labarai

Tare da tsufa na yawan jama'a da ci gaba da ganewar cututtukan zuciya da jiyya, ciwon zuciya na yau da kullum (rashin zuciya) shine kawai cututtukan zuciya da ke karuwa da yawa.Yawan masu fama da ciwon zuciya na kasar Sin a shekarar 2021 kimanin miliyan 13.7, ana sa ran za su kai miliyan 16.14 nan da shekarar 2030, mutuwar zuciya za ta kai miliyan 1.934.

Rashin gazawar zuciya da fibrillation (AF) sukan kasance tare.Har zuwa 50% na sababbin marasa lafiya marasa lafiya suna da fibrillation na atrial;Daga cikin sababbin lokuta na fibrillation atrial, kusan kashi ɗaya bisa uku suna da gazawar zuciya.Yana da wuya a bambance tsakanin sanadi da sakamakon ciwon zuciya da ciwon zuciya, amma a cikin marasa lafiya da ciwon zuciya da ciwon zuciya, bincike da yawa sun nuna cewa catheter ablation yana rage haɗarin duk abin da ke haifar da mutuwa da ciwon zuciya.Duk da haka, babu ɗayan waɗannan binciken da ya haɗa da marasa lafiya tare da ciwon zuciya na ƙarshen zamani tare da ciwon zuciya, kuma ƙa'idodin kwanan nan game da raunin zuciya da ablation sun haɗa da ablation a matsayin shawarwarin Class II ga marasa lafiya tare da kowane nau'i na fibrillation na zuciya da kuma rage raguwar ejection, yayin da amiodarone shine shawarar Class I

Nazarin CASTLE-AF, wanda aka buga a cikin 2018, ya nuna cewa ga marasa lafiya tare da fibrillation na atrial hade da gazawar zuciya, catheter ablation ya rage haɗarin duk abin da ke haifar da mutuwa da bugun zuciya idan aka kwatanta da magani.Bugu da kari, da yawan karatu sun kuma tabbatar da amfanin catheter ablation a inganta bayyanar cututtuka, juyar da gyare-gyaren zuciya, da kuma rage atrial fibrillation load.Duk da haka, marasa lafiya tare da fibrillation na atrial hade tare da raunin zuciya na ƙarshe sau da yawa ana cire su daga yawan binciken.Ga waɗannan marasa lafiya, ƙayyadaddun ƙayyadaddun lokaci don dashen zuciya ko dasa na'urar taimako na ventricular hagu (LVAD) yana da tasiri, amma har yanzu akwai rashin shaidar shaidar likita game da ko zubar da catheter zai iya rage mutuwa da jinkirta ƙaddamarwar LVAD yayin jiran zuciya. dashi.

Binciken CASTLE-HTx cibiya ce ta tsakiya, buɗaɗɗen lakabin, mai bincike-wanda aka ƙaddamar da gwajin sarrafawa mai inganci.An gudanar da binciken ne a Herz-und Diabeteszentrum Nordrhein-Westfale, cibiyar da ke dashen zuciya a Jamus wanda ke yin dashe kusan 80 a shekara.Jimillar marasa lafiya 194 tare da raunin zuciya na ƙarshen zamani tare da alamar fibrillation mai alamun alamun da aka kimanta don cancanta don dashen zuciya ko shigar da LVAD daga Nuwamba 2020 zuwa Mayu 2022. Duk marasa lafiya suna da na'urori na zuciya da za a iya dasa su tare da ci gaba da lura da bugun zuciya.Duk marasa lafiya an bazu a cikin rabo na 1: 1 don karɓar ablation na catheter da magani na jagora ko don karɓar magani kaɗai.Maƙasudin ƙarshe na farko shine haɗaɗɗiyar sanadin mutuwa, dasa LVAD, ko dashen zuciya na gaggawa.Ƙarshen ƙarshe na biyu sun haɗa da duk-mutuwar mutuwa, LVAD implantation, gaggawa gaggawa na zuciya, mutuwar zuciya da jijiyoyin jini, da kuma canje-canje a cikin ɓarna na ventricular ejection juzu'i (LVEF) da nauyin fibrillation na atrial a 6 da 12 watanni na biyo baya.

A cikin Mayu 2023 (shekara daya bayan rajista), Kwamitin Kula da Bayanai da Tsaro ya gano a cikin wani bincike na wucin gadi cewa abubuwan da suka faru