Wake wazizwa sengathi inhliziyo yakho ishaya ngokushesha okukhulu, ingalawuleki? Kufana nesigubhu sishaya ngokushesha kodwa ngaphandle kwesigqi. Kwezokwelapha, lesi simo sisibiza ngokuthi i-Atrial Fibrillation . Esikhathini esiningi, lokhu kungalawulwa ngemithi. Kodwa-ke, uma kungenakulawulwa ngemithi, namuhla sikhuluma ngendlela yokwelapha ekhethekile esetshenziswa odokotela.
Kalula nje, kuyini i-AV Node Ablation?
Kulungile, igama lizwakala liyinkimbinkimbi kancane, kodwa inqubo ilula kakhulu. Kalula nje, i-AV Node Ablation inqubo engangenisi kakhulu ehilela ukulimaza indawo encane yezicubu enhliziyweni yakho ebizwa ngokuthi i-AV node (i-Atrioventricular node) ngokushisa noma ukubanda okukhulu, okuyekisa ukusebenza kwayo.
Manje cishe ucabanga ukuthi, "O, ubuqonde ukukhubaza ingxenye yenhliziyo?" Ungakhathazeki, ake sicacise ngalokho.
Cabanga ngale node ye-AV njengendlela enkulu yokuhlangana ohlelweni lukagesi lwenhliziyo. Izimpawu zikagesi zithunyelwa zisuka emakamelweni aphezulu (i-atria) yenhliziyo ziye emakamelweni aphansi (ama-ventricle) ngale ndlela yokuhlangana. Ku-fibrillation ye-atrial, izimpawu zikagesi ezivela emakamelweni aphezulu ziyaphazamiseka kakhulu futhi ziyashesha. Ngakho-ke, ukuze sivimbe lezi zimpawu eziphazamisekile ukuthi zingayi emakamelweni aphansi, sivala le ndlela yokuhlangana (i-AV node).
Ngemuva kwalokho, ukuze ulawule ukushaya kwenhliziyo yakho, uzofakelwa umshini wokushaya kwenhliziyo ohlala njalo ngaphambi noma phakathi nalokhu kwelashwa. Lokhu kusho ukuthi umshini wokushaya kwenhliziyo uzothatha imisebenzi ye-AV node. Lokhu kuzosiza ukugcina ukushaya kwenhliziyo kusesimweni esifanele.
Ubani ngempela odinga lokhu kwelashwa?
I-Atrial Fibrillation yisimo okumele selashwe. Kodwa-ke, i-AV Node Ablation ayifanele wonke umuntu. Udokotela wakho angaphakamisa lokhu kwelashwa uma uwela kwesinye sezigaba ezilandelayo:
- Uma imithi ingasebenzi: Uma imithi enikezwa ukulawula i-atrial fibrillation ingakwazi ukulawula ukushaya kwenhliziyo yakho.
- Uma ungakwazi ukubekezelela imithi: Abanye abantu bakuthola kunzima ukuqhubeka nokusebenzisa imithi ngenxa yemiphumela emibi.
- Uma ezinye izindlela zokwelapha zehlulekile: Uma ezinye izindlela zokwelapha, njengokuhlukaniswa kwemithambo yamaphaphu, zehlulekile ukulawula izinga lokushaya kwenhliziyo.
- Uma usuvele unayo i-pacemaker: Ngezinye izikhathi lokhu kwelashwa kungaphakanyiswa nakubantu asebevele besebenzisa i-pacemaker ngezinye izizathu.
I-AV Node Ablation ayiphathi nje kuphela i-Atrial Fibrillation, kodwa futhi nezinye izinhliziyo eziningana ezingajwayelekile ezenzeka emakamelweni aphezulu enhliziyo. Isibonelo:
- Ukukhukhuleka kwe-Atrial
- I-Supraventricular Arrhythmias
Indlela ukwelashwa okusebenza ngayo, isinyathelo ngesinyathelo
Nakuba lokhu kungesiwo ukuhlinzwa okukhulu, kuyinto eyenziwa ngokucophelela okukhulu.
Kwenzekani ngaphambi kokwelashwa?
Uma ungenayo kakade i-pacemaker, uzofakelwa i-pacemaker ehlala njalo amasonto ambalwa ngaphambi kwalokhu kwelashwa, noma ngezinye izikhathi ngosuku lokwelashwa. Ngaphezu kwalokho, udokotela wakho uzokwenza ucwaningo lwe-electrophysiology yenhliziyo yakho ukuze athole indawo eqondile ye-AV node.
Uma uqala ukwelashwa:
1. I-cannula encane (IV) izofakwa emthanjeni engalweni yakho bese unikezwa umuthi wokukulalisa kancane (i-sedation).
2. Ukuqaqamba ebusweni besikhumba endaweni efana ne-groin, intamo, noma ingalo.
3. Ngayo, kufakwa amapayipi amade (ama-catheter) amahle kakhulu enhliziyweni yakho ngomunye wemithambo yakho.
Kwenzekani ngesikhathi sokwelashwa?
Ngemva kokufaka i-catheter, ithimba lezokwelapha:
- Izimpawu zakho ezibalulekile kanye nesigqi senhliziyo kuzoqhubeka nokubhekwa.
- Kusetshenziswa ubuchwepheshe be-X-ray, i-catheter iqondiswa ku-node ye-AV.
- Kusetshenziswa isihloko se-catheter ekhethekile, i-AV node iyavalwa ukushisa (i-Radiofrequency ablation) noma ukubanda okukhulu (i-Cryoablation) .
Ngemva kokwelashwa?
Uma inqubo isiqediwe, udokotela uzokhipha ama-catheter awabambe endaweni yawo cishe imizuzu eyi-15. Uzobe usucelwa ukuthi ulale embhedeni amahora ambalwa. Ngokuvamile uzohlala esibhedlela ubusuku bonke bese ubuyela ekhaya ngosuku olulandelayo.
Umehluko phakathi kwe-AV Node Ablation ne-PVI
Abanye abantu bakhetha ukwelashwa okubizwa ngokuthi i-Pulmonary Vein Isolation (PVI) esikhundleni se-AV Node Ablation. Nakuba kokubili kuhlose ukulawula i-Atrial Fibrillation, kunomehluko omncane endleleni yokusebenza kanye nemiphumela. Ake sikubheke ngale ndlela.
| Isici | Ukususwa kwe-AV Node | Ukuhlukaniswa Kwemithambo Yemiphunga Yephaphu (i-PVI) |
|---|---|---|
| Inhloso eyinhloko | Ukuvimba izimpawu zikagesi eziphazamisayo ukuthi zingayi engxenyeni engezansi yenhliziyo. | Ukwakheka kwesithiyo esizungeze indawo lapho kuvela khona izimpawu zikagesi eziphazamisayo (imithambo yamaphaphu). |
| Imfuneko ye-Pacemaker | Kuyadingeka ngempela impilo yonke. | Ngokuvamile akudingeki. |
| Izinga lempumelelo | Kuphezulu kakhulu (ngaphezu kuka-90%). | Iphansi impela (phakathi kuka-60% - 80%). |
Yiziphi izinzuzo nezingozi?
Izinzuzo zalokhu
- Isilinganiso senhliziyo esihle: Kungenzeka ukulawula isigqi senhliziyo ngaphandle kwemithi (noma kunjalo, kungadingeka uqhubeke nokuthatha imithi yokunciphisa igazi).
- Izinga elihle lokuphila: Izimpawu ziyancipha, impilo iba ngcono.
- Ukuzivocavoca kungenza: Amandla omzimba okusebenza kanzima ayanda.
- Ukuncipha kokulaliswa esibhedlela: Inani lokulaliswa esibhedlela noma ukuvakashela i-Emergency Treatment Unit (ETU) liyancipha.
Ingabe zikhona izingozi?
Njenganoma yikuphi ukwelashwa kwezokwelapha, kunezingozi ezincane kakhulu, kodwa lezi azivamile.
- Izinkinga nge-pacemaker efakiwe.
- I-Ventricular arrhythmias (ukushaya kwenhliziyo okungajwayelekile emakamelweni aphansi enhliziyo).
- Ukwehla kokusebenza kwe-ventricle yesobunxele yenhliziyo (lokhu kungalungiswa nangokufaka i-pacemaker lead eyengeziwe (i-Biventricular pacing).
Into ebaluleke kakhulu ukuthi i-AV Node Ablation iyindlela yokwelapha ehlala njalo engenakushintshwa (engenakuguqulwa) . Yingakho kudingeka i-pacemaker impilo yonke. Lokhu kuyinto okufanele uyicabangele ngokucophelela ngaphambi kokwenza lesi sinqumo.
Kunini lapho udinga ukubonana nodokotela?
Ngemva kokusebenzisa i-pacemaker, kuzodingeka ubone udokotela wakho njalo. Ngokuvamile ngemva kwenyanga yokuqala, bese kuba kanye noma kabili ngonyaka. Kodwa-ke, uma uhlangabezana nanoma yiziphi izimpawu ezilandelayo, bona udokotela wakho ngokushesha.
| Ithuba | Izimpawu okufanele uzibheke |
|---|---|
| Uma usola ukuthi kukhona ukutheleleka endaweni ye-pacemaker: | |
| Izimpawu zokutheleleka | Imfiva |
| Ukuthuthumela ngenxa yokubanda | |
| Ubuhlungu, ukubomvu, noma ukuvuvukala lapho kukhona khona i-pacemaker | |
| Uma ucabanga ukuthi i-pacemaker yakho ayisebenzi kahle: | |
| Izinkinga zokusebenza | Isiyezi (i-vertigo) |
| Ukuhamba ungenawo iwashi (ukuguga) | |
| Ubunzima bokuphefumula | |
Ukunquma ukuba ne-AV Node Ablation akulula. Ngoba akunakuphikiswa futhi kuzodingeka uphile nomshini wokushaya indlwabu impilo yakho yonke. Kodwa-ke, izinga lempumelelo liphezulu kakhulu. Ngakho-ke, xoxa ngayo yonke imibuzo yakho kanye nokwesaba kwakho nodokotela wakho. Into ebaluleke kakhulu ukwazi konke nokwenza isinqumo esifanele wena.
Umlayezo Wokuya Nawe Ekhaya
- I-AV Node Ablation iyindlela yokwelapha ephumelela kakhulu ye-atrial fibrillation enzima engakaze ilawulwe ezinye izindlela zokwelapha.
- Lokhu ukwelashwa okuhlala njalo, okungenakuguqulwa, futhi ngemva kokwelashwa uzodinga i-pacemaker impilo yakho yonke.
- Lokhu kwelashwa kunezinga lempumelelo elingaphezu kuka-90% futhi kungathuthukisa kakhulu ikhwalithi yempilo yakho.
- Lesi yisinqumo esikhulu. Ngakho-ke, yenza isinqumo esinolwazi ngokuxoxa ngokukhululekile ngezinzuzo, izinkinga, kanye nanoma yikuphi ukukhathazeka ongase ube nakho nodokotela wakho.
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