Pōʻai puʻuwai

He pilikia ka poloka puʻuwai ma nā hōʻailona uila i ka puʻuwai.

ʻO ka maʻamau, hoʻomaka ka puʻuwai puʻuwai i kahi ma nā keʻena kiʻekiʻe o ka puʻuwai (atria). ʻO kēia wahi ka mea mālama i ka naʻau. Hele nā ​​hōʻailona uila i nā keʻena haʻahaʻa o ka puʻuwai (ventricles). Mālama kēia i ka puʻuwai kuʻi paʻa a maʻa mau.

Kū ka palaka puʻuwai ke lohi ka hōʻailona uila a i ʻole hiki i nā keʻena lalo o ka puʻuwai. Pākuʻi paha kou puʻuwai, a i ʻole lele ʻia i nā paʻi. Hoʻoholo paha ka palaka puʻuwai iā ia iho, a i ʻole he kū mau paha ia a koi ʻia i ka lāʻau.

Aia he ʻekolu degere o ka poloka puʻuwai. ʻO ka poloka puʻuwai kekelē ʻo ia ka ʻano akahai a ʻo ke kolu o ka degere ka ʻoi loa.

Poloka naʻau degere mua:

• Kākaʻikahi ka loaʻa ʻana o nā ʻōuli a i ʻole ke kumu o nā pilikia

Palaka naʻau kekelē ʻelua:

• ʻAʻole hiki i ka uila uila i nā keʻena haʻahaʻa o ka puʻuwai.
• Hala paha ka puʻuwai i ka paʻi a kuʻi paha a lohi paha a kūlike ʻole hoʻi.
• Pēpē paha ʻoe, maule paha, a i ʻole loaʻa nā ʻōuli ʻē aʻe.
• He koʻikoʻi paha kēia ma kekahi hihia.

Palaka naʻau kekelē ʻekolu:

• ʻAʻole neʻe ka hōʻailona uila i nā keʻena haʻahaʻa o ka puʻuwai. I kēia hihia, kuʻi nā keʻena o lalo i ka helu haʻahaʻa loa, a ʻaʻole i kuʻi ke keʻena o luna a me lalo i ke kaʻina (kekahi ma hope o kekahi) e like me ka hana maʻamau.
• ʻAʻole hiki i ka puʻuwai ke pauma i ke koko i ke kino. Hiki i kēia ke alakaʻi i ka nāwaliwali a me ka liʻiliʻi o ka hanu.
• He pilikia kēia e pono ai i ke kōkua lapaʻau koke.

Hoʻokumu ʻia ka poloka puʻuwai e:

• Nā hopena o nā lāʻau. Hiki i ka puʻuwai puʻuwai ke lilo i hopena o digitalis, beta-blockers, calcium channel blockers, a me nā lāʻau ʻē aʻe.
• ʻO kahi puʻuwai puʻuwai e hōʻino ai i ka ʻōnaehana uila i ka puʻuwai.
• Nā maʻi puʻuwai, e like me ka maʻi puʻuwai puʻuwai a me ka sarcoidosis cardiac.
• ʻO kekahi mau maʻi, e like me ka maʻi Lyme.
• ʻOki kino puʻuwai.

Hiki paha iā ʻoe ke poloka puʻuwai no ka mea ua hānau ʻia ʻoe me ia. Ua makaʻu ʻoe no kēia inā:

• He kīnā kou naʻau.
• He maʻi autoimmune kou makuahine, e like me ka lupus.

ʻO kekahi poʻe maʻamau, e loaʻa i kahi poloka kekelē mua ma ka hoʻomaha a i ka hiamoe paha. Kū pinepine kēia i nā poʻe olakino ʻōpio.

E kamaʻilio me kāu mea mālama ola e pili ana i kāu mau hōʻailona. Okoa paha nā ʻōuli no ka poloka puʻuwai o ka puʻuwai mua, ʻelua, a me ke kolu.

