Ukuthi yini i-AVNRT? Izimpawu, Izimbangela, Nokwelashwa

I-AVNRT imele i-AV Nodal Reentrant Tachycardia, uhlobo oluvamile lwesivinini sokubetha kwenhliziyo oluyenza inhliziyo yakho ibaleke ngokuzumayo. Inhliziyo yakho inendlela yamandla kagesi ebizwa nge-AV node evamise ukubambisana nokubetha kwenhliziyo, kodwa ngezinye izikhathi le ndlela ithuthukisa isikhululo esengeziwe esingenza inhliziyo yakho ibetha ngokushesha kakhulu kunokujwayelekile.

Lesi simo sihlupha abantu abangaba ngu-2 ku-1,000 futhi ingenye yezifo zokubetha kwenhliziyo ezilashwa kalula. Nakuba ukubetha kwenhliziyo okusheshayo ngokuzumayo kungase kubonakale kuyesabekayo, i-AVNRT ayivamile ukubangela ukuphazamiseka okukhulu futhi iphendula kahle ekwelapheni.

Iyini i-AVNRT?

I-AVNRT kwenzeka lapho isimiso samandla kagesi senhliziyo yakho sidala indlela encane e-AV node, okwenza inhliziyo yakho ibetha ngokushesha nangokulinganayo. Cabanga ngakho njengokuphazamiseka kwamandla kagesi okwenza inhliziyo yakho ibaleke ngokuzumayo, ngokuvamile phakathi kwama-150 kuya kuma-250 ama-beats ngomzuzu.

Iziqephu ngokuvamile ziqala futhi ziyeke ngokuzumayo, zihlale noma yikuphi kusukela emizuzwini embalwa kuya emahoreni amaningana. Abantu abaningi bahlangabezana neziqephu ezihlala phakathi kwemizuzu engu-10 kuya kuyihora, nakuba lokhu kuhlukahluka kumuntu ngamunye.

Iziqephu ngokuvamile ziqala futhi ziyeke ngokuzumayo, zihlale kusukela emizuzwini embalwa kuya emahoreni amaningana. Abantu abaningi bahlangabezana neziqephu ezihlala phakathi kwemizuzu engu-10 kuya kuyihora, nakuba lokhu kuhlukahluka kumuntu ngamunye.

Ziyini izimpawu ze-AVNRT?

Isimpawu esiqaphelekayo kakhulu ukubetha kwenhliziyo okusheshayo ngokuzumayo okubenza uzizwe sengathi inhliziyo yakho ibetha noma iduduzuka ngokushesha esifubeni sakho. Ungase uzizwe sengathi inhliziyo yakho nje iye yashintshela ezingeni eliphezulu ngaphandle kokuxwayisa, futhi ngokuvamile ungazizwa ukushaya kwenhliziyo ngayinye.

Nawa izimpawu ezivamile ongazihlangabezana nazo phakathi neziqephu:

• Ukushaya kwenhliziyo okusheshayo ngokuzumayo (ukushaya) okuqala futhi kuyeke ngokuzumayo
• Ukuzizwa ukhuluphala noma ukhanya
• Ukuphefumula okufushane noma ukuzizwa sengathi awukwazi ukuthola umoya
• Ukungakhululeki noma ukucindezeleka esifubeni
• Ukuzizwa ukukhathazeka noma ukwesaba
• Ukukhathala noma ubuthakathaka
• Ukukhishwa isikhathi
• Ukuphefumula okufushane noma ukuzizwa sengathi awukwazi ukuthola umoya

Abanye abantu nabo bahlangabezana nezimpawu ezingavamile njengokuthi ukushaya komphimbo, lapho ungazizwa khona ukushaya kwakho kubetha entanyeni yakho. Ungase uzizwe udinga ukuya emathisini ngokushesha noma ngemuva nje kwenkathi, lokhu kwenzeka ngoba umzimba wakho ukhulula ama-hormone athile ngesikhathi sokushaya kwenhliziyo okusheshayo.

Phakathi kweziqephu, abantu abaningi bazizwa beqondile ngokuphelele futhi abanawo ama-symptom nhlobo. Iziqephu zingase zenzeke nsuku zonke, masonto onke, nyanga zonke, noma ngisho neminyaka ngaphandle, kuye ngumuntu.

