Chii chinonzi Pulmonary Vein Isolation? Chinangwa, Maitiro & Mhedzisiro

Pulmonary vein isolation inzira yemoyo isingade kuvhiyiwa zvakanyanya inorapa atrial fibrillation nekugadzira mavanga anodzorwa akatenderedza pulmonary veins. Mavanga aya anovharisa zviratidzo zvemagetsi zvisina kujairika zvinokonzera kuti moyo wako urove zvisina kujairika, zvichibatsira kudzorera rhythm yemoyo yakajairika.

Funga nezvazvo sekudzokorodza sisitimu yemagetsi yemoyo wako. Maitiro acho anoshandisa kupisa kana simba rinotonhora kugadzira zvivharo zvidiki, zvakanyatsojeka zvinodzivirira zviratidzo zvemagetsi zvisina kurongeka kubva mukukanganisa rhythm yechisikigo yemoyo wako.

Chii chinonzi pulmonary vein isolation?

Pulmonary vein isolation (PVI) inzira inobva kukatheta inorapa atrial fibrillation nekuparadzanisa pulmonary veins kubva ku left atrium. Iyo pulmonary veins ndiyo midziyo mina yeropa inotakura ropa rakazara neoksijeni kubva kumapapu ako kudzokera kumoyo wako.

Munguva yemaitiro, chiremba wako anogadzira pateni yedenderedzwa yematishu emavanga akatenderedza imwe neimwe pulmonary vein vhura. Iri tishu remavanga rinoshanda semhepo yemagetsi, ichidzivirira zviratidzo zvemagetsi zvisina kujairika kubva mumitsipa kubva kusvika kumakamuri epamusoro emoyo wako.

Maitiro acho anonziwo pulmonary vein ablation kana catheter ablation. Inoitwa mune yakakosha cardiac catheterization lab ne electrophysiologist, cardiologist anonyanya kuziva nezvematambudziko erhythm yemoyo.

Nei pulmonary vein isolation ichiitwa?

Pulmonary vein isolation inonyanya kuitwa kurapa atrial fibrillation (AFib), chirwere chakajairika cherhythm yemoyo chinokonzera kurova kwemoyo kusina kujairika uye kazhinji nekukurumidza. AFib inoitika kana zviratidzo zvemagetsi mumoyo mako zvisina kurongeka, zvichikonzera kuti makamuri epamusoro adengenyeke panzvimbo yekurova zvinobudirira.

Chiremba wako angakurudzira PVI kana uine AFib ine zviratidzo zvisingapinduri zvakanaka kumishonga. Izvi zvinosanganisira nyaya dzaunosangana nadzo nguva zhinji dzekurova kwemoyo nekukurumidza, kufema nekukurumidza, kurwadziwa muchipfuva, kuneta, kana dzungu zvinokanganisa zvikuru hupenyu hwako hwezuva nezuva.

Maitiro acho anonyanya kubatsira vanhu vane paroxysmal AFib, uko zviitiko zvinouya nekupfuura zvisingafungidzike. Inogonawo kubatsira avo vane persistent AFib vanoda kuderedza kuvimba kwavo nemishonga yenguva refu kana avo vasingakwanise kutsungirira mishonga yeAFib nekuda kwemigumisiro.

Mune dzimwe nguva, PVI inogona kurudzirwa kuderedza njodzi yako yekurohwa. AFib inowedzera njodzi yekurohwa nekuti kurova kwemoyo kusingaite kunogona kukonzera kuti ropa riumbike mumoyo mako, iro rinogona kutamira kuuropi hwako.

Ndeapi maitiro ekuita pulmonary vein isolation?

Pulmonary vein isolation inoitwa mune cardiac catheterization lab iwe uri pasi pe conscious sedation kana general anesthesia. Maitiro acho anowanzo tora maawa maviri kusvika ku4, zvichienderana nekukomba kwenyaya yako.

Chiremba wako anotanga nekuisa machubhu matete, anochinjika anonzi catheters kuburikidza nemidzi yeropa mumugumo wako kana mumutsipa. Aya macatheter anotungamirirwa kumoyo wako achishandisa X-ray imaging uye advanced mapping systems inogadzira mufananidzo we3D wekushanda kwemagetsi kwemoyo wako.

