Odwala ena omwe ali ndi mtima wathanzi akhoza kukhala ndi kusintha kwakukulu kwa zizindikiro, kuchepetsa matenda opatsirana, komanso kuchepa kwa imfa ndi mtundu wina wa pacemaker wotchedwa resynchronization therapy (CRT). Ngati mwapezeka kuti muli ndi vuto la mtima, muyenera kuyankhula ndi dokotala wanu za momwe mungagwiritsire ntchito CRT.
Momwe CRT imagwirira ntchito
CRT imagwiritsa ntchito teknoloji yothamanga mtima kuti iwonetsenso zomwe zimachitika m'magulu oyenera komanso omanzere odwala omwe akudwala mtima chifukwa cha kuchepa kwa mtima .
Pafupifupi munthu mmodzi mwa anthu atatu omwe ali ndi vuto la mtima ali ndi chizoloŵezi choyendetsa magetsi chomwe chimatchedwa " bundle bundle branch block" (LBBB) (kapena kusiyana kwa LBBB komwe kumadziwika kuti "kuchepetsa kupititsa patsogolo"). ndipo amasiya ma ventricles kuti asinthe mwachitsulo. Mwa kulankhula kwina, mmalo mogunda nthawi yomweyo zitsulo ziwiri zimagunda pang'ono pang'ono, chimodzimodzi chimzake. Izi zimachepetsa kwambiri ntchito ya mtima kwa odwala omwe akudwala mtima, Zizindikiro za mtima kuchepa kwambiri.
CRT imagwiritsira ntchito chipangizo chodzidzimutsa chodziwika bwino chomwe chimatha kuyenda ponseponse ma ventricles mosiyana. Izi ndi zosiyana ndi zowononga zokhazokha, zomwe zimayenda mozungulira basi.
Pogwiritsira ntchito nthawi yoyendetsa makina awiri, CRT imatha kubwezeretsa kumenyana kwawo kotero kuti zowomba zimagwirizanitsa panthawi imodzimodzi mmalo mwa sequentially.
Pamene ntchito yazitsulo ziwirizi zimagwirizanitsidwa motere, mphamvu ya mtima ikuwonjezeka, ndipo kuchuluka kwa ntchito zomwe zimatengera mtima kupopera magazi kuchepa.
Kugwira ntchito kwa CRT
Mayesero angapo opatsirana pogwiritsa ntchito chithandizo chachipatala awonetsetsa kuti ntchito ndi chitetezo cha CRT ndi odwala omwe ali ndi mtima wosagwira ntchito komanso ofesi ya nthambi.
Kufufuza kwa meta kuyang'ana pa mayesero 14 awa omwe analembetsa odwala 4420 omwe ali ndi mtima wolephera anapeza kuti, mwa odwala oyenera, CRT mokhulupirika imakulitsa zizindikiro ndi mphamvu zothandizira, imachepetsa mlingo wa hospitali, ndi kuchepetsa imfa.
Zofukufuku zawonetsanso kuti CRT imatha kusintha maonekedwe ndi mtima, kuyesera kuchepetsa kukula kwa ventricle yotsalira, motero kumapanga kachigawo kakang'ono kotsekemera ka ventricular.
Mavuto a CRT
CRT ndi pacemaker, choncho imayambitsa mavuto omwe mungayang'ane ndi wina aliyense, kuphatikizapo chiopsezo chochepa cha matenda, kuwonongeka kwa mtima kapena mitsempha ya magazi, ndi kutuluka magazi. Kuwonjezera apo, pangozi yowonjezereka ikuphatikizidwa pakuyika kutsogolo kothamanga komwe kumatha kuyendetsa kumapeto kwa ventricle. Pa pafupifupi mmodzi mwa odwala 20, kuchoka kwa ventricular pacing sikungatheke ndipo CRT siingagwiritsidwe ntchito.
Kodi Ndi Anthu Otani Amene Akulephera Kulimbana ndi Mtima?
Zotsatira zovomerezeka zimalimbikitsa kuti CRT iwonedwe ngati odwala omwe ali ndi vuto la mtima lomwe limatulutsa zizindikiro zazikulu, omwe ali ndi kachigawo kakang'ono kotsekedwa ka ventricular ka 0.35 kapena m'munsi, ndi lachitsulo chotsalira.
Zowoneka kuti, odwala ambiri omwe amakumana ndi CRTyi adzakumananso ndi zofunikira zowonongeka ( ICD ).
Chotero mtundu wamba wa CRT chipangizo chogwiritsidwa ntchito mu mankhwala a zamankhwala ndiphatikiza chipangizo cha ICD-CRT.
Mawu Ochokera
Ngati muli ndi vuto la mtima lomwe limakulepheretsani kugwira ntchito mwachizolowezi, ndipo mwalandira kale mankhwala opatsirana pofuna kuthandizira mtima , muyenera kukambirana za mwayi wa CRT ndi dokotala wanu. Dokotala wanu adzakuthandizani kudziwa ngati ndinu oyenerera pa njira iyi ya mankhwala komanso ngati CRT ikuyenera.
> Zotsatira:
> Burkhardt, JD, Wilkoff, BL. Kugwiritsa ntchito mphamvu zamagetsi komanso kupatsirana mtima kwa mtima: kupereka njira zamagetsi zothandizira mtima. Kuzungulira kwa 2007; 115: 2208.
> McAlister FA, Ezekowitz J, Hooton N, et al. Thandizo lachilendo la mtima kwa odwala ndi kusokonezeka kwa systolic ventricular: kusinthika mwachidwi. JAMA 2007; 297: 2502.
> Yambani CW, Jessup M, Bozkurt B, et al. 2013 ACCF / AHA kutsogolera kuyendetsa mtima kulephera: chidule cha executive: lipoti la American College Association of Cardiology Foundation / American Heart Association Task Force pa ndondomeko zoyenera. Circulation 2013; 128: 1810.