arrhythmia

I-Arrhythmia yigama elibanzi elihlanganisa uhla lwezinkinga zesigqi senhliziyo. Isigqi semvelo senhliziyo silawulwa uhlelo oluyinkimbinkimbi lwethonya likagesi elisuka ku-node ye-sinoatrial (SA), ngokuvamile ebizwa ngokuthi i-pacemaker yemvelo yenhliziyo. Enhliziyweni enempilo, amasignali kagesi axhumanisa ukufinyela kwenhliziyo ahamba ezindleleni ezikhethekile, eqinisekisa ukushaya kwenhliziyo okungaguquki nokujwayelekile. Kodwa-ke, lezi zimpawu zikagesi zingase ziphazamiseke kubantu abane-arrhythmia, okuholela ekuziphatheni okungajwayelekile, okusheshayo, noma okunensayo. isilinganiso senhliziyo.

Izinhlobo ze-Arrhythmia

I-arrhythmia ingahlukaniswa ngezigaba eziningana ezihlukene, ngasinye sinezici zayo ezihlukile kanye nemiphumela engaba khona:

• I-Atrial Fibrillation (AFib): I-AFib iwuhlobo oluvame kakhulu lwe-arrhythmia, oluhlukaniswa ukushaya kwenhliziyo okusheshayo nokungajwayelekile emakamelweni angaphezulu enhliziyo (atria). Kungandisa ingozi unhlangothi nezinye izinkinga zenhliziyo nemithambo yegazi.
• I-Ventricular Tachycardia (VT): Lesi simo sihlanganisa ukushaya kwenhliziyo okusheshayo okuvela emagumbini aphansi enhliziyo (ama-ventricles). I-VT ingaba yingozi empilweni uma ingaphathwa kahle.
• I-Bradycardia: Lolu hlobo lwe-arrhythmia luhlukaniswa ukushaya kwenhliziyo okunensayo, ngokuvamile okungaphansi kwama-60 beats ngomzuzu. I-Bradycardia ingabangela ukukhathala, isiyezi, futhi, ezimweni ezimbi kakhulu, uyaquleka.
• I-Premature Ventricular Contractions (PVCs): Lokhu ukushaya kwenhliziyo okwengeziwe okuvela kuma-ventricles futhi kuzwakala njengokushaya kwenhliziyo "yeqiwe" noma "okubhakuzayo".
• I-Supraventricular Tachycardia (SVT): Lesi simo sihilela ukushaya kwenhliziyo okusheshayo okuvela ngaphezu kwama-ventricles, ngokuvamile emakamelweni aphezulu enhliziyo.

Izimpawu Eziyisixwayiso Nezimpawu Zokushaya Kwenhliziyo Okungahleliwe

Izimpawu ezivame kakhulu eziyisixwayiso nezimpawu ze-arrhythmic heartbeat zihlanganisa:

• Ukushaya kwenhliziyo noma umuzwa "wenhliziyo ebhakuzayo" noma "egijimayo".
• ubuhlungu besifuba noma ukungakhululeki, ikakhulukazi ngesikhathi sokusebenza ngokomzimba
• Ukuphelelwa umoya
• Isiyezi noma ikhanda elikhanyayo
• Iziqephu zokuquleka noma eduze nokuquleka
• Ukukhathala noma ubuthakathaka
• Ukushaya kwenhliziyo okungajwayelekile noma okweqiwe 
• Ukuzwa ukungakhululeki noma ukubhujiswa okuzayo

Izimbangela Nezingozi Ze-Arrhythmia

Izici ezihlukahlukene, kokubili izakhi zofuzo nezemvelo, zingabangela i-arrhythmia. Ezinye zezimbangela ezivame kakhulu nezici eziyingozi ze-arrhythmia zihlanganisa:

• Izimo zenhliziyo yesakhiwo: Izimo zenhliziyo nemithambo yegazi, njengesifo semithambo yenhliziyo, ukuphazamiseka kwamavalvu enhliziyo, nokukhubazeka kwenhliziyo ozalwa nakho, kungaphazamisa isimiso sikagesi senhliziyo futhi kubangele i-arrhythmia.
• Ukungalingani kwe-Electrolyte: Ukungazinzi kuma-electrolyte, njenge i-potassiumsodium, kanye calcium, ingathinta izimpawu zikagesi zenhliziyo futhi ibe nomthelela ekuthuthukisweni kwe-arrhythmia.
• Izici zendlela yokuphila: Imikhuba efana nokweqisa utshwala ukudla, ukusetshenziswa kwe-caffeine, ukucindezeleka, nokuntuleka kokuzivocavoca umzimba kungandisa ingozi ye-arrhythmia.
• Izimo zezempilo eziyisisekelo: Imibandela efana yegilo ukuphazamiseka, sikashukela, Futhi apnea kuhlotshaniswa nethuba elikhulayo lokuthuthukisa i-arrhythmia.
• Imithi: Imithi ethile, kuhlanganise nencwadi kadokotela izidakamizwa kanye nezithako ezithengwayo, zingase zibangele noma zibhebhethekise i-arrhythmia.
• I-Genetics: Kwezinye izimo, i-arrhythmia ingase ibe nengxenye yofuzo, ukuguqulwa kofuzo okuqondile okwandisa ukuthambekela komuntu kulesi simo.

Izinkinga ze-Arrhythmia

Ezinye zezinkinga ezivame kakhulu ezihlobene ne-arrhythmia zihlanganisa:

• I-Stroke: I-Atrial fibrillation, uhlobo oluvame kakhulu lwe-arrhythmia, ingandisa ingozi yokushaywa yisifo ngokufika izikhathi ezinhlanu.
• Ukuhluleka kwenhliziyo: I-arrhythmia ende noma eqinile ingenza buthaka imisipha yenhliziyo futhi iphazamise ikhono layo lokupompa igazi ngokuphumelelayo, okuholela ekuthuthukiseni ukuhluleka kwenhliziyo.
• Ukuboshwa kwenhliziyo okungazelelwe: Kwezinye izimo, izinhlobo ezithile ze-arrhythmia, njenge-ventricular tachycardia noma i-ventricular fibrillation, zingabangela ngokuzumayo. ukuboshwa komzimba, isimo esisongela ukuphila esidinga ukungenelela kwezokwelapha ngokushesha.
• Izinga lempilo elincishisiwe: Izimpawu ezihambisana ne-arrhythmias, njengokushaya kwenhliziyo, isiyezi, nokukhathala, zingaba nomthelela omkhulu emisebenzini yomuntu yansuku zonke kanye nekhwalithi yokuphila iyonke.
• Ukwanda kwengozi yokulaliswa esibhedlela: Abantu abane-arrhythmia engalawuleki noma eqinile bangadinga ukulaliswa njalo esibhedlela, okungaholela ezinkingeni zezempilo ezengeziwe kanye nezindleko zokunakekelwa kwezempilo ezikhuphukile.

Ukuxilongwa kwe-Arrhythmia

Udokotela angasebenzisa izindlela ezilandelayo ukuxilonga i-arrhythmia:

• I-Electrocardiogram (ECG noma i-EKG): Lokhu kuhlolwa kuqopha ukusebenza kukagesi kwenhliziyo, kusize ukukhomba uhlobo nephethini ye-arrhythmia.
• I-Holter monitoring: Idivayisi ephathekayo egqokwa amahora angu-24 kuya kwangu-48 erekhoda ngokuqhubekayo ukusebenza kukagesi wenhliziyo, engasiza ekutholeni ama-arrhythmias aphakathi nendawo.
• Ukuhlolwa kokucindezeleka: Lokhu kuhlola kuhlola ukusebenza kwenhliziyo phakathi nomsebenzi womzimba, okungasiza ekuboneni ama-arrhythmias ngesikhathi Ukuvivinya.
• I-Echocardiogram: Lokhu kuhlolwa kwesithombe kudala ukumelela okubonakalayo kwenhliziyo, okungasiza ekuboneni izinkinga eziyisisekelo zesakhiwo ezingase zibe nomthelela ku-arrhythmia.

