I-Tachycardia ye-ventricular

I-ventricular tachycardia yisifo esibi senhliziyo esibangela ukushaya kwenhliziyo ngokushesha okukhulu. Lesi simo siqala emagumbini aphansi enhliziyo futhi singabangela imiphumela ebulalayo uma singelashwa ngokushesha. Lo mhlahlandlela uhlose ukunikeza isithombe esicacile se-ventricular tachycardia, ehlanganisa izimbangela zayo, izimpawu, kanye nezinkinga ezingase zibe khona. Sizohlola ukuthi odokotela basixilonga kanjani lesi simo futhi sixoxe ngezinketho ezahlukene zokwelapha, okuhlanganisa imithi nezinqubo.

Iyini i-ventricular tachycardia?

I-ventricular tachycardia (VT) isifo esibi senhliziyo esiqala emagumbini aphansi enhliziyo, aziwa ngokuthi ama-ventricles. Ibangela inhliziyo ukuthi ishaye ngokushesha kakhulu, ngokuvamile ngenani lokushaywa okungaphezu kuka-100 ngomzuzu. Lokhu kushaya kwenhliziyo okusheshayo kungavimbela inhliziyo ekumpompeni igazi ngokuphumelelayo, okungase kwehlise ukugeleza kwegazi ezithweni zomzimba nezicubu.

Okulandelayo yizinhlobo ezimbili eziyinhloko ze-ventricular tachycardia: 

• I-VT Eqhubekayo: Ihlala ngaphezu kwamasekhondi angu-30 noma idinga ukungenelela kwezokwelapha ngokushesha ngenxa yomthelela wayo ekusakazweni kwegazi. 
• I-VT engasimeme: Ima phakathi nemizuzwana engama-30 futhi ayibangeli izinkinga ezisheshayo ze-haemodynamic.

I-ventricular tachycardia nayo ingahlukaniswa ngokusekelwe ekubukeni kwayo ku-electrocardiogram (ECG): 

• I-Monomorphic VT ibonisa iphethini eyodwa, ezinzile yomsebenzi kagesi
• I-Polymorphic VT inephethini eguqukayo. 
• I-Torsades de Pointes ibonakala njengephethini ehlukile yokusonteka kwamagagasi e-ECG.

Izimbangela Nezingozi Ze-Ventricular Tachycardia

I-ventricular tachycardia inezimbangela ezihlukahlukene kanye nezici eziyingozi. Lokhu kubandakanya:

• Ischemic Isifo senhliziyo noma I-Coronary Artery Disease: Yimbangela evame kakhulu ye-VT. Lesi simo senzeka lapho umsipha wenhliziyo ungalitholi igazi elanele nomoya-mpilo ngenxa yokuvaleka kwemithambo yenhliziyo.
• Ezinye Izimbangela Ezihlobene Nenhliziyo:
  • Ukuhluleka kwenhliziyo
  • I-myocarditis
  • Inhliziyo ekhulisiwe (i-cardiomyopathy)
  • Isifo se-valve yenhliziyo
  • Ukuhlaselwa kwenhliziyo kwangaphambilini 
  • Ukuhlinzwa okushiya izibazi enhliziyweni 
  • Sarcoidosis 
  • Ama-Amyloidosis
• I-Idiopathic Ventricular Tachycardia: Kwezinye izimo, ikakhulukazi kubantu abasha, i-tachycardia ye-ventricular ingase yenzeke ngaphandle kwenkinga yenhliziyo ebonakalayo. 

