Ni iki cyitwa Implantable Cardioverter Defibrillator (ICD)? Intego, Uburyo & Ibivamo

Implantable cardioverter defibrillator (ICD) ni igikoresho gito cya elegitoroniki gishyirwa munsi y'uruhu rwawe kugira ngo kigenzure umuvuduko w'umutima wawe kandi gitange umuriro utabara ubuzima igihe bibaye ngombwa. Tekereza nk'umurinzi wawe bwite ureba umutima wawe amasaha 24/7, yiteguye kwinjira niba hari umuvuduko mubi ugaragaye. Iki gikoresho gitangaje cyagize uruhare mu gufasha abantu babarirwa muri za miliyoni kubaho ubuzima bwuzuye, bwizewe nubwo bafite indwara z'umutima zibashyira mu kaga ko gupfa urupfu rutunguranye.

Ni iki cyitwa implantable cardioverter defibrillator?

ICD ni igikoresho gikoresha batiri gifite ubunini nk'ubwa telefone ntoya igashyirwa mu buryo bwo kubaga munsi y'uruhu hafi y'igufwa ryawe ryo mu gituza. Ihuza n'umutima wawe binyuze mu nsinga zoroheje, zoroheje zizwi nka leads zigenzura ibikorwa by'amashanyarazi by'umutima wawe buri gihe. Iyo igikoresho kivumbuye umuvuduko w'umutima uteye akaga, gishobora gutanga uburyo butandukanye bwo kuvura butangirira ku gukoresha umuvuduko woroshye kugeza ku muriro utabara ubuzima.

Iki gikoresho gikora gisesengura buri gihe imiterere y'umuvuduko w'umutima wawe. Niba cyumva ventricular tachycardia (umuvuduko w'umutima wihuta cyane) cyangwa ventricular fibrillation (umuvuduko w'umutima utagira gahunda, utagira akamaro), gisubiza ako kanya. Izi ngorane zishobora gutuma umutima wawe uhagarara gutera amaraso neza, niyo mpamvu igisubizo cyihuse cya ICD ari ingenzi cyane ku buzima bwawe.

ICD zigezweho zifite ubuhanga buhanitse kandi zishobora gushyirwaho gahunda byihariye kubyo umutima wawe ukeneye. Muganga wawe ashobora guhindura imiterere akoresheje interineti ndetse no kubona amakuru yerekeye ibikorwa by'umutima wawe hagati yo gusura ibitaro. Iyi tekinoroji ituma habaho ubuvuzi bwihariye bujyana n'uko indwara yawe ihinduka uko igihe kigenda.

Kuki hakorwa implantable cardioverter defibrillator?

Abaganga basaba ICD kubantu barokotse guhagarara kw'umutima gutunguranye cyangwa bafite ibyago byinshi byo guhura n'imiterere y'umutima itera ubuzima. Intego y'ibanze ni ukwirinda urupfu rutunguranye rw'umutima, rushobora kuba iyo sisitemu y'amashanyarazi y'umutima wawe idakora neza kandi igahagarika gutera amaraso neza. Ushobora kuba ukwiriye niba warigeze guhura na ventricular tachycardia cyangwa ventricular fibrillation, cyangwa niba imikorere y'umutima wawe yagabanutse cyane.

Indwara nyinshi z'umutima zituma ugira amahirwe menshi yo gukenera ICD. Cardiomyopathy, aho imitsi y'umutima wawe igenda iba mibi cyangwa ikaguka, ni imwe mu mpamvu zisanzwe. Abarwayi bafite umutima udakora neza bafite ejection fraction munsi ya 35% nubwo bafashwa n'imiti myiza akenshi bungukirwa no kurindwa na ICD. Gutera umutima mbere bishobora gusiga ibikomere bituma habaho kutagira umutekano w'amashanyarazi, bituma imiterere iteye akaga ishobora kubaho.

Abantu bamwe baragwa indwara zibashyira mu kaga ko gupfa umutima gutunguranye. Hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, na bimwe mu bibazo bya channel ya ion byose bishobora kongera ibyago byawe cyane. Long QT syndrome na Brugada syndrome ni urugero rw'indwara zarazwe aho ICD zitanga uburinzi bukomeye, ndetse no kubarwayi bakiri bato.

