Uyini Umehluko phakathi kwe-Pacemaker ne-Subcutaneous Defibrillator?

By UCristiano Antonino Kugcine ukubuyekezwa Septhemba 28, 2022

Ama-Pacemaker nama-subcutaneous defibrillator ayimishini yezokwelapha engatshalwa ngokuhlinzwa futhi iboniswa ezigulini ezinokuphazamiseka kwenhliziyo.

Ngokuqondile ngenxa yokufana kwendlela ezitshalwe ngayo nendlela esebenza ngayo, lezi zisetshenziswa zombili zivame ukudideka omunye nomunye.

Eqinisweni, zingamathuluzi amabili ahlukene:

i-pacemaker, esetshenziswa kabanzi kakhulu, iyithuluzi le-elekthronikhi eliqapha ukushaya kwenhliziyo futhi lilethe umfutho kagesi uma lithola imvamisa ephansi noma ephansi kakhulu. Ekusebenzeni, isetshenziselwa ukuxazulula lokho kuvinjelwa kwenhliziyo okubangela i-pathological bradycardia (ukushaya kwenhliziyo okuhamba kancane kakhulu, okubangela isiyezi noma ukuquleka).
I-subcutaneous i-defibrillator, ebizwa nangokuthi i-implantable defibrillator noma i-ICD (Implantable Cardioverter Defibrillator), iyithuluzi elifakwe ngokuhlinzwa elikwazi ukubona ukushaya kwenhliziyo okungajwayelekile noma okuyingozi. Uma kudingekile, iletha ukushaqeka okusindisa ukuphila okusetha kabusha ukusebenza kwenhliziyo kuqanda futhi kuvumela isigqi senhliziyo esivamile ukuthi sibuyiselwe.

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Ama-Pacemaker nama-Subcutaneous Defibrillators, Asetshenziselwa Yini

Umehluko omkhulu phakathi kwe-pacemaker kanye ne-subcutaneous defibrillator usezinjongoni ezifakwe ngayo:

I-Pacemaker ifakwa ezigulini ezine-bradycardia futhi ngenxa yalokho ezinesigqi senhliziyo esinensa kakhulu. I-Pacemaker ihlale iqapha inhliziyo yabo futhi ingenela ngokuzenzakalelayo lapho ithola isigqi senhliziyo esiphansi kakhulu, ithumela amathonya kagesi aphumelelayo ukuyibuyisela.
I-subcutaneous defibrillator, ngakolunye uhlangothi, isebenza kokubili esimweni sesigqi senhliziyo esiphansi kakhulu (njenge-pacemaker) futhi esimweni sesigqi senhliziyo esishintshe kakhulu. Kulezi zimo iphinde inikeze ukushaqeka, okuvuselela inhliziyo, ukubuyisela isigqi esivamile.

Kuye ngohlobo lwesifo senhliziyo esitholwe, udokotela uzoncoma ukuthi iyiphi idivayisi efaneleka kakhulu.

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Okufakwe Kubo Ama-Pacemakers kanye nama-Subcutaneous Defibrillators

Ukwelapha ama-pathologies ahlukene, kuyacaca ukuthi lawa madivaysi amabili akhonjiswe izinhlobo ezahlukene zeziguli, kuye ngokushaya kwenhliziyo:

I-Pacemaker iboniswa ezigulini eziphethwe i-bradycardia, okungukuthi isigqi senhliziyo esinensa kakhulu. Le pathology ibonakala ngesigqi senhliziyo esinensayo (ngaphansi kwama-beats angama-60 ngomzuzu). Ngakho igazi elinomoya-mpilo elimpontshwayo alanele ukuhlangabezana nezidingo zomzimba, okubangela ukwehla kwamandla, isiyezi, i-dyspnoea kanye nokuquleka.
I-subcutaneous ICD defibrillator iboniswa ezigulini ezine-arrhythmias ezimbi futhi isebenza ukuvimbela ukufa okungazelelwe. Iziguli ezikhethiwe zokufakelwa zingabantu abaye banikeza i-ventricular arrhythmias noma ukuboshwa kwenhliziyo; basengozini enkulu yokuba ne-ventricular arrhythmia noma ukuboshwa kwenhliziyo.