Hezvino zvinoitika panguva yematanho makuru emaitiro:

1. Kuratidza sisitimu yemagetsi yemoyo wako kuti uone nzvimbo chaiyo uko zviratidzo zvisina kujairika zvinobva
2. Kuisa ablation catheter pamukova wega wega pulmonary vein
3. Kupa simba re radiofrequency (kupisa) kana cryoenergy (kutonhora) kugadzira nyama yechironda inodzorwa
4. Kuyedza kuparadzaniswa nekuongorora kuti zviratidzo zvemagetsi kubva kumapulmonary veins zvakavharwa zvachose
5. Kutarisa rhythm yemoyo wako kuti uone kuti maitiro acho akabudirira

Nyama yakaoma inotanga kuumbwa pakarepo asi inoenderera mberi ichikura kwemavhiki akati wandei. Iyi nzira yekupora inobatsira kuona kuti kupatsanurwa kwemagetsi kunoramba kuri kwenguva refu uye kunoshanda kwenguva refu.

Nzira yekugadzirira sei pulmonary vein isolation yako?

Kugadzirira pulmonary vein isolation kazhinji kunotanga mavhiki akati wandei usati waita maitiro ako. Chiremba wako achapa mirairo yakatarwa kune zvaunoda iwe pachako uye nhoroondo yako yekurapa.

Unogona kuda kumisa mishonga yakati wandei usati waita maitiro acho, kunyanya zvinoderedza ropa. Zvisinei, usambomisa chero mushonga usina mirairo yakajeka kubva kuchikwata chako chehutano, sezvo nguva iyi yakakosha kuchengeteka kwako.

Kugadzirira kwako kunogona kusanganisira matanho aya akakosha:

• Kuita bvunzo dzisati dzaitwa dzakadai sebasa reropa, chest X-ray, uye echocardiogram
• Kutora maantibayoti akanyorwa kana uine mamiriro emoyo akati wandei
• Kutsanya kwemaawa 8-12 usati waita maitiro acho (hapana chikafu kana chinwiwa kunze kwemvura shoma nemishonga)
• Kuronga munhu wekukutyaira kumba mushure mekuita maitiro acho
• Kubvisa zvishongo, polish yezvipikiri, uye malenzi usati wasvika

Chiremba wako anogona zvakare kukurudzira transesophageal echocardiogram (TEE) kuti utarise ropa rinovhara mumoyo wako usati waita maitiro acho. Iyi inzira yekuchengetedza kuti ive nechokwadi chekuti maitiro acho anogona kuitwa zvakachengeteka.

Nzira yekuverenga sei mhedzisiro yako ye pulmonary vein isolation?

Kubudirira kwe pulmonary vein isolation kunoyerwa nekuti inodzora sei zviratidzo zvako zve atrial fibrillation uye kudzivirira zviitiko zveramangwana. Chiremba wako achatarisa kufambira mberi kwako kuburikidza nekutevera-kumusoro kusangana uye kuongorora rhythm yemoyo.

Kubudirira kwakakurumidza kunotemwa panguva yemaitiro acho pachayo. Chiremba wako anoedza kana pulmonary veins yakaparadzaniswa zvachose nekutarisa kuti hapana zviratidzo zvemagetsi zvinogona kupfuura pakati pemitsipa uye atrium yako yemoyo wekuruboshwe.

Kubudirira kwenguva refu kunoongororwa pamusoro pemwedzi nemakore kuburikidza nemaitiro aya:

• Miedzo yeEKG yenguva dzose yekutarisa rhythm yemoyo wako panguva yekushanya muhofisi
• Holter monitors kana zviitiko zvekutarisa zvinorekodha rhythm yemoyo wako kwemaawa makumi maviri nemana-makumi mana nemasere kana kupfuura
• Kutevera zviratidzo kuti uone kana uine zviitiko zvishoma zvekuita kwemoyo nekukurumidza, kufema kwemhepo, kana kusagadzikana muchipfuva
• Miedzo yekushushikana yekurovedza muviri kuti uve nechokwadi chekuti rhythm yemoyo wako inoramba yakagadzikana panguva yekushanda kwemuviri

Mitengo yekubudirira inosiyana, asi zvidzidzo zvinoratidza kuti 70-80% yevanhu vane paroxysmal AFib vanoramba vasina zviitiko zveAFib gore rimwe mushure mekuvhiyiwa. Vamwe vanhu vangada kuvhiyiwa zvakare kana AFib ikadzoka, izvo zvakajairika zvachose uye hazvireve kuti kuvhiyiwa kwekutanga kwakakundikana.

