He aha te Atrial Fibrillation Ablation? Te Whāinga, te Hātepe & ngā Hua

Ko te atrial fibrillation ablation he hātepe rongoā e whakamahi ana i te kaha wera, makariri rānei hei hanga i ngā kiko iti i ngā ruma o runga o tō ngākau. Ko ēnei kiko ka aukati i ngā tohu hiko koretake e pā ana ki te patupatu o tō ngākau, e āwhina ana ki te whakahoki i te manawataki noa, tū tonu.

Whakaarohia me te mea kei te whakahou i te pūnaha hiko i tō ngākau. Ki te whai koe i te atrial fibrillation (AFib), ka pōhēhē te kaiwhakatere tūturu o tō ngākau i ngā tohu hiko koretake. Ko te hātepe ablation e hanga ana i ngā arai rautaki e aukati ana i ēnei tohu hē mai i te horapa puta noa i tō ngākau.

He aha te atrial fibrillation ablation?

Ko te atrial fibrillation ablation he hātepe ngākau iti e rongoā ana i ngā patupatu ngākau koretake. I te wā o te hātepe, ka whakamahi tō tākuta i tētahi ngongo angiangi, ngāwari e kīia ana ko te catheter hei tuku i te kaha ki ngā wāhi motuhake o te kiko o tō ngākau.

Ka hangaia e te kaha ngā kiko iti, whakahaerehia e mahi ana hei arai mō ngā tohu hiko e pā ana ki tō AFib. He tū tonu ēnei kiko, ā, e āwhina ana i tō ngākau ki te pupuri i te manawataki noa. Ko te hātepe te nuinga e arotahi ana ki ngā uaua pūkahukahu, he puna noa o te mahi hiko koretake.

E rua ngā momo kaha ablation e whakamahia ana. Ka whakamahi te radiofrequency ablation i te kaha wera, i te wā e whakamahi ana te cryoablation i te makariri nui. E rua ngā tikanga e whakatutuki ana i te whāinga kotahi o te hanga kiko kiko e aukati ana i ngā ara hiko hē.

He aha te take e mahia ana te atrial fibrillation ablation?

Ka tūtohu pea tō tākuta i te AFib ablation i te wā kāore i angitu ngā rongoā ki te whakahaere i tō patupatu ngākau koretake. Ka noho te hātepe hei kōwhiringa i te wā e pā ana tonu koe i ngā tohu pēnei i te patupatu, te poto o te manawa, te ngenge rānei ahakoa te tango i ngā rongoā manawataki ngākau.

He maha ngā wā ka whakaarohia te whakakorenga mō te hunga e hiahia ana ki te whakaiti i te whakawhirinaki ki ngā rongoā wā-roa. Ko ētahi tāngata e pā ana ki ngā pānga taha mai i ngā rongoā AFib, ā, ko ētahi e pai ana ki tētahi huarahi rongoā tino whakatau. Ka taea e te tikanga te whakapai ake i tō kounga o te oranga mā te whakaiti, te whakakore rānei i ngā wāhanga AFib.

He mea nui anō te wā o te whakakorenga. E whakaatu ana te rangahau ko te wawaotanga wawe, ina koa ki ngā tāngata e tamariki ana, he iti ake ngā āhuatanga o te ngākau, he pai ake te angitu. Ka arotake tō tākuta i tō āhuatanga motuhake, tae atu ki te roa o tō AFib me tō hauora ngākau whānui.

Ko ētahi momo AFib e pai ake ana te urupare ki te whakakorenga i ētahi atu. Ko te Paroxysmal AFib, e haere mai ana, e haere ana i runga i tōna ake, te tikanga he nui ake te angitu i te persistent AFib, e roa ana i te whitu rā. Heoi, ka whai hua tonu te whakakorenga mō te persistent AFib i te nuinga o ngā wā.

He aha te tikanga mō te whakakorenga atrial fibrillation?

Ko te tikanga whakakorenga te tikanga e 3 ki te 6 haora, ā, ka mahia i roto i tētahi taiwhanga hiko-ngākau motuhake. Ka whiwhi koe i te whakamaarama mārama, i te rongoā whānui rānei kia pai ai koe i te wā o te tikanga.