Ziyini izinhlobo ze-AVNRT?

Kunezinhlobo ezimbili eziyinhloko ze-AVNRT, kuye ngokuthi isinyathelo samandla kagesi sihamba kuphi ngendlela engeziwe. Uhlobo olukhona kuwe luthinta izimpawu zakho nezinketho zokwelapha, nakuba zombili ziphendula kahle ekwelapheni.

I-AVNRT ejwayelekile yiyona ehlala ikhona kakhulu, ihlupha abantu abangaba ngu-90% abanesimo. Kulolu hlobo, isinyathelo samandla kagesi sihamba phansi ngendlela eyodwa bese sibuyela kwenye, sidala i-loop encane ebangela ukushaya kwenhliziyo okusheshayo.

I-AVNRT engavamile ayivamile futhi ihilela isinyathelo samandla kagesi esihamba ngakuqondana ngezindlela. Lolo hlobo luthambekele ekubangeleni izimpawu ezihlukile kancane futhi lungase lube nzima kakhulu ukulwelapha, kodwa liyaphendula kahle ezindleleni zokwelapha ezifanayo.

Yini ebangela i-AVNRT?

I-AVNRT ithuthuka lapho uzalwa khona ngezindlela zamandla kagesi ezengeziwe e-AV node yakho ezidala amathuba e-loop encane yamandla kagesi. Abantu abaningi abane-AVNRT banalezi zindlela ezengeziwe kusukela ekuzalweni, nakuba izimpawu ngokuvamile zingabonakali kuze kube kamuva ekuphileni.

Izici eziningana zingase zibangele iziqephu uma usuvele unezindlela zamandla kagesi ezikhona:

• Ukucindezeleka komzimba noma kwengqondo
• I-caffeine noma izithuthukisi
• Ukusetshenziswa kotshwala
• Ukuphelelwa amanzi
• Ukulala okuncane
• Imithi ethile
• Ukushintsha kwama-hormone (njengangesikhathi sokukhulelwa noma isondo)
• Ukuzivocavoca noma umsebenzi womzimba ozumayo

Ngezinye izikhathi iziqephu zenzeka ngaphandle kwanoma yisiphi isizathu esicacile, okungase kube yinto ecasulayo kodwa kuyinto evamile ngokuphelele. Isimiso samandla kagesi senhliziyo yakho singase sibe nokuqaphela ukushintsha okuncane emzimbeni wakho ongasenqapheli.

Ezimweni ezingavamile, i-AVNRT ingathuthuka ngemuva kokucutshungulwa kwenhliziyo noma ngenxa yezinye izimo zenhliziyo, kodwa izimo eziningi zimane nje zibangelwa indlela isimiso samandla kagesi senhliziyo yakho esithuthukile ngaphambi kokuba uzalwe.

Nini okufanele ubona udokotela nge-AVNRT?

Kufanele ubona udokotela uma uhlangabezana neziqephu zokushaya kwenhliziyo okusheshayo, ikakhulukazi uma ziqala futhi ziyeke ngokuzumayo. Nakuba i-AVNRT ngokuvamile ingabi yingozi, kubalulekile ukuthola ukuxilongwa okufanele ukuze kuqale ukuxilongwa kwezinye izinkinga zokubetha kwenhliziyo futhi ufunde ukuthi ungazilawula kanjani izimpawu zakho.

Funani ukunakekelwa kwezokwelapha ngokushesha uma uhlangabezana nanoma yiziphi izimpawu ezilandelayo phakathi neziqephu zokushaya kwenhliziyo okusheshayo:

• Ubuhlungu besifuba obukhulu
• Ukuphelelwa umoya noma ukuphelelwa umoya
• Ukuphefumula okufushane kakhulu
• Ukuphazamiseka noma ubunzima bokucabanga ngokucacile
• Iziqephu ezihlala isikhathi esingaphezu kwemizuzu engu-30

Xhumana nodokotela wakho uma iziqephu zakho ziqala ukwenzeka kaningi, zihlale isikhathi eside kunokujwayelekile, noma uma uthuthukisa izimpawu ezintsha. Ngisho noma izimpawu zakho zibonakala zingenangozi, ukuthola ukuxilongwa kungakunika ukuthula kwengqondo nokufinyelela ekwelapheni okuphumelelayo.

