweni, livale umthambo. Le yeyona ngxaki iyingozi kakhulu .
• Uxinzelelo lwegazi oluphantsi .
• Ukungaphumeleli kwentliziyo okubangelwa kukunganyamezelani.

Kungoko ke kubalulekile ukuba uqaphele le meko kwaye ufune unyango ngokukhawuleza.

Ifunyaniswa njani le nto? Zeziphi iimvavanyo ezenziwayo?

Ukuba uneempawu ezichazwe apha ngasentla, xa ubona ugqirha, uza kukuxilonga, akubuze ngembali yakho yezonyango, aze emva koko akuyalele iimvavanyo ezininzi ukuqinisekisa imeko.

Iimvavanyo ezixhaphakileyo zezi:

• I-Electrocardiogram (ECG okanye EKG) : Le irekhoda umsebenzi wombane wentliziyo. Ingachaza ngokucacileyo ukuba kukho `(A-fib ene-RVR)`.
• I-Echocardiogram : Oku kufana ne-ultrasound scan yentliziyo. Ingajonga ukuba amagumbi entliziyo kunye neevalvu zisebenza kakuhle na, kwaye inkulu kangakanani intliziyo.
• I-Cardiac CT scan okanye i-MRI scan : Ezi zinokubonelela ngolwazi oluthe kratya malunga nokwakheka kwentliziyo.
• Uvavanyo lwegazi : Olu vavanyo lunceda ekufumaneni izinto ezifana neengxaki ze-thyroid kunye notshintsho kwii-electrolytes egazini.

Luluphi unyango lwale nto?

Iindaba ezimnandi zezokuba kukho unyango olusebenzayo lwe-A-fib ene-RVR. Ugqirha wakho uneenjongo ezimbini eziphambili: ukulawula iimpawu zakho, nokuthintela iingxaki ezichazwe apha ngasentla ukuba zenzeke.

Ezi zilandelayo zisetyenziswa kakhulu njengonyango:

• Ukulinganisela ii-Electrolytes : Ekubeni ukwanda okanye ukuncipha kwee-electrolytes ezifana ne-potassium kunye ne-magnesium emzimbeni kunokuchaphazela isigqi sentliziyo, unyango lusetyenziselwa ukuzigcina zisebenza kakuhle.
• Amayeza : Unyango oluphambili loku ngamayeza.

Ngawaphi amayeza/unyango olusetyenziswayo?

Kukho iintlobo ezahlukeneyo zamayeza anikwa i-'A-fib ene-RVR':

• Ii-Beta-blockers : Umzekelo, i-metoprolol (iLopressor® okanye iToprol®XL). Ezi zisebenza ngokunciphisa isantya sentliziyo kancinci kwaye zinciphise uxinzelelo entliziyweni.
• Izithinteli zeCalcium channel : Umzekelo, iDiltiazem (Diltzac® okanye iCardizem®). Olu hlobo lwamayeza lukwanciphisa isantya sentliziyo ngokulawula ukungena kwecalcium kwiiseli zemisipha yentliziyo.
• Imithi yokulwa nokubetha kwentliziyo : Umzekelo, i-amiodarone (iPacerone® okanye iCordarone®) okanye i-digoxin (iLanoxin® okanye iCardoxin®). Ezi zinceda ukubuyisela isingqisho sentliziyo esingalinganiyo.

Eyona nto ibalulekileyo! Xa une-`(A-fib)`, kukho ithuba elikhulu lokuba igazi liqhekeke entliziyweni. Ukuba la mahlwili egazi aya engqondweni, i-`(Stroke)` inokwenzeka. Ke ngoko, amayeza okuthintela ukugabha kwegazi , okanye oko sikubiza ngokuba "zizinto ezinciphisa igazi", phantse ahlala enikwa.

Kwabanye abantu abangakwaziyo ukuqhubeka nokusebenzisa la mayeza okunciphisa igazi, inkqubo ekhethekileyo ebizwa ngokuba yi-left atrial appendage closure inokwenziwa ukuthintela ukwakheka kwamahlwili egazi.

Ngamanye amaxesha kunzima ukulawula le meko ngamayeza kuphela. Kwimeko ezinjalo, ezinye iindlela zonyango zinokufuneka:

• Ukususwa kwe-catheter : Oku kuquka ukufumana iindawo zentliziyo apho kuvela khona imiqondiso yombane engaguqukiyo, kunye nokudlulisa i-catheter encinci (ityhubhu encinci) emlenzeni okanye engalweni iye entliziyweni, 'ikhubaza' iindawo apho kuvela khona imiqondiso engaguqukiyo. Emva koko imiqondiso engaguqukiyo iyeka ukuza.
• I-Pacemaker : Abanye abantu banesixhobo esincinci esifakwe phantsi kolusu ukulawula izinga lentliziyo yabo. Oku kubizwa ngokuba yi-pacemaker. Sithumela imiqondiso yombane entliziyweni, ingakumbi xa izinga lentliziyo licotha.
• Ukuguqulwa kwentliziyo ngombane : Oku kuquka ukunika i-anesthetic emfutshane kunye nokunika i-electroshock elawulwa ngaphandle entliziyweni, ebuyisela ngokukhawuleza isigqi sentliziyo.
• Inkqubo ye-Maze : Le yinkqubo enzima ngakumbi. Kwenziwa imingxunya emincinci kwi-atria yentliziyo ukuze kudalwe iindlela ezichanekileyo zokuhamba kwemiqondiso yombane. Oku kudla ngokwenziwa ngexesha lotyando lwentliziyo.