I-Pacemaker ne-Subcutaneous Defibrillator: Ukufakelwa

Mayelana nenqubo yokufakelwa, awukho umehluko omkhulu phakathi kwalokhu kokubili.

Eqinisweni, lezi zinsimbi ezimbili zifakwe ngaphansi kwesikhumba ngaphansi kwe-clavicle yesokunxele ngenqubo yokuhlinzwa, eyenzeka ngaphansi kwe-anesthesia yendawo futhi ngokuvamile ihlala imizuzu engu-45 kuya kwangu-90.

Inqubo yenziwa njengenqubo esesigulini.

I-pacemaker, idivayisi kagesi elingana nohlamvu lwemali lwama-euro angu-2, ibekwe endaweni yesifuba, ngaphansi kwethambo lekholomu.

Ixhunywe ocingweni olulodwa noma ezimbili (umthofu) ezibuye zixhumane nemisipha yenhliziyo.

Imikhondo idlulisa ulwazi kusuka kumshini wenhliziyo kuya enhliziyweni futhi ithumele amathonya kagesi uma kunesidingo.

I-Pacemaker ihlelwa ngekhompyutha ekhethekile, ngenxa yalokho uchwepheshe angakwazi ukubuka lonke ulwazi oluphathelene nenhliziyo yesiguli nokusebenza kwayo.

Ukufakwa kwe-subcutaneous defibrillator kulandela izinyathelo ezifanayo nokufakwa kwe-pacemaker

Ingxenye yokuqala iphathelene nokubekwa kwemithofu, okungukuthi 'izintambo zikagesi' ezifinyelela inhliziyo. Inombolo yabo ingahluka ukusuka kokukodwa kuye kokuthathu, kuye ngohlobo lwedivayisi okufanele ifakwe.

Imikhondo ifakwa emthanjeni (i-subclavian noma i-cephalic, imvamisa kwesokunxele).

Uma isingenile ohlelweni lwe-venous, imikhondo iphushwa emagumbini enhliziyo (i-ventricle engakwesokudla, i-atrium yangakwesokudla, i-coronary sinus) futhi ibekwe ezindaweni lapho izwa khona kangcono ukusebenza kwenhliziyo futhi ngaleyo ndlela ikwazi ukuvuselela inhliziyo ngamandla amancane kakhulu.

Ngemuva kokuhlola ukuzinza kwama-catheter kanye nemingcele yawo kagesi, ukuhola kunamathele emisipha engaphansi bese ixhunywe ku-defibrillator, ebekwe ngaphansi kwesikhumba.

Inkokhelo ihlala isikhathi esingakanani?

Ama-Pacemakers nama-defibrillators anikwa amandla ibhethri le-lithium elingashajwa.

Ngakho-ke, ibhethri liyaphuma ngemva kwesikhathi esithile, kuye ngokuthi i-defibrillator noma i-pacemaker.

Ngokusobala, inani lezikhathi lapho idivayisi ingena khona ngempela ibalulekile: amadivaysi ahlala eqapha umsebenzi wenhliziyo futhi angenele kuphela ngokushaqeka uma kunesidingo.

Lapho bengenela kakhulu, kulapho icala liphela ngokushesha.

Ngokusobala, ama-pacemaker ahlala phakathi kweminyaka eyi-7 ne-10, kuyilapho ama-defibrillator ehlala phakathi kweminyaka emi-5 neyi-7.

Uma ibhethri idinga ukushintshwa, yonke idivayisi iyashintshwa ngoba ibhethri ihlanganiswe ngaphakathi.