Ka whakauru tō tākuta i ētahi katita angiangi mā ngā wāhi iti i tō rohe o te tūtae. Ka ārahina ēnei katita mā te āta i tō toto ki tō ngākau mā te whakamahi i te arataki X-ray. Kotahi te katita e hanga ana i tētahi mahere 3D taipitopito o te mahi hiko o tō ngākau, ā, ko ētahi atu e tuku ana i te pūngao whakakorenga.

He mea nui te tukanga mahere, ā, he wā tōna. Ka ako tō tākuta i ngā tauira hiko o tō ngākau kia kitea ai te wāhi e puta mai ana ngā tohu koretake. Mā tēnei tika e whakarite ai ko ngā wāhi raruraru anake e rongoatia ana, ka waiho te kiko ngākau hauora kāore i pā.

I te wā o te whakawātea, ka pōturi pea koe i te mamae, i te pēhanga rānei i tō uma. Ko te tuku pūngao te nuinga o te wā ka roa noa iho i ētahi hēkona i ia wāhi. Ka whakamātau tō tākuta i ngā wāhi kua rongoatia kia mōhio kei te aukatia pai ngā ara hiko kōaro.

I muri i te tukanga, ka aroturukihia koe i tētahi wāhi whakaora mō ētahi haora. Ka pēhia kaha ngā wāhi whakauru katetā, ka hīra rānei ki tētahi pūrere kati kia kore ai e toto. Ka taea e te nuinga o ngā tūroro te hoki ki te kāinga i te rā kotahi, i muri rānei i te noho pō.

Me pēhea te whakarite mō tō whakawātea wiri atrial?

Ka tīmata te whakarite mō te whakawātea AFib i ētahi wiki i mua i tō tukanga. Ka mahi pea tō tākuta i ētahi atu whakamātau, tae atu ki te mahi toto, te echocardiogram, me te CT scan, te MRI rānei o tō ngākau. Mā ēnei whakamātau e āwhina ki te waihanga i tētahi mahere taipitopito mō tō tukanga.

Me kōrero koe i ō rongoā o nāianei ki tō rōpū hauora. Ko ētahi rongoā whakaheke toto me whakatika, me whakamutu rānei mō tētahi wā, engari me haere tonu ētahi atu. Kaua rawa e whakamutu i te tango rongoā kua whakaritea me te kore tohutohu mai i tō tākuta.

I te rā i mua i tō tukanga, ka whiwhi koe i ngā tohutohu motuhake mō te kai me te inu. I te nuinga o te wā, me karo koe i te kai me ngā wai mō te 8 ki te 12 haora i mua i te tukanga. He mea nui tēnei wā nohopuku mō tō haumaru i te wā o te whakamaimoa.

Whakaritea mō tō wā whakaora i mua. Whakaritea kia haere mai tētahi ki te kawe i a koe ki te kāinga, me te noho ki a koe mō ngā haora 24 tuatahi. Me karo koe i te hiki taumaha me ngā mahi kaha mō te wiki i muri i te tukanga.

Whakakīa ngā kākahu pai, ngā kākahu whānui mō tō noho i te hōhipera. Whakahaerehia ngā rongoā e tango ana koe, me te rārangi o ō rongoā katoa me ngā inenga. Mā te whai i ēnei mōhiohio e āwhina ana i tō rōpū hauora ki te whakarato i te manaakitanga pai.

Me pēhea te pānui i ō hua whakawātea wiri atrial?

Kāore i te wātea tonu te angitu i muri i te whakakorenga AFib, ā, me whai wā tō ngākau ki te whakaora. Ko ngā marama tuatahi i muri i te tikanga e kiia ana ko te "wā pōuri," i roto i tērā wā he mea noa ētahi manawataki koretake i te wā e whakatika ana tō ngākau ki ngā huringa.

