Pali njira ziwiri zochizira matenda opatsirana pogonana :
- Yesetsani kuchotseratu matenda a atrial pamodzi ndi kubwezeretsa ndi kukhala ndi mtima wabwinobwino ( Werengani za kayendedwe ka kayendedwe kake )
- Lolani kuti mafinyria ayambe kupitirira pamene akuwongolera kutentha kwa mtima ( Werengani za njira yamagetsi )
Chifukwa cha zinthu ziwiri izi, osadziwa kanthu kena, pafupifupi aliyense angayambe kusankha kusankha kuyimba.
Komabe, mchitidwe weniweni, njirayi nthawi zambiri imakhala yosagwira ntchito komanso yopanda chitetezo kusiyana ndi momwe angayendetsere.
Chifukwa chake kayendedwe ka kayendedwe kake kawirikawiri ndi kovuta kuti mankhwala osokoneza bongo ndi ofunika kwambiri pofuna kubwezeretsa ndi kusunga mtima wachibadwa. Mankhwalawa samakhala ofunika, omwe ali ndi poizoni, kapena onse awiri. (Zindikirani kuti odwala ena, kuchotseratu kupha tizilombo toyambitsa matenda pogwiritsa ntchito njira yowonjezereka ndi kotheka.)
Chinthu chomwe chimakhudza kwambiri mankhwala osokoneza bongo ndizoopsa kwambiri, zomwe zimawathandiza kuti zikhale zovuta komanso zovuta kuzipereka ndikuzitenga. Pali mitundu iwiri yambiri ya poizoni yomwe imapezeka ndi mankhwala osokoneza bongo:
- Zotsatira zachizoloŵezi zomwe zimawonedwa ndi mankhwala ambiri, monga chifuwa, kusowa tulo, kusokonezeka kwa m'mimba, ndi zina zotero.
- Proarrhythmia, yomwe imayambitsa vuto lalikulu ndi mankhwala osokoneza bongo.
Proarrhythmia
"Proarrhythmia" kumangotanthauza kuyambitsa maginthmias. Izi zikutanthauza kuti m'malo mochotsa mankhwalawa, mankhwalawa akhoza kuwathandiza. Mankhwala osokoneza bongo amagwira ntchito mwa kusintha magetsi a minofu ya mtima. Zimakhala kuti mukasintha zinthu zamagetsi ziwiri zinthu zingatheke-mukhoza kupanga arrhythmias pang'ono kuti zichitike (chomwe chiri cholinga), kapena m'malo mwake mukhoza kupanga arrhythmias kuti zichitike.
Choipa kwambiri, mitundu ya arrhythmias yotulutsidwa ndi proarrhythmia (mosiyana ndi mafinyntriyake yokha) ingawonongeke. Choncho, nthawi iliyonse yomwe mankhwala osokoneza bongo amagwiritsidwa ntchito, pali chiopsezo chowopsa chomwe chimachititsa kuti madokotala ndi odwala asafune kuzigwiritsa ntchito pokhapokha ngati ziri zofunikadi.
Mankhwala ena amakhala ochepa kwambiri kuposa ena ndipo odwala ena amatha kukhala ndi ziphuphu kuposa ena. Matendawa amatha kuwerengedwa kuti mankhwalawa asagwiritsidwe ntchito.