Yelashwa kanjani i-Arrhythmia?

Ukwelashwa kwe-arrhythmia kuncike ohlotsheni, ubunzima, kanye nembangela eyisisekelo. Izinketho zokwelapha zihlanganisa:

• Imithi: Imithi ethile, njengemithi elwa nokuvuvukala, i-beta-blockers, noma i-calcium channel blockers, ingasiza ekulawuleni isigqi senhliziyo futhi ilawule izimpawu ze-arrhythmia.
• I-Cardioversion: Le nqubo isebenzisa ukushaqeka kukagesi noma imithi ukubuyisela isigqi senhliziyo.
• I-Ablation: Le ndlela yokuhlasela kancane isebenzisa ukushisa noma amandla abandayo ukucekela phansi izindawo ezithile zenhliziyo ezibangela i-arrhythmia.
• Imishini efakelwayo: Kwezinye izimo, i-pacemaker noma i-cardioverter-defibrillator (ICD) efakwayo ingase ibaluleke ukuze isize ukulawula isigqi senhliziyo.
• Ukushintsha indlela yokuphila: Ukwamukela indlela yokuphila enempilo, njengokugcina ukudla okulinganiselayo, ukuvivinya umzimba njalo, nokulawula ukucindezeleka, kungasiza ukuvimbela noma ukulawula i-arrhythmia.

Prevention

Okulandelayo ezinye izinyathelo ezinganciphisa ubungozi bokuthuthukisa i-arrhythmia noma ukuphatha izimo ezikhona:

• Gcina indlela yokuphila enempilo: Ukudla ukudla okuhambisana nenhliziyo, ukuzivocavoca njalo, nokuzuza nokugcina unempilo isisindo ingaphatha futhi inciphise ingozi yokuthuthukisa i-arrhythmia.
• Lawula izimo zezokwelapha ezicashile: Izimo zesistimu ezifana nomfutho wegazi ophakeme, isifo sikashukela, noma ukuphazamiseka kwegilo kungaba nomthelela ekwakhiweni kwe-arrhythmia.
• Gwema izinto ezibangisayo: Izinto ezithile, njenge-caffeine, i-nicotine, noma utshwala, zingase ziqalise noma zenze iziqephu ze-arrhythmia zibe zimbi nakakhulu.
• Lawula ingcindezi: Ingcindezi yesikhathi eside ingaba nomthelela ekuthuthukisweni kwe-arrhythmia, ngakho-ke kubalulekile ukuthola izindlela ezinempilo zokulawula ingcindezi, njengokuzindla, i-yoga, noma ezinye izindlela zokuphumula.
• Ukuhlolwa okuvamile: Ukuhlolwa okujwayelekile nodokotela wakho kungasiza ekutholeni nokuqapha noma yiziphi izinguquko empilweni yenhliziyo, okuvumela ukungenelela kusenesikhathi kanye nokwelashwa uma kunesidingo.

