Ngati mwapezeka ndi matenda a mtima , chithandizo chidzadalira mtundu womwe muli nawo komanso momwe ulili. Ngati sizingayambitse zizindikiro zazikulu ndipo simungapangitse kukhala ndi vuto linalake loipa kwambiri, mwina simukusowa chithandizo chilichonse. Komabe, ngati zizindikiro zanu ndizoopsa ndipo / kapena dokotala wanu akuganiza kuti wanu arrhythmia angasanduke chinachake choipa, iye angapangire chithandizo chomwe chili choyenera pa zosowa zanu.
Malemba
Kawirikawiri, pali zifukwa ziwiri zomwe dokotala angakonde kukupatsani pa mankhwala kuti mukhale ndi mtima wambiri. Choyamba, arrhythmia ikhoza kukupangitsani kuti mukhale ndi zizindikiro, monga piratations kapena kumutu , ndipo mankhwala angakhale ofunika kuthetsa zizindikiro. Kapena, chachiwiri, arrhythmia ikhoza kukupwetekani kapena kuopseza kuti muchite zimenezo.
Mankhwala Osokoneza Bongo
Mankhwala osokoneza bongo ndi mankhwala omwe amasintha magetsi a matupi a mtima, ndipo pochita zimenezi, sintha momwe chizindikiro cha magetsi cha mtima chikufalikira pamtima mwako. Popeza tachycardias (arrhythmias yomwe imachititsa kuti mtima ufulumire mofulumira) nthawi zambiri imagwirizana ndi zosavuta mu chizindikiro cha magetsi, mankhwala omwe amasintha chizindikiro cha magetsi anu amatha kusintha ma arrhythmias. Mankhwala oletsa antiarrhymic amagwira bwino ntchito, makamaka pochita zinthu zosiyanasiyana, pochiza mitundu yambiri ya tachycardias.
Mwamwayi, mankhwala osokoneza bongo monga gulu amachititsa mavuto ambiri a mtundu umodzi, ndi zotsatira zake, zingakhale zovuta kutenga.
Mankhwala amatsinje aliwonse amadziwika okha, ndipo asanayambe kumwa mankhwalawa, m'pofunika kuti dokotala adziwe bwinobwino zomwe zingatheke ndi mankhwala osankhidwa.
Komabe, pali vuto limodzi loopsya lomwe limakhala lofala pafupifupi mankhwala onse opatsirana pogonana: Nthawi zina mankhwalawa amachititsa kuti chiwerengerochi chikhale choipa m'malo mokhala bwino.
Mbali imeneyi ya mankhwala osokoneza bongo-yotchedwa proarrhythmia-imatuluka kuti ikhale malo enieni a mankhwala omwe amasintha chizindikiro cha magetsi. Mwachidule, pamene muchita chilichonse kusintha momwe magetsi amatha kufalikira pamtima, nkotheka kuti kusinthako kumapangitsa tachycardia kukhala yabwino, kapena ikhoza kuipitsa.
Amagwiritsidwa ntchito kwambiri mankhwala osokoneza bongo monga Cordarone kapena Pacerone (amiodarone), Betapace (sotalol), Rhythmol (propafenone), ndi Multaq ( dronedarone ). Amiodarone ndi mankhwala osokoneza bongo kwambiri komanso amalephera kuyambitsa mankhwala osokoneza bongo kusiyana ndi mankhwala ena. Mwamwayi, mitundu ina ya poizoni yomwe imawonedwa ndi amiodarone , monga kuwonongeka kwa mapapo kapena chiwindi, ikhoza kukhala yonyansa kwambiri, ndipo mankhwalawa ayenera kugwiritsidwa ntchito, ngati mankhwala osokoneza bongo, pamene kuli kofunika kwambiri.
Mfundo yaikulu ndi yakuti madotolo ali-ndipo ayenera kukhala osayenerera kupereka mankhwala osokoneza bongo. Mankhwalawa ayenera kugwiritsidwa ntchito pokhapokha ngati arrhythmia ikupereka zizindikiro zazikulu kapena ikuwopsyeza moyo wanu wamtima.
