Izinqubo zokubuyisela isigqi senhliziyo: i-cardioversion kagesi

By UCristiano Antonino On Feb 20, 2023

I-Electrical cardioversion, CVE, iyindlela yokwelapha esetshenziselwa ukubuyisela isigqi senhliziyo esivamile ezigulini ezihlushwa i-atrial fibrillation, flutter noma tachycardia futhi lapho i-pharmacological cardioversion ingazange iphumelele.

I-cardioversion kagesi - uma idingeka

Isizathu esivame kakhulu salolu hlobo lokungajwayelekile isifo senhliziyo; ngezinye izikhathi isiguli siyakubona ukuguqulwa, kodwa ngokuvamile sibona kuphela imiphumela yako, njengokushaya kwenhliziyo, ubuthakathaka, isiyezi, ukuquleka kanye ne-asthenia.

Izinga eliphezulu lenhliziyo elibangelwa yilawa ma-arrhythmias lilimaza imisipha ye-myocardial njengoba, uma iphikelela, iholela ekunciphiseni umsebenzi we-contractile kanye nokunciphisa ingxenyana ye-ejection; ingxenye ye-ejection evumela ukuthi sihlole ukusebenza kwepompo yenhliziyo futhi iyinkomba enhle ye-contractility ye-myocardial.

Endabeni ye-fibrillation ye-atrial, ukungabi khona kwe-contractility ku-atria kubangela ukujikeleza kwegazi okungavamile emigodini yenhliziyo, futhi kuma-arrhythmias ahlala isikhathi esingaphezu kwamahora angu-48, i-thrombi ingase yakheke ezingxenyeni ezithile ze-atrium; i-thrombi engase ihlakazeke futhi ihlakazeke ekujikelezeni kwe-arterial kulandela ukuqalisa kabusha kwe-atrial contractility, okubangela imivimbo kanye/noma i-embolism.

I-anamnesis enembile ngesikhathi sokuqala kwezimpawu idlala indima ebalulekile ekwelashweni okufanele kwamukelwe; uma kudlula amahora angaphezu kwama-48 kusukela ekuqaleni kwezimpawu, kuphoqelekile ukwenza inkathi yokwelashwa kwe-anticoagulant ekugcineni lapho i-cardioversion kagesi ingenziwa ngokuphepha, ngaleyo ndlela kuncishiswe izingozi ze-cardio-embolic.

I-cardioPROTECTION KANYE NE-CARDIOPULMONARY RESUSCITATION? VAKASHELA I-EMD112 BOOTH EMPILWENI YESIMO ESIPHUTHUMAYO MANJE UKUFUNDA KABANZI

Kunezinhlobo ezimbili ze-cardioversion, i-cardioversion kagesi kanye ne-pharmacological cardioversion

I-Cardioversion kagesi isebenzisa ukushaqeka kukagesi okukhiqizwa yi- i-defibrillator futhi idluliselwa esigulini kusetshenziswa ama-electrode afakwa esifubeni.

I-Pharmacological cardioversion, ngakolunye uhlangothi, ihilela ukuphathwa kwezidakamizwa ezithile zokulwa nokuvuvukala.

I-Cardioversion ngokuvamile iyindlela yokwelapha ehleliwe, eyenzeka esikhungweni sesibhedlela, kodwa ngaphandle kokulaliswa esibhedlela.

Eqinisweni, ekupheleni kokwelashwa, uma konke kuhambe kahle, isiguli singase sikhishwe futhi sibuyele ekhaya.

UKUBALULEKA KOKUQEQESHWA EKUHLANGANENI: VAKASHELA I-SQUICCIARINI RECUE BOOTH FUTHI UTHOLA INDLELA YOKUSILUNGISELELA ESIPHUTHUMAYO.

I-cardioversion kagesi ngokuvamile ibekezelelwa kahle ngisho neziguli esezikhulile futhi aziyona ingozi

Ayiphikiswa ezigulini ezinama-pacemakers noma ama-defibrillators afakwayo.

Ukuphikisana kuhlobene ne-anesthesia ephelele edingekayo ye-cardioversion kagesi yangaphandle, ukuze kuphephiswe isiguli ubuhlungu nokuzwa ukushaqeka kukagesi enhliziyweni.

