Ke hoʻomaikaʻi nei i kāu Prognosis Atrial Fibrillation

Anter

• He aha ka wānana no kahi kanaka me AFib?
• He aha nā pilikia e hiki ke hana me AFib?
• Pehea e mālama ʻia ai ʻo AFib?
• Nā Lapaʻau
• Cardioversion
• Nā kaʻina hana
• Pehea e hiki ai iā ʻoe ke pale iā AFib?

He aha ka fibrillation atrial?

Aibrial fibrillation (AFib) kahi ʻano puʻuwai e hoʻonāukiuki i nā keʻena o luna o ka puʻuwai (ʻike ʻia ʻo atria).

Pale kēia haʻalulu i ka puʻuwai mai ka pauma ʻana me ka maikaʻi. ʻO ka maʻamau, hele ke koko mai kahi atrium a i ka ventricle (keena haʻahaʻa o ka puʻuwai), kahi e hoʻokahe ʻia ai i nā akehena a i ʻole ke koena o ke kino.

Ke kuʻi ke atrium ma kahi o ka paipa ʻana, hiki i ke kanaka ke manaʻo e like me ka flip-flop a i ʻole ka lele ʻana o ka puʻuwai. Pākuʻi paha ka naʻau me ka wikiwiki loa. Hōʻino paha lākou, pōkole o ka hanu, a nāwaliwali.

Ma waho aʻe o nā naʻau a me nā palpitations e hiki ke hele mai me AFib, ʻoi aku ka nui o ka makaʻu o ka poʻe no ka huehue koko. Ke pume pū ʻole ke koko, ʻo ke koko e kū i ka puʻuwai e ʻoi aku ka maʻalahi i ka ʻōpala.

Weliweli nā Clots no ka mea hiki iā lākou ke kumu i ka hahau. Wahi a ka American Heart Association, ua koho ʻia he 15 a 20 mau pākēneka o ka poʻe i loaʻa ka maʻi kīʻaha pū kekahi me AFib.

Loaʻa nā lāʻau a me nā lāʻau lapaʻau ʻē aʻe no nā poʻe me AFib. Kaohi ka hapa nui, ʻaʻole hoʻōla, i ke ʻano. Hiki i ka loaʻa ʻana o ka AFib ke hoʻonui i ka makaʻu o ke kanaka no ka holo pono ʻole o ka puʻuwai. Hiki i kāu kauka ke koi aku i kahi kauka lāʻau inā manaʻo ʻoe he AFib paha kāu.

He aha ka wānana no kahi kanaka me AFib?

Wahi a Johns Hopkins Medicine, ua koho ʻia he 2.7 miliona mau ʻAmelika ma AFib. ʻO ka hapaʻelima o nā poʻe āpau i loaʻa i ka maʻi kō kekahi me AFib lākou.

ʻO ka hapa nui o ka poʻe 65 a ʻoi paha o ka poʻe i loaʻa iā AFib ka lawe ʻana i nā lāʻau lapaʻau hōʻemi koko e hōʻemi i ka likelike o nā pilikia e like me ka hahau ʻana. Hoʻonui kēia i ka wānana holoʻokoʻa no ka poʻe me AFib.

Ke ʻimi nei i ka mālama ʻana a me ka mālama ʻana i nā kipa mau ʻana me kāu kauka hiki ke hoʻomaikaʻi maʻamau i kāu wānana ke loaʻa iā ʻoe ʻo AFib. Wahi a ka American Heart Association (AHA), 35 pākēneka o ka poʻe i loaʻa ʻole ka lāʻau no AFib e hele i ka maʻi hahau.

Hoʻomaopopo ka AHA i kahi ʻāpana o AFib i hana iki i ka make. Eia nō naʻe, hiki i kēia mau ʻāpana ke hāʻawi iā ʻoe i ka ʻike ʻana i nā pilikia ʻē aʻe, e like me ka hahau ʻana a me ka maikaʻi ʻole o ka puʻuwai, i hiki ai i ka make.

I ka pōkole, hiki i ka AFib ke hoʻopili i kou ola. Hōʻike ia i kahi hana maikaʻi ʻole i ka puʻuwai e pono e kamaʻilio ʻia. Eia nō naʻe, loaʻa nā lapaʻau he nui i hiki ke kōkua iā ʻoe e kaohi i kāu mau ʻōuli a hōʻemi i kou makaʻu no nā hanana nui, e like me ka hahau a me ka puʻuwai puʻuwai.

He aha nā pilikia e hiki ke hana me AFib?