Impamvu zitavugwa cyane ariko z'ingenzi zirimo cardiac sarcoidosis, aho selile zifite ubushyuhe zigira ingaruka ku sisitemu y'amashanyarazi y'umutima wawe. Indwara ya Chagas, imiti imwe n'imwe, n'uburinganire bukomeye bwa electrolyte na bwo bushobora guteza imiterere aho ICD iba ngombwa. Muganga wawe azatekereza ku buzima bwawe muri rusange, ubuzima bwitezwe, n'imibereho yawe mugihe akora iyi nama.

Ni iki gikurikizwa mugihe gushyiraho cardioverter defibrillator?

Gushyiraho ICD bikorwa akenshi ku munsi umwe mu laboratwari y’ibijyanye n’imikorere y’umutima cyangwa mu cyumba cy’ubuvuzi bw’umutima. Uzasinzirizwa mu buryo bworoshye, bivuze ko uzaruhuka kandi wumve neza ariko ntuzata umutwe burundu. Iki gikorwa gikunze kumara isaha 1-3, bitewe n’uburyo ikibazo cyawe kigoye kandi niba ukeneye andi mayeri cyangwa ibindi bikorwa.

Muganga wawe azakora agace gato, akenshi ku ruhande rw’ibumoso munsi y’igufwa ryawe ry’ijosi, hanyuma akore umwanya munsi y’uruhu rwawe kugira ngo hakwirakwizwe ICD. Hanyuma, imigozi ishyirwa mu buryo bwitondewe mu muyoboro w’amaraso mu mutima wawe hakoreshejwe imirasire ya X. Iki gikorwa gisaba ubuhanga kuko imigozi igomba gushyirwa neza kugira ngo yumve imikorere y’amashanyarazi y’umutima wawe kandi itange ubuvuzi neza.

Iyo imigozi imaze gushyirwaho, muganga wawe azagerageza sisitemu kugira ngo arebe niba byose bikora neza. Ibi birimo kureba niba igikoresho gishobora kumva neza umuvuduko w’umutima wawe no gutanga ubuvuzi bukwiye. Hanyuma, ICD ishyirwa mu mwanya munsi y’uruhu rwawe, kandi igice gifungwa hamwe n’imitsi cyangwa uruhu rwo kubaga.

Nyuma y’iki gikorwa, uzagenzurwa amasaha menshi kugira ngo urebe ko nta ngorane zihise zibaho. Abantu benshi barashobora gutaha uwo munsi, nubwo bamwe bashobora gukenera kurara ijoro kugira ngo barebe. Muganga wawe azategura gahunda yo gusuzumwa nyuma y’ibyumweru bike kugira ngo arebe uko urimo gukira kandi akore impinduka zose zikenewe ku mikorere y’igikoresho cyawe.

Ni gute witegura igikorwa cyo gushyiraho defibrillator yo mu mutima?

Kwitegura gushyiraho ICD yawe bitangirana n’ikiganiro kirambuye n’ikipe yawe y’ubuvuzi ku byo witegura. Uzagomba guhagarika kurya no kunywa byibuze amasaha 8 mbere y’iki gikorwa, kimwe no kwitegura ibindi bikorwa byo kubaga. Muganga wawe azasuzuma imiti yawe yose kandi ashobora kukusaba guhagarika imiti imwe n’imwe ituma amaraso ataguma cyangwa guhindura indi miti mbere yo kubagwa.

Menyesha ikipe yawe y'ubuvuzi ku bijyanye n'uburwayi bwose ufite, cyane cyane ku miti, amarangi akoreshwa mu kugenzura, cyangwa latex. Niba urwaye diyabete, uzahabwa amabwiriza yihariye yerekeye uko ucunga isukari yo mu maraso yawe mbere na nyuma y'igikorwa. Muganga wawe kandi azashaka kumenya ku bijyanye n'indwara zose za vuba aha, kuko indwara zishobora gutuma gukira bigorana.

Tegura igihe cyo koroherwa ukoresheje uburyo bwo gutegura umuntu wo kukujyana mu rugo nyuma y'igikorwa. Uzakenera ubufasha mu bikorwa bya buri munsi mu minsi mike ya mbere, cyane cyane ikintu cyose gisaba kuzamura ukuboko kwawe ku ruhande ICD yashyizweho. Gura imyenda yoroshye, yagutse idashyira igitutu ku gice cyakomeretse.