Chii chakanakisa mhedzisiro yekuparadzaniswa kwetsinga yemumhepo?

Mhedzisiro yakanakisa yekuparadzaniswa kwetsinga yemumhepo ndeyekusununguka zvachose kubva muzviitiko zveatrial fibrillation uchichengetedza basa remoyo rakajairika. Izvi zvinoreva kuti hauna kurova kwemoyo kusingaite, palpitations, kana zviratidzo zvine chekuita neAFib muhupenyu hwako hwezuva nezuva.

Mhedzisiro yakanaka inosanganisirawo kuvandudzwa kwemhando yehupenyu. Vanhu vazhinji vanoshuma kushivirira kuri nani kwekuita maekisesaizi, kuderedzwa kwekuneta, uye kushushikana kushoma nezvemamiriro avo emoyo mushure mePVI yakabudirira.

Mhedzisiro yenguva refu yakanakisa inosanganisira zvinhu zvikuru izvi:

• Rhythm yemoyo yakajairika isina zviitiko zveAFib
• Kuderedzwa kwekudiwa kwemishonga yerhythm yemoyo
• Kuderera kwengozi yekurova nekuda kwerhythm yemoyo yakajairika
• Kuvandudzwa kwemukana wekurovedza muviri uye mazinga esimba
• Kuvandudzwa kwemhando yehupenyu uye kuvimba mumabasa ezuva nezuva

Kunyangwe iwe uchifanira kuenderera mberi nemimwe mishonga mushure mePVI, kuvhiyiwa kwakabudirira kazhinji kunobvumira madosi akaderera kana mishonga mishoma kupfuura kare. Chiremba wako achashanda newe kuti uwane chiyero chakakodzera chemamiriro ako ega.

Ndezvipi zvinhu zvine njodzi zvekuda kuparadzaniswa kwetsinga yemumhepo?

Zvimwe zvinhu zvinogona kuwedzera mukana wako wekuva ne atrial fibrillation yakakomba zvakakwana kuti ufanirwe kuita pulmonary vein isolation. Kunzwisisa izvi zvinokonzera njodzi kunobatsira iwe nachiremba wako kuti muite zvisarudzo zvine ruzivo pamusoro pekurapa.

Zera ndicho chinhu chikuru chinokonzera njodzi, sezvo AFib ichiwanzova yakajairika sezvaunokura. Zvisinei, vanhu vaduku vanogonawo kuva ne AFib, kunyanya kana vaine mamwe mamiriro ezvinhu ari pasi.

Zvinowanzoitika zvinokonzera njodzi zvinogona kutungamirira pakuda PVI zvinosanganisira:

• High blood pressure isina kutarisirwa zvakanaka nekufamba kwenguva
• Zvirwere zve mwoyo zvinosanganisira coronary artery disease, matambudziko e heart valve, kana heart failure
• Diabetes, kunyanya kana mazinga e shuga yeropa achiwanzokwira
• Obesity, iyo inoisa imwe strain pamoyo wako
• Sleep apnea, iyo inogona kukonzera irregular heart rhythms
• Thyroid disorders, kunyanya overactive thyroid
• Kunwa doro zvakanyanya kana binge drinking
• Nhoroondo yemhuri ye atrial fibrillation kana mamwe matambudziko e heart rhythm

Vamwe vanhu vanova ne AFib vasina chero zvinokonzera njodzi zvakajeka, uye izvozvo zvakajairika zvachose. Chinhu chakakosha ndechokuwana kurapwa kwakakodzera kana zviratidzo zvichikanganisa zvakanyanya hupenyu hwako.

Ndezvipi zvingaitika zve pulmonary vein isolation?

Nepo pulmonary vein isolation ichiwanzoita yakachengeteka, semamwe maitiro ekurapa, inotakura zvimwe zvine njodzi. Zvizhinji zvezvinetso hazviwanzowanikwi uye zvinogona kutarisirwa zvakanaka kana zvikaitika.

Zvinetso zvinowanzoitika zvinowanzoita zviduku uye zvinogadziriswa nekukurumidza. Izvi zvinogona kusanganisira temporary bruising kana soreness panzvimbo yekuiswa catheter, iyo inowanzoita inopora mukati memazuva mashoma.