Mankhwala Osokoneza Bongo a Nodal
Mankhwala otchedwa AV nodal omwe amaletsa mankhwala osokoneza bongo- beta blockers , calcium channel blockers , ndi digoxin-ntchito potsegula chizindikiro cha magetsi pamtima pamene akudutsa muzithunzi za AV pochoka pa atria kupita ku ventricles.
Izi zimapangitsa mankhwala osokoneza bongo a AV kuvomereza kwambiri makamaka pochiza tachycardias (SVT). Mitundu ina ya SVT, makamaka AV nodal reentrant tachycardia ndi tachycardias zomwe zimayambitsidwa ndi timapepala, zimafuna kuti kachilombo ka AV kayendetse bwino magetsi, ndipo ngati nthenda ya AV ingapangidwe kuyendetsa pang'onopang'ono chizindikiro cha magetsi, SVT imangoima.
Kwa SVT yomwe imadziwika kuti matenda a atrial fibrillation , mankhwala osokoneza bongo a AV amachititsa kuti magazi asamayimitse, koma amachepetse mtima wanu kuti athetse zizindikiro. Ndipotu, kulamulira mtima wanu ndi mankhwala osokoneza bongo a AV ndi njira yabwino kwambiri yogwiritsira ntchito mankhwala osokoneza bongo .
Zitsanzo za beta blockers ndi Sectral (acebutolol), Tenormin (atenolol), Zebeta (bisoprolol), Lopressor kapena Toprol-XL (metoprolol), Corgard (nadolol), Bystolic (nebivolol), ndi Inderal LA kapena InnoPran XL (propranolol). Izi zingachititse zotsatira zoyipa monga kupsinjika maganizo, kuchepa kwa mtima, kutopa, matenda a Raynaud, kusokonezeka kwa kugonana, kuthamanga kwa mpweya, komanso kupuma kwapansi.
Zina zokhazokha za calcium ndizopindulitsa kuchiza arrhythmias, kuphatikizapo Cardizem kapena Tiazac (diltiazem), ndi Calan kapena Verelan (verapamil). Zotsatira zoyipa zimaphatikizapo kutupa mapazi, kudzimbidwa, kutsegula m'mimba, ndi kutsika kwa magazi.
Anticoagulants
Ngati muli pa chiopsezo chokhazikitsa magazi, zomwe zingayambitse matendawa, dokotala wanu angapereke anticoagulant (magazi ochepa) . Mankhwalawa amachititsa kuti magazi anu asatseke ndi kuimitsa zomwe muli nazo kale kuti mukhale wamkulu, ngakhale kuti sangathe kuchepetsa kukula kwa magazi omwe alipo. Ngati mwakhala ndi stroke kapena muli ndi matenda a atrial, pali mwayi wodokotala wanu adzakuikani pa anticoagulant. Zotsatira zoyipa za anticoagulants zimaphatikizapo kuphulika, mpweya, kutsegula m'mimba, kusunthira, kusanza, komanso kusamva njala.
Mankhwala Ochepetsa Mankhwala Oopsa a Kachidwi Omangidwa
Mankhwala ochepa amalingalira kuti amachepetsa chiopsezo cha kumangidwa kwadzidzidzi kwa mtima, mwinamwake pochepetsa chiopsezo cha ventricular tachycardia kapena ventricular fibrillation , arrhythmias yomwe imapangitsa mtima kumangidwa . Kafukufuku amasonyeza kuti beta blockers amawoneka kuti amachepetsa chiopsezo cha kumangidwa kwadzidzidzi kwa mtima mwa kutseka zotsatira za adrenaline pamutu wa mitsempha, motero kuchepetsa mwayi wokhala ndi arrhythmias wakupha. Odwala onse amene apulumuka mtima kapena omwe ali ndi mtima wolephera ayenera kutenga beta.
Mankhwala ena omwe adokotala anu angakupatseni ngati muli pachiopsezo chomangidwa mwamsanga mwadzidzidzi amachititsa kuti asiotensin-converting enzyme (ACE) inhibitors , calcium channel blockers, ndi amiodarone ya antiarrhythmic mankhwala.
Zida zosinthika
Mitundu ina ya arrhythmias ingafunike chipangizo chothandizira kuti muthe kusintha mtima wanu.