Ziyini izici ezingozi ze-AVNRT?

I-AVNRT ingathinta noma ubani, kodwa izici ezithile zenza kube lula ukuthuthukisa izimpawu. Ukuqonda lezi zici ezingozi kungakusiza ukuthi uqonde ukuthi kungani ungase uhlangabezane neziqephu nokuthi yini ongayenza ngayo.

Izici eziyinhloko ezingozi zihlanganisa:

• Ukuba owesifazane (abesifazane banethuba elingaphezulu kabili lokuba ne-AVNRT kunabesilisa)
• Ubudala phakathi kweminyaka engu-20-40 (nakuba ingaqala kunoma yiliphi iminyaka)
• Umlando womndeni wezinkinga zokubetha kwenhliziyo
• Amazinga aphezulu ocindzekeleko noma ukukhathazeka
• Ukusetshenziswa okuvamile kwe-caffeine noma utshwala
• Ukukhulelwa noma ukushintsha kwama-hormone
• Izimo ezithile zenhliziyo (nakuba abantu abaningi abane-AVNRT banenhliziyo evamile)

Ukuba nalezi zici ezingozi akusho ukuthi uzokuthuthukisa ngokuqinisekile i-AVNRT, futhi abantu abaningi abangenazo izici ezingozi basaphila iziqephu. Isimo ngokuvamile sibonakala sigijima emindenini, okubonisa ukuthi kungase kube khona ingxenye ye-genetic, nakuba lokhu akusaziwa ngokuphelele.

Ziyini izinhlanganisela ezingase zenzeke ze-AVNRT?

I-AVNRT ayivamile ukubangela ukuphazamiseka okukhulu, ikakhulukazi uma ixilongwe futhi ilawulwe kahle. Abantu abaningi abanesimo bahlala impilo evamile ngokuphelele phakathi kweziqephu futhi banemiphumela emihle yesikhathi eside.

Kodwa-ke, kunezinhlelo ezingase zenzeke okufanele uzazi:

• Ukuphelelwa umoya (syncope) phakathi kweziqephu, ikakhulukazi uma zishesha kakhulu noma zihlala isikhathi eside
• Ukukhathazeka noma ukuhlaselwa ukwesaba okubangelwa izinzwa zomzimba
• Ukunciphisa ikhwalithi yempilo ngenxa yokwesaba iziqephu noma ukulinganiselwa kwemisebenzi
• Izimo ezingavamile zeziqephu ezihlala isikhathi eside eziholela ekuthuthukisweni kwemisipha yenhliziyo

Ezimweni ezingavamile kakhulu, iziqephu ze-AVNRT zingase zibangele ezinye izinkinga zokubetha kwenhliziyo ezingathi sína, kodwa lokhu ngokuvamile kwenzeka kuphela kubantu abasenesifo senhliziyo esikhulu esikhethekile. Kubantu abaningi abanjenhliziyo evamile, i-AVNRT ihlala iyisimo esingenangozi kulo lonke impilo yabo.

Umphumela wokuzizwa ungase ube nzima kakhulu kunesimpawu somzimba. Abantu abaningi bathuthukisa ukukhathazeka mayelana nokuthi iziqephu ezilandelayo zingase zenzeke nini, okungase kwenze iziqephu zibe lula ukwenzeka.

I-AVNRT ingavikeleka kanjani?

Nakuba ungakwazi ukuvimbela i-AVNRT ekukhuleni njengoba ngokuvamile ikhona kusukela ekuzalweni, ngokuvamile unganciphisa ubukhulu nokuqina kweziqephu ngokubona nokuqeda izinto ezibangela iziqephu.