Izici eziyingozi zokuthuthukisa i-ventricular tachycardia zihlanganisa: 

• Umlando wesifo senhliziyo
• Umlando womndeni wezinkinga zesigqi senhliziyo
• Ukungajwayelekile kwe-electrolyte okukhulu. 
• Ukusetshenziswa ngokweqile kwe-caffeine noma utshwala 
• Ukusetshenziswa kwezidakamizwa zokuzijabulisa njenge-cocaine noma i-methamphetamines

Izimpawu ze-ventricular tachycardia

Izimpawu zalokhu kuphazamiseka kwesigqi senhliziyo zingahluka kusukela komnene kuye kokuqina. Lokhu kungase kuhlanganise: 

• I-Palpitations noma i-Rapid Pulse: Abantu bangase bezwe inhliziyo yabo igijima noma ishaya esifubeni. 
• Ubuhlungu besifuba: Lokhu kungaphatheki kahle kungase kusuke kubuhlungu obuncane kuye ebuhlungwini obubukhali, obukhulu. Kuvame ukuchazwa njengokuzwakala kwengcindezi noma ukucinana kwesifuba.
• Ubunzima bokuphefumula noma ukuphefumula: Lesi sibonakaliso singacindezela kakhulu futhi singase sibe sibi kakhulu ngokusebenza komzimba.
• Isiyezi, Ikhanda Elikhanyayo, noma Ukuquleka (Ukuphelelwa umoya): Kungenzeka ngenxa yokuncipha kokugeleza kwegazi okubangelwa ukushaya kwenhliziyo okusheshayo. 
• Ezinye Izimpawu Ze-Tachycardia Ye-Ventricular: Lezi zihlanganisa ukuzizwa ukhathele ngokungavamile noma ukhathele, ukuzwa ukushaya kwenhliziyo okweqiwa noma isigqi senhliziyo esingavamile.

Izinkinga

I-ventricular tachycardia ingaholela ezinkingeni ezinkulu, ikakhulukazi kubantu abanezimo zenhliziyo ezingaphansi. Lokhu kubandakanya:

• I-Arrhythmia esongela ukuphila: Ezigulini ezinokukhubazeka kwenhliziyo yesakhiwo, i-ventricular tachycardia ingaqhubekela esigqi esiyingozi esingase sibangele ukufa kungazelelwe.
• I-Ablation: Kuyindlela yokwelapha evamile esetshenziselwa ukwelapha lesi simo futhi ngokuvamile inomlando omude wokuphepha nempumelelo. Izinkinga ezingaba khona zokukhipha isisu zihlanganisa ukulimala kwenhliziyo noma imithambo yegazi, amahlule egazi, ukopha, kanye nokutheleleka.
• Imithi: Kwezinye izimo, izidakamizwa ezisetshenziselwa ukuphatha i-ventricular tachycardia zingabangela ngokuxakayo ama-arrhythmias amaningi, kuhlanganise nalawo ayingozi angase aholele ekufeni kungazelelwe.

Sifo

Ukuxilongwa kwe-tachycardia ye-ventricular kudinga indlela ebanzi ehilela ukuhlolwa ngokomzimba, ukubuyekezwa komlando wezokwelapha, nokuhlolwa okuhlukahlukene. 

• I-Electrocardiogram (ECG noma EKG): Ikhombisa ukuthi inhliziyo ishaya kanjani. 
• I-Holter Monitor: Odokotela bangancoma ukuthi ugqoke le divayisi ekhaya uma i-ECG evamile inganikezi ulwazi olwanele. Le divayisi encane ye-ECG igqokwa usuku noma ngaphezulu ukurekhoda umsebenzi wenhliziyo phakathi nemisebenzi yansuku zonke. 
• I-Event Monitor: Ngokuqapha isikhathi eside, imonitha yomcimbi ingasetshenziswa kuze kube yizinsuku ezingu-30 noma i-loop rekhoda efakelwayo kuze kube iminyaka emithathu.
• Izivivinyo Zokucindezeleka Zokuzivocavoca: Zenziwa ukuze kuhlolwe ukusebenza kwenhliziyo phakathi nomsebenzi womzimba. 
• Ukuhlolwa Kwesithombe: I-X-ray yesifuba, ama-echocardiograms, i-MRI yenhliziyo, noma ama-CT scan angasiza ukuhlola ukwakheka kwenhliziyo futhi abone noma yiziphi izinkinga ezibangela i-ventricular tachycardia.
• Ucwaningo lwe-Electrophysiological (EP): Idala imephu enemininingwane yamasignali kagesi wenhliziyo, isiza ukukhomba lapho kwenzeka khona ukusayina okuyiphutha. 
• Ukuhlolwa Kwethebula Le-Tilt: Kungenziwa ukuze kuqondwe ukuthi i-ventricular tachycardia iholela kanjani ekuqulekeni ngokuqapha izinga lokushaya kwenhliziyo kanye noshintsho lomfutho wegazi ezindaweni ezahlukene zomzimba.