Menya neza ko usobanukiwe n'inzitizi zikurikira igikorwa, akenshi zirimo kwirinda kuzamura ibintu biremereye no gukora imyitozo ikomeye y'ukuboko mu byumweru 4-6. Muganga wawe azatanga amabwiriza yihariye yerekeye igihe ushobora gusubira ku kazi, gutwara imodoka, no gusubira mu bikorwa bisanzwe. Kugira ibyiringiro bifatika ku bijyanye n'inzira yo koroherwa bizagufasha gukira neza.

Ni gute usoma ibisubizo byawe bya implantable cardioverter defibrillator?

Gusobanukirwa ibikorwa bya ICD yawe birimo kumenya ubwoko butandukanye bw'ubuvuzi bushobora gutanga n'icyo amakuru asobanura ku buzima bwawe. Icyuma cyawe kibika amakuru arambuye yerekeye imirimo y'umutima wawe, ubuvuzi ubwo aribwo bwose bwatanzwe, n'uko umutima wawe witwaye. Aya makuru asuzumwa mu gihe cyo gukurikirana buri gihe, akenshi buri mezi 3-6.

Ikintu cy'ingenzi cyo gusobanukirwa ni uko ICD yawe itanga uburyo butandukanye bwo kuvura bitewe n'icyo umutima wawe ukeneye. Anti-tachycardia pacing (ATP) irimo imitsi yihuse, itarimo ububabare ishobora guhagarika imirimo yihuse y'umutima utagize icyo wumva. Cardioversion itanga urugero rwo gutungura uzumva ariko ntirukomeye nka defibrillation. Defibrillation ni uburyo bukomeye bwo kuvura, bugenewe guhagarika imirimo y'umutima iteye akaga cyane.

Raporo y'ibikoresho byawe izerekana uburyo izi terapi zagiye zikenewe kandi niba zaragize icyo zigeraho. Shocks zikwiye bisobanura ko ICD yawe yamenye neza kandi ivura umuvuduko w'umutima uteye akaga. Shocks zitakwiriye zibaho iyo igikoresho cyibeshye kikavuga ko umuvuduko usanzwe cyangwa utari akaga ari nk'uwuteye ubwoba, ibyo bishobora kubaho ariko ntibisanzwe cyane ku bikoresho bigezweho.

Gukurikiranwa hakoreshejwe ikoranabuhanga rishobozwa na interineti bituma muganga wawe ashobora kugenzura imikorere y'ibikoresho byawe n'ibikorwa by'umutima wawe hagati y'amasaha yo kwa muganga. Iri koranabuhanga rishobora kumenya ibibazo hakiri kare kandi rigafasha ikipe yawe y'abaganga gukora impinduka kugira ngo iteze imbere uburyo bwo kukwitaho. Uziga kumenya igihe igikoresho cyawe cyatanze terapi n'igihe cyo kuvugana n'umuganga wawe.

Ni gute wakwitwara mu buzima bwawe ufite cardioverter defibrillator yashyizweho?

Kubaho ufite ICD bisaba impinduka zimwe na zimwe, ariko abantu benshi basubira mu buzima bufite akamaro kandi bwuzuye mu mezi make nyuma yo gushyirwaho. Ikintu cy'ingenzi ni ukumenya ibikorwa bifite umutekano n'ingamba ugomba gufata. Muganga wawe azatanga amabwiriza asobanutse ashingiye ku miterere yawe bwite, ariko amahame rusange akoreshwa ku barwayi benshi ba ICD.

Imyitozo ngororamubiri muri rusange irashishikarizwa kuko imyitozo ifitiye akamaro ubuzima bw'umutima wawe muri rusange. Uzagomba kwirinda imikino ikorana n'abandi ishobora kwangiza igikoresho cyawe, ariko kugenda, koga, gutwara igare, n'ibindi bikorwa byinshi bifite umutekano rwose. Tangira gahoro gahoro hanyuma wongere urwego rw'ibikorwa byawe uko ukira kandi ukagira icyizere ku gikoresho cyawe.

