Atrial Fibrillation: ʻIke, Heluhelu, a ʻO ʻoe

Anter

• Hoʻonui
• Nā kumu a me nā kumu pilikia
• Nā ʻōuli
• Nā pilikia
• Nā hoʻāʻo a me ka hōʻailona
• Lapaʻau
• Kāohi
• Nā kumukūʻai

ʻO ka fibrillation Atrial, i kapa ʻia ʻo AFib a i ʻole AF, kahi puʻuwai puʻuwai kūwaho ʻole (arrhythmia) i hiki ke alakaʻi i nā pilikia pili i ka puʻuwai e like me ke koko, hahau, a me ka puʻuwai puʻuwai.

He kūlana koʻikoʻi ʻo AFib e hiki ke hana me ka ʻole o nā hōʻailona a i ʻole nā ​​hōʻailona akā hiki ke hopena i nā pilikia hoʻoweliweli ke ola inā haʻalele ʻole ʻia.

ʻO ka hoʻohaʻahaʻa maʻamau o nā olonā o nā keʻena o luna o ka puʻuwai (ka atria) ʻae maʻamau no ka hoʻokaʻawale a hoʻopau piha ʻana o ke koko mai nā keʻena luna o ka puʻuwai i kāna mau haʻahaʻa (nā ventricle).

I ka AFib, eia nō naʻe, hoʻokae a wikiwiki paha nā hōʻailona uila e hana i ka atria me ka wikiwiki a me ka chaotically (fibrillate).

ʻO ke koko i hoʻokahe ʻole ʻia i waho o ka atria hiki ke noho a malū paha ma laila. I mea e hoʻonui ai i ka pono o ka puʻuwai a hōʻalo i nā ʻano maʻi like ʻole, pono e hana ʻo nā keʻena luna a me lalo o ka puʻuwai ma ke ʻano he kime. ʻAʻole hiki kēlā i ka wā o AFib.

Hiki paha ʻo AFib i nā hanana pōkole, a i ʻole he kūlana mau ia. I kekahi manawa, pono ke kōkua olakino pilikia. Eia ka mea e pono ai ʻoe e ʻike:

Hoʻonui

ʻO AFib ka arrhythmia maʻamau i ʻike ʻia i ka hana lapaʻau.

ʻO nā kuhi o ka hoʻolaha ʻana o AFib ma ʻAmelika Hui Pū ʻIa mai kahi kokoke. Ua manaʻo ʻia e piʻi aʻe kēlā helu i.

Ma ka honua holoʻokoʻa, ʻo ka helu i koho ʻia o nā kānaka me AFib i ka makahiki 2010 he 33.5 miliona, e like me kahi noi ma 2013. Ma kahi o 0.5 pākēneka o ko ka honua heluna.

Wahi a ka, ma kahi o 2 pākēneka o ka poʻe ma mua o 65 mau makahiki i loaʻa iā AFib, ʻoiai ma kahi o 9 ka pākēneka o nā makahiki 65 a ʻoi paha i loaʻa iā ia.

Wahi a a, ʻo ka poʻe ʻike ʻole i ke keʻokeʻo he prevalence haʻahaʻa a me nā hanana o ka loaʻa ʻana iā AFib.

Nā kumu a me nā kumu pilikia

ʻEhā ʻano nui o AFib.

ʻO ka fibrillation atrial paroxysmal ke hoʻomaka ʻo AFib me ka ʻole o ka ʻōlelo aʻoaʻo a kū like me ka emo ʻole. ʻO ka hapanui o ka manawa, holoi kēia ʻano o AFib iā ia iho i loko o 24 mau hola, akā hiki ke hala i hoʻokahi pule.

Ke hoʻolōʻihi ʻo AFib ma mua o hoʻokahi pule, kāhea ʻia hoʻomau ʻoia fibrillation.

ʻO AFib e mau ana ma mua o hoʻokahi makahiki me ka hele ʻole lōʻihi-paʻa paʻa atrial fibrillation.

Ua kāhea ʻia ʻo AFib e hoʻomau nei ʻoiai ʻo ka lapaʻau ʻana fibrillation atrial paʻa.

