Yini i-Ivabradine: Ukusetshenziswa, Umthamo, Imiphumela Eceleni nokuningi

I-Ivabradine iyimithi yenhliziyo esiza ukwehlisa izinga lokushaya kwenhliziyo yakho uma ishaya ngokushesha kakhulu. Isebenza ngendlela ehlukile kuneminye imithi yenhliziyo ngokugxila engxenyeni ethile yesistimu kagesi yenhliziyo yakho ebizwa ngokuthi "i-funny current" noma i-If current. Lokhu kuyenza ibe usizo ikakhulukazi kubantu abanezinhliziyo zabo ezigijima ngisho nalapho bephumule, ibasiza ukuthi bazizwe bekhululekile futhi banciphise ukucindezeleka emisipha yenhliziyo yabo.

Yini i-Ivabradine?

I-Ivabradine iyimithi kadokotela okufanele uyithole futhi ingeyeqembu lemithi ebizwa ngokuthi i-hyperpolarization-activated cyclic nucleotide-gated (HCN) channel blockers. Ngokulula, iyisithuthisi sezinga lokushaya kwenhliziyo esisebenza ngokuvimba amasignali kagesi athile enhliziyweni yakho. Ngokungafani nama-beta-blockers noma ama-calcium channel blockers, i-ivabradine igxila ngqo ku-pacemaker yemvelo yenhliziyo ngaphandle kokuthinta umfutho wegazi lakho noma amandla okushaya kwenhliziyo yakho.

Lo muthi wenzelwe ukubhekana nesidingo esithile sabantu abanezinhliziyo zabo ezishaya ngokushesha kakhulu, ikakhulukazi labo abanenhliziyo ehlulekayo noma i-chronic stable angina. Inikeza indlela eyingqayizivele yokuphatha izinga lokushaya kwenhliziyo engaba usizo ikakhulukazi lapho eminye imithi ingafaneleki noma ingasebenzi kahle yodwa.

Isetshenziselwani i-Ivabradine?

I-Ivabradine ikakhulukazi inikezwa izimo ezimbili eziyinhloko zenhliziyo lapho ukulawula izinga lokushaya kwenhliziyo kubalulekile empilweni yakho. Udokotela wakho angase ancome lo muthi uma inhliziyo yakho ishaya ngokushesha kakhulu ngokuqhubekayo, okubeka ukucindezeleka okwengeziwe ohlelweni lwakho lwe-cardiovascular.

Ukusetshenziswa kokuqala okuyinhloko kungokwehluleka kwenhliziyo okungamahlalakhona kubantu abadala abanomfutho wenhliziyo ojwayelekile kodwa isilinganiso senhliziyo yabo sihlala ngaphezu kwama-70 beats ngomzuzu ngaphandle kokuthatha umthamo omkhulu we-beta-blockers. Kulesi simo, i-ivabradine isiza ukunciphisa umsebenzi enhliziyweni yakho, iyivumele ukuba ipompe ngempumelelo enkulu futhi mhlawumbe ithuthukise izimpawu zakho ezinjengokuphefumula kanzima nokukhathala.

Ukusetshenziswa kwesibili okuyinhloko kungokwe-angina ezinzile ezingamahlalakhona, okuyizinhlungu zesifuba ezenzeka lapho inhliziyo yakho ingatholi igazi elinothile nge-oxygen elanele. Lapho ama-beta-blockers engakufanele noma enganikezi ukulawula okwanele, i-ivabradine ingasiza ukunciphisa isilinganiso senhliziyo yakho futhi inciphise imvamisa yezigameko ze-angina.

Isebenza Kanjani I-Ivabradine?

I-Ivabradine isebenza ngokugxila ku-pacemaker yemvelo yenhliziyo yakho, ikakhulukazi ivimba

I-Ivabradine kufanele ithathwe ngendlela eqondile njengoba kunqunywe udokotela wakho, ngokuvamile kabili ngosuku ngokudla. Ukuyithatha ngokudla kusiza umzimba wakho ukuba umunce imithi ngendlela efanele futhi kunganciphisa ithuba lokucasuka kwesisu. Isikhathi sokuthatha imithamo yakho kufanele sibe ngendlela efanayo ngangokunokwenzeka, ngokuvamile ngamabili ngamabili.