Nawa amasu amaningi abantu abawatholayo awusizo ekuvimbeleni iziqephu:

• Linganisa ukusetshenziswa kwe-caffeine, ikakhulukazi ikhofi, iziphuzo zamandla, netiye ezithile
• Linganisa ukusetshenziswa kotshwala noma ukusiyeke ngokuphelele
• Hlala unamanzi usuku lonke
• Thola ukulala okuvamile, okwanele (amahora angu-7-9 ngobusuku)
• Lawula ukucindezeleka ngezindlela zokuphumula, ukuzivocavoca, noma ukwelulekwa
• Gwema ukuzivocavoca okukhulu ngokuzumayo (shisa kancane)
• Qaphela izithuthukisi ne-decongestants ezingaphezulu kokuthengiswa

Gcina idayari yeziqephu zakho, ubhale ukuthi ubenzeni, udle, noma uzizwa kanjani ngaphambi kokuba ziqale. Lokhu kungakusiza ukuthi ubone izindlela nezinto ezibangela iziqephu ongasenqapheli.

Abanye abantu bathola ukuthi izikhundla noma imisebenzi ethile ihlala ibangele iziqephu, njengokugoba ngokushesha noma ukuwela phansi ezindaweni ezithile. Uma usuqonde lezi zinto ezibangela iziqephu, ungashintsha imisebenzi yakho ngokufanele.

I-AVNRT ixilongwa kanjani?

Ukuxilongwa kwe-AVNRT kuqala ngodokotela wakho oqaphela incazelo yakho yezimpawu futhi enze ukuhlolwa komzimba. Isici esiyinhloko yiyindlela yokuqala nokuyeka ngokuzumayo kweziqephu zokushaya kwenhliziyo okusheshayo, okuyisici esiyinhloko salesi simo.

Udokotela wakho cishe uzokukhipha i-electrocardiogram (ECG noma EKG) kuqala, nakuba lolo hlolo lungase lube liqondile uma ungenayo iziqephu lapho luqaliswa khona. I-ECG ngesikhathi seziqephu ibonisa iphethini ethile eqinisekisa ukuxilongwa kwe-AVNRT.

Uma iziqephu zingavamile, udokotela wakho angase akukhuthaze ukugqoka i-monitor yenhliziyo amahora angu-24 kuya emakhulwini. Le divayisi ibhala ukushaya kwenhliziyo yakho ngokuqhubekayo futhi ingabamba iziqephu lapho zenzeka ngokwemvelo. Amanye ama-monitors angagqokwa izinsuku ezingaba ngu-30 ukuze kukhuphuke amathuba okurekhoda iziqephu.

Ezimweni ezithile, udokotela wakho angase enze ucwaningo lwe-electrophysiology, ukuhlolwa okukhethekile lapho ama-wires amancane afakwa khona ngemithambo yegazi ukuze afunde isimiso samandla kagesi senhliziyo yakho ngokuqondile. Lolo hlolo lungaxilonga ngokuqinisekile i-AVNRT futhi lunqume indawo eqondile yezindlela zamandla kagesi ezengeziwe.

Iyini ukwelashwa kwe-AVNRT?

Ukwelashwa kwe-AVNRT kugxile ekuyekiseni iziqephu eziqala manje lapho zenzeka futhi ukuvimbela iziqephu ezizayo ukuba zenzeke. Izindaba ezinhle ukuthi lesi simo siphendula kahle ekwelapheni, futhi abantu abaningi bangafinyelela ekulawuleni okuhle kwesimpawu.

Ukuyekisa iziqephu ezisebenza manje, udokotela wakho angase akufundise ama-vagal maneuvers. La yizindlela ezilula njengokucindezela njengokungathi une-bowel movement, ukukhokha ngamandla, noma ukufaka ubuso bakho emanzini abandayo. Lezi zenzo ngezinye izikhathi zingase zilungise isimiso samandla kagesi senhliziyo yakho futhi ziyeke iziqephu.

Imithi ingase ibe yiphumelela kakhulu ekubeni iyeke iziqephu nokubavimbela. Ngeziqephu eziqala manje, imithi efana ne-adenosine ingase inikezwe ngemithambo yegazi ezindaweni zezokwelapha ukuze ibuyisele ngokushesha izinga elijwayelekile. Ukuvimbela, odokotela ngokuvamile bancoma i-beta-blockers noma i-calcium channel blockers, ezenza kube lula ukuba iziqephu zenzeke.