Pacemaker
Ngati mtima wanu uli wocheperapo kapena wochuluka kwambiri, dokotala wanu angakulimbikitseni pachipangizo chamagetsi, chojambulidwa ndi batri chimene chimapangitsa mtima wanu kugunda mofulumira, mofulumira. Imaikidwa pansi pa khungu lanu pafupi ndi collarbone yanu, kumene imagwirizanitsidwa ndi waya ku mtima wanu. Phokoso la pacemaker limapanga mphamvu zamagetsi zomwe zimathandiza mtima wanu kumenyera mwachizolowezi, kuteteza arrhythmias.
Chokhazikika Chojambula Chojambula Magetsi (ICD)
Ngati mwagwidwa ndi mtima mwadzidzidzi, mutapezeka kuti muli ndi ventricular tachycardia kapena ventricular fibrillation, kapena muli pachiopsezo chokhazikitsa imodzi mwa izi, dokotala wanu angapangire kuti tizilombo ta cardioverter defibrillator (ICD) . Zida zimenezi zingalepheretse kufa mwadzidzidzi kuchokera kumangidwe kwa mtima, chomwe ndi chifukwa chachikulu chimene amagwiritsira ntchito. Monga pacemaker, ICD imagwiranso ntchito piritsi ndipo imayikidwa pansi pa khungu lanu pafupi ndi collarbone yanu. Ma waya okhala ndi electrode pamalangizo amamangiriridwa pamtima wanu ndipo ICD imawunika mtima wanu mosalekeza. Mosiyana ndi pacemaker, ICD imangothamanga pamene imazindikira nyimbo yachilendo, kutumiza mantha kapena kupweteka kwa mtima wanu kuti mubwererenso. Popeza ma ICD samapewa arrhythmias, mumayenera kumwa mankhwala.
Kuchita Opaleshoni ndi Njira Zoyendetsedwa ndi Zapadera
Pali njira zamakono kapena opaleshoni zomwe zingagwiritsidwe ntchito kuti muzitsatira dongosolo lanu. Apanso, mankhwalawa amadalira mtundu ndi kuuma kwa chigawo chanu.
Ablation
Mitundu ina ya arrhythmias imayambitsidwa ndi zolakwika zomwe zimapezeka mkati mwa magetsi. Pazochitikazi, ndondomeko yowonjezera njira ingathe kusokoneza kusayeruzika kwa magetsi. Mankhwalawa angagwiritsidwe ntchito ngati mankhwala ngati simungathe kulekerera mankhwala kapena sakugwira ntchito. Cholinga cha njirayi kawirikawiri ndicho kuchotsa chigamulo chonsecho.
Ngakhale njira zowonjezerapo zikhoza kuchitidwa mu chipinda chogwirira ntchito pamene opaleshoni yamtima yowonekera , njira yowonjezera yowonjezera yowonjezera imakwaniritsidwa pa njira yapadera ya catheterization ya mtima yotchedwa electrophysiology study (EPS).
Maphunzirowa amachitidwa ndi makina osokoneza maganizo a mtima omwe ali ndi matenda a cardiologists omwe amaphunzitsidwa mwapadera pochiza mtima wa arrhythmias. EPS ikhoza kuchitidwa ngati njira yoyezetsa matenda pamene kuli kofunika kuthetsa ndondomeko ya arrhythmia ndipo kawirikawiri kuti musankhe ngati njira yobweretsera ikhoza kuthetsa arrhythmia. Masiku ano, maphunziro ambiri a electrophysiology amaphatikizapo kuyezetsa kuyezetsa matenda ndi njira yowonjezera.
Pakati pa ndondomeko yowonjezera, phalasitiki yapadera yomwe imakhala ndi ma electrode pampoto, imakhala pamalo osiyanasiyana mkati mwa mtima wanu, ndipo dongosolo lonse la magetsi lamapiko limaphunziridwa ndi kupangidwa mapu. Ngati malo osadziwika amadziwika kuti ndi omwe amachititsa kupanga arrhythmia, nsonga ya catheter imatsogoleredwa kumalo osalongosoka, ndipo kuperewera kwachitidwa kupyolera mu catheter. Kupereka chakudya kumaphatikizapo kutumiza mtundu wina wa mphamvu kupyolera mu catheter (mphamvu ya kutentha, mphamvu yozizira, kapena mphamvu zamagetsi) kuti awononge (ablate) minofu pampando wa catheter. Izi zimapanga njira ya magetsi imene ikupangitsa kuti muyambe kuyenda.