Ukwelashwa kwe-ventricular tachycardia

Ukwelashwa kwe-tachycardia ye-ventricular kuncike ekuqineni kwesimo kanye nezimbangela zaso, okuhlanganisa:

• Ukuboshwa kwenhliziyo ngenxa ye-tachycardia ye-ventricular, ukuvuselela ngokushesha ngemva kwephrothokholi yokusekela impilo ethuthukisiwe kubalulekile.
• I-Cardioversion: I-cardioversion yamanje eqondile iyindlela yokwelapha eyinhloko ye-hemodynamically engazinzile ye-ventricular tachycardia. Lokhu kuhlanganisa ukuletha ukushaqeka kukagesi okulawulwayo enhliziyweni ukuze kubuyiselwe isigqi esivamile. 
• Ukuphathwa Kwemithi: Imithi ngokuvamile iwumugqa wokuqala wokwelashwa kwe-ventricular tachy yeziguli ezizinzile ze-haemodynamically. Ama-Beta-blockers asetshenziswa ngokujwayelekile ukunciphisa ukushaya kwenhliziyo futhi anciphise amathuba okuvela kwe-ventricular tachycardia.
• I-Catheter Ablation: Kwezinye izimo, odokotela bangancoma ukukhishwa kwe-catheter. Lokhu kuhilela ukusebenzisa ukushisa noma amandla abandayo ukucekela phansi izicubu zenhliziyo, okubangela izimpawu ezingavamile. 
• I-Implantable Cardioverter-Defibrillator (ICD): Odokotela bangase basikisele i-cardioverter-defibrillator (ICD) efakelwayo yokuphatha isikhathi eside. Lo mshini, ofakwe ngaphansi kwesikhumba eduze kwethambo lekholomu, uqapha ngokuqhubekayo isigqi senhliziyo futhi ulethe ukushaqeka ukuze usethe kabusha inhliziyo uma kutholwa isigqi esingavamile.

Uzoyibona Nini Udokotela

Ukuqaphela isikhathi sokufuna usizo lwezokwelapha nge-ventricular tachycardia kubalulekile. Uma uba nezimpawu ezinjengobuhlungu besifuba, ukuquleka, noma ukushaya kwenhliziyo okusheshayo nokungavamile, kubalulekile ukushayela ucingo oluphuthumayo ngokushesha. Lezi zimpawu zingase zibonise isimo esisongela ukuphila esidinga ukunakekelwa okuphuthumayo kwezokwelapha.

Prevention

Nakuba kungase kungenzeki ukuvimbela i-ventricular tachycardia ngokuphelele, kunezinyathelo ezimbalwa ongazithatha ukuze unciphise ingozi yakho. Lokhu kubandakanya:

• Iba nokudla okunomsoco okukhethwe izithelo, imifino, okusanhlamvu, amafutha angagcwalisiwe
• Zivocavoce njalo 
• Prakthiza i-yoga 
• Uma ukhuluphele ngokweqile noma ukhuluphele, yehlisa isisindo somzimba eseqile 
• Qaphela ngezikhuthazi ezifana ne-caffeine, njengoba zingabangela i-arrhythmia. 
• Hlela ukulala amahora angu-9 ubusuku ngabunye
• Utshwala ngokusesilinganisweni noma bugweme ngokuphelele. 
• Uma ubhema, ukuyeka kubalulekile impilo inhliziyo. 
• Gwema izidakamizwa zokungcebeleka njenge-cocaine.