ʻO nā mea kūpono ʻole a hōʻino paha i ka hanana o ka puʻuwai ke kumu maʻamau o ka atrial fibrillation. E hoʻomohala paha ʻoe iā AFib inā ʻoe:

• kahe koko kiʻekiʻe
• maʻi puʻuwai coronary, kīnā o ka puʻuwai, a i ʻole kūleʻa puʻuwai
• maʻi maʻi rumatika a pericarditis paha
• hyperthyroidism
• momona
• diabetes a i ʻole metabolic syndrome
• maʻi maʻi a i ʻole maʻi maʻi ʻōpū
• ʻāpana moe
• kahi moʻolelo ʻohana o AFib

Hoʻopili pū ʻia ʻo AFib me ka hoʻonui ʻana o ka make i nā kānaka me nā ʻano maʻi puʻuwai ʻē aʻe a me nā kaʻina hana, me ka maikaʻi ʻole o ka puʻuwai a me ka hahau.

Hiki i nā lawena ke hoʻonui i ka makaʻu no AFib. Pākuʻi ʻia kēia i ka ʻai ʻana i ka caffeine a me ka hoʻohana hewa ʻana i ka ʻalekohola. ʻO nā pae kiʻekiʻe a i ʻole nā ​​kūlana olakino noʻonoʻo kekahi mea i loko o AFib.

Hoʻonui ka manawa o ka hoʻomohala ʻana iā AFib me ka makahiki. ʻO nā poʻe me AFib ma waena o nā makahiki o 65 a me 85. ʻOi aku ka nui o ka AFib i nā kāne. Eia nō naʻe, ʻoi aku ka lōʻihi o ka noho ʻana o nā wahine ma mua o nā kāne, ʻo ka helu nui o nā kāne a me nā wahine me AFib e like me ka like.

ʻOiai ʻo ka poʻe kūpuna o ʻEulopa i ka fibrillation atrial ma, ua ʻike ʻia ka noiʻi he nui o kāna mau pilikia - e like me ka hahau ʻana, ka maʻi puʻuwai, a me nā puʻuwai puʻuwai - ʻoi aku ka maʻamau i waena o ʻAmelika ʻAmelika.

Nā ʻōuli

ʻAʻole ʻoe e ʻike i nā ʻōuli o AFib i nā manawa āpau, akā ʻo kekahi mau hōʻailona maʻamau e pili pū me ka palpitations puʻuwai a me ka hanu liʻiliʻi.

Hiki i nā ʻōuli ʻē aʻe ke hoʻopili pū me:

• kuʻi naʻau kaulike ʻole
• lightheadedness a ʻūpā paha
• maʻule a huikau paha
• luhi loa
• hōʻoluʻolu umauma a ʻeha paha

Nā pilikia

Ke hoʻonui nei i ka ʻike e hoʻomaopopo pinepine ʻole ʻia ka atrial fibrillation akā he kūlana koʻikoʻi ia.

Inā loaʻa iā ʻoe nā hōʻailona a ʻaʻole paha, hāʻawi ʻo AFib iā ʻoe i ka makaʻu ʻoi loa o ka hahau. Wahi a ka American Heart Association, inā loaʻa iā ʻoe ʻo AFib, ʻoi aku kou manawa he 5 mau manawa i loaʻa i kahi hahau ma mua o ka mea i loaʻa ʻole iā ia.

Inā wikiwiki wikiwiki kou puʻuwai, hiki i ka hopena o ka puʻuwai. Hiki iā AFib ke hoʻoulu i ke koko i loko o kou puʻuwai. Hiki i kēia mau huʻa ke hele i loko o ke kahe o ke koko, a laila ka hopena i kahi paʻa.

Ua hōʻike ʻia kahi noiʻi ʻoi aku ka nui o ka makaʻu o nā wahine me AFib i ka hahau a me ka make ʻana ma mua o nā kāne me AFib.

Nā hoʻāʻo a me ka hōʻailona

ʻO ke kānana kahi ʻāpana o kāu mālama maʻamau inā 65 a ʻoi kou mau makahiki, a i ʻole inā he mau kumu ʻe aʻe kāu. Inā loaʻa iā ʻoe nā ʻōuli o AFib, e ʻike i kāu kauka.