Ungathatha i-ivabradine ngobisi, amanzi, noma yisiphi isiphuzo esingenawo utshwala ngesikhathi sokudla kwakho. Into ebaluleke kakhulu ukuba nokudla esiswini sakho lapho uthatha umthamo ngamunye. Lokhu akudingeki ukuba kube ukudla okukhulu - ngisho nokudla okulula noma isidlo sasekuseni esincane nesidlo sakusihlwa kuzosebenza kahle.

Udokotela wakho cishe uzoqala ngomthamo ophansi futhi awunyuse kancane kancane ngokusekelwe endleleni inhliziyo yakho esabela ngayo nokuthi uyikwazi kangakanani imithi. Ungalokothi ulungise umthamo wakho wedwa, njengoba izinga lokushaya kwenhliziyo yakho kudingeka liqashwe ngokucophelela ukuze kuqinisekiswe ukuthi imithi isebenza ngokuphepha nangempumelelo.

Uma udinga ukuyeka ukuthatha i-ivabradine, udokotela wakho uzokuqondisa ekunciphiseni kancane kancane kunokuyeka kungazelelwe. Lokhu kusiza ekuvimbeleni noma yimaphi imiphumela engase ibe khona ezingeni lokushaya kwenhliziyo yakho.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Ivabradine?

I-Ivabradine ngokuvamile inqunyelwe njengomuthi wesikhathi eside, okusho ukuthi cishe uzoyithatha izinyanga noma iminyaka kunamasonto ambalwa nje. Isikhathi esiqondile sincike esimweni sakho senhliziyo esithile nokuthi usabela kahle kangakanani ekwelashweni.

Kubantu abanenhliziyo ehlulekayo engapheli, i-ivabradine ivame ukuba yingxenye yohlelo lokwelashwa lwesikhathi eside kanye neminye imithi yenhliziyo. Udokotela wakho uzoqapha njalo izinga lokushaya kwenhliziyo yakho nomsebenzi wenhliziyo wonke ukuze anqume ukuthi imithi iyaqhubeka yini ukukuzuzisa.

Uma uthatha i-ivabradine ye-chronic stable angina, ubude bokwelashwa buzoxhomeka ezimpawini zakho nokuthi ezinye izindlela zokwelapha zisebenza kahle kangakanani. Abanye abantu bangase bayidinge unomphela, kanti abanye bangase bakwazi ukuyinciphisa noma bayiyeke uma isimo sabo sithuthuka ngezinguquko zokuphila noma ezinye izindlela zokwelapha.

Udktela wakho uzohlela ukuhlolwa njalo ukuze ahlulele ukuthi kufanele uqhubeke yini nokuthatha i-ivabradine. Bazocabangela izinto ezinjengokusabela kwenhliziyo yakho, noma yimaphi imiphumela emibi oyitholayo, kanye nezinguquko empilweni yakho yonke yenhliziyo.

Yini Imiphumela Emibi ye-Ivabradine?

Njengayo yonke imithi, i-ivabradine ingabangela imiphumela emibi, nakuba abantu abaningi beyibekezelela kahle. Ukuqonda ukuthi okulindelekile kungakusiza uzizwe uqiniseka ngokwengeziwe ngemithi yakho futhi wazi ukuthi ungaxhumana nini nomhlinzeki wakho wezempilo.

Imiphumela emibi evame kakhulu ongase uyithole ihlanganisa ukuphazamiseka okubonakalayo, ikakhulukazi ukubona izibani eziqhakazile noma ama-halo azungeze izibani. Lokhu kwenzeka ngoba i-ivabradine ingathinta umsebenzi kagesi ku-retina yamehlo akho. Lezi zinguquko ezibonakalayo zivame ukuba zesikhashana futhi zivame ukuthuthuka njengoba umzimba wakho ujwayela imithi.

Nansi imiphumela emibi evame kakhulu abantu abayibikayo:

• I-Luminous phenomena noma ama-phosphenes (ukubona amabala aqhakazile noma ukukhanya)
• Ukubona okungacacile, ikakhulukazi ekukhanyeni okuqhakazile
• Ukushaya kwenhliziyo okuhamba kancane (i-bradycardia)
• Ikhanda
• Isiyezi noma ukuzwa ukukhathala
• Ukukhathala noma ukuzizwa ukhathele ngokungavamile

Le miphumela emibi ngokuvamile imnene futhi ithambekele ekuthuthukiseni ngokuhamba kwesikhathi njengoba umzimba wakho ujwayela imithi. Abantu abaningi bathola ukuthi bangaqhubeka nemisebenzi yabo yansuku zonke ngaphandle kokuphazamiseka okukhulu.