Ibikoresho bimwe na bimwe bya elegitoroniki bishobora kubangamira ICD yawe, nubwo ibi bitaba kenshi ku byitegererezo bishya. Ugomba kwirinda guhura igihe kirekire n'imirerere ikomeye ya magnetike, nk'iyo dusanga muri mashini za MRI (keretse ufite igikoresho gihuye na MRI), ibikoresho byo gutunganya ibyuma, n'imashini zimwe na zimwe zikora mu nganda. Ibikoresho byinshi byo mu rugo, harimo na microwave na telefone zigendanwa, bifite umutekano gukoreshwa bisanzwe.

Ingendo zo mu kirere muri rusange zirizewe niba ufite ICD, nubwo ugomba kumenyesha abashinzwe umutekano ibyerekeye igikoresho cyawe mbere yo kunyura mu byuma bishakisha ibyuma. Uzajyana ikarita iranga ICD yawe isobanura ibitekerezo byihariye. Abantu benshi basanga igikoresho cyabo ntigihindura cyane imirimo yabo ya buri munsi iyo bamaze kumenyera kubana nacyo.

Ni ibihe bintu byongera ibyago byo gukenera implantable cardioverter defibrillator?

Ibintu byinshi byongera amahirwe yawe yo gukenera ICD, aho intege nke z'umutima ariyo mpamvu isanzwe. Iyo imikorere y'umutima wawe imanuka munsi ya 35% y'ibisanzwe (bipimwa nk'igice cyo gusohora), uri mu kaga gakomeye k'imikorere idasanzwe y'umutima hatitawe ku mpamvu yabyo. Ibi bishobora kubaho bitewe n'ibitero by'umutima, indwara ziterwa na virusi, ibintu bya genetike, cyangwa impamvu zitazwi.

Ibitero by'umutima byabayeho mbere bitera imitsi y'ibikomere ishobora gutera imikorere idasanzwe y'amashanyarazi mu mutima wawe. Iyo ikomere rinini, ibyago byawe biriyongera. N'iyo igitero cy'umutima wawe cyabayeho imyaka myinshi ishize, imitsi y'ibikomere iracyahari kandi ishobora kuzamo ibibazo nyuma y'igihe. Amateka y'umuryango y'urupfu rutunguranye rw'umutima, cyane cyane mu bafitanye isano bari munsi y'imyaka 50, birerekana ko ushobora kuba warazwe indwara yongera ibyago byawe.

Indwara zimwe na zimwe zongera cyane ibyago byawe. Kugabanuka kw'umutima biturutse ku mpamvu iyo ari yo yose, cyane cyane iyo ihujwe n'ibimenyetso nubwo hakoreshwa imiti, akenshi bituma habaho gutekereza kuri ICD. Cardiomyopathy, yaba yagutse, hypertrophic, cyangwa restrictive, ishobora guteza imikorere idahagije y'amashanyarazi. Indwara za genetike nka arrhythmogenic right ventricular cardiomyopathy cyangwa indwara zimwe na zimwe z'inzira ya ion zishobora gusaba uburinzi bwa ICD ndetse no ku barwayi bakiri bato.

Ibintu bike ariko by'ingenzi byongera ibyago birimo indwara ya sarukoyide ya korari, itera umubyimbirwe mu mikaya y'umutima wawe. Indwara ya Chagas, ikunda kugaragara mu turere tumwe na tumwe, ishobora kwangiza sisitemu y'amashanyarazi y'umutima wawe. Imiti imwe n'imwe, cyane cyane imiti imwe ya shimi, ishobora kunaniza imikaya y'umutima wawe kandi ikongera ibyago byawe. Indwara ikomeye y'impyiko n'indwara zimwe na zimwe ziterwa n'umubiri zishobora no gutuma habaho ibibazo by'umutima.

Ni izihe ngaruka zishobora guterwa no gushyiraho imashini ya cardioverter defibrillator?

Nubwo gushyiraho ICD muri rusange bifite umutekano, gusobanukirwa ingaruka zishobora kuvuka bifasha gufata ibyemezo bifitiye inyungu kandi kumenya ibibazo hakiri kare. Ibintu bisanzwe ni bito kandi bifitanye isano n'uburyo bwo kubaga ubwabyo. Ibi birimo kuva amaraso, gukomeretsa, no kutoroherwa by'agateganyo ahantu hakorewe icyo gikorwa, ibyo bikunda gukira mu byumweru bike.