Ka aroturukihia e tō tākuta tō manawataki mā ngā momo tikanga. Ka mau pea koe i tētahi aroturuki ngākau mō ētahi rā, wiki rānei hei whai i te mahi hiko o tō ngākau. Ka whiwhi ētahi tūroro i ngā rekoata ā-roto e aroturuki tonu ana i te manawataki mō te toru tau.

He rerekē ngā reiti angitu i runga i tō momo AFib me ētahi atu āhuatanga. Mō te paroxysmal AFib, ko ngā reiti angitu te 70-85% i muri i te tikanga kotahi. He iti ake ngā reiti angitu o te AFib tonu, tata ki te 60-70%. Me whai pea ētahi tūroro i tētahi tikanga whakakorenga tuarua kia tutuki ai ngā hua pai.

Ka whai koe i ngā tūhono whai muri i te wātea ki te aromatawai i tō ahunga whakamua. Ko ēnei haerenga te tikanga kei roto ko ngā electrocardiograms (ECGs) me ngā kōrero mō ngā tohu e pā ana ki a koe. Ka aromatawai hoki tō tākuta mēnā ka taea e koe te whakaiti, te whakamutu rānei i ētahi rongoā.

Kia mōhio koe ka puta pea ngā raruraru onge, ahakoa he mea noa. Ko ēnei pea ko te toto, te mate, te kino ki ngā hanganga tata, i roto rānei i ngā wā onge, te whiu. Ka aroturukihia e tō rōpū hauora ēnei mea ka whakatika wawe i a rātou mēnā ka puta.

Me pēhea te pupuri i te hauora ngākau i muri i te whakakorenga atrial fibrillation?

I muri i te whakakorenga angitu, ka noho te pupuri i te hauora ngākau hei mahi tahi i waenga i a koe me tō rōpū hauora. Ahakoa e whakatika ana te tikanga i te raruraru hiko, ko te tiaki i tō hauora ngākau katoa ka āwhina i te angitu mo te wā roa.

He mea nui ngā huringa o te noho i te oranga ki te ārai i te hokinga mai o te AFib. Ko te korikori tinana i ngā wā katoa, e whakaaetia ana e tō tākuta, ka āwhina i te whakakaha i tō ngākau me te whakapai ake i te oranga katoa. Me tīmata pōturi, me te whakanui haere i ngā taumata mahi i runga i ngā tohutohu a tō tākuta.

He mea nui te whakahaere i ētahi atu āhuatanga hauora. Ka taea e te pēhanga toto tiketike, te mate huka, me te moe apinīa te whai wāhi ki te hokinga mai o te AFib. Mā te mahi tahi me tō rōpū hauora ki te arotau i te rongoā mō ēnei āhuatanga ka tautoko i te hauora o tō ngākau mō te wā roa.

Ka taea e te kai me te whakahaere taumaha te whai pānga nui ki ō hua. Mā te pupuri i te taumaha hauora ka whakaiti i te pēhanga ki tō ngākau, i te wā e whakawhāiti ana i te waipiro me te kawhe ka ārai pea i ngā mea e pā ana ki te AFib. E kitea ana e ētahi tāngata tūroru ka taea e ētahi kai, inu rānei te whakaoho i ngā wāhanga, nō reira he mea whai hua te pupuri i te rārangi tohu.

Ka taea hoki e ngā tikanga whakahaere i te ahotea pēnei i te whakaaroaro, te yoga, ngā mahi manawa hōhonu rānei te tautoko i te hauora o te ngākau. Ka taea e te ahotea mau tonu te whakaoho i ngā wāhanga AFib i ētahi tāngata, nō reira ko te kimi i ngā huarahi hauora ki te whakahaere i te ahotea ka noho hei wāhanga o tō mahere tiaki tonu.

He aha te putanga pai rawa atu mō te tango i te atrial fibrillation?

Ko te putanga pai rawa atu mai i te tango AFib ko te herekore katoa mai i ngā manawataki ngākau kōaro me te kore e hiahia ki ngā rongoā tonu. He maha ngā tāngata tūroru e whakatutuki ana i tēnei whāinga me te wheako i ngā whakapainga nui i roto i te kounga o tō rātou oranga, ngā taumata pūngao, me te oranga whānui.