Ngaba kukho naziphi na iziphumo ebezingalindelekanga zonyango?

Njengakwezinye iindlela zonyango, ezinye iziphumo ebezingalindelekanga okanye iingxaki zinokwenzeka ngolu nyango lwe-`(A-fib with RVR)`. Nangona kunjalo, azenzeki kubo bonke abantu, kwaye zihlala zincinci.

• Kwimithi : Abanye abantu banokufumana izinto ezifana neentloko ezibuhlungu, uxinzelelo lwegazi oluphantsi, isiyezi, kunye nokuphazamiseka kwesisu.
• Iinkqubo ezifana nokususwa kwe-catheter zinokubangela i-cardiac tamponade okanye, ngokungaqhelekanga, ukuhlaselwa yintliziyo.
• Ngamanye amaxesha ii-pacemakers zingasebenzi kakuhle.
• Ukubetha kwentliziyo okanye "i-A-fib" kunokuphinda kwenzeke kangangeenyanga ezimbalwa emva kwenkqubo yeMaze .

Ugqirha wakho uza kukwazisa ngale nto. Akukho mfuneko yokukhathazeka, kuba oogqirha basoloko bezama ukunciphisa ezi ngozi.

Ndiza kuziva bhetele nini emva konyango?

Oku kuxhomekeke ngokwenene kunyango olufumanayo. Amanye amayeza, afana namayeza e-intravenous (IV), anokunceda ukunciphisa izinga lentliziyo yakho kwaye aqale ukuziva ngcono kwimizuzu embalwa . Amanye amayeza angathatha ixesha elide ukusebenza. Eyona nto ibalulekileyo kukulandela imiyalelo kagqirha wakho ngokuchanekileyo.

Ndingayinciphisa njani le ngozi?

Kukho izinto ezininzi onokuzenza ukunciphisa umngcipheko wokuba ne-`(A-fib ene-RVR)`. Ezi azilungelanga nje kuphela imeko, kodwa nakwimpilo yakho iyonke:

• Zilolonge ngesantya esiphakathi ubuncinane imizuzu eli-150 ngeveki : ukuhamba, ukukhwela ibhayisekile, okanye ukudada kulungile.
• Yitya ukutya okunempilo kwentliziyo: Faka imifuno, iziqhamo, iimbotyi, iinkozo ezipheleleyo, kunye nentlanzi ekutyeni kwakho. Nciphisa ioyile, ityuwa, kunye neswekile.
• Nciphisa ukusetyenziswa kotywala : Kungcono ukunciphisa utywala kangangoko kunokwenzeka.
• Ziphephe ngokupheleleyo iimveliso zecuba : Ukuba uyatshaya, yeka.
• Ukuba unezinye izifo ezifana noxinzelelo lwegazi oluphezulu, i-cholesterol ephezulu, i-sleep apnea, okanye isifo seswekile, zilawule kakuhle.

Ukuba ndine-`(A-fib ene-RVR)`, ndimele ndilindele ntoni?

Ukufumanisa ukuba une-`(A-fib ene-RVR)` kunokuba yinto eyoyikisayo. Kodwa khumbula, le yimeko enokulawulwa kwaye ungaphila ubomi obuhle . Into ebalulekileyo kukumisela imikhwa esempilweni ekhankanyiweyo ngaphambili, uthabathe amayeza achazwe ngugqirha wakho ngqo, kwaye ufune unyango olukhethekileyo ukuba kuyimfuneko.

Ukuba ayinyangwa, inokukhokelela kwiimeko ezinzima ezifana nesifo sentliziyo, ukusilela kwentliziyo, okanye isifo sohlangothi. Unyango olufana nokususwa kwe-catheter lubonakaliswe luphumelela kubantu abaninzi. Inkqubo yeMaze inezinga lempumelelo eliyi-80% ukuya kwi-90%, kwaye inokubonelela ngesiqabu sexesha elide kwiimpawu.

Le meko iza kuhlala ixesha elingakanani?

``(I-A-fib ene-RVR)`` yimeko enokuhlala iminyaka ngamanye amaxesha. Kwabanye abantu, ukuphindaphinda kunye nobude bale meko kunokwanda ngokuhamba kwexesha. Yiyo loo nto kubalulekile ukuqhubeka nokulandela icebiso likagqirha wakho kwaye ufumane uhlolo rhoqo.

Ndingazinyamekela njani?

