Ake sithole kahle ngomsebenzi kagesi wenhliziyo yakho? (Isifundo se-Electrophysiology - Isifundo se-EP)

Ingabe uzizwa into engavamile enhliziyweni yakho, njengokuphaphazela? Ngezinye izikhathi odokotela bathi badinga ukwenza isivivinyo ukuze babheke eduze umsebenzi kagesi wenhliziyo yakho. Yilapho-ke sikhuluma khona ngalesi "Sifundo se-Electrophysiology", noma njengoba sikubiza ngamafuphi, "Isifundo se-EP". Ungesabi, ake sixoxe ngalokhu kalula.

Kuyini ucwaningo lwe-EP?

Kalula nje, isifundo se-EP siwukuhlolwa okuhlaziya ngokunembile umsebenzi kagesi enhliziyweni yakho. Cabanga, inhliziyo yethu idinga isignali encane kagesi ukuze ishaye. Uma lezi zimpawu zisebenza kahle, inhliziyo ishaya ngendlela ehlelekile. Ngezinye izikhathi kukhona okungahambi kahle ngalezi zimpawu zikagesi, okusho ukushaya kwenhliziyo okungajwayelekile ( i-arrhythmia ) . Yilapho kusetshenziswa khona isifundo se-EP ukuthola ukuthi inkinga iyini nokuthi inkinga ikuphi.

Odokotela basebenzisa ama-catheter enhliziyo (amashubhu amancane kakhulu, amancane) namakhompyutha ukwenza lokhu. Lawa mashubhu afakwa enhliziyweni yakho futhi alinganisa umsebenzi kagesi wenhliziyo yakho kusukela lapho. Kufana ne- EKG , kodwa lawa ma-sensor, afakwa ngaphakathi kwenhliziyo yakho, anganikeza ulwazi olunemininingwane eminingi nolunembile kunezinzwa ezibekwe ngaphandle kwesifuba sakho.

Cabanga ngakho njengebhasi elihamba ngomzila walo ojwayelekile, ngesikhathi esifanele, nangendlela ehlelekile. Kodwa ukushaya kwenhliziyo okungajwayelekile (i-arrhythmia) kufana nebhasi elingahambi ngomzila walo ojwayelekile, mhlawumbe liqala endaweni engafanele, leqe ukuma, noma lingahambi yonke indlela. Noma lingahamba ngokushesha kakhulu, noma lingahamba kancane kakhulu. Lezo yizinhlobo zezimpawu ezingaguquki okudingeka odokotela bazibheke. Yilapho kuphela lapho benganquma khona ukuthi lesi simo siyingozi nokuthi bangasiphatha kanjani.

Uyibona kanjani le nqubo yenhliziyo kagesi?

Ilebhu lapho kwenziwa khona lesi `(EP Study)` ifana nehhovisi lomphenyi. Udokotela ochwepheshe owenza lokhu yi-`( Electrophysiologist )` onolwazi oluhle ngamaphethini esigqi senhliziyo. Angasho ukuthi izingxenye ezahlukene zenhliziyo zisebenza kanjani kumaphethini ahlukene wamagagasi kutheyiphu ye-`(EKG)`.

Laba odokotela bafunde amaza e-EKG, ukuthi kufanele abukeke kanjani ngokujwayelekile, nokuthi kusho ukuthini uma amaza ebukeka ehlukile. Banaka kakhulu lapho ukushaya kwenhliziyo okungajwayelekile kuqala khona futhi kuphelela khona ku-EKG.

Bese becabanga ukuthi, "Kulungile, yilokho okungaba yikho." Bese bekuhlola ku-EP Lab. AbanyeBanikeza imithi (njenge-Adenosine, i-Isoproterenol) yokusheshisa nokunciphisa ijubane lenhliziyo , bese bebona ukuthi umsebenzi kagesi wenhliziyo ushintsha kanjani ngaleso sikhathi. Lokhu kwenziwa ngokwecebo elithile, hhayi nje ukuqagela. Ngokusekelwe olwazini oluqoqwe, bacabanga ngezimbangela eziningana ezingaba khona, bese benza izivivinyo kuze kube yilapho bethola ukuthi inkinga iyini ngempela .

