Ingabe inhliziyo yakho ngezinye izikhathi ishaya ngamandla ngaphandle kwesizathu? Izwakala sengathi isigubhu sishaya esifubeni sakho, ngaphandle kwesigqi, futhi izwakala iyesabeka kakhulu, akunjalo? Lesi simo mhlawumbe sikwenza ukhathale, ube nesiyezi, futhi uphelelwe umoya. Lolu hlobo lokushaya kwenhliziyo okungajwayelekile, ikakhulukazi isimo odokotela abasibiza ngokuthi 'i-Atrial Fibrillation' (AFib), ngezinye izikhathi asilawulwa kahle ngemithi enqunyiwe ukuyilawula. Yilapho odokotela becabangela khona ukwelashwa okukhethekile okubizwa ngokuthi 'i-AV Node Ablation'.
Kalula nje, kuyini i-AV Node Ablation?
Kulungile, lokhu kungase kubonakale njengegama eliyinkimbinkimbi, kodwa masiligcine lilula.
Okokuqala, ake sibheke uhlelo lukagesi lwenhliziyo yethu. Cabanga ngenhliziyo yakho njengendlu enamakamelo amane. Amakamelo amabili amancane phezulu abizwa ngokuthi i-atria. Amakamelo amabili amakhulu phansi abizwa ngokuthi ama-ventricle. Ukuze inhliziyo isebenze kahle, la makamelo kumele afinyele ngendlela ehlelekile nenesigqi. Lo msebenzi ulawulwa uhlelo lukagesi lwemvelo ngaphakathi kwenhliziyo.
Esimweni esifana ne-'Atrial Fibrillation' (AFib), izimpawu zikagesi emakamelweni amabili aphezulu enhliziyo (atria) ziyaphazamiseka, zibangele ukuthi zishaye ngokushesha okukhulu nangokungajwayelekile. Kufana ne-orchestra engenamqhubi, wonke umuntu edlala ingoma yakhe.
Lapha, ngaphambi kokuba lezi zimpawu zikagesi eziphazamisayo zihambe zisuka emakamelweni aphezulu ziye emakamelweni amakhulu (amaseli), kufanele zidlule "esangweni" elincane. Leli sango yilokho esikubiza ngokuthi i-AV node . Leli sango le-AV lifana nephoyisa lomgwaqo. Lizama ukulawula isimo ngokuvumela ukuthi kudlule okuncane kakhulu kwezimpawu ezisheshayo neziphazamisayo ezivela ngenhla.
Kodwa ngezinye izikhathi le nkinga iba nkulu kangangokuthi ngisho ne-AV node ayikwazi ukuyilawula. Yilapho odokotela benza khona lokho okubizwa ngokuthi 'i-AV Node Ablation.'
I-`Ablation` isho ukucisha ingxenye yethishu ngokusebenzisa ukushisa noma ukubanda okukhulu. Ngakho-ke i-`AV Node Ablation` isho ukucisha ngamabomu "isango" (i-AV node) lapho izimpawu eziphazamisayo zidlula khona.
Lokhu kubangela ukuthi ugesi ophazamisekile emakamelweni angenhla uyeke ngokuphelele ukuya emakamelweni amakhulu okupompa angaphansi.
Kungani i-pacemaker idingeka kakhulu?
Lena yinto ebaluleke kakhulu okudingeka uyazi ngale ndlela yokwelapha.
Uma sesilivalile unomphela isango elivumela izimpawu ezivela phezulu ukuthi zidlule phansi (i-AV node), amakamelo amabili (amaseli) enhliziyo awasatholi isignali yokushaya. Ingabe inhliziyo izoyeka ukushaya-ke? Cha. Yingakho odokotela befaka i-pacemaker ehlala njalo kuwe njengesixazululo.
Le pacemaker iyidivayisi esebenza ngebhethri elincane.Ithumela izimpawu zikagesi emakamelweni aphansi enhliziyo ukuze ishaye ngesigqi esithile nangesivinini esithile. Kalula nje, sivala ingxenye engasebenzi kahle yesistimu kagesi yemvelo yenhliziyo bese siyishintsha ngesilawuli sikagesi sokwenziwa esisebenza kahle kakhulu.
Into ebaluleke kakhulu ukuthi ukwelashwa okubizwa ngokuthi i-AV Node Ablation akulungiseki futhi kuhlala njalo. Lokhu kusho ukuthi ngemva kokwenziwa, kuzodingeka uhlale nomshini wokushaya indlwabu impilo yakho yonke.
Kunconywa bani lokhu kwelashwa?