Kuchiza Matenda a M'thupi
Mankhwala asanu ndi amodzi omwe amagwiritsidwa ntchito powagwiritsa ntchito pochizira matendawa: propafenone (Rhythmol), flecainide (Tambocor), sotalol (Betapace), dofetilide (Tikosyn), amiodarone (Cordarone), ndi dronedarone (Multaq). Kwa aliyense amene amamwa mankhwalawa, chithandizochi chiyenera kukhala chodziwika bwino kuti chichepetse chiopsezo, koma zotsatirazi zikhoza kupangidwa:
- Rhythmol ndi Tambocor zimakhala zolekerera bwino malinga ngati sizipangitsa ma prostarimia. Kwa odwala omwe ali achichepere komanso odwala, omwe alibe matenda a mtima komanso omwe ali pachiopsezo chachikulu kuti adwale matenda a mtima, amachititsanso kuti asamakhale ndi kachilombo kochepa. Ndipo mwa odwala awa, iwo akhoza kusankha bwino kuyesa kubwezeretsa nyimbo yachibadwa kwa odwala omwe ali ndi matenda oopsa a atrial. Amaonedwa kuti ndi ogwira mtima kwambiri. Komabe, kwa odwala omwe ali ndi matenda ena amtima, kapena omwe ali ndi chiopsezo chowonjezeka cha matenda a mtima, mankhwalawa ndi omwe angapangitse moyo kukhala woopsa komanso ayenera kupeŵa nthawi zonse.
- Betapace ndi Tikosyn amavomerezedwa bwino ngati sangapangitse proarrhythmia. Komabe, mankhwalawa amatha kutulutsa mthupi mwa wina aliyense ndipo mosamala ayenera kutengedwa ndi madokotala kuti achepetse chiopsezo. Inde, pa nkhani ya Tikosyn, a FDA adalengeza kuti madokotala ayenera kuphunzitsidwa mwapadera asaloledwe kupereka mankhwalawa. Mankhwalawa ndi othandiza kwambiri poletsa matenda opatsirana pogonana.
- Cordarone ndi mankhwala osakanikirana kwambiri. Ngakhale kuti imakhala yothandiza kwambiri kuposa mankhwala ena alionse pochiza matenda oopsa, ndipo pamene imayambitsa pang'ono proarrhythmia, zikutheka kwambiri kuti zimayambitsa zotsatira zina zomwe zingakhale zofunikira komanso ngakhale kuopseza moyo. Chotsatira chake, Cordarone ayenera kupeŵa ngati kuli kotheka. Pogwiritsidwa ntchito, kuyang'anitsitsa mosamala kumayenera kupangidwa poizoni malinga ngati wodwala atenga mankhwalawa kwa miyezi ingapo mankhwalawa atayimitsidwa. Mukhoza kuwerenga za mbali zosiyana za Cordarone apa .
- Multaq ndi msuweni wa Cordarone ndipo anapangidwa ndi chiyembekezo kuti zingakhale zothandiza monga Cordarone popanda poizoni. Koma, pomwe Multaq ndizochepa kwambiri poizoni kuposa Cordarone, sizothandiza kuthetsa mafinya. Multaq sichitha kugwiritsidwa ntchito kwa anthu omwe ali ndi mtima wolephera . Nazi zambiri zokhudza kugwiritsidwa ntchito kwa Multaq pochiza matenda opatsirana pogonana.
Mfundo Yofunika Kwambiri
Ziyenera kuonekeratu kuti kuchiza matenda opatsirana pogonana ndi mankhwala osokoneza bongo-ndiko kuti, njira yowonetsera kubwezeretsa ndi kusunga nyimbo yachibadwa-ingakhale yovuta kwambiri. Pachifukwa ichi, anawonjezera kuti zovuta zachipatala sizinapangitse phindu lonse la mankhwalawa, ndi bwino kuti odwala azipewa mankhwala osokoneza bongo pokhapokha m'malo mwa njira yowononga mankhwala.
Zotsatira:
Fogoros, RN. Kuchiza kwa Supraventricular Arrhythmias. Mu: Fogoros, RN. Mankhwala Osokoneza Bongo - Malangizo Othandiza. Blackwell Publishing, Malden, MA: 2007.
Sukulu ya American College of Cardiology Foundation, American Heart Association, European Society of Cardiology, et al. Kusamalira Odwala Amene Ali ndi Matenda Aakulu Ambiri (Kuphatikizidwa kwa 2006 ACCF / AHA / ESC ndi 2011 ACCF / AHA / HRS Zotsatira): Lipoti la American College of Cardiology / American Heart Association Task Force on Practice Guidelines . Circulation 2013; 127: 1916.