Kungani wenza lolu cwaningo lwe-EP?

Ucwaningo lwe-EP lungatshela udokotela wakho okuningi ngokushaya kwenhliziyo yakho okungajwayelekile . Isibonelo:

• Uhlobo luni lokuphazamiseka kwesigqi senhliziyo (i-arrhythmia) onalo?
• Iyini imbangela yalokhu kungahambi kahle?
• Le nkinga iqala kuphi enhliziyweni?
• Iyini imbangela yokuthi uvame ukuzizwa unesiyezi futhi ube nenkinga yokuphupha ?
• Nquma ukuthi yikuphi ukwelashwa okungcono kakhulu kwalokhu.
• Hlola ukuthi imithi oyithathayo njengamanje isebenza kahle yini.
• Thola ukuthi usengozini yokufa ngokuzumayo kwenhliziyo .

Udokotela unquma ukwenza i-EP Study lapho engakwazi ukuthola ulwazi olwanele ezivivinyweni ezifana ne-ECG, i- Holter monitor (idivayisi eqapha isigqi senhliziyo ngenkathi usembhedeni cishe usuku olulodwa noma ezimbili), i -event recorder , i- stress test (eqapha inhliziyo ngesikhathi sokuzivocavoca), i-echocardiogram (i-ultrasound scan yenhliziyo), noma i-angiogram (eqapha imithambo yegazi enhliziyweni).

Ngezinye izikhathi, kuye ngesimo sakho kanye nolwazi olutholakale ku-EP Study, ukwelashwa okubizwa ngokuthi i-Catheter Ablation kungenziwa ngesikhathi esifanayo . Lokhu kusho ukuthi izindawo ezincane enhliziyweni ezibangela izimpawu zikagesi ezingajwayelekile ziyavalwa nge-catheter (ithubhu) efakwe enhliziyweni.

Kufanele uzilungiselele kanjani izifundo ze-EP?

Kunezinto ezimbalwa okufanele uzilungiselele ngaphambi kwalokhu kuhlolwa. Ungakhathazeki, lezi yizinto ezivamile.

• Hlela ukuba othile akuphelezele uye esibhedlela futhi ubuya naso. Ngeke ukwazi ukushayela amahora angama-24 ngemva kokuhlolwa.
• Uma unemibuzo noma ukukhathazeka mayelana nalolu vivinyo, sicela uxoxe ngakho nodokotela.
• Sitshele uma une-allergy ku-latex noma uke waba nezinkinga zokubulala izinzwa ngaphambilini .
• Izingubo ezikhululekileWoza ugqoke.
• Susa zonke izimonyo kanye ne-nail polish ngaphambi kokuya esibhedlela.
• Shiya zonke izinto zokuhloba eziyigugu njengendandatho, imigexo, namawashi ekhaya. Letha izibuko zakho nezinsiza zokuzwa uma unazo.

Ake sibheke nemithi nokudla:

• Tshela udokotela wakho ngayo yonke imithi oyithathayo (eyalelwe udokotela, ethengiswa ngaphandle kwemithi kadokotela, imithi yesintu, amavithamini) .
• Letha imithi yakho eyanele usuku olulodwa. Kodwa ungayithathi uze ukhulume nodokotela wakho.
• Buza udokotela wakho ukuthi yimiphi imithi okufanele uyithathe ngaphambi kokuhlolwa, yimiphi imithi okufanele uyeke, nini ukuyeka, nokuthi nini ukuqala futhi . Ungayeki noma yimuphi umuthi ngaphandle kweseluleko sikadokotela wakho.
• Uma unesifo sikashukela, buza ukuthi kufanele uwushintshe kanjani umuthi wakho wesifo sikashukela .
• Yidla ngokujwayelekile ngobusuku bangaphambi kokuhlolwa.
• Ungadli, uphuze, noma uhlafune noma yini ngemva kwamabili ebusuku ngaphambi kokuhlolwa. Ungalinge ngisho nokuhlafuna itshungama, iminti, noma amanzi. Lokhu kubaluleke kakhulu ekuphepheni kwakho.
• Uma kufanele uphuze umuthi, phuza kanye noma amabili amanzi.
• Ungagwinyi amanzi ngenkathi uxubha amazinyo akho.