Ko te tango angitu te tikanga ka taea e koe te hoki ki ngā mahi i karo pea koe nā te tohu AFib. Ko te manawanui ki te whakakori tinana ka pai ake, ā, he maha ngā tāngata tūroru e kī ana he nui ake te māia me te iti ake o te āwangawanga mō tō rātou āhuatanga ngākau.

Heoi, he rerekē te ahua o te angitu mō ia tangata. E hiahia ana ētahi tāngata tūroru ki ngā rongoā engari i ngā horopeta iti ake, i te wā e iti ake ana ētahi atu i ngā wāhanga AFib ahakoa kāore i te whakakorehia katoatia. Ko te whakaiti i te kawenga AFib e whakaarohia ana he pai.

Ka taea hoki e te angitu o te tikanga te whakaiti i tō tūponotanga ki te whiu me ētahi atu raruraru e pā ana ki te AFib. He maha ngā tāngata tūroru ka taea te whakamutu i ngā rongoā whakaheke toto i muri i te tango angitu, ahakoa kei runga i ō āhuatanga tūpono whiu takitahi tēnei whakatau.

Kei te haere tonu te pai o nga hua mo te wa roa i te wa e ahu whakamua ana nga tikanga whakakore. Ko te nuinga o nga turoro e angitu ana ka mau tonu o ratou hua mo nga tau maha, ahakoa ka hiahia etahi ki etahi atu tikanga, rongoa ranei i te wa e koroheke ana.

He aha nga mea morearea mo nga raruraru o te whakakorenga o te atrial fibrillation?

Ahakoa he haumaru te whakakorenga o te AFib, ka taea e etahi mea te whakanui i to tupono ki nga raruraru. Ko te pakeke tetahi mea hei whakaaro, na te mea he iti ake te tupono o nga turoro pakeke ki nga raruraru, ahakoa ko te pakeke anake kaore e whakakore i tetahi mai i te tikanga.

Ka pa te ahua o to hauora ki to ahua morearea. Ko nga ahuatanga penei i te mate ngakau nui, nga raruraru whatukuhu, nga mate toto ranei ka nui ake te uaua o te tikanga. Ka ata titiro te roopu hauora ki enei mea i te wa e whakatau ana mena he tika te whakakorenga mo koe.

Ko te momo me te roa o to AFib ka pa ano ki te morearea. Ko te AFib tonu kua roa nei e noho ana mo nga tau maha ka hiahia pea ki te whakakorenga nui ake, ka nui ake pea te tupono ki nga raruraru. Heoi, ka taea e nga tohunga hiko hiko te mahi i enei tikanga i te haumaru.

Ko nga tikanga ngakau o mua, nga pokanga ranei ka uaua ake te whakakorenga. Ko te kiko kiko mai i nga mahi o mua ka pa ki te waahi o nga katheta, ki te pehea ranei te tuku hiko. Ka arotakehia e to taakuta to hitori rongoa kia pai ai te whakamahere i te huarahi haumaru.

Ko etahi rongoa, ina koa nga mea whakaheke toto, me ata whakahaere i te wa o te tikanga. Ka hangaia e to roopu hauora he mahere motuhake mo te whakahaere i enei rongoa hei whakaiti i nga morearea o te toto me te whakaheke toto.

He pai ake te whakakorenga o te atrial fibrillation wawe, te whakaroa ranei?

E kii ana nga rangahau hou ko te whakakorenga wawe, ina koa i roto i nga turoro taiohi he iti ake nga ahuatanga o te ngakau, he maha nga wa ka pai ake nga hua. Ka taea e te wawaotanga wawe te aukati i nga huringa hiko me te hanganga e uaua ai te rongoa i te AFib i te wa.

Heoi anō, kei runga i tō āhuatanga ake te wā. Mēnā e pai ana te whakahaere o tō AFib mā ngā rongoā, ā, kāore koe e pā ana ki ngā tohumate nui, tērā pea ka tūtohu tō tākuta kia haere tonu te whakahaere rongoā. E whai pānga ana te whakatau ki te whakataurite i ngā painga o te ablation ki ngā mōrearea iti engari tūturu o te tukanga.