Udukoko ni ikibazo gikomeye ariko gike gishobora kubaho ahantu hakorewe icyo gikorwa cyangwa hafi y'imashini ubwayo. Ibimenyetso birimo umutuku wiyongereye, gushyuha, kubyimba, cyangwa kuvamo amazi ahantu hakorewe icyo gikorwa, hamwe n'umuriro cyangwa kumva utameze neza. Udukoko twa imashini mubisanzwe dusaba kuvurwa n'imiti yica udukoko rimwe na rimwe gukuraho sisitemu yose, niyo mpamvu gukurikiza amabwiriza yo kwita ku nyuma y'igikorwa ari ingenzi cyane.

Ibibazo bifitanye isano n'umugozi bishobora kubaho mugihe cyangwa nyuma yo gushyiraho. Pneumothorax, aho umwuka winjira mu mwanya uri hafi y'igihaha cyawe, bibaho mu buryo bugera kuri 1-2% by'ibikorwa kandi bishobora gusaba kuvurwa. Kwimurwa kw'umugozi, aho insinga ziva ahantu hagenewe, bishobora kugira ingaruka ku mikorere y'imashini kandi bishobora gusaba kongera gushyirwa ahantu. Umugozi uvunika ni gake ariko bishobora kubaho nyuma yimyaka yo gushyiraho, cyane cyane abarwayi bakora cyane.

Imikorere mibi y'ibikoresho ntisanzwe ku byuma bigezweho bya ICD ariko bishobora kurimo gutanga umuriro mwinshi utari ngombwa, kunanirwa kumenya imirimo mibi y'umutima, cyangwa ibibazo bya batiri. Imirasire ya elegitoroniki ituruka ku byuma bimwe na bimwe bishobora guhungabanya imikorere by'agateganyo, nubwo ibyo bidasanzwe. Abantu bamwe bahura n'ibibazo byo mu mutwe, harimo guhangayika kubera guhabwa umuriro cyangwa kwiheba bifitanye isano n'uburwayi bw'umutima bwabo. Ibyo byiyumvo ni ibisanzwe kandi bivurwa hakoreshejwe ubufasha bukwiriye.

Ni ryari nkwiriye kubonana na muganga ku byerekeye icyuma cyanjye gishinzwe gukosora umuvuduko w'umutima?

Ugomba guhita uvugana n'umuganga wawe niba wakiriye umuriro uturutse kuri ICD yawe, kabone n'iyo wumva umeze neza nyuma yaho. Nubwo umuriro akenshi ugaragaza ko icyuma cyawe gikora neza, muganga wawe akeneye gusuzuma ibyabaye no kumenya niba hari ibikeneye guhindurwa. Umuriro mwinshi mu gihe gito, witwa umuyaga w'amashanyarazi, bisaba ubufasha bwihutirwa bw'ubuvuzi.

Ibimenyetso byo kwandura hafi y'icyuma cyawe bisaba isuzuma ryihutirwa ry'ubuvuzi. Irinde umutuku wiyongera, ubushyuhe, kubyimba, cyangwa kubabara ahantu hakorewe icyuma, cyane cyane niba biherekejwe n'umuriro, guhinda umushyitsi, cyangwa kumva utameze neza. Icyo aricyo cyose gituruka ahakorewe icyuma, cyane cyane niba gifite ibicu cyangwa gifite impumuro, gikeneye kwitabwaho ako kanya. Ibyo bimenyetso bishobora kugaragaza kwandura kw'icyuma, bikaba bisaba kuvurwa bikomeye.

Ibimenyetso byo gukora nabi kw'icyuma birimo kumva umutima wawe wiruka utabonye ubuvuzi bukwiriye, cyangwa guhabwa umuriro iyo utumva umutima wawe utera mu buryo budasanzwe. Niba wumva uribwa umutwe, ugata umutwe, cyangwa ubona ububabare mu gituza nk'uko wabyumvaga mbere yo kubona ICD yawe, ibyo bishobora kugaragaza ko icyuma cyawe kidakora neza cyangwa ko uburwayi bwawe bwihinduye.