Isiphetho

Ukunakekela inhliziyo kuyisihluthulelo sokulawula i-tachycardia ye-ventricular. Lokhu kusho ukudla kahle, ukuhlala umatasa, nokuphila impilo enempilo. Uma kukhona okukukhathazayo ngenhliziyo yakho, ungalindi ukukhuluma nodokotela wakho. Ngokunakekelwa okufanele nokunakwa, abantu abaningi abanalesi simo bangaphila ukuphila okugcwele, okusebenzayo. Khumbula, impilo yenhliziyo yakho isezandleni zakho, ngakho yinakekele.

Imibuzo Evame Ukubuzwa

1. Iyini imbangela ehamba phambili ye-ventricular tachycardia?

Isizathu esiyinhloko se-tachycardia ye-ventricular ngokuvamile isifo senhliziyo ye-ischemic, ikakhulukazi ezigulini ezinomlando wokuhlaselwa yinhliziyo. Ukulimala kwemisipha yenhliziyo kungadala izindlela ezingavamile zikagesi, okuholela kulesi simo. Ezinye izimbangela ze-tachycardia ye-ventricular zihlanganisa i-cardiomyopathy, ukuhluleka kwenhliziyo, i-myocarditis, nesifo se-valve yenhliziyo.

2. Ingabe i-tachycardia ye-ventricular ingahamba?

I-ventricular tachycardia ngezinye izikhathi ingase ixazulule ngokwayo, ikakhulukazi uma izici ezihlehliswayo ezifana nokungalingani kwe-electrolyte noma imithi ethile ibangela lokho. Nokho, ezimweni eziningi, kudinga ukwelashwa. 

3. I-ventricular tachycardia iwuthinta kanjani umzimba wami?

I-ventricular tachycardia ingaba nomthelela omkhulu emzimbeni wakho. Kungaholela ekushayeni kwenhliziyo okusheshayo, kwehlise amandla enhliziyo okupompa igazi ngokuphumelelayo. Lokhu kungaholela ekuphefumuleni, ubuhlungu besifuba, isiyezi, futhi, ezimweni ezimbi kakhulu, ukuquleka noma ukuboshwa kwenhliziyo.

4. Isiphi isizathu esivame kakhulu se-ventricular tachycardia?

Isizathu esivame kakhulu se-tachycardia ye-ventricular isifo senhliziyo esingaphansi kwe-ischemic. Lesi simo senzeka lapho umsipha wenhliziyo ungalitholi igazi elanele nomoya-mpilo ngenxa yokuvaleka emithanjeni yenhliziyo, ngokuvamile okubangelwa isifo sokuqina kwemithambo yegazi.

5. Kuthatha isikhathi esingakanani ukululama ekwelapheni i-ventricular tachycardia?

Isikhathi sokululama esivela ekwelashweni kwe-ventricular tachycardia siyahlukahluka ngokusekelwe ekwelashweni okuqondile okusetshenzisiwe. Ngezinqubo ezifana nokukhishwa kwe-catheter, iziguli zingase zikwazi ukuya ekhaya ngalolo suku noma zidinga ukulala ubusuku ukuze zibhekwe. Abantu abaningi bangabuyela emsebenzini ngemva kwamasonto ambalwa, kodwa ukugwema imisebenzi ekhandlayo kuyatuseka.

6. Ingabe i-tachycardia ye-ventricular ingelapheka?

Nakuba i-tachycardia ye-ventricular ingaphathwa ngokuphumelelayo, ukwelashwa okuphelele kuncike kumbangela eyinhloko. Kwezinye izimo, ukwelapha imbangela yempande kungaqeda i-arrhythmia. Kodwa-ke, ezigulini eziningi, ukuphathwa okuqhubekayo ngokusebenzisa imithi, izinguquko zokuphila, noma amadivaysi afana ne-cardioverter-defibrillators efakelwayo kungase kudingeke ukulawula isimo nokuvimbela izinkinga.

UDkt. Nikhilesh Jain

MBBS, DNB (Medicine), MRCPI, IDCCM, FIECMO
Izibhedlela ze-CARE CHL, e-Indore

Ukuze Ubhukhe Isikhathi, shayela:

+91 406 810 6585