Yini ongayilindela ngosuku lwesifundo se-EP?

Ukuhlolwa kwakho kuzokwenziwa ekamelweni elikhethekile elibizwa ngokuthi i-Electrophysiology Lab (EP Lab) noma i-Catheterization Lab .

Ngemva kokuba ulaliswe embhedeni, udokotela kanye nethimba lakho bazokwenza okulandelayo:

• Umugqa we-intravenous (IV) (ofana nomugqa we-saline) uzofakwa engalweni noma esandleni sakho. Yilapho uzonikezwa khona imithi kanye noketshezi ngesikhathi sokuhlolwa.
• Uma kudingeka, amakhwapha akho, izingalo, noma intamo yakho kuzogundwa futhi kuhlanzwe ngesisombululo sokubulala amagciwane.
• Uzombozwa kusukela entanyeni kuya ozwaneni ngendwangu engcolile.
• Ukuze uvimbele izandla zakho ukuthinta izindawo ezingenwe amagciwane, kufakwa ibhande okhalweni lwakho bese izingalo zakho ziphakanyiswa.

Kwenzekani ngesikhathi socwaningo lwe-EP?

Manje yisikhathi esibaluleke kakhulu. Nazi izinto udokotela azozenza:

• Imbobo yakho, intamo, noma ingalo (lapho kufakwa khona i-catheter) izofakwa umuthi okhethekile.
• Bese kuthi, amaningana ala ma-catheter (amapayipi amancane) afakwe emthanjeni omkhulu embotsheni yakho, entanyeni, noma engalweni.
• Ukusebenzisa i-'Fluoroscopy' (lokhu kufana nevidiyo ye-'X-ray') kanye nomshini we-'Ultrasound', lawa ma-catheter aqondiswa ngqo enhliziyweni yakho, emakamelweni ayo. Lawa ma-catheter asetshenziselwa ukuthola nokuqopha umsebenzi kagesi wenhliziyo. Lokhu kukuvumela ukuthi uqonde kangcono 'iSistimu Yokuqhutshwa Kwemithambo', uhlelo lapho izimpawu zikagesi zihamba khona enhliziyweni yakho.
• Nge-catheter eyodwa,Idivayisi ebizwa ngokuthi i-pacemaker ithumela izimpawu zikagesi ezincane ukuze isheshise ukushaya kwenhliziyo yakho. Ngalesi sikhathi, ungase uzizwe inhliziyo yakho ishaya ngokushesha okukhulu.
• Kuye ngesimo sakho, uma kukhona ukuxhumana okunephutha okubangela izimpawu zikagesi ezingajwayelekile, kungenziwa kusebenze kusetshenziswa inqubo ebizwa ngokuthi i-`Catheter Ablation` .

Into ebaluleke kakhulu ukuthi uma uzizwa ungakhululekile noma ungajwayelekile ngesikhathi se-EP Study, tshela udokotela noma umhlengikazi lapho.

Uma unesifo sokushaya kwenhliziyo okungajwayelekile, udokotela wakho uzokunikeza imithi nge-IV yakho ukuze abone ukuthi bayilawula kahle kangakanani. Uma kudingeka, bangase bakunike nomfutho omncane kagesi nge-patch esifubeni sakho ukusiza ekubuyiseleni isigqi senhliziyo yakho.

Kuyo yonke le nqubo yokuhlolwa, ithimba lakho lezokwelapha lizosebenzisa amathuluzi ahlukahlukene:

• I-Fluoroscopy: Umshini omkhulu we-X-ray ongaphezulu kwakho. Lokhu kuvumela udokotela ukuthi aqaphe njalo i-catheter engaphakathi kwenhliziyo yakho esikrinini se-X-ray.
• `I-Defibrillator / I-Pacemaker / I-Cardioverter`: Lokhu kuxhunywe ku-patch emhlane wakho kanye ne-patch esifubeni sakho. Kunganikeza ukushaya kwenhliziyo kagesi ukusheshisa ukushaya kwenhliziyo okuhamba kancane noma kumise isigqi esiyingozi.
• I-Electrocardiogram (EKG): Lokhu kuxhunywe ezinhlakeni eziningana ezinamathelayo esifubeni sakho, kanye nama-catheter angaphakathi kwenhliziyo yakho. Kuveza isithombe sezimpawu zikagesi ezidlula enhliziyweni yakho.
• I-Intracardiac Echocardiogram: Lokhu kuyi-ultrasound encane. Kuyasiza ukuqondisa i-catheter ngokunembile ngesikhathi sokuhlolwa.
• Isiqaphi Somfutho Wegazi: Lokhu kunamathiselwe ekhaphethini engalweni yakho futhi kuqapha umfutho wegazi lakho phakathi nokuhlolwa.
• I-Oximeter Monitor: Lesi isiqeshana esincane osifaka emunweni wakho. Silinganisa izinga lomoya-mpilo egazini lakho.

Yini ongayilindela ngemva kokuhlolwa?

Ngemva kokuthi i-EP Study isiqediwe, udokotela uzosusa i-catheter esinqeni sakho, engalweni, noma entanyeni bese efaka ingcindezi endaweni okwesikhashana ukuze amise ukopha.

• Kuzodingeka uhlale embhedeni cishe ihora elilodwa kuya kwamane . Uma i-catheter ifakwe nge-groin, kufanele ugcine umlenze wakho uqondile ngangokunokwenzeka futhi ungawushukumisi.
• Kuye ngemiphumela yokuqala yokuhlolwa kwakho, kungadingeka uhlale esibhedlela uma kudingeka .
• Ibhandeji elincane elihlanzekile (ibhandeji) lifakwa phezu kwe-catheter. Lingasuswa ngosuku olulandelayo. Ezimweni eziningi, izithungo azidingeki.
• Indawo elimele kufanele igcinwe ihlanzekile futhi yomile .
• Ngemva kokuhlolwa, ungadla futhi uthathe umuthi.
• Ungaqhubeka nemisebenzi yakho evamile ngosuku olulandela ukuhlolwa.Kodwa kuzodingeka unciphise izinto ezifana nokuphakamisa izinsimbi cishe isonto lonke.

Ingabe kukhona izingozi kulokhu?

Ucwaningo lwe-EP ngokuvamile luwukuhlolwa okuphephile kakhulu. Kodwa-ke, njenganoma iyiphi inqubo yezokwelapha, kunezingozi ezithile. Lokhu kufaka phakathi:

• Ukutheleleka noma ukopha endaweni yokufakwa kwe-catheter.
• Ukushaya kwenhliziyo okungajwayelekile (i-Arrhythmia) .
• Kwakha ihlule legazi ku-catheter bese libhajwa emthanjeni wegazi.
• Ukulimala emthanjeni wegazi, ivalvu yenhliziyo, noma igumbi lenhliziyo.
• Ukuhlaselwa yinhliziyo.
• Isifo sohlangothi.

Kodwa ungakhathazeki, odokotela bakho benza lolu cwaningo lwe-EP endaweni elawulwa kahle. Futhi bathatha izinyathelo ezikhethekile zokunciphisa izingozi kuwe. Uma unemibuzo mayelana nezingozi nezinzuzo zalolu vivinyo, khuluma nodokotela wakho.

Yiziphi izinzuzo zocwaningo lwe-EP?

Ungathola izinzuzo ezilandelayo ku-`(EP Study)`:

• Uzothola izimpendulo zemibuzo yakho mayelana nokuthi yini engalungile ngesigqi senhliziyo yakho.
• Mhlawumbe uma inkinga ingaxazululwa nge-"Catheter Ablation", singase singabi nasidingo sokuqhubeka nokuphuza imithi ethile.
• Izinga lempilo yakho lizothuthuka.
• Kwezinye izinkinga zesigqi senhliziyo, ukuzelapha nge-"Catheter Ablation" kungaba yindlela engabizi kakhulu kunokuhlinzwa kwe-"Arrhythmia".

Ucwaningo lwe-EP luvame ukuphephile. Ingozi yokufa ngenxa yalokhu iphansi kakhulu, cishe oyedwa kwabayi-5,000.