Kurikiza gahunda yawe isanzwe yo gukurikirana, akenshi ikubiyemo kugenzura ibikoresho buri mezi 3-6. Hagati y'amasaha yo kwisuzumisha, vugana na muganga wawe niba ufite impungenge ku bikoresho byawe, ubona impinduka mu bimenyetso byawe, cyangwa ubona ibibazo bishya bifitanye isano n'umutima. Ntuzuyaze kuvugana n'ibibazo - itsinda ryawe ry'ubuvuzi rishaka kumenya ko wumva ufite icyizere kandi ufite umutekano hamwe na ICD yawe.

Ibikunze kubazwa ku bijyanye na defibrillators ishyirwa mu mubiri

Ibibazo.1 Ese defibrillator ishyirwa mu mubiri ni nziza ku mutima wananiwe?

Yego, ICDs zirashobora kugirira akamaro abantu bafite umutima wananiwe, cyane cyane abafite igipimo cyo gusohoka kw'amaraso munsi ya 35%. Umutima wananiwe wongera ibyago byo gupfa urupfu rutunguranye kubera imirimo y'umutima iteye akaga, kandi ICD itanga uburinzi bukomeye ku byabaye biteye ubuzima bw'akaga. Abarwayi benshi bafite umutima wananiwe bahabwa ibikoresho bivanga byitwa CRT-D (ubuvuzi bwo guhuza umutima na defibrillator) byongera imikorere y'umutima kandi bitanga uburinzi bw'imirimo y'umutima.

Ibibazo.2 Ese kugira ICD bitera ibibazo by'umutima?

Oya, ICDs ntizitera ibibazo by'umutima - zishyirwaho kugirango zivure indwara z'umutima zisanzwe kandi zirinde ingaruka ziteye akaga. Igikoresho ubwacyo ntigisenya umutima wawe cyangwa ngo gite ibibazo bishya. Ariko, imigozi rimwe na rimwe irashobora gutera ingaruka ntoya nk'amaraso yiziritse cyangwa indwara, ariko ibi ni bike kandi inyungu zo kurinda urupfu rutunguranye rurenze cyane ibi byago ku bantu bakwiriye.

Ibibazo.3 Ese urashobora kubaho ubuzima busanzwe hamwe na ICD?

Abantu benshi bafite ICD babaho ubuzima bwiza kandi bwuzuye, bagira impinduka ntoya gusa mu bikorwa byabo bya buri munsi. Urashobora gukora, kugenda, gukora imyitozo, kandi witabire ibikorwa byinshi wari usanzwe ukora mbere. Inzitizi nyamukuru zirimo kwirinda imikino ikoranwa imibiri no kwitonda hafi y'umuriro ukomeye wa elegitoronike. Abantu benshi bavuga ko bumva bafite icyizere kandi bafite umutekano bazi ko igikoresho cyabo kibarinda imirimo y'umutima ishobora guteza ubuzima bwabo akaga.

Q.4 Urugohe rw'umuriro wa ICD rumeze rute?

Umuriro wa ICD wumvikana nk'uruguma rukomeye cyangwa guterwa mu gituza cyawe, akenshi bisobanurwa nk'aho usa no guterwa na baseball. Ibyiyumvo bimara akanya gato, nubwo ushobora kumva ubabara nyuma. Nubwo bitaryoshye, abantu benshi boroherwa n'umuriro kandi bumva bashimira uburinzi batanga. Muganga wawe ashobora guhindura imiterere kugirango agabanye umuriro utari ngombwa mugihe akomeza umutekano wawe.

Q.5 Batterie ya ICD imara igihe kingana iki?

Batterie za ICD zigezweho zisanzwe zimara imyaka 7-10, nubwo ibi bitandukana bitewe n'uko igikoresho cyawe gitanga imiti kandi n'imiterere y'igikoresho cyawe. Muganga wawe akurikirana ubuzima bwa batterie mugihe cyo kugenzura buri gihe kandi azategura kubagwa kugirango asimbuze igihe bibaye ngombwa. Gusimbuza batterie mubisanzwe biroroshye kuruta gushyiraho bwa mbere kuko insinga akenshi zitagomba guhindurwa, ahubwo igice cy'imashini gusa.