ʻO nā pilikia mua ʻelua e pili ana iā AFib ka hahau a me ka hōʻeha puʻuwai. ʻO ka hoʻonui ʻia o ka makaʻu no ke kāpili ʻana i ke koko ke hopena i kahi haʻihaʻi haʻihaʻi mai kou puʻuwai a hele i kou lolo. ʻOi aku ka kiʻekiʻe o ka makaʻu no ka hahau inā loaʻa iā ʻoe kēia mau mea pilikia.

• diabetes
• puʻuwai puʻuwai
• kahe koko kiʻekiʻe
• moʻolelo o ka hahau ʻana

Inā loaʻa iā ʻoe ʻo AFib, e kamaʻilio me kāu kauka e pili ana i kāu pilikino no ka hōʻeha a me nā ʻanuʻu e hiki ai iā ʻoe ke hana e pale i ka hanana ʻana o kekahi.

ʻO ka maikaʻi ʻole o ka puʻuwai kahi pilikia maʻamau e pili pū ana me AFib. ʻO kou kuʻi puʻuwai a me ka puʻuwai ʻole ʻana o kou puʻuwai i kāna mele manawa maʻamau hiki ke hana i kou puʻuwai e hana ʻoi aku e pīpī i ke koko me ka maikaʻi.

Ma hope o ka manawa, hiki i kēia ke hopena i ka ʻole o ka puʻuwai. ʻO kēia ka paʻakikī o kou puʻuwai e kaapuni i ke koko e lawa ai nā makemake o kou kino.

Pehea e mālama ʻia ai ʻo AFib?

Loaʻa nā lapaʻau he nui no AFib, mai nā lāʻau a haʻi i ke ʻoki.

ʻO ka mea mua, he mea nui e hoʻoholo i ke kumu o kāu AFib. ʻO kahi laʻana, hiki i nā kūlana e like me ka apnea a me nā maʻi thyroid ke kumu iā AFib. Inā hiki i kāu kauka ke kauoha i nā lāʻau lapaʻau e hoʻoponopono i ka maʻi maʻi, hiki i kāu AFib ke hele i kahi hopena.

Nā Lapaʻau

Kau kauka paha i kau lāʻau e kōkua i ka puʻuwai e mālama i ka helu o ka puʻuwai maʻamau a me ke mele. ʻO nā laʻana me:

• amiodarone (Cordarone)
• digoxin (Lanoxin)
• dofetilide (Tikosyn)
• propafenone (Rythmol)
• sotalol (Betapace)

Kau kauka paha i ke kauka lāʻau hōʻemi koko e hōʻemi i kou makaʻu i ka hoʻomohala ʻana i kahi ʻōpala e hiki ai ke hōʻeha. ʻO nā laʻana o kēia mau lāʻau:

• apixaban (Eliquis)
• dabigatran (Pradaxa)
• rivaroxaban (Xarelto)
• edoxaban (Savaysa)
• warfarin (Coumadin, Jantoven)

ʻO nā lāʻau mua ʻehā i helu ʻia ma luna a kaulana pū kekahi me nā non-vitamin K oral anticoagulants (NOACs). Paipai ʻia nā NOAC ma luna o warfarin ke ʻole ʻoe he kaulike a paʻakikī i ka stenosis mitral a i ʻole ka pahu naʻau puʻuwai.

Hiki iā ʻoe ke kauka ke kauoha i nā lāʻau e cardiovert kūpono i kou puʻuwai (hoʻihoʻi i kou puʻuwai i ka mele maʻamau). Lawe ʻia kekahi o kēia mau lāʻau i loko o ke kino, ʻoiai lawe ʻia e kekahi e ka waha.

Inā hoʻomaka koke kou puʻuwai e hoʻokuʻi, hiki i kāu kauka ke ʻae iā ʻoe i ka haukapila a hiki i ka manawa e hiki ai i nā lāʻau ke hoʻopaʻa i ka helu o kou puʻuwai.

Cardioversion

ʻAʻole maopopo ke kumu o kāu AFib a pili paha i nā kūlana e hoʻonāwaliwali pono ai ka puʻuwai. Inā lawa kou olakino, hiki i kāu kauka ke koi aku i kahi kaʻina hana i kapa ʻia ka cardioversion uila. Hoʻopili kēia i ka hāʻawi ʻana i kahi haʻalulu uila i kou puʻuwai e hoʻonohonoho hou i kāna mele.