Mō ngā tūroro e pā ana ki te AFib tohumate ahakoa ngā rongoā, ka taea e te ablation wawe te ārai i te āhuatanga kia kore e kaha ake te mau tonu. Ko te Paroxysmal AFib (ngā wāhanga e haere mai ana, e haere ana) te nuinga he nui ake ngā reiti angitu i te AFib mau tonu, e whai hua ana te wawaotanga wawe.

He mea nui anō tō tau me tō hauora whānui ki ngā whakatau wā. Ko ngā tūroro tamariki e iti ana ētahi atu raruraru hauora he pai rawa te putanga mai i te ablation wawe. Ko ngā tūroro pakeke, ko te hunga rānei e maha ana ngā āhuatanga hauora, ka whai hua pea mai i te huarahi haere haere.

Ko te mea nui ko te whai kōrero tuwhera ki tō electrophysiologist mō tō āhuatanga motuhake. Ka taea e rātou te āwhina i a koe ki te mārama ki ngā painga me ngā mōrearea o te ablation i ngā wāhanga rerekē o tō haerenga AFib.

He aha ngā raruraru ka puta mai i te ablation atrial fibrillation?

Ko te nuinga o ngā ablation AFib ka oti me te kore raruraru, engari he mea nui kia mārama ki ngā mōrearea ka puta. Ko ngā raruraru iti noa ko te pānga, te mamae rānei i ngā wāhi whakauru catheter, e ngaro ana i roto i ngā rā torutoru.

Ka puta pea ngā raruraru nui engari kāore i te nuinga. Ko ēnei pea ko te toto e hiahia ana ki te aro rongoā, te mate i ngā wāhi whakauru, te kino rānei ki ngā oko toto. E aroturuki ana tō rōpū rongoā i ēnei take, ā, ka taea te whakatika wawe mēnā ka puta mai.

Heoi anō, he mea tika kia whakahua i ngā raruraru kino, ahakoa he iti iho i te 1% o ngā tukanga ka puta. Ka taea e ēnei te whakauru i te whiu, te kino ki te kōpū (kei muri i te ngākau), te whara rānei i te uaua phrenic, e whakahaere ana i tō diaphragm. Ko te stenosis uaua pulmonary, e whāiti ana ngā uaua kua rongoatia, he tētahi atu mea ka puta.

Ko te fistula atrial-esophageal he raruraru tino onge engari he kino, ka puta he hononga kōaro i waenga i te ngākau me te kōpū. Ka puta tēnei i roto i te iti iho i te 1 i roto i te 1,000 ngā tukanga engari me whai wāhi tonu te rongoā mēnā ka puta.

He maha ngā whakatūpato a tō rōpū rongoā hei whakaiti i ēnei tūponotanga. Ka whakamahi rātou i te aroturuki i te pāmahana, ka whakatika i ngā taumata pūngao mā te āta, me te whakamahi i te ārahi whakaahua hei whakarite i te whakatakoto tika o te catheter. Ko te wheako o tō electrophysiologist me te hōtaka ablation o te hōhipera ka pā hoki ki te haumaru whānui.

Āhea ahau e kite ai i te tākuta i muri i te ablation atrial fibrillation?

Me whakapā atu koe ki tō tākuta tonu mēnā ka pā mai te mamae o te uma, te poto o te manawa, ngā tohu rānei o te whiu pēnei i te ngoikore ohorere, ngā uaua ki te kōrero, te piko rānei o te kanohi. E hiahia ana ēnei tohu ki te arotake rongoā ohorere.

Ko te nui rawa o te toto mai i ngā wāhi whakauru catheter he tētahi atu take hei rapu i te manaakitanga tonu. Ahakoa he mea noa te pānga, ko te toto e kore e mutu i te pēhi, te toto rānei e mākū ana i roto i ngā takai maha e hiahia ana ki te manaakitanga rongoā.