Eminye imiphumela emibi engavamile kodwa ebucayi idinga ukunakekelwa kwezokwelapha ngokushesha. Nakuba kungavamile, kufanele uqaphele lezi zinto ezingenzeka ukuze ukwazi ukufuna usizo uma kudingeka.

• Ukushaya kwenhliziyo okungajwayelekile (i-atrial fibrillation)
• Ukushaya kwenhliziyo okuhamba kancane kakhulu (ngaphansi kwama-50 beats ngomzuzu)
• Ubuhlungu besifuba noma ukwanda kwe-angina
• Isiyezi esikhulu noma ukuquleka
• Ukuphefumula kanzima noma ubunzima bokuphefumula

Uma uhlangabezana nanoma yiziphi zalezi zimpawu ezingathi sína, xhumana nodokotela wakho ngokushesha noma funa ukwelashwa okuphuthumayo. Ukuphepha kwakho yikho konke okubalulekile, futhi lezi zimpawu zidinga ukuhlolwa ngokushesha.

Ubani Ongafanele Athole i-Ivabradine?

I-Ivabradine ayifanele wonke umuntu, futhi zikhona izimo ezithile lapho udokotela wakho engeke akubhalele lo muthi. Ukuqonda lezi zinto ezingavumelekile kusiza ekuqinisekiseni ukuphepha kwakho kanye nokusebenza kahle kohlelo lwakho lokwelapha.

Akufanele uthathe i-ivabradine uma unezinkinga ezithile zokushaya kwenhliziyo, ikakhulukazi uma ungenayo i-sinus rhythm ejwayelekile. Umuthi wenzelwe ngqo ukusebenza ne-pacemaker yemvelo yenhliziyo yakho, ngakho-ke awusebenzi noma awuphephile kubantu abanokushaya kwenhliziyo okungajwayelekile njenge-atrial fibrillation.

Nazi izimo eziyinhloko ezingakuvimbela ukuthi uthathe i-ivabradine:

• Izinga lokushaya kwenhliziyo ekuphumuleni elingaphansi kwama-70 ngomzuzu ngaphambi kokwelashwa
• Ukwehluleka kwenhliziyo okukhulu noma ukwanda kwamuva kwezimpawu zokwehluleka kwenhliziyo
• Umfutho wegazi ophansi kakhulu (hypotension)
• Izinkinga zesibindi ezinzima
• Ukukhulelwa noma ukuncelisa ibele
• Iminyaka engaphansi kwengu-18

Udokotela wakho uzophinda aqaphele ngokubhala i-ivabradine uma unezinye izimo ezingase zihlangane nomuthi noma zikhuphule ingozi yakho yemiphumela emibi.

Ngaphezu kwalokho, imithi eminingi ingahlangana ne-ivabradine, ikakhulukazi lezo ezithinta ama-enzyme afanayo esibindini sakho acubungula umuthi. Udokotela wakho uzobuyekeza yonke imithi yakho yamanje ukuze aqinisekise ukuthi akukho ukuhlangana okuyingozi ngaphambi kokukuqala ku-ivabradine.

Amagama Omkhiqizo we-Ivabradine

I-Ivabradine itholakala ngaphansi kwamagama amaningi omkhiqizo, i-Corlanor iyigama lomkhiqizo elivame kakhulu e-United States. Kwamanye amazwe, ungase uyithole ithengiswa ngaphansi kwamagama afana ne-Procoralan, Coralan, noma amanye amagama omkhiqizo wesifunda.

Kungakhathaliseki igama lomkhiqizo, zonke izinhlobo ze-ivabradine ziqukethe isithako esifanayo esisebenzayo futhi zisebenza ngendlela efanayo. Umehluko omkhulu ungase ube ekubukekeni kwethebhulethi, amandla atholakalayo, noma izithako ezincane ezingasebenzi ezisetshenziswa ekwakhiweni.

I-pharmacy yakho ingase ishintshe omunye umkhiqizo ngomunye ngokuya ngokutholakala noma ukumbozwa komshuwalense. Lokhu kuvamile ukuthi kuphephe, kodwa uma uqaphela noma yiziphi izinguquko endleleni ozizwa ngayo ngemuva kokushintsha imikhiqizo, yazisa udokotela wakho. Bangasiza ukuthola ukuthi ngabe ushintsho luhlobene nokwakheka okuhlukile noma ngabe ezinye izinto zingase zihileleke.