I-AV Node Ablation akuyona indlela yokwelapha wonke umuntu. Kunezizathu eziningana eziyinhloko zokuthi kungani udokotela angase akuncomele yona:
- Uma yonke eminye imithi enikezwe ukulawula ukushaya kwenhliziyo yakho okungajwayelekile yehlulekile.
- Uma ungakwazi ukuqhubeka nokusebenzisa umuthi ngenxa yemiphumela emibi emibi kakhulu .
- Uma usuvele une-pacemaker efakiwe ngesinye isizathu.
- Uma ukusebenza kwenhliziyo yakho kuba buthaka ngenxa yesimo sakho se-'AFib'.
Lesi sinqumo senziwa ngemva kokuba udokotela wakho wenhliziyo ekuhlolile ngokucophelela.
Uzilungiselela kanjani ngaphambi kokwelashwa?
Uma ungenayo kakade i-pacemaker, udokotela wakho uzokufaka i-pacemaker emasontweni ambalwa ngaphambi kokukhipha isisu, ngesikhathi esifanayo ne-ablation, noma ngemva kokuba isiqediwe.
Ngaphezu kwalokho, ngaphambi kokwenza i-'ablation', odokotela benza i- EP Study ('Electrophysiology Study') . Lokhu kuhilela ukumaka imizila kagesi yenhliziyo ukuze bathole indawo eqondile ye-AV node esizoyivala.
Indlela ukwelashwa okusebenza ngayo - isinyathelo ngesinyathelo
Ungesabi ukusho ukuthi kuwukuhlinzwa okukhulu. I-AV Node Ablation inqubo engangenisi kakhulu evame ukwenziwa ngembobo encane esikhumbeni, ngaphandle kokusikwa okukhulu. Ake sibheke ukuthi kwenziwa kanjani.
| Izinyathelo | Incazelo elula yalokho okwenzekayo |
|---|---|
| 1. Ukulungiselela | I-cannula encane (IV) ifakwa emthanjeni engalweni yakho bese unikezwa imithi yokukusiza ulale futhi uphumule, ukuze ungazizwa ubuhlungu obukhulu. |
| 2. Ukuba ndikindiki | Indawo yakho yembobo, ingalo, noma intamo izophelelwa amandla. Yilapho i-catheter izofakwa khona. |
| 3. Ukufaka i-catheter | Ama-catheter ayimibhobho emincane kakhulu, emide, eguquguqukayo efakwa intambo isuka endaweni ethintekile idlule emthanjeni iye enhliziyweni. |
| 4. Ukuqapha | Phakathi nokwelashwa, odokotela nabahlengikazi baqapha izinto ezifana nokushaya kwenhliziyo yakho kanye nomfutho wegazi ezikrinini zekhompyutha. |
| 5. Ukuthola i-AV node | Esebenzisa ama-X-ray kanye nokumapha ngogesi kwenhliziyo, udokotela uzothola indawo eqondile ye-AV node. |
| 6. Ukususwa (ukuvalwa) | Idivayisi ekhethekile esesiqongweni se-catheter isebenzisa ukushisa (`amandla e-radiofrequency`) noma ukubanda okukhulu (`cryoablation`) ukuvimba i-AV node. |
Lonke lolu hlelo lungathatha kusukela ngaphansi kwehora kuya emahoreni amaningana.
Yiziphi izinzuzo nezingozi?
Njenganoma yikuphi ukwelashwa kwezokwelapha, kunezinzuzo kanye nezingozi ezincane kakhulu.
Izinzuzo eziyinhloko
- Ngeke kudingeke ukuthi uthathe imithi yokulawula ukushaya kwenhliziyo yakho (kodwa kungase kudingeke uqhubeke nokuthatha imithi yokunciphisa igazi).
- Izimpawu ezifana nesiyezi, ukukhathala, kanye nokuphelelwa umoya ziyancishiswa futhi izinga lempilo liyathuthuka.
- Uzokwazi ukwenza imisebenzi eminingi yomzimba kunangaphambili.
- Kunciphisa isidingo sokulaliswa esibhedlela noma ukuya eMnyangweni Wezimo Eziphuthumayo (ETU) njalo ngenxa yezinkinga zenhliziyo.
- Lokhu kuyimpumelelo enkulu kakhulu kanye nokuphephaUkuba yindlela yokwelapha.
Izinkinga ezingaba khona (ezingavamile kakhulu)
Izinkinga azivamile, kodwa kubalulekile ukuziqaphela.
- Ukuqongelela koketshezi olwelwesini oluzungeze inhliziyo (i-pericardial effusion).
- Olunye uhlobo lokushaya kwenhliziyo okungajwayelekile.
- Ukwehla kokusebenza kwe-ventricle yesobunxele yenhliziyo (lokhu kungalungiswa nge-pacemaker ekhethekile).
- Ukufa ngokuzumayo (lokhu akuvamile kakhulu).
Udokotela wakho uzokuchazela kabanzi ngalezi zingozi.
Kwenzekani ngemva kokwelashwa?
Ngemva kokuqeda ukwelashwa, udokotela uzokhipha ama-catheter bese ebamba izindawo zokufaka endaweni cishe imizuzu eyi-15. Ngemva kwalokho, kuzodingeka ulale embhedeni amahora ambalwa.
Ngokuvamile uzolala esibhedlela ubusuku bonke bese ubuyela ekhaya ngakusasa. Kuvamile ukuzizwa ukhathele futhi udabukile izinsuku ezimbili noma ezintathu ngemva kokubuyela ekhaya. Kodwa uzokwazi ukuqhubeka nemisebenzi yakho evamile zingakapheli izinsuku ezimbalwa.
Uzocelwa ukuthi uze uzobona udokotela wakho cishe inyanga eyodwa ngemuva kokufakwa kwe-pacemaker. Ngemva kwalokho, kuzodingeka ukuthi uhlolwe kanye noma kabili ngonyaka.
Uzobona nini udokotela
Ngemva kokwelashwa, uma uhlangabezana nezimpawu ezilandelayo, yazisa udokotela wakho ngokushesha.
| Ithuba | Izici okufanele uziqaphele |
|---|---|
| Izimpawu zokutheleleka | Uma indawo lapho kufakwe khona i-pacemaker ibuhlungu, ivuvukile, ibomvu, noma izizwa inomkhuhlane noma ibanda (lokhu kungenzeka ezinyangeni kamuva). |
| Uma ucabanga ukuthi kunenkinga nge-pacemaker yakho | Uma uzwa isiyezi njalo, ukuphelelwa amandla, noma ubunzima bokuphefumula. |
Ingabe zikhona ezinye izindlela zokwelapha ezihlukile?
Yebo. Olunye ukwelashwa okubhekwa njengolunye uhlobo lwe-'AV Node Ablation' yi -'Pulmonary Vein Isolation' (PVI) .
Lokhu kuhilela ukuthola izindawo lapho izimpawu zikagesi ezingavamile ezibangela i-AFIB ziqala khona (emithanjeni yamaphaphu) bese uzisusa ukuze uzimise. Ngemva kokwelashwa kwe-PVI, i-pacemaker ngokuvamile ayidingeki. Kodwa-ke, udokotela wakho uzonquma ukuthi yikuphi kwalokhu kwelashwa okubili okungcono kakhulu kuwe.
Ukwenza isinqumo sokuba ne-AV Node Ablation akulula. Akunakuguqulwa. Futhi abanye abantu abawuthandi umqondo wokuhlala ne-pacemaker impilo yabo yonke. Kodwa-ke, izinga lempumelelo yalokhu kwelashwa licishe libe yi-100%. Futhi impumuzo kanye nekhwalithi yempilo yakho okulethayo kuphezulu kakhulu.
Ngakho-ke, xoxa ngokukhululekile ngayo yonke imibuzo yakho kanye nokwesaba kwakho nodokotela wakho. Uzokuchazela konke futhi akusize wenze isinqumo esingcono kakhulu ngesimo sakho.
Umlayezo Wokuya Nawe Ekhaya
- I-AV Node Ablation iyindlela yokwelapha ephumelelayo yokushaya kwenhliziyo okungajwayelekile (i-Atrial Fibrillation) okunzima ukuyilawula ngemithi.
- Lokhu kuvimbela unomphela izimpawu zikagesi eziphazamisayo ezihamba zisuka emakamelweni aphezulu enhliziyo ziye emakamelweni aphansi.
- Lokhu kuyindlela yokwelapha engenakuguqulwa, okusho ukuthi ayinakuguqulwa uma isiqediwe.
- Ngemva kokuhlinzwa kwe-AV Node Ablation, kubalulekile ukugqoka i-pacemaker ehlala njalo impilo yakho yonke ukuze ulondoloze ukushaya kwenhliziyo okuvamile.
- Lokhu kwelashwa kunezinga eliphezulu kakhulu lempumelelo, kunciphisa izimpawu futhi kuthuthukisa kakhulu ikhwalithi yokuphila.
- Ngaphambi kokwenza noma yiziphi izinqumo, xoxa ngokucophelela ngezinzuzo, izinkinga, kanye nezinketho zokwelashwa nodokotela wakho wenhliziyo.
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