Imibuzo Evame Ukubuzwa

1. Iyini imbangela ehamba phambili ye-arrhythmia?

Izimbangela eziphambili zokushaya kwenhliziyo okungajwayelekile yilezi:

• Izimo zenhliziyo ezingaphansi, njengesifo se-coronary artery, izinkinga ze-valve yenhliziyo, noma ukuzalwa ukukhubazeka kwenhliziyo
• Ukungalingani ku-electrolyte yomzimba, njenge i-potassium noma i-sodium
• Imithi ethile noma izithasiselo
• Ukucindezeleka, ukukhathazeka, noma ezinye izici ezingokomzwelo
• Ukusetshenziswa ngokweqile kwezikhuthazi, njenge-caffeine noma i-nicotine
• Izimo ezithile zezokwelapha, ezifana nokuphazamiseka kwegilo noma i-apnea yokulala

2. Ingabe i-arrhythmia ibucayi?

Ubukhulu be-arrhythmia bungahluka kakhulu. Ezinye izinhlobo ze-arrhythmia, njenge-atrial fibrillation noma i-ventricular tachycardia, ingaba yingozi futhi yandise ingozi yezinkinga, njenge unhlangothi noma ukuhluleka kwenhliziyo. Nokho, ezinye izinhlobo ze-arrhythmia, njengokufinyela kwe-ventricular ngaphambi kwesikhathi (PVCs), zingase zingabi yingozi futhi zingadingi ukwelashwa ngokushesha.

3. Ingabe i-arrhythmia iyelapheka? 

Yebo, i-arrhythmias eminingi iyelapheka. I-PSVT ingenye ye-arrhythmias evamile futhi iyelapheka ngokuphelele. Ukwenza ucwaningo lwe-EP nokuthola isifunda esingavamile esiholela ku-arrhythmia kungenziwa ngenqubo ehlasela kancane (okufana ne-angiography) futhi ngemva kokuba leso siguli sikhululekile emithini yokuphila isikhathi eside.

4. Liyini ikhambi lasekhaya le-arrhythmia?

Nakuba awekho amakhambi aqondile asekhaya angakwazi ukwelapha i-arrhythmia, kunezinguquko ezithile endleleni yokuphila nezindlela zemvelo ezingasiza ukuphatha lesi simo:

• Ukunciphisa ukukhathazeka kanye nokucindezeleka ngokusebenzisa amasu okuphumula, njengokuphefumula okujulile, ukuzindla, noma i-yoga
• Ukugcina uhlelo lokudla olunempilo olucebile ngezithelo, imifino, nokusanhlamvu
• Ukuhlala u-hydrated nokuqinisekisa ibhalansi efanele ye-electrolyte
• Ukunciphisa ukusetshenziswa kwezikhuthazi, njenge-caffeine, i-nicotine, noma utshwala
• Ukuzivivinya njalo, njengoba kugunyazwe udokotela
• Ukuphumula ngokwanele  

5. Yini engingakwazi ukudla/ukuphuza nginalesi simo?

Izincomo ezithile zokudla kwabantu abane-arrhythmia zingahluka futhi zincike kumbangela kanye nohlobo lwe-arrhythmia:

• Ukunciphisa noma ukugwema izikhuthazi, ezifana ne-caffeine, i-nicotine, notshwala, njengoba zingashukumisa noma zenze iziqephu ze-arrhythmia zibe zimbi nakakhulu.
• Gxila ekudleni okunomsoco ngokugxila ekudleni okuphelele, okungakacutshungulwa
• Ukugwema ukweqisa sodium ukuthatha, njengoba kungaholela ekugcineni uketshezi futhi kube kubi kakhulu izinhlobo ezithile ze-arrhythmia
• Ukunciphisa ukusetshenziswa kokudla okunamafutha agcwele noma ama-trans, njengoba kungaba nomthelela ekuthuthukisweni kwezimo zenhliziyo ezingaphansi.
• Ukuqinisekisa i-hydration eyanele kanye nebhalansi efanele ye-electrolyte, njengoba ukungalingani kungaba nomthelela ku-arrhythmia.

UDkt. Ashutosh Kumar

MD (BHU), DM (PGI), FACC (USA), FHRS (USA), FESC (EURO), FSCAI (USA), PDCC (EP), CCDS (IBHRE, USA), CEPS (IBHRE, USA)
CARE Izibhedlela, Bhubaneswar, CARE Izibhedlela, HITEC City, Hyderabad

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