Izingozi zenqubo zincane futhi izinkinga azivamile; kungabangela ukushisa kwesikhumba endaweni lapho ama-electrode asetshenziswa khona esimweni se-cardioversion kagesi yangaphandle kanye nokunciphisa okwesikhashana umfutho wegazi.

Kungase kwenzeke isigqi senhliziyo esingavamile ngemva kokwelashwa.

Uma ama-thrombi ekhona ngaphakathi kwe-atrium yesokunxele yenhliziyo, angase ahlehle futhi athuthele kwezinye izifunda kulandela ukushaqeka, okubangela i-embolism.

Ngenxa yalesi sizathu, i-cardioversion kagesi yandulelwa i-transesophageal echocardiogram kanye nokwelashwa ngezidakamizwa ze-anticoagulant.

UMSAKAZO WABAHLELI EMHLABENI WONKE? IMITHETHO YOMSAKAZO: VAKASHELA I-BOOTH YAYO KU-EXPO EZIPHUTHUMAYO

Ukwenza i-Electrical Cardioversion

I-cardioversion kagesi ehleliwe iyinqubo edinga ukwamukelwa eSibhedlela Sosuku.

Ngaphambi kokwenza i-cardioversion kagesi, isazi senhliziyo sazisa isiguli mayelana nenqubo futhi siqala ukulungiswa ngemva kokusayina imvume enolwazi.

Ukuze ugweme izinhlungu ezibangelwa ukukhishwa kukagesi, kuzokwenziwa i-sedation ejulile ngama-hypnoinducers, futhi kwezinye izimo, uma kunikezwe ukusetshenziswa kwezidakamizwa ezithile, udokotela obulala izinzwa uzobizwa.

I-cardioversion kagesi ihilela ukulethwa kokushaqeka kukagesi nge-defibrillator ngokusebenzisa izingcwecwe ezimbili zensimbi ezinamathele ezibekwe esifubeni sesiguli; lawa mapuleti abekwe: i-subclavear engakwesokudla - i-apical kwesokunxele noma i-antero-posterior.

Uma i-sedation isisungulwe, udokotela wenhliziyo, ezilungisa ngokwesisindo sesiguli, uzokhetha amandla okukhipha adingekayo futhi avumelanise ukulethwa kokushaqeka ngomkhuba we-electrocardiogram; ukushaqeka kufanele kwenziwe esiqongweni se-R ngoba uma bekungenzeka ku-T wave kungabangela ukuqala kwe-arrhythmias eyingozi.

Ngemva kokuthola imingcele ebalulekile, udokotela uyaqhubeka nokuletha ukushaqeka; uma isigqi singabuyiswanga ngokushaqeka kokuqala, ukushaqeka okungafika kokuthathu kungaphindaphindwa ngokwandisa kancane kancane ama-joule.

Ukudlula kwamandla kagesi kubangela ukufinyela ngokushesha kwamangqamuzana e-myocardial ngokusetha kabusha izifunda ezingavamile, okuvumela ukubuyiselwa kwesigqi se-sinus.

Ukubuyiselwa kwesigqi senhliziyo esivamile kwenzeka ku-75-90% wamacala ekuqalisweni kwamuva kwe-atrial fibrillation kanye ne-90-100% ezimweni ze-flutter arrhythmia.

AMA-DEFIBRILLATOR, IZIBONAKALISO ZOKUQAPHELA, AMADIVAYISI OKUMINCI WE-CHEST: VAKASHELA I-PROGETTI BOOTH EMBUKENI ESIPHUTHUMAYO

Ukuvusa isiguli ngokuqapha imingcele yaso ebalulekile

I-Convalescence ngemva kwe-cardioversion kagesi ayidingi izinyathelo ezikhethekile zokuqapha futhi ungabuyela emisebenzini yakho yansuku zonke ngemva kwamahora angu-24, ngaphandle uma kuboniswe ngenye indlela udokotela wakho.

Kuyadingeka ukulandela ngokucophelela ukwelashwa kwesondlo okunqunyiwe, kungaba yizidakamizwa ze-anticoagulant futhi, uma kunesidingo, izidakamizwa zokulwa ne-arrhythmic.

Ukuze ugweme ukubuyela emuva, kuyasiza ukulandela indlela yokuphila enempilo: ukunciphisa ukucindezeleka ngangokunokwenzeka, ukuqeda ukubhema notshwala, nokugcina ukuzivocavoca umzimba njalo.