Zaka zaposachedwapa, njira zowonjezerapo zowonjezereka zakhala zikupita patsogolo, ndipo zimagwiritsa ntchito ma mapulogalamu a mapulogalamu apakompyuta omwe amagwiritsira ntchito zithunzi zojambula 3-D ndi mapu a magetsi kuti afotokoze malo omwe akuyenera kuwathandiza. Nthawi zambiri amatenga maola angapo ndipo mukusowa tsiku limodzi kapena awiri kuchipatala.
Ablation amagwira ntchito 60 peresenti mpaka 80 peresenti ya nthawi ya anthu omwe ali ndi vuto lopweteka kwambiri monga matenda opatsirana pogonana, atrial tachycardia, ndi tricycardia ya ventricular. Kwa anthu omwe ali ndi tachycardias yapamwamba, kupambana kwake ndi 90 peresenti mpaka 95 peresenti.
Kutsegula mtima
Kwa mitundu ina ya arrhythmias monga mafinydriyriyamu komanso ventricular fibrillation, cardioversion ikhoza kukhala chithandizo cha mankhwala. Mwa njirayi, mtima wanu umagwedezeka ndi magetsi kapena zikhomo pamphuno mwanu kuchokera ku defibrillator. Kusokonezeka kungakulimbikitseni mtima wanu kuti ubwerere mu nyimbo yachibadwa.
Maze Njira
Ngati simunayankhe mankhwala ena a arrhythmias kapena mukuchita opaleshoni ya mtima pa chifukwa chinanso, dokotala wanu angakulimbikitseni njira yobweretsera . Izi zimaphatikizapo kupanga zozizwitsa kumtunda kwa mtima wanu (atria) zomwe zimawombera ndi kuteteza maganizo a magetsi kuti asapangitse chiwalochi chifukwa chakuti zovuta sizikhoza kupyola minofu yambiri.
Coronary Bypass
Panthawi ya matenda oopsa a mitsempha ya chiberekero yomwe imayambitsa matenda anu, dokotala wanu angakulimbikitseni kupititsa patsogolo , zomwe zingathandize kuti mtima wanu ukhale wabwino.
Zothetsera Pakhomo ndi Moyo Wamoyo
Kupanga kusintha kwa moyo wanu kungakuthandizeni kukhala ndi thanzi labwino komanso kuchepetsa chiopsezo cha matenda a mtima.
Kudya Chakudya Chopatsa Moyo
Onetsetsani kuti chakudya chanu chimadzaza ndi mbewu zosiyanasiyana, zipatso, ndi masamba komanso kuti mchere, cholesterol, ndi mafuta ndi ochepa. Pitani ku mkaka wopanda mafuta kapena mafuta osadya mafuta ndikudya nyama zowonda, nkhuku, ndi nsomba.
Pitirizani Kusuntha
Kuchita masewera olimbitsa thupi kumateteza mtima wanu. Yesetsani kupeza tsiku lililonse kapena kukhazikitsa cholinga kuti muwonjezere ntchito yanu ndikugwira ntchitoyi.
Yang'anani kulemera kwanu
Kulemera kwambiri kapena kunenepa kumapangitsa kuti mukhale ndi matenda a mtima chifukwa mumagwira ntchito molimba mtima. Kudya chakudya chopatsa thanzi komanso kuwonjezera masewera olimbitsa thupi kungakuthandizeni kuti mukhale ndi thanzi labwino.
Sula Chizolowezi Chosuta
Ngati uli wosuta, yesetsani kusiya. Ili ndilo lingaliro labwino kwambiri lomwe mungapange kwa thupi lanu lonse, osati kutchula mtima wanu.
Sungani Kuthamanga kwa Magazi Oyenera ndi Mitsempha ya Cholesterol
Gwiritsani ntchito kusintha kwa moyo wanu pamwambapa ndikuonetsetsa kuti mutenga mankhwala aliwonse omwe mwawakakamiza kuti muthamangitse magazi komanso / kapena kolesterolini.