I loko o kēia kaʻina hana, hāʻawi ʻia ʻoe i nā lāʻau hōʻoluʻolu, no laila ʻaʻole ʻoe e ʻike i ka haʻalulu.

I kekahi mau hanana, e kau kauka i kāu lāʻau hoʻoliʻiliʻi koko a hana i kahi hana i kapa ʻia ʻo transesophageal echocardiogram (TEE) ma mua o ka cardioversion e hōʻoia i ka loaʻa ʻole o ke koko i kou puʻuwai e hiki ai i ka maʻi hahau.

Nā kaʻina hana

Inā ʻaʻole mālama ka cardioversion a i ʻole lawe i nā lāʻau i kāu AFib, hiki i kāu kauka ke koi aku i nā kaʻina hana ʻē aʻe. Hoʻopili paha lākou i kahi abheh catheter, kahi e wili ʻia ai kahi catheter ma o kahi aʻa i loko o ka pulima a i ʻole ka ʻūlū.

Hiki ke kuhikuhi i ka catheter i nā wahi o kou puʻuwai e hoʻopilikia nei i ka hana uila. Hiki i kāu kauka ke ablate, a luku paha, i ka wahi liʻiliʻi o nā mea kiko e hoʻopiʻi nei i nā hōʻailona kūlike ʻole.

ʻO kekahi hana i kapa ʻia ka hana maze hiki ke hana ʻia me ka ʻoki puʻuwai puʻuwai, e like me ka bypass puʻuwai a i ʻole ka pani pani. Hoʻopili kēia hana i ka hana ʻana i nāʻiʻo makaʻu i ka puʻuwai no laila ʻaʻole hiki i nā impulses uila maʻamau ke hoʻoili.

Koi aku paha ʻoe i kahi pacemaker e kōkua i kou puʻuwai e noho i ke mele. Hoʻokomo paha kāu mau kauka i kahi mea mālama i ka maʻi ma hope o ka hoʻopau ʻana o kahi node AV.

ʻO ka piko AV ka pacemaker nui o ka puʻuwai, akā hiki iā ia ke hoʻouna i nā hōʻailona kū ʻole ke loaʻa iā ʻoe ʻo AFib.

E hana ʻoe i kauka scar ma kahi o ka piko AV e pale ai i nā hōʻailona kū ʻole i ka lawe ʻia. A laila e hoʻokomo ʻo ia i ka pacemaker e hoʻouna i nā hōʻailona puʻuwai puʻuwai pololei.

Pehea e hiki ai iā ʻoe ke pale iā AFib?

Pono ka hoʻomaʻamaʻa ʻana i kahi nohona ola olakino ke loaʻa iā ʻoe ʻo AFib. ʻO nā kūlana e like me ke kiʻekiʻe o ke koko a me nā maʻi puʻuwai hiki ke hoʻonui i kou makaʻi no AFib. I ka pale ʻana i kou puʻuwai, hiki iā ʻoe ke pale i ke ʻano mai ka hanana ʻana.

Nā laʻana o nā ʻanuʻu hiki iā ʻoe ke hana e pale aku iā AFib:

• Kaohi ʻana i ka paka.
• ʻO ka ʻai ʻana i kahi papaʻai olakino naʻau i haʻahaʻa i ka momona momona, ka paʻakai, ka kolesterol, a me nā momona trans.
• ʻO ka ʻai ʻana i nā meaʻai i kiʻekiʻe i ka momona, me nā hua piha, nā mea kanu, nā huaʻai, a me nā waiū momona momona a me nā kumu protein.
• Ke komo nei i ka hana hoʻoikaika kino e kōkua iā ʻoe e mālama i kahi kaupaona olakino no kou nui a me kāu kino.
• Paipai ʻia ka lilo ʻana o ke kaupaona inā ʻoi nui kou kino i kēia manawa.
• Ke nānā mau nei i kou kaomi koko a ʻike i ke kauka inā ʻoi aku ia ma mua o 140/90.
• Ke pale nei i nā meaʻai a me nā hana i ʻike ʻia e hoʻomaka ai kāu AFib. ʻO nā laʻana me ka inu rama a me ka caffeine, ʻai ʻana i nā meaʻai i loaʻa ka monosodium glutamate (MSG), a me ka hoʻokomo ʻana i ka hoʻoikaika kino.

Hiki ke hāhai i kēia mau kaʻina āpau a pale ʻole iā AFib. Eia nō naʻe, kahi nohona olakino e hoʻomaikaʻi i kou olakino holoʻokoʻa a wānana inā loaʻa iā AFib.