Hoʻokomo paha ka hōʻoia diagnostics i kahi electrocardiogram (EKG a i ʻole ECG) e nānā i ka hana uila o kou puʻuwai. ʻO kekahi hōʻike ʻē aʻe e kōkua paha ka Holter monitor, kahi ECG lawe hiki ke nānā i kāu mele puʻuwai no kekahi mau lā.

ʻO kahi echocardiogram kahi hōʻike noninvasive ʻē aʻe hiki ke hana i nā kiʻi o kou puʻuwai, i hiki i kāu kauka ke nānā no nā mea kūpono ʻole.

Hiki paha i kāu kauka ke kauoha i nā hoʻāʻo ʻana i ke koko e nānā no nā ʻano kumu e hōʻike ana i kāu mau ʻōuli, e like me nā pilikia thyroid. Hiki i kahi X-ray umauma ke hāʻawi i kāu kauka i kahi nānā ʻoi aku i kou puʻuwai a me nā māmā e ʻike ai inā aia kekahi kumu maopopo no kāu mau ʻōuli.

Lapaʻau

Mālama ʻia ʻo AFib me nā loli nohona, nā lāʻau lapaʻau, nā kaʻina hana, a me nā ʻoki kino e kōkua ai i ka pale ʻana i ke koko, hoʻolohi i ka puʻuwai, a i ʻole hoʻihoʻi i ka leʻa maʻamau o ka puʻuwai.

Inā loaʻa iā ʻoe ka fibrillation atrial, e ʻimi pū kāu kauka no nā maʻi e hiki ke kumu iā ia a loiloi i kou makaʻu i ka hoʻomohala ʻana i nā clots koko weliweli.

Hiki i ka mālama ʻana iā AFib ke hoʻopili pū i:

• nā lāʻau e kāohi ai i ka puʻuwai a me ka helu
• ʻo ka lāʻau hoʻomāliʻi ʻana i ke koko e pale ai i nā kahe koko mai ka hana ʻana a hoʻemi i ka weliweli o ka hahau
• ʻoki kino
• loli ka nohona olakino e hoʻokele i nā kumu pilikia

Hiki i nā lāʻau ʻē aʻe ke kōkua i ka hoʻonui ʻana i ka helu o kou puʻuwai. Pākuʻi ʻia kēia mau beta blockers (metoprolol, atenolol), blockers calcium (diltiazem, verapamil), a me digitalis (digoxin).

Inā ʻaʻole kūleʻa kēlā mau lāʻau, hiki i nā lāʻau ʻē aʻe ke kōkua i ka mālama ʻana i ka puʻuwai puʻuwai maʻamau. Pono kēia mau lāʻau i ke ana pono a me ka nānā ʻana:

• amiodarone (Cordarone, Pacerone)
• dofetilide (Tikosyn)
• flecainide (Tambocor)
• ibutilide (Corvert)
• propafenone (Rythmol)
• sotalol (Betapace, Sorine)
• disopyramide (Norpace)
• procainamide (Procan, Procapan, Pronestyl)

Hiki i ka puʻuwai puʻuwai maʻamau ke hoʻihoʻi ʻia me ka hoʻohana ʻana i nā haʻalulu haʻahaʻa i loko o ke kaʻina hana i kapa ʻia ka cardioversion uila. Inā ʻaʻole holo pono kēlā, hiki i kāu kauka ke hoʻāʻo i kahi mea i kapa ʻia ʻo ablasi, kahi e hana ai i ka scarring ʻana a i ʻole ka luku ʻana i nā mea i loko o kou puʻuwai e hōʻino ai i nā hōʻailona uila hewa e hana ana i ka arrhythmia.

ʻO Atrioventricular node ablasi kahi koho ʻē aʻe. I kēia kaʻina hana, hoʻohana ʻia nā alapine radiowave e luku i kahi ʻāpana o nā meaola. I ka hana ʻana pēlā, ʻaʻole hiki i ka atria ke hoʻouna i nā impulses uila.