ʻAʻohe ou hōʻailona paha no ka poloka puʻuwai mua. ʻAʻole paha ʻoe e ʻike he poloka kou naʻau a hiki i kona hōʻike ʻana ma kahi hōʻike i kapa ʻia he electrocardiogram (ECG).

Inā loaʻa iā ʻoe ka lua-kekelē a i ʻole kekelē-koloka poloka puʻuwai, e hoʻopili ʻia nā ʻōuli:

• ʻEha ʻeha.
• Puʻupuʻu.
• Maule paha a maule paha.
• Ka luhi.
• Nā palpitations puʻuwai - Palpitations ke manaʻo kou puʻuwai e like me ke kuʻi ʻana, ke kuʻi pinepine ʻana, a ke heihei paha.

E hoʻouna paha kāu mea hāʻawi iā ʻoe i ke kauka puʻuwai (cardiologist) e nānā a loiloi hou paha i ka poloka puʻuwai.

E kamaʻilio pū ka mea kauka lāʻau iā ʻoe e pili ana i kāu mōʻaukala olakino a me nā lāʻau āu e lawe nei. E hana pū ka mea cardiologist:

• Hana i kahi hōʻike kino piha. E nānā ka mea hāʻawi iā ʻoe no nā hōʻailona o ka holo pono ʻole o ka naʻau, e like me nā kuʻekuʻe a me nā wāwae i pehu.
• Hana i kahi hoʻokolohua ECG e nānā i nā hōʻailona uila i kou puʻuwai.
• Pono ʻoe e komo i kahi mākaʻi puʻuwai no 24 a 48 mau hola a ʻoi aku paha ka lōʻihi e nānā i nā hōʻailona uila i kou puʻuwai.

ʻO ka mālama ʻana no ka poloka puʻuwai e pili ana i ke ʻano o ka poloka puʻuwai āu i loaʻa ai a me ke kumu.

Inā ʻaʻohe ou ʻōuli koʻikoʻi a ʻano palupalu kou naʻau, pono ʻoe e:

• E hoʻopaʻa i nā manawa maʻamau me kāu mea hāʻawi.
• E aʻo pehea e nānā ai i kāu pulse.
• E makaʻala i kāu mau hōʻailona a ʻike i ka manawa hea e kāhea ai i kāu mea hāʻawi inā loli nā ʻōuli.

Inā loaʻa iā ʻoe ka lua-a i ʻole kolu o ka poloka puʻuwai, pono ʻoe i kahi pacemaker e kōkua i kou puʻuwai e hoʻokau pinepine.

• ʻOi aku ka liʻiliʻi o ka pacemaker ma mua o ka papa o nā kāleka a liʻiliʻi paha e like me ka wrist. Hoʻokomo ʻia i loko o ka ʻili ma kou umauma. Hāʻawi ia i nā hōʻailona uila e hoʻokuʻi i kou puʻuwai i ka manawa maʻamau a me ka lepe.
• Heʻuʻuku loa kahi ʻano hou o ka pacemaker (e pili ana i ka nui o 2 a i 3 mau pila capsule)
• I kekahi manawa, inā e manaʻo ʻia ka poloka puʻuwai e hoʻonā i kahi lā a ʻoi paha, e hoʻohana ʻia kahi mea hoʻāla wā ʻole. ʻAʻole hoʻokomo ʻia kēia ʻano hāmeʻa i ke kino. Ma kahi o kahi uea e hoʻokomo ʻia ai ma o ka aa a kuhikuhi ʻia i ka puʻuwai a pili i ka pacemaker. Hiki ke hoʻohana ʻia kahi pacemaker manawa pōkole i kahi pilikia ma mua o ka hoʻokomo ʻia ʻana o kahi pacemaker paʻa. Nānā ʻia ka poʻe me ka mea mālama i ka manawa ʻole i loko o kahi keʻena mālama nui i ka haukapila.
• ʻO ka puʻuwai puʻuwai i hoʻokumu ʻia e ka puʻuwai puʻuwai a i ʻole ke ʻoki puʻuwai e hele aku ke ola ʻoe.
• Inā kumu ka lāʻau i ka poloka puʻuwai, hiki i ka hoʻololi ʻana i nā lāʻau ke hoʻoponopono i ka pilikia. Mai kū a hoʻololi paha i ke ala āu e lawe ai i nā lāʻau āpau ke ʻōlelo ʻole kāu mea lawelawe iā ʻoe e hana pēlā.