Zvimwe zvakakomba asi zvisingawanzoitiki zvinogona kusanganisira:

• Kubuda ropa panzvimbo yekuisa catheter iyo inogona kuda kumanikidzwa kana imwe kurapwa
• Mavhiri eropa anogona kufamba kune dzimwe nhengo dzemuviri wako
• Kukuvadzwa kwetsinga dzeropa panguva yekuisa catheter
• Kukuvara kusingatarisirwi kune esophagus, iyo iri pedyo nemoyo
• Pulmonary vein stenosis, uko tsinga dzakarapwa dzinoita diki
• Pericarditis, iyo iri kuzvimba kwesac rinotenderedza moyo wako
• Matambudziko matsva emoyo, kunyangwe izvi zviri zvekanguva

Zvisingawanzoitiki asi matambudziko akakomba anosanganisira sitiroko, kurwisa kwemoyo, kana kukuvadzwa kune zvivakwa zviri pedyo. Electrophysiologist wako achakurukura njodzi idzi newe uye achatsanangura maitiro avanozvideredza panguva yekuita kwako.

Ndingafonera rinhi chiremba mushure me pulmonary vein isolation?

Unofanira kubata chiremba wako nekukasira kana ukaona chero zviratidzo zvinonetsa mushure me pulmonary vein isolation. Kunyange kusagadzikana kumwe kuri kwakajairika, zviratidzo zvakati wandei zvinoda kutariswa kwekurapa nekukurumidza.

Fonera chiremba wako nekukasira kana ukaona kubuda ropa kwakanyanya, kuzvimba, kana kurwadziwa kunowedzera panzvimbo yekuisa catheter. Tsvagawo kutarisirwa nekukasira kana ukaona kurwadziwa muchipfuva, kufema kwakanyanya, kana zviratidzo zvehutachiona senge fivha kana kutonhora.

Heano mamiriro anoda kutariswa kwekurapa nekukurumidza:

• Kubuda ropa kwakanyanya kubva panzvimbo yekuisa iyo isingamire nekumanikidzwa zvinyoro
• Zviratidzo zvehutachiona zvinosanganisira fivha, kutsvuka, kudziya, kana kubuda kubva panzvimbo yekuisa
• Kurwadziwa kwakanyanya muchipfuva kana kumanikidzwa kunonzwa kwakasiyana nezviratidzo zvako zvenguva dzose zveAFib
• Kutanga kamwe kamwe kwekutadza kufema kwakanyanya kana kuoma kufema
• Zviratidzo zve sitiroko senge kushaya simba kamwe kamwe, matambudziko ekutaura, kana shanduko dzekuona
• Kuramba uine nyonganyonga, kurutsa, kana kutadza kuchengeta mvura pasi

Pakuongorora nguva dzose, munowanzoona chiremba wenyu mukati memavhiki 1-2 mushure mekuvhiyiwa. Musangano uyu unopa mukana wekuti timu yako yehutano iongorore kufambira mberi kwekurapa kwako uye kupindura mibvunzo kana kunetseka kwamungave mune.

Mibvunzo inowanzo bvunzwa pamusoro pe pulmonary vein isolation

Ko pulmonary vein isolation yakanaka kune marudzi ese e atrial fibrillation?

Pulmonary vein isolation inoshanda zvakanyanya kune paroxysmal atrial fibrillation, uko zvikamu zvinouya uye kuenda zvega. Kubudirira kunowanzoita kwakanyanya muboka iri, ne70-80% yevanhu vachiramba vasina zvikamu zveAFib mushure megore rimwe.

Kune persistent AFib, uko zvikamu zvinogara kwenguva refu kupfuura mazuva manomwe, PVI inogona kuramba ichishanda asi inogona kuda mamwe maitiro e ablation. Chiremba wako angangoda kugadzira mamwe mavanga mumoyo mako kupfuura kungoisa pulmonary veins.

Vanhu vane long-standing persistent AFib vanogona kuve nemitengo yakaderera yekubudirira nePVI chete. Zvisinei, maitiro acho anogona kuramba achipa zororo rakakura rezviratidzo uye kuvandudzwa kwemhando yehupenyu, kunyangwe kana kurapa kwakakwana kusingawanikwi.

Ko kubudirira kwe pulmonary vein isolation kunorapa atrial fibrillation zvachose here?

Pulmonary vein isolation inogona kupa rusununguko rusingaperi kubva ku atrial fibrillation, asi hachisi nguva dzose mushonga wemugumo. Vanhu vazhinji vanoramba vasina AFib kwemakore mushure mekuvhiyiwa, nepo vamwe vachigona kusangana nezvikamu zvisingawanzoitiki.

Kubudirira kwePVI kunoenderana nezvinhu zvakati wandei zvinosanganisira rudzi rweAFib yaunayo, yakagara kwenguva yakareba sei, uye hutano hwemoyo wako hwese. Vamwe vanhu vangada maitiro ekudzokorora kana AFib ikadzoka, izvo zviri chikamu chakajairika chekurapa.

Kunyangwe kana AFib ichidzoka dzimwe nguva, vanhu vazhinji vachiri kusangana nekuvandudzwa kukuru muzviratidzo zvavo uye mhando yehupenyu. Zvikamu zvinowanzoita zvishoma, zvipfupi muhurefu, uye zviri nyore kubata nemishonga.

Ndingaita maekisesaizi zvakajairika mushure me pulmonary vein isolation?

Vanhu vazhinji vanogona zvishoma nezvishoma kudzokera kumaitiro ekurovedza muviri uye mabasa emuviri mushure me pulmonary vein isolation. Zvisinei, unozofanira kutevera nguva yakatarwa yekutangazve mhando dzakasiyana dzemabasa.

Mumazuva mashoma ekutanga mushure mekuvhiyiwa, unofanira kudzivisa kusimudza zvinhu zvinorema, kurovedza muviri zvakanyanya, uye mabasa anogona kukonzera kushushikana panzvimbo yekuiswa kwe catheter. Kufamba zvishoma kazhinji kunokurudzirwa kusimudzira kupora uye kudzivirira magwamba eropa.

Chiremba wako achapa gwara rakatarwa zvichienderana nemamiriro ako ega. Vanhu vazhinji vanowana kuti vanogona kurovedza muviri zvakanyanya zvakanaka mushure mekubudirira PVI nekuti rhythm yavo yemoyo yakagadzikana uye vanonzwa kufema kushoma panguva yebasa remuviri.

Ndichiri kuda kutora zvinoderedza ropa mushure me pulmonary vein isolation here?

Kana ucharamba uchitora zvinoderedza ropa mushure me pulmonary vein isolation zvinoenderana nezvinhu zvako zvekutyisidzira sitiroko. Sarudzo haina kubva chete pakuti kuvhiyiwa kwakabudirira mukudzora AFib yako.

Chiremba wako achashandisa masisitimu ekuyera senge CHA2DS2-VASc score kuongorora njodzi yako yesitiroko zvichibva pazvinhu zvakaita se zera, bonde, chirwere cheshuga, high blood pressure, uye nhoroondo yesitiroko yapfuura. Kana chiyero chako chichiratidza njodzi yakakwira, unogona kuda kuramba uchitora zvinoderedza ropa kwenguva refu.

Vamwe vanhu vane zvibodzwa zvishoma zvenjodzi yesitiroko vanogona kumira zvinoderedza ropa mushure mekubudirira PVI, asi sarudzo iyi inofanira kugara ichiitwa mukubvunzana nechikwata chako chehutano. Vachafunga nezve mufananidzo wako wekurapa wakazara pavanenge vachiita chirevo ichi.

Zvinotora nguva yakareba sei kupora kubva ku pulmonary vein isolation?

Vanhu vazhinji vanogona kudzokera kumabasa ezuva nezuva mukati memazuva mashoma kusvika vhiki mushure me pulmonary vein isolation. Zvisinei, kupora kwakakwana uye mabhenefiti akazara ekuvhiyiwa anogona kutora mavhiki akati wandei kusvika kumwedzi.

Nzvimbo dzekuisa catheter dzinowanzo pora mukati memazuva 3-5, kunyangwe unogona kuva nemaronda kana kunzwa kurwadziwa kwemavhiki maviri. Unozofanira kudzivisa kusimudza zvinhu zvinorema uye kurovedza muviri zvakanyanya kwevhiki kuti kupora kwakakodzera kuitike.

Nyama yemaronda yakagadzirwa panguva yekuita oparesheni inoenderera mberi ichikura kwemwedzi 2-3 mushure mePVI. Munguva iyi, unogona kusangana nekurova kwemoyo kusingaite zvakanaka kana zviitiko zveAFib, izvo zvinowanzo pera apo kupora kunopera. Chiremba wako achanyatso tarisa kufambira mberi kwako munguva iyi.