Ukwelashwa okuqinisekile kakhulu ukucutshungulwa kwe-catheter ablation, inqubo engavamile lapho odokotela basebenzisa ama-wires amancane afakwa khona ngemithambo yegazi ukuze athole futhi asuse izindlela zamandla kagesi ezengeziwe ezibangela i-AVNRT. Le nqubo inenkambo yokuphumelela engaphezu kuka-95% futhi ingalapha lesi simo.

I-ablation ngokuvamile iyanconywa kubantu abaneziqephu ezivamile, abaphenduli kahle emithini, noma abathanda isisombululo esiqinile. Le nqubo ngokuvamile ithatha amahora angu-1-3 futhi abantu abaningi bayeka ekhaya ngosuku olufanayo noma ngemuva kokulala ebusuku.

Ukuthi ungazilawula kanjani i-AVNRT ekhaya?

Ukufunda ukuthi ungazilawula kanjani iziqephu ze-AVNRT ekhaya kungakunika ukuzethemba nokunciphisa ukukhathazeka ngesimo sakho. Iziqephu eziningi ziyoyeka zodwa, kodwa kunezindlela ezingakusiza ukuthi uziphelelise ngokushesha.

Uma uzizwa iziqephu ziqala, zama lezi zindlela ze-vagal maneuvers ezingase zilungise ukushaya kwenhliziyo yakho:

1. Cindezela njengokungathi une-bowel movement imizuzwana engu-10-15
2. Khokha ngamandla izikhathi eziningi
3. Faka ubuso bakho embizeni yamanzi abandayo
4. Gcoba ngobumnene i-carotid artery entanyeni yakho (uma ufundeke udokotela wakho)

Hlala uzolile futhi thola indawo enhle yokulala noma ukuwela phansi phakathi kweziqephu. Zikhumbuze ukuthi nakuba le nzwani ingakhululeki, iziqephu ze-AVNRT azivamile ukuba yingozi futhi ziyodlula. Ukuphefumula okujulile, okucothayo kungakusiza ukuthi uhlale uzolile futhi kungase kusize ukuphelisa iziqephu ngokushesha.

Gcina irekhodi leziqephu zakho kwijayari, ubhale isikhathi, ubude, izinto ezibangela iziqephu, nokuthi yini esize ukuphelisa. Ulwazi lolu lubalulekile kudoctor wakho futhi lungakusiza ukuthi ubone izindlela esimweni sakho.

Kufanele ulungiselele kanjani i-appointment yakho nodokotela?

Ukulungiselela kahle i-appointment yakho nodokotela kungakusiza ukuqinisekisa ukuthi uthola ukuxilongwa okuchane kakhulu nelenqubo yokwelapha ephumelelayo. Njengoba iziqephu ze-AVNRT ngokuvamile zingakwazi ukubikezelwa, ukulungiselela okuhle kuba kubaluleke kakhulu.

Ngaphambi kwe-appointment yakho, bhala incazelo eningiliziwe yeziqephu zakho kufaka phakathi ukuthi ngokuvamile zenzeka nini, zihlala isikhathi esingakanani, zizizwa kanjani, nokuthi yini ebonakala izibangela. Bhala futhi noma yiziphi izindlela noma izikhundla ezisiza ukuphelisa iziqephu noma ezenza zibe zimbi.

Letha uhlu oluphelele lwazo zonke imithi oyithathayo, kufaka phakathi imithi engaphezulu kokuthengiswa, izithuthukisi, nama-vitamins. Ezinye zalezi zingase zithinte ukushaya kwenhliziyo noma zisebenzisane nokwelashwa kwe-AVNRT. Lungiselela futhi uhlu lwemibuzo mayelana nesimo sakho, izinketho zokwelapha, nokuthi yini okulindelekile.

Uma kungenzeka, letha ilungu lomndeni noma umngani e-appointment yakho. Bangakusiza ukuba ukhumbule ulwazi oluqakathekile futhi banikeze ukwesekwa, ikakhulukazi uma uzizwa ukukhathazeka ngezimpawu zakho noma ukwelashwa okungenzeka.

Yini eyinhloko mayelana ne-AVNRT?

I-AVNRT iyisimo esivamile, esilashwa sokushaya kwenhliziyo esibangela iziqephu zokushaya kwenhliziyo okusheshayo kodwa ngokuvamile ayiholeli ekuphucekeni okukhulu. Nakuba inhliziyo esheshayo ngokuzumayo ingase ibe yinto ebangela ukwesaba, ukuqonda ukuthi lesi simo ngokuvamile asibi kungasiza ukunciphisa ukukhathazeka nokuthuthukisa ikhwalithi yempilo yakho.

Into ebaluleke kakhulu okumele uyikhumbule ukuthi ukwelashwa okuphumelelayo kukhona, kusukela ekuguquleni indlela yokuphila okulula nemithi kuya ekuhlinzweni okuphumelelayo kwe-ablation. Abantu abaningi abane-AVNRT bangafinyelela ekulawuleni okuhle kwesimpawu futhi bahlale impilo evamile ngokuphelele.

Ungavumeli ukwesaba iziqephu kulawule impilo yakho. Ngokunakekelwa kwezokwelapha okufanele, ukugwema izinto ezibangela iziqephu, kanye nezindlela zokulawula ekhaya, ungalawula i-AVNRT ngempumelelo futhi ugcine impilo esebenzayo, eanelisayo. Isifuba ukusebenzisana neqembu lakho lezokunakekelwa kwezempilo ukuthola indlela yokwelapha efanele isimo sakho esithile.

Imibuzo evamile mayelana ne-AVNRT

Ingalashwa ngokuphelele yini i-AVNRT?

Yebo, i-AVNRT ngokuvamile ingalashwa ngokuphelele nge-catheter ablation, inqubo engavamile esusa izindlela zamandla kagesi ezengeziwe ezibangela lesi simo. Le nqubo inenkambo yokuphumelela engaphezu kuka-95% futhi abantu abaningi abasaphanga iziqephu ngemuva kokwelashwa okuphumelelayo kwe-ablation.

Kuphephile yini ukuzivocavoca nge-AVNRT?

Abantu abaningi abane-AVNRT bangazivocavoca ngokuphephile, nakuba kufanele uxoxe ngezinga lakho lomsebenzi nodokotela wakho. Abanye abantu bathola ukuthi ukuzivocavoca okukhulu ngokuzumayo kungase kubangele iziqephu, ngakho ukushisa kancane nokuhlala unamanzi kuba kubaluleke kakhulu. Abaningi abadlali bezemidlalo balawula i-AVNRT ngokwelashwa okufanele.

Ingabe ukukhulelwa kungathinta i-AVNRT?

Ukukhulelwa kungenza iziqephu ze-AVNRT zenzeke kaningi ngenxa yokushintsha kwama-hormone nokwanda kwegazi. Kodwa-ke, i-AVNRT ngokuvamile ayibangeli ukuphazamiseka ngesikhathi sokukhulelwa noma ukubeletha. Odokotela bakho bangalawula lesi simo ngokuphephile ngesikhathi sokukhulelwa besebenzisa izindlela nemithi ephephile kuwe nengane yakho.

Ingabe i-AVNRT iyoba zimbi ngokuhamba kwesikhathi?

I-AVNRT ngokuvamile ayibi zimbi ngokuhamba kwesikhathi kubantu abaningi. Abanye abantu bathola ukuthi iziqephu ziqala ukwenzeka kaningi noma kancane njengoba bekhula, kodwa isimo ngokwalo ngokuvamile sihlala siqondile. Izindlela zamandla kagesi ezengeziwe ezibangela i-AVNRT zikhona kusukela ekuzalweni futhi ngokuvamile azithuthuki ngezinkinga ezengeziwe ngokuhamba kwesikhathi.

Ingabe ukucindezeleka kudala iziqephu ze-AVNRT?

Ukucindezeleka kuyinto evamile ebangela iziqephu ze-AVNRT, kodwa akubangeli isimo esikhethekile. Udinga ukuba nezindlela zamandla kagesi ezengeziwe kusukela ekuzalweni ukuze ukucindezeleka kubangele iziqephu. Ukuphatha ukucindezeleka ngezindlela zokuphumula, ukuzivocavoca okuvamile, nokulala okwanele kunganciphisa kakhulu ubukhulu beziqephu kubantu abaningi.