Me ka nānā mau ʻana a me ka mālama ʻana, pono ʻoe e hoʻomau me ka hapa nui o kāu hana maʻamau.

Hiki i ka poloka puʻuwai ke hoʻonui i ka makaʻu no:

• Nā ʻano ʻē aʻe o nā pilikia puʻuwai puʻuwai (arrhythmia), e like me ka atrial fibrillation. E kamaʻilio i kāu mea hāʻawi e pili ana i nā ʻōuli o nā arrhythmia ʻē aʻe.
• Maʻi hohola.

Inā loaʻa kahi pacemaker, ʻaʻole hiki iā ʻoe ke kokoke i nā māla ikaika. Pono ʻoe e hōʻike i ka poʻe he pacemaker kāu.

• Mai hele i loko o ke keʻena palekana maʻamau ma kahi kahua mokulele, hale hoʻokolokolo, a i ʻole nā ​​wahi ʻē aʻe e koi ai i nā poʻe e hele wāwae i kahi kānana palekana. E haʻi i nā limahana palekana he pacemaker kāu a noi no kahi ʻano ʻē aʻe o ka loiloi palekana.
• MAI kiʻi i kahi MRI me ka ʻole e haʻi aku i ka ʻenehana MRI e pili ana i kāu pacemaker.

Kāhea i kāu mea hāʻawi inā manaʻo ʻoe:

• Puʻupuʻu
• Nāwaliwali
• Māloʻo
• Kuʻi ka puʻuwai puʻuwai
• Kuʻi ka naʻau
• ʻEha ʻeha

Kāhea i kāu mea hāʻawi inā loaʻa nā hōʻailona o ka puʻuwai puʻuwai:

• Nawaliwali
• Nā wāwae wāwae, nā wāwae wāwae, a me nā wāwae paha
• Manaʻo pōkole o ka hanu

AV Poloka; Arrhythmia; Poloka puʻuwai kekelē ʻekahi; Poloka naʻau degere ʻelua; Mobitz ʻano 1; Palaka ʻo Wenckebach; Mobitz ʻano II; Poloka naʻau degere ʻekolu; Pacemaker - poloka puʻuwai

Kusumoto FM, Schoenfeld MH, Barrett C, Edgerton JR, et al. ʻO 2018 ACC / AHA / HRS alakaʻi ma ka loiloi a me ka hoʻokele ʻana o nā mea maʻi me ka bradycardia a me ka lohi o ka hoʻoiho ʻana o ka naʻau. Kaapuni. 2018: CIR0000000000000628. PMID: 30586772 www.ncbi.nlm.nih.gov/pubmed/30586772.

ʻO Olgin JE, ʻo Zipe DP. Bradyarrhythmias a me atrioventricular poloka. I: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. ʻO ka maʻi puʻuwai ʻo Braunwald: He puke aʻo no ka lāʻau Cardiovascular. 11th hua. Piladelapia, PA: Elsevier; 2019: chap 40.

CD Swerdlow, Wang PJ, Zipe DP. Pacemakers a me implantable cardioverter-defibrillators. I: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. ʻO ka maʻi puʻuwai ʻo Braunwald: He puke aʻo no ka lāʻau Cardiovascular. 11th hua. Piladelapia, PA: Elsevier; 2019: chap 41.