Ko te kirika, ina koa ka haere tahi me te makariri, te piki rānei o te mamae i ngā wāhi whakauru, ka tohu pea i te mate. Kaua e tatari kia kite mēnā ka pai ake ngā tohu i a rātou anō – he mea nui te rongoā wawe o ngā mate mō ngā putanga pai.

Mō te aroturuki i ngā wā katoa, ka kite koe i tō tākuta i roto i ngā wiki i muri i te tukanga. Ka taea e tēnei haerenga te rōpū rongoā ki te tirotiro i tō whakaora, te arotake i ngā tohu, me te whakamahere i te aroturuki tonu i tō manawataki ngākau.

E pā ana ētahi tūroro ki te pā o te ngākau, ki ngā rāpoi rānei i ngā marama tuatahi i muri i te whakawātea. Ahakoa he mea noa i te wā o te whakaora, he mea nui kia whakamōhio koe i ēnei tohu ki tō tākuta kia taea e rātou te whakatau mēnā e hiahiatia ana he arotake atu.

Ngā pātai e pā ana ki te whakawātea o te atrial fibrillation

Q.1 He pai te whakawātea o te atrial fibrillation mō te ārai i te whiu?

Ka taea e te whakawātea AFib te whakaiti i tō tūponotanga whiu mā te whakakore, te whakaiti rānei i ngā rāpoi ngākau koretake. Ki te pōrearea tō ngākau, ka taea e te toto te kohikohi i ngā ruma o runga, ka hanga i ngā pūtau toto ka haere ki tō roro, ka puta he whiu.

Heoi anō, ka whakaaro tō tākuta ki ō āhuatanga tūponotanga whiu whānui i te wā e whakatau ana mō ngā rongoā whakaheke toto. Ka taea e ētahi tūroro te whakamutu i ēnei rongoā i muri i te whakawātea angitu, engari me haere tonu ētahi atu i runga i te pakeke, te pēhanga toto, te mate huka, ētahi atu āhuatanga rānei.

Q.2 Ka pā te whakawātea o te atrial fibrillation i te kino o te ngākau?

Ka hangaia e te tikanga whakawātea he kino i te ahua o ngā kiko iti e aukati ana i ngā ara hiko koretake. He tika, he whāinga tēnei kino rongoā, i hangaia hei whakapai ake i te mahi o tō ngākau, kaua ki te whara i a ia.

Ko te hanganga o te kiko kiko he wāhanga o te tukanga whakaora, ā, kāore i te pā ki te kaha o te pōpō o tō ngākau. Ka pā te nuinga o ngā tūroro i te mahi ngākau pai ake i muri i te whakawātea angitu i te mea ka noho rite, whai hua hoki te rāpoi o tō ngākau.

Q.3 Ka hoki mai te atrial fibrillation i muri i te whakawātea?

Ka taea e te AFib te hoki mai i muri i te whakawātea, ahakoa te nuinga o ngā reiti angitu he tiketike. Tata ki te 70-85% o ngā tūroro me te paroxysmal AFib e noho ana i te kore o ngā rāpoi koretake i muri i te tikanga kotahi. Me hiahia ētahi tūroro ki te whakawātea tuarua kia tutuki ai ngā hua pai.

Ko ngā āhuatanga e pā ana ki te hokinga mai ko te momo o te AFib kei a koe, te roa o tō whai, me te hauora o tō ngākau. Ka kōrero tō tākuta i tō tūponotanga whai hua i runga i ēnei āhuatanga.

Q.4 E hia te roa o te whakaora i muri i te whakakorenga o te atrial fibrillation?

Ko te whakaora tuatahi mai i te tikanga ka 3-7 rā pea, i te wā e tika ana kia karo koe i te hiki taumaha me ngā mahi kaha. Ka hoki te nuinga o ngā tūroro ki te mahi i roto i ngā rā torutoru ki te wiki, i runga i ngā whakaritenga o tā rātou mahi.

Ka 2-3 marama pea te whakaora katoa, i te wā e urutau ana tō ngākau ki ngā huringa i mahia i te wā o te whakakorenga. Ka pā pea ētahi manawataki koretake i te wā o tēnei