Sungani Maganizo Anu
Kusokonezeka maganizo kungathandize kupanga arrhythmias, Onetsetsani kuti mumatenga nthawi yochita zinthu zomwe mumakonda. Phunzirani njira zina zochezera. Yesetsani zokhumudwitsa zanu ndi kuchita masewera olimbitsa thupi.
Mowa Wambiri
Dokotala wanu sangakonde kuti muzimwa mowa chifukwa zingapangitse mtima wanu kugunda mofulumira, koma ngati mutero, onetsetsani kuti mukuchita moyenera. Zakudya zabwino za mowa ndi zakumwa zoledzeretsa tsiku ndi tsiku kwa amayi ndi abambo oposa zaka 65 ndi zakumwa ziwiri pa tsiku kwa amuna oposa 65.
Sungani Malo Anu Osankhidwa
Ngakhale mutakhala bwino, onetsetsani kuti mukusunga dokotala wanu komanso chisamaliro chanu chonse. Tengani mankhwala anu motsogoleredwa ndipo dokotala wanu adziwe ngati muli ndi zizindikiro kapena zovulaza.
Mankhwala Osakaniza Owonjezera (CAM)
Palinso mankhwala ena omwe angathandize kuthana ndi arrhythmias kapena nkhawa zomwe zingawapangitse kuipa. Izi zikuphatikizapo:
Vagal Maneuvers
Ngati muli ndi tachycardia yapamwamba, zovuta zozizwitsa zotchedwa vagal kuyenda zingathandize kuchepetsa kapena kuziletsa. Njirazi zimagwira ntchito pogwiritsa ntchito vagus nerve, zomwe zimayambitsa mtima wanu, ndipo zimaphatikizapo:
- Kukugwedeza
- Kukuda
- Sungani nkhope yanu mumadzi a ayezi
- Kusunga mpweya wanu mukuyesera kukakamiza kuchotsa
- Kuyika zala zanu pazokopa zanu ndi kupondereza mofatsa
Lankhulani ndi dokotala wanu za kugwiritsira ntchito vagal chifukwa iwo sangakhale njira yabwino ya chithandizo kwa inu.
Kupangidwanso
Ngakhale kufufuza kwina kuli kofunika, kafukufuku wasonyeza kuti kudulidwa kwa mankhwala kungakhale mankhwala otetezeka ndi othandiza kwa arrhythmias, makamaka paroxysmal supraventricular tachycardia, ventricular beat premature, sinus tachycardia, ndi mafinyria atrial. Kuonjezera apo, kupopera thupi kumakhala ndi zoopsa zochepa, kotero izi zingakhale zoyenera.
Kuchepetsa Kupanikizika kwa Kupanikizika
Popeza kupanikizika ndi chinthu chomwe chingapangitse mayendedwe anu kukhala ovuta, mwina mukuyesera kuchepetsa kuchuluka kwa nkhawa zomwe mumamva. Nazi njira zina zothandizira:
- Yoga
- Kusinkhasinkha
- Njira zotsegula ngati kupuma kwakukulu, kusungulumwa kwapang'onopang'ono, ndi kuyang'ana
> Zotsatira:
> American Heart Association. Mankhwala a Arrhythmia. Kusinthidwa September 2016.
> Bohnen M, Stevenson WG, Tedrow UB, ndi al. Zochitika ndi Zowonongeka za Mavuto Aakulu Kuchokera M'nyengo Yamakono Yamatenda Kutengera Mtima Wachimake wa Arrhythmias. Mtima Rhythm . November 2011; 8 (11): 1661-6. lembani: 10.1016 / j.hrthm.2011.05.017.
> Li Y, Barajas-Martinez H, Li B, ndi al. Kufanizitsa Kufananirana kwa Kupangidwira Kwambiri ndi Mankhwala Osokoneza Bongo Poletsa Kupewa Maganizo a Cardiac Arrhythmias: Kukonzekera Mwadongosolo ndi Kusanthula Meta Zoyesedwa Zowonongeka. Malire mu Physiology . 2017; 8: 358. lembani: 10.3389 / fphys.2017.00358.
> Chipatala cha Mayo Clinic. Mtima Arrhythmia. Chipatala cha Mayo. Idasinthidwa pa December 27, 2017.
Mitchell LB. Zowona za Mafilimu Osayembekezeka Amtima. Buku la Merck: Version ya Ogula.