Ngiyithola kanjani imiphumela? Ngenzenjani ngokulandelayo?

Ngemva kokuhlolwa, udokotela uzokutshela imiphumela yokuqala . Ngokusekelwe kuleyo miphumela, uzonquma ukuthi ungaya ekhaya noma ukuthi udinga ukuhlala esibhedlela. Udokotela angakucela ukuthi ubuye ngosuku oluhlukile ukuze uxoxe ngemiphumela ye-EP Study kanye nokwelashwa kwakho okwengeziwe.

Uma imiphumela ikhombisa noma yini engavamile, udokotela wakho angase akwazi ukuyelapha ngokushesha nge-"Catheter Ablation". Uma kungenjalo, kungadingeka bahlele ezinye izindlela zokwelapha noma bakunikeze imithi. Abanye abantu bangadinga ezinye izindlela zokwelapha, njenge- "Pacemaker" , ngisho nangemva kwe-"Catheter Ablation".

Udinga ukubona udokotela ngasiphi isikhathi?

Uma ubuyela ekhaya ngemva kokuhlolwa, kufanele nakanjani ushayele udokotela wakho ucingo uma uhlangabezana nanoma yiziphi zalezi zimpawu:

• Uma indawo ye-catheter ibomvu, ivuvukele, noma inoketshezi oluphuma kuyo.
• Uma uzwa ukungazweli noma umuzwa ongajwayelekile engalweni noma emlenzeni lapho kufakwe khona i-catheter.
• Kungaba engalweni noma emlenzeni lapho kufakwe khona i-catheterUma iminwe yakho ibanda, ilahlekelwa umuzwa, noma ishintsha umbala.
• Uma uzohlanza.
• Uma unezinhlungu esifubeni .

Shayela ku-1990 ukuze uthole ukwelashwa okuphuthumayo, noma uye esibhedlela esiseduze, uma uhlangabezana nanoma yikuphi kwalokhu okulandelayo:

• Uma ukopha kungayeki ngisho nangemva kokucindezela nokubamba indawo ye-catheter.
• Uma ukuvuvukala okuzungeze inxeba kukhula ngokuzumayo.

Imibuzo embalwa eyengeziwe kuwe.

Ingabe sivukile uma senza ucwaningo lwe-EP?

Yebo. Unikezwa imithi nge-IV ukuze uzole futhi uzizwe ulele kancane. Kodwa awukalele ngokuphelele.

Kuthatha isikhathi esingakanani isifundo se-EP?

Ngokuvamile kuthatha cishe ihora elilodwa kuya kwamane .

Ingabe isifundo se-EP sibuhlungu?

Uzonikezwa umuthi wokudambisa ukuze ungezwa ubuhlungu. Kodwa-ke, ungase uzwe umuzwa omncane wokuncinza esikhumbeni lapho kufakwe khona i-catheter.

Izinto ezibaluleke kakhulu okufanele uzikhumbule

Uma ucelwa ukuba wenze isifundo se-EP, kungase kubonakale kuyinto enkulu kunanoma yikuphi ukuhlolwa kwenhliziyo owake wakwenza ngaphambili. Kodwa udokotela wakho uku-oda ngesizathu esithile. Ukwenza lokhu ukuze athole ukuthi kwenzekani enhliziyweni yakho futhi akusize . Ucwaningo lwe-EP luhilela ukufaka amathuluzi enhliziyweni yakho, kodwa luwukuhlolwa okuphephile. Lunikeza udokotela wakho ulwazi aludingayo ukuze elaphe ukushaya kwenhliziyo yakho okungajwayelekile.

Khumbula, ithimba lezokwelapha lizokwenza konke okusemandleni alo ukukwenza ukhululeke ngesikhathi sokuhlolwa. Khuluma nabo nganoma yimiphi imibuzo noma ukukhathazeka ongase ube nakho. Lokhu kuzokusiza uzizwe ukhululekile kakhudlwana.

Izinga lokushaya kwenhliziyo , isifundo se-EP, isifo senhliziyo, i-catheter, umsebenzi kagesi wenhliziyo, i-arrhythmia, ukuhlolwa kwenhliziyo