Impilo yakho isezandleni zakho. Khumbula oku:

• Sela onke amayeza owanikwe ngugqirha wakho ngokuchanekileyo nangexesha elifanelekileyo. Ungaphoswa nalusuku olunye.
• Bona ugqirha wakho ngexesha elicwangcisiweyo lokulandela. Kubaluleke kakhulu ukubona ukuba uqhuba njani.
• Zilolonge rhoqo. Nokuba yinto elula njengokuhamba imihla ngemihla inokuphucula umgangatho wobomi bakho kwaye ikuncede wenze imisebenzi yemihla ngemihla ngokulula.

Ndifanele ndimbone nini ugqirha?

Ukuba ufumana naziphi na kwezi mpawu kwakhona, okanye ukuba ufumana ezintsha, bona ugqirha ngoko nangoko:

• Iintlungu zesifuba.
• Ukuba isantya sentliziyo yakho singaphezulu kwe-100 beats ngomzuzu xa uphumle.
• Isiyezi.
• Ubunzima bokuphefumla.

Ndingaya nini kwiYunithi yoNyango oluNgxamisekileyo (i-ETU) ?

Ukuba unale mpawu, kuya kufuneka uye kwiYunithi yoNyango oluNgxamisekileyo (ETU) ngaphandle kokulibazisa :

• Iimpawu zestroke : Intloko ebuhlungu ngequbuliso, ukubona okufipheleyo, ubunzima bokuthetha, ubunzima bokuhamba, kunye nokugoba kwelinye icala lobuso.
• Ukopha kakhulu ngenxa yezinto ezinciphisa igazi: Ukuhlanza ubomvu, ukuphuma kwendle ebomvu okanye emnyama, ukuphuma komchamo obomvu.
• Intlungu yesifuba okanye ezinye iimpawu zokuhlaselwa yintliziyo okanye ukuminxeka kwentliziyo : Ukuphefumla nzima, ukungakhululeki esiswini, kunye nokubila.

Ndingayibuza yiphi imibuzo ugqirha wam?

Xa undwendwela ugqirha wakho, ungabuza le mibuzo ukuze uqonde kakuhle imeko yakho:

• Kukangaphi kufuneka ndidibane nogqirha (ukulandelelana)?
• Kuthatha ixesha elingakanani ukubona iziphumo zotshintsho kwindlela yokuphila?
• Undicebisa ngamayeza anjani? Yintoni isizathu soko?
• Ngaba kufuneka ndifumane unyango olufana ne-cardioversion, i-ablation, okanye inkqubo ye-maze?

Ukuziva ukubetha kwentliziyo okungaqhelekanga kunokuba yinto ebangela uxinezeleko. Nangona kunjalo, kukho unyango olusebenzayo kwesi sifo esibizwa ngokuba yi-"A-fib with RVR". Ugqirha wakho anokukunceda ukhethe unyango olukufaneleyo. Ngokubona ugqirha wakho ngexesha kwaye uthathe amayeza akho owayalelweyo kanye njengoko eyalelwe, unokunceda ukukhusela impilo yakho.

Umyalezo Omele Uwuthathe Ekhaya: Ezona zinto zibalulekileyo ekufuneka uzikhumbule

Kulungile, masishwankathele ezinye zezinto ekufuneka uzikhumbule koko sithethe ngako:

• ``(A-fib with RVR)`` yimeko apho isingqisho sentliziyo singahambelaniyo kwaye sibetha ngokukhawuleza kakhulu.
• Ukuba ufumana iimpawu ezinje ngokuxinana kwesifuba, isiyezi, okanye ubunzima bokuphefumla , qiniseka ukuba ucela ingcebiso kugqirha.
• Oku kunokubangelwa zizinto ezininzi, kuquka uxinzelelo lwegazi oluphezulu kunye nesifo sentliziyo.
• Istroke yenye yezona ngxaki ziyingozi zoku, ngoko ke kubaluleke kakhulu ukuthatha amayeza okunciphisa igazi.
• Kukho iindlela ezahlukeneyo zonyango, ezinje ngamayeza kunye nokususwa kwe-catheter.
• Utshintsho olusempilweni kwindlela yokuphila (ukutya kakuhle, ukuzilolonga, kunye nokuyeka ukutshaya) lunceda kakhulu ekulawuleni le meko.
• Sela amayeza kanye njengoko ugqirha ewayalele. Landela ugqirha ngemihla ebekiweyo.
• Ukuba ufumana iimpawu zesilumkiso esingxamisekileyo (iimpawu zestroke, ukopha kakhulu, iintlungu zesifuba eziqatha) , yiya esibhedlele ngoko nangoko.

Awuwedwa. Baninzi abantu abaphila nale meko. Ngonyango olufanelekileyo nendlela yokuphila efanelekileyo, nawe ungaphila ubomi obusempilweni. Ungoyiki ukuthetha noogqirha bakho nize nisombulule iingxaki zakho.

Ukubetha kwentliziyo ngokukhawuleza , isifo sentliziyo, i-A-fib, i-RVR, ukubetha kwentliziyo ngokukhawuleza, iintlungu zesifuba, istroke