Mālama kahi pacemaker i nā ventricle e kuʻi maʻamau. ʻO ke keʻoki ʻana ʻo Maze kahi koho i mālama ʻia no nā poʻe e makemake ana i kahi ʻano o ka ʻoki puʻuwai. Hana ʻia nā ʻoki liʻiliʻi i ka atria i hiki ʻole ai i nā hōʻailona uila chaotic ke hele i loko.

Ma ke ʻano he ʻāpana o kāu lapaʻau ʻana, e aʻo ʻia ʻoe e mālama i ka papaʻai olakino naʻau. ʻO ka hoʻoikaika mau kahi mea nui o ke olakino puʻuwai, no laila e nīnau i kāu kauka i ka nui o ka hoʻoikaika kino iā ʻoe.

E ʻike mau i kāu kauka no ka mālama ʻana. E hōʻalo hoʻi ʻoe i ka puhipaka.

Kāohi

ʻAʻole hiki iā ʻoe ke pale aʻe iā AFib, akā aia kekahi mau mea hiki iā ʻoe ke hana e mālama i kou puʻuwai olakino.

E hooikaika e malama i kou koko, pae kolesterol, pae triglyceride, a me ke kaupaona ma waena o ka pae maʻamau.

Hōʻike ka ʻikepili i ka nui o ke kino a me ka momona o nā kānaka me ka AFib hōʻailona nāna i koho no ka pohō kaumaha a me ka mālama ʻana i nā mea pilikia weliweli i ʻoi aku ka liʻiliʻi o nā haukapila, cardioversions, a me nā kaʻina hana abatu ma mua o kā lākou mau hoa i hōʻole i ke kākau inoa ʻana.

Hiki ke hoʻololi i nā ʻano nohona ʻē aʻe i:

• ka mālama ʻana i ka papaʻai haʻahaʻa i ka kolesterol, nā momona momona, a me nā momona trans
• ka ʻai ʻana i nā mea kanu, nā huaʻai, a me nā hua nui
• ke kiʻi ʻana i ka hoʻoikaika kino i kēlā me kēia lā
• haʻalele i ka puhipaka
• inu waiona i ke kaulike
• e hōʻalo nei i ka caffeine inā hoʻomaka ia i kāu AFib
• ke lawe nei i kāu mau lāʻau āpau e like me ka lepili a i ʻole nā ​​kuhikuhi a kāu kauka
• ke noi nei i kāu kauka ma mua o ka hoʻohui ʻana i nā lāʻau a me nā mea hoʻopihapiha i kāu regimen
• hoʻonohonoho i nā kipa maʻamau me kāu kauka
• ka hōʻike ʻana i ka ʻeha o ka umauma, nā pilikia hanu, a i ʻole nā ​​hōʻailona ʻē aʻe i kāu kauka koke
• ka mālama ʻana a me ka mālama ʻana i nā kūlana olakino ʻē aʻe

Nā kumukūʻai

He kūlana pipiʻi ʻo AFib. ʻO ka nui o ke kumukūʻai no AFib ma United States i hōʻea ʻia ma kahi o $ 26 biliona kālā i kēlā me kēia makahiki.

Wāwahi ʻia, he $ 6 biliona kēia no ka mālama pono ʻana i ka mālama ʻana iā AFib, $ 9.9 biliona e mālama ai i nā maʻi puʻuwai puʻuwai ʻē aʻe a me nā kumu pilikia, a me $ 10.1 biliona e mālama ai i nā pilikia olakino noncardiovascular pili.

, ʻoi aku ka nui o nā haukapila 750,000 i kēlā me kēia makahiki ma muli o AFib. Hāʻawi pū ke ʻano i aneane 130,000 make i kēlā me kēia makahiki.

Hōʻike ka CDC i ka helu o ka make mai AFib ma ke ʻano kumu a i ʻole kumu kumu o ka make e piʻi ana ma mua o ʻelua mau makahiki.

ʻO kahi loiloi hou o nā maʻi Medicare ma waena o 1998 a 2014 i loaʻa i ka poʻe me ka fibrillation atrial e ʻoi aku ka nui o ka hopohopo (37.5 pakeneka vs. 17.5 pākēneka) a make paha i ka wā o ka haukapila (2.1 pākēneka vs. 0.1 pākēneka) ma mua o ka like poʻe me ka ʻole o AFib.