Ezinye izindlela ze-Ivabradine

Uma i-ivabradine ingakulungele noma inganikezi ukulawula okwanele kwesilinganiso senhliziyo yakho, imithi eminingana ehlukile ingasiza ekuphatheni isimo sakho. Udokotela wakho uzocabangela isimo sakho esithile, ezinye izimo zezempilo, kanye nemigomo yokwelashwa lapho ekhetha inketho engcono kakhulu.

Ama-beta-blockers avame ukuba yindlela yokuqala yokwelashwa kokulawulwa kwesilinganiso senhliziyo futhi afaka imithi efana ne-metoprolol, i-carvedilol, ne-bisoprolol. Le mithi ayisheshisi nje kuphela isilinganiso senhliziyo yakho kodwa futhi yehlisa umfutho wegazi futhi ingaqinisa ikhono lenhliziyo yakho lokumpompa ngokuhamba kwesikhathi.

Ama-calcium channel blockers, njenge-diltiazem noma i-verapamil, amelela enye ikilasi lemithi enganciphisa isilinganiso senhliziyo. Lokhu kusebenza ngokuthinta ukunyakaza kwe-calcium emangqamuzaneni enhliziyo yakho, okuthonya kokubili isilinganiso senhliziyo namandla okuncipha.

Kubantu abanenhliziyo ehlulekayo, ama-ACE inhibitors noma ama-ARBs (angiotensin receptor blockers) angase asetshenziswe kanye noma esikhundleni se-ivabradine. Le mithi isiza inhliziyo yakho ukuthi isebenze kahle ngokunciphisa umsebenzi nokuthuthukisa ukugeleza kwegazi.

Udokotela wakho angase futhi ancome ukuhlanganiswa kwemithi ehlukene ukuze kuzuzwe ukulawulwa okungcono kakhulu kwesilinganiso senhliziyo ngenkathi kuncishiswa imiphumela emibi. Okubalulekile ukuthola ibhalansi efanele yezidingo zakho zomuntu ngamunye nesimo sempilo.

Ingabe i-Ivabradine ingcono kune-Metoprolol?

I-Ivabradine kanye ne-metoprolol yomibili imithi esebenza kahle yokwehlisa izinga lokushaya kwenhliziyo, kodwa isebenza ngezindlela ezehlukene futhi inezinzuzo ezihlukile ngokuya ngesimo sakho esithile. Esikhundleni sokuthi eyodwa ibe ngcono kunenye, ukukhetha kuncike ezidingweni zakho zempilo kanye nokuthi uyikwazi kangakanani ukubekezelela imithi ngayinye.

I-Metoprolol iyi-beta-blocker esetshenziswe amashumi eminyaka futhi inocwaningo oluningi olusekela ukusetshenziswa kwayo ekuhlulekeni kwenhliziyo nezinye izimo zenhliziyo. Ayigcini nje ngokunciphisa izinga lokushaya kwenhliziyo kodwa futhi yehlisa umfutho wegazi futhi ingathuthukisa ukusebenza kwenhliziyo ngokuhamba kwesikhathi. Kodwa-ke, abanye abantu bahlangabezana nokukhathala, izandla nezinyawo ezibandayo, noma ubunzima bokuphefumula ngama-beta-blockers.

I-Ivabradine inikeza inzuzo eyingqayizivele ngoba iqondisa ngqo izinga lokushaya kwenhliziyo ngaphandle kokuthinta kakhulu umfutho wegazi noma ukuphefumula. Lokhu kuyenza ibaluleke ikakhulukazi kubantu abadinga ukulawulwa kwezinga lokushaya kwenhliziyo kodwa abakwazi ukubekezelela imiphumela yokwehlisa umfutho wegazi yama-beta-blockers, noma kulabo asebenomfutho wegazi ophansi.

Ezimweni eziningi, odokotela basebenzisa i-ivabradine kanye ne-metoprolol ndawonye esikhundleni sokukhetha eyodwa kunenye. Le nhlanganisela ingahlinzeka ngokulawulwa okungcono kwezinga lokushaya kwenhliziyo kunanoma iyiphi imithi yodwa ngenkathi ivumela imithamo ephansi ngayinye, okungenzeka ukuthi inciphisa imiphumela emibi.

Udokotela wakho uzocabangela izinto ezinjengomfutho wegazi lakho, ukusebenza kwezinso, isimo sokuphefumula, neminye imithi lapho enquma ukuthi iyiphi indlela engcono kuwe. Ukukhetha

Yebo, i-ivabradine ngokuvamile iphephile kubantu abanesifo sikashukela futhi ingase inikeze ezinye izinzuzo ngaphezu kweminye imithi yenhliziyo. Ngokungafani nama-beta-blockers, angakwazi ukufihla izimpawu zokuxwayisa zikashukela ophansi futhi enze ukuphathwa kwesifo sikashukela kube yinselele enkulu, i-ivabradine ayiphazamisi ikhono lomzimba wakho lokubona noma ukusabela ezingeni likashukela elishintshayo.

Abantu abanesifo sikashukela bavame ukuba nengozi enkulu yezinkinga zenhliziyo, ngakho-ke ukuphatha izinga lenhliziyo ngempumelelo kubaluleke kakhulu. I-Ivabradine ingasiza ekunciphiseni ukucindezeleka enhliziyweni yakho ngaphandle kokwenza kube nzima ukuphathwa kwesifo sikashukela sakho. Kodwa-ke, udokotela wakho usazoqhubeka ekuhloleni ngokucophelela, njengoba isifo sikashukela singathinta indlela umzimba wakho oqhubula ngayo imithi.

Uma unesifo sikashukela nezinkinga zenhliziyo, qiniseka ukuthi ugcina bonke abahlinzeki bakho bezempilo benolwazi ngayo yonke imithi yakho. Lokhu kusiza ukuqinisekisa ukuthi ukwelashwa kwakho isifo sikashukela nemithi yenhliziyo kusebenza kahle ndawonye.

Ngingenzani Uma Ngisebenzisa Ngengozi I-Ivabradine Eningi Kakhulu?

Uma ngengozi uthatha i-ivabradine eningi kakhulu, xhumana nodokotela wakho noma isikhungo sokulawula ubuthi ngokushesha, ngisho noma uzizwa ulungile. Ukuthatha okuningi kungabangela ukuthi izinga lenhliziyo yakho lehle ngendlela eyingozi, okungaba yingozi futhi kudinga ukunakekelwa kwezokwelapha.

Izimpawu zokuthi ungase uthathe okuningi zihlanganisa ukuzizwa unesiyezi kakhulu, ukukhathala, noma ukuzizwa ubuthakathaka, ukuzwa izinga lenhliziyo elihamba kancane ngokungavamile, noma ukuba nobunzima bokuphefumula. Uma uhlangabezana nanoma yiziphi zalezi zimpawu, funa ukunakekelwa kwezokwelapha eziphuthumayo ngokushesha.

Ngesikhathi ulinde usizo lwezokwelapha, zama ukuhlala uzolile futhi uhlale phansi noma ulale endaweni enethezekile. Ungazami ukuzenza uhlanze ngaphandle uma uqondiswe ngqo ngumhlinzeki wezempilo. Gcina ibhodlela lemithi nawe ukuze ubonise abasebenzi bezokwelapha ukuthi uthathe ini kanye nokuthi uthathe malini.

Ukuvimbela ukweqisa imithamo ngengozi, cabangela ukusebenzisa umhleli wamaphilisi noma ukusetha izikhumbuzi zocingo ngeshejuli yakho yemithi. Lokhu kungakusiza ukuthi ulandelele ukuthi ngabe usuyithathile yini umthamo wakho wosuku.

Kufanele Ngenzeni Uma Ngedlula Umthamo We-Ivabradine?

Uma udlula umthamo we-ivabradine, yithathe ngokushesha lapho ukhumbula, kodwa kuphela uma sekudlule amahora angaphansi kwangu-6 kusukela ngesikhathi somthamo wakho ohleliwe. Uma sekudlule amahora angaphezu kwangu-6, noma uma sekuseduze isikhathi somthamo wakho olandelayo, weqa umthamo odluliwe bese uqhubeka neshejuli yakho ejwayelekile.

Ungalokothi uthathe imithamo emibili ngesikhathi esisodwa ukuze ulungise umthamo odluliwe. Lokhu kungabangela ukuthi izinga lokushaya kwenhliziyo yakho lehle kakhulu, okungaba yingozi. Kungcono ukweqa umthamo owodwa kunokubeka engcupheni yokuthatha imithi eningi kakhulu ngesikhathi esisodwa.

Uma uvame ukukhohlwa imithamo, khuluma nodokotela wakho mayelana namaqhinga okukusiza ukuthi ukhumbule. Bangase batusa ukusetha ama-alamu ocingo, ukusebenzisa umhleli wamaphilisi, noma ukuthatha imithi yakho ngesikhathi esifanayo nomunye umsebenzi wansuku zonke njengokudla.

Ukuphuthelwa umthamo ngezikhathi ezithile ngokuvamile akuyona ingozi, kodwa zama ukuthatha i-ivabradine ngokuqhubekayo njengoba kunqunyiwe. Ukuthatha imithi njalo kusiza ukugcina amazinga aqinile emithi emzimbeni wakho, okuhlinzeka ngokuqapha izinga lokushaya kwenhliziyo eliphumelela kakhulu.

Ngingayeka Nini Ukuthatha I-Ivabradine?

Kufanele uyeke kuphela ukuthatha i-ivabradine ngaphansi kokuqondisa nokuqashwa kukadokotela wakho. Noma ngabe uzizwa ungcono kakhulu, ukuyeka kungazelelwe kungabangela ukuthi izinga lokushaya kwenhliziyo yakho likhuphuke ngokushesha, okungase kwenze izimpawu zakho zibe zimbi noma kubeke ingcindezi enhliziyweni yakho.

Udokotela wakho ngokuvamile uzofuna ukunciphisa umthamo wakho kancane kancane kunokuyeka konke ngesikhathi esisodwa. Le nqubo, ebizwa ngokuthi i-tapering, ivumela inhliziyo yakho ukuthi ilungiswe kancane kancane kushintsho lomuthi futhi inciphisa ingozi yemiphumela yokubuyela emuva.

Isinqumo sokuyeka i-ivabradine sincike ezintweni eziningana, okuhlanganisa ukuthi isimo senhliziyo yakho silawulwa kahle kangakanani, ukuthi ngabe usebenzisa eminye imithi yenhliziyo, kanye nesimo sakho sempilo esiphelele. Abanye abantu bangase badinge ukuyithatha isikhathi eside, kanti abanye bangase bakwazi ukuyeka uma isimo sabo sithuthuka kakhulu.

Ukuqokwa okuvamile kokulandela nodokotela wakho kubalulekile ekunqumeni ukuthi nini nokuthi kanjani ukulungisa noma ukuyeka imithi yakho ngokuphepha. Bazobheka izinga lokushaya kwenhliziyo yakho, izimpawu, kanye nomsebenzi wenhliziyo jikelele ukuze benze isinqumo esingcono kakhulu sempilo yakho.

Ngingakwazi yini ukuzivocavoca ngenkathi ngithatha i-Ivabradine?

Yebo, ngokuvamile ungenza umsebenzi ngenkathi uthatha i-ivabradine, futhi empeleni, umsebenzi ofanele womzimba uvame ukukhuthazwa njengengxenye yohlelo lwakho lwempilo yenhliziyo yonke. Kodwa-ke, imithi izothinta indlela izinga lokushaya kwenhliziyo yakho elisabela ngayo ekuzivocavoceni, ngakho-ke uzodinga ukulungisa okulindelekile kwakho nendlela yakho.

Njengoba i-ivabradine yehlisa izinga lokushaya kwenhliziyo yakho ekuphumuleni, izinga lokushaya kwenhliziyo yakho ngesikhathi sokuzivocavoca nalo lizoba ngaphansi kunalokho okwakunjalo ngaphambi kokuqala imithi. Lokhu kusho ukuthi awukwazi ukuncika ezingeni lokushaya kwenhliziyo elijwayelekile lokuzivocavoca. Kunalokho, gxila endleleni ozizwa ngayo ngesikhathi somsebenzi - kufanele ukwazi ukuqhubeka nengxoxo ngesikhathi sokuzivocavoca okulinganiselwe.

Qala noma yiluphi uhlelo olusha lokuzivocavoca kancane kancane futhi unake indlela umzimba wakho osabela ngayo. Uma uhlangabezana nokuphefumula okungavamile, ubuhlungu besifuba, isiyezi, noma ukukhathala okukhulu ngesikhathi sokuzivocavoca, yeka umsebenzi bese uthintana nodokotela wakho.

Umhlinzeki wakho wezempilo angakusiza ukuthi uthuthukise uhlelo lokuzivocavoca olufanele olucabangela isimo senhliziyo yakho, izinga lokufaneleka kwamanje, nemiphumela ye-ivabradine. Bangase batusa ukusebenza ngohlelo lokuvuselela inhliziyo uma unenhliziyo ehlulekayo noma ezinye izinkinga zenhliziyo ezibalulekile.