Ngezinye izikhathi ungase uzizwe sengathi inhliziyo yakho ayishayi ngesigqi, ngezinye izikhathi inhliziyo yakho ishaya ngokushesha okukhulu, sengathi iyagxuma, noma ezinye izibhaxa ziyayekwa. Lolu hlobo lokushaya kwenhliziyo okungajwayelekile akuyona into okufanele ithathwe kalula. Lokhu kubizwa ngokuthi i-Atrial Fibrillation (Afib) kwisayensi yezokwelapha. Namuhla sizokhuluma ngenqubo ekhethekile esetshenziswa njengokwelapha lesi simo.
Kalula nje, kuyini i-Pulmonary Vein Isolation (PVI)?
Ukuhlukaniswa Kwemithambo Yezinhlungu Ze ...
Cabanga ngalokhu. Inhliziyo yethu iyisitho esimangalisayo. Ukushaya kwayo kulawulwa uhlelo olubucayi kakhulu lwezimpawu zikagesi. Kodwa kumuntu onalesi simo esibizwa ngokuthi i-Afib, amakamelo amabili aphezulu enhliziyo (esiwabiza ngokuthi i-atria) aqala ukuthola izimpawu zikagesi ezingalungile nezingavamile. Lezi zimpawu ezingalungile zibangela ukuthi ingxenye engenhla yenhliziyo ishaye ngokushesha okukhulu, njengokungathi iyathuthumela. Uma lokhu kuqhubeka, ingozi yezimo ezibucayi ezifana nesifo sohlangothi iphezulu kakhulu.
Ngakho-ke uyazi ukuthi lezi zimpawu zikagesi ezinephutha zivame ukuqala kuphi? Kunemithambo emine ethwala igazi elihlanzekile, elinomoya-mpilo lisuka emaphashini ethu liye e-atrium yesobunxele yenhliziyo. Lena yilokho esikubiza ngokuthi i-Pulmonary Veins . Kuseduze naleyo mithambo emine lapho izimpawu ezinephutha ezibangela i-Afib zivame ukuqala khona.
Ukwelashwa kwe-Pulmonary Vein Isolation (PVI) kuhilela ukuhlonza lapho izimpawu ezingavamile ziqala khona nokudala isithiyo esincane ukuze sizivimbele ekufinyeleleni kwezinye izingxenye zenhliziyo. Lesi sisithiyo sidalwa ngokusebenzisa ukushisa okuthambile noma ukubanda okukhulu ukudala inani elincane lezicubu zesibazi kulezo zindawo. Lesi sisithiyo sivimbela izimpawu zikagesi ezingavamile ukuba zingadluli kulelo phuzu. Kufana nokuvala indlela engalungile. Bese inhliziyo iqala ukushaya ngendlela evamile futhi. Le nqubo ibizwa ngokuthi i-Heart Ablation .
Ubani ngempela odinga lokhu kwelashwa?
Lokhu kwelashwa akusikho okwawo wonke umuntu. Udokotela wakho uzocabangela izici eziningana ngaphambi kokunquma ukuthi kulungile yini kuwe. Lokhu kwelashwa kuvame ukubafanele abantu abalandelayo:
- Kulabo abasenezimpawu (ukushaya kwenhliziyo okukhulu, ukukhathala, ukuphelelwa umoya) naphezu kokuthatha imithi yokulwa nokuphazamiseka kwemizwa ukulawula isimo sabo se-Afib.
- Uma le mithi ibangela imiphumela emibi noma uma umzimba ungakwazi ukubekezelela imithi.
Khumbula, odokotela bacabanga ngalesi sinyathelo esilandelayo kuphela uma imithi yehluleka ukulawula lesi simo.
Ingabe lokhu kwelashwa kungenziwa ngaphandle kokusebenzisa imithi?
Lena inkinga abantu abaningi abanayo. Abacwaningi basaphenya ukuthi i-PVI iyindlela yokwelapha engcono kakhulu kwabanye iziguli kunemithi. Ezinye izifundo zikhombisile ukuthi i-PVI isebenza kangcono kunemithi. Kodwa akukabi yindlela yokwelapha ejwayelekile. Ngakho-ke indlela yamanje ukuzama imithi kuqala bese ucabangela i-PVI uma lokho kungasebenzi.
Wazi kanjani ukuthi lokhu kwelashwa kulungile kuwe?
Akunakwenzeka ukusho ngokushesha ukuthi uyakufanelekela yini lokhu. Kuzodingeka uhlolwe ngokuphelele ngokwezokwelapha. Udokotela uzoqala ngokubuza ngomlando wakho wezokwelapha bese enza ukuhlolwa ngokomzimba. Ngemuva kwalokho uzoyala ukuhlolwa okuningana okuhlobene nenhliziyo. Ezinye zazo yilezi:
- I-Echocardiogram: Lokhu kunganikeza isithombe esicacile somsebenzi kanye nesakhiwo senhliziyo.
- I-Electrocardiogram (EKG): Ukuhlolwa okuqopha umsebenzi kagesi wenhliziyo.
- I-Holter Monitor: Lona umshini omncane we-EKG onamathele emzimbeni wakho amahora angama-24 noma angama-48. Ungaqapha ukuthi isigqi senhliziyo yakho sishintsha kanjani usuku lonke.
Udokotela uzothatha isinqumo sokugcina sokuthi ukwelashwa kwe-PVI kuyakufanelekela yini noma cha ngokusekelwe emiphumeleni yalezi zivivinyo.
Iphathwa kanjani i-PVI? Yiziphi izindlela eziyinhloko?
Ukususwa kwemithambo yegazi emaphashini kuyindlela yokwelapha ebizwa ngokuthi i-Catheter Ablation . Lokhu kusho ukuthi akwenziwa ngokusika okukhulu esifubeni njengokuhlinzwa. Kunalokho, kwenziwa ngokufaka ipayipi elincane kakhulu, elide (i-catheter) ngemithambo yegazi emikhulu e-groin noma entanyeni nasenhliziyweni.
Kunezindlela ezimbili eziyinhloko zokulungisa izicubu zesibazi esikhulume ngazo ekuqaleni.
| Indlela yokwelapha | Incazelo |
|---|---|
| Ukususwa kwe-Radiofrequency (kusetshenziswa ukushisa) | Lena yindlela evame ukusetshenziswa kakhulu. Lapha, amagagasi omsakazo asetshenziswa esicongweni se-catheter ukuze kukhiqizwe ukushisa, kubhubhise izicubu ezithola izimpawu ezingalungile futhi kudale isibazi. |
| I-Cryoablation (ukusetshenziswa komkhuhlane omkhulu) | Le ndlela isebenzisa ukubanda okukhulu ukuze iqandiswe okwesikhashana futhi ibhubhise unomphela izicubu okukhulunywa ngazo. |
Iyiphi kulezi zindlela ezimbili engcono kakhulu?
Ayikho indlela yokusho ukuthi enye indlela ingcono kunenye. Zombili zinezinzuzo nezinkinga zazo. Ucwaningo lukhombisile ukuthi akukho mehluko omkhulu emiphumeleni nasekuphepheni kwalezi zindlela ezimbili. Udokotela wakho uzokuchazela ngaphambi kokwelashwa ukuthi iyiphi indlela engcono kakhulu kuwe.
Kwenzekani ngesikhathi sokwelashwa? Ingabe ngizozwa ubuhlungu?
Ngokuvamile, phakathi nalokhu kwelashwa, unikezwa i-anesthesia ngokuphelele (i-General Anesthesia) . Lokhu kusho ukuthi uzobe ulele ngokuphelele. Ngakho-ke, ngeke uzwe ubuhlungu noma ukungakhululeki ngesikhathi sokwelashwa. Uma uvuka, konke kuzobe sekuphelile. Kwezinye izimo ezikhethekile, lokhu kungenziwa ngokufaka izinzwa endaweni efanele kuphela (i-anesthesia yendawo). Udokotela uzokwazisa ngalokhu kusenesikhathi.
Kwenzekani isinyathelo ngesinyathelo
1. Ukulungiselela: Okokuqala, uzonikezwa i-anesthesia. Ngemuva kwalokho, indawo esesinqeni sakho noma entanyeni lapho kuzofakwa khona i-catheter izohlanzwa futhi isuswe izimpawu.
2. Ukufakwa kwe-catheter: Udokotela uzofaka ama-catheter amabili amancane (amashubhu) avela endaweni engenalutho ngomthambo wegazi aye e-atrium yesobunxele yenhliziyo.
3. Ukutholwa kwesignali: I-catheter eyodwa ikhomba ngqo ukuthi izimpawu zikagesi ezinephutha zivela kuphi.
4. Ukususwa kwezicubu: Enye i-catheter iletha ukushisa (i-Radiofrequency) noma umkhuhlane (i-Cryoablation) esikhulume ngawo, ibhubhisa izicubu ezifanele futhi idale isibazi.
5. Ukuqeda: Ngemva kokuba ukwelashwa sekuqediwe ngempumelelo, udokotela ususa ngokucophelela womabili ama-catheter bese ebeka ibhandishi elincane phezu kwezindawo zokufaka.
Inhliziyo yami izoqashwa kanjani ngesikhathi sokwelashwa?
Ithimba lezokwelapha lizoqhubeka nokuqapha ukusebenza kwenhliziyo nomzimba wakho phakathi nesikhathi sonke sokusebenzisa i-anesthesia, lisebenzisa amadivayisi amaningana.
| Idivayisi | Ukusebenza kahle |
|---|---|
| I-cardioverter | Lokhu kungaqapha ukushaya kwenhliziyo yakho uma kuphansi kakhulu noma kuphezulu kakhulu. Kuxhunywe ezitikheni ezimbili ozinamathisela esifubeni sakho nasemhlane. |
| I-Electrocardiogram (EKG) | Ungaqapha njalo ukusebenza kukagesi kwenhliziyo yakho ngesikrini esisebenzisa izitika ezimbalwa ozinamathisela esifubeni sakho. |
| Isiqaphi Sokucindezeleka Kwegazi | Umfutho wegazi lakho ulinganiswa njalo nge-cuff exhunywe engalweni yakho. |
| I-Oximeter Monitor | Izinga lomoya-mpilo egazini lihlolwa nge-clip encane enamathiselwe emunweni. |
| I-Fluoroscopy | Lokhu kufana nomshini omkhulu we-X-ray. Lokhu kuvumela udokotela ukuthi abuke i-catheter idlula enhliziyweni esikrinini. Ngezinye izikhathi uketshezi olukhethekile (udayi ohlukile) lungafakwa ukuze imithambo yegazi ibonakale kahle. |
| I-Echocardiography ye-Intracardiac | Idivayisi encane ye-ultrasound efakwa enhliziyweni nge-catheter. Lokhu kuvumela umbono ocacile wezakhiwo ezingaphakathi kwenhliziyo nalapho i-catheter ithinta khona udonga lwenhliziyo. |
Yonke inqubo ingathatha amahora amane kuya kwayisithupha , ngakho-ke kungumqondo omuhle ukwazisa umndeni wakho kusenesikhathi. Kungase kudingeke futhi ukuthi uhlale esibhedlela ubusuku bonke ngemva kokwelashwa.
Kwenzekani ngemva kokwelashwa?
Ngemva kokuphela kokwelashwa, udokotela uzokhuluma nawe nomndeni wakho ngemiphumela. Kuzodingeka uphumule embhedeni cishe amahora amane kuya kwayisishiyagalombili. Abahlengikazi bazoqapha ukushaya kwenhliziyo yakho kanye nesigqi sayo ubusuku bonke. Ezimweni eziningi, uzokwazi ukuya ekhaya ngakusasa ekuseni. Ngaphambi kokuba uye ekhaya, abahlengikazi bazohlola izindawo ze-catheter bese besusa amabhandeji bese bewahlanza.
Yiziphi izingozi ezingaba khona?
I-PVI ngokuvamile iyindlela yokwelapha ephephile kakhulu. Kodwa-ke, njenganoma iyiphi inqubo yezokwelapha, kunengozi encane. Izinto ezinjalo azenzeki njalo.
- Ukungezwani komzimba nodayi wokuqhathanisa osetshenziswa kuma-X-ray.
- Ukutheleleka endaweni yokufakwa kwe-catheter.
- Ukulimala odongeni lwenhliziyo (cishe ingozi engu-1%).
- Ukulimala kwemithambo yamaphaphu (cishe ingozi engu-1%).
- Isifo sohlangothi (ingozi engaba ngu-0.5%).
Ungesabi lezi zingozi. Ithimba lakho lezokwelapha lizokwenza konke okusemandleni alo ukuvimbela lokhu ukuthi kungenzeki. Udokotela wakho uzokuchazela konke lokhu ngaphambi kokwelashwa.
Isikhathi sokululama kanye nokunakekelwa kokulandelela
Phakathi nezinsuku ezimbili zokuqala (amahora angu-48) ngemva kokwelashwa, ungase uzizwe ubuhlungu kancane, ukhathele, noma ungaphatheki kahle esifubeni. Lokhu kuvamile. Ngemva kwalokho, ungaqhubeka kancane kancane nemisebenzi yakho evamile. Kodwa-ke , kungathatha amasonto ambalwa ngaphambi kokuthi uqalise imisebenzi enzima, njengokuzivocavoca umzimba.
Into ebalulekile ukuthi kuthatha amasonto amaningana ukuthi isibazi sokususwa kwesikhumba siphole ngokuphelele futhi sibonise imiphumela. Ngakho-ke ukushaya kwenhliziyo yakho ngeke kubuyele esimweni esijwayelekile ngokushesha ngemva kokwelashwa. Ungase ube nezimpawu ze-Afib emavikini okuqala ayi-10 noma ngaphezulu. Akuvamile ukuthi isimo sakho sibe sibi kakhulu ngaphambi kokuba sibe ngcono. Ngakho ungesabi.
Ngemva kokwelashwa, uzonikezwa imithi eminingana izinyanga eziningana:
- Imithi yokulwa nokushaya kwenhliziyo: Lawula isigqi senhliziyo kuze kube yilapho imiphumela yokususwa kwenhliziyo itholakala.
- Ama-anticoagulant (ama-blood thinner): Nciphisa ingozi yokushaywa yisifo sohlangothi. Kungase kudingeke uqhubeke uthatha le mithi.
Uzoba ne-aphoyintimenti yakho yokuqala yokulandelela ezinyangeni ezintathu kuya kwezine ngemva kokwelashwa, kanye nelandelayo cishe ngonyaka kamuva. Phakathi nalezi aphoyintimenti, udokotela wakho angaphinda izivivinyo ezifana ne-CT scan, i-echocardiogram, noma i-EKG ukuhlola isimo senhliziyo yakho.
Umlayezo Wokuya Nawe Ekhaya
- I-Pulmonary Vein Isolation (PVI) iyindlela yokwelapha ephumelelayo yesifo sokushaya kwenhliziyo okungajwayelekile esibizwa ngokuthi i-Atrial Fibrillation (Afib).
- Lokhu kwenzelwa labo abanezimpawu ezingenakukwazi ukulawulwa ngemithi.
- Lokhu akusilo ukuhlinzwa okukhulu. Kuyindlela yokwelapha lapho i-catheter (ipayipi elincane) idluliselwa khona ngemithambo yegazi iye enhliziyweni.
- Kungathatha amasonto noma izinyanga eziningana ukululama ngokuphelele nokubona imiphumela ngemva kokwelashwa. Ungakhathazeki.
- Ngisho nangemva kokwelashwa, kubalulekile ukuthatha imithi enqunywe udokotela (ikakhulukazi imithi yokunciphisa igazi) njengoba kuyalelwe futhi uye emitholampilo ngezinsuku ezihleliwe.
- Uma uzwa izimpawu ezifana nobuhlungu besifuba, ukuphelelwa umoya, noma isiyezi, yazisa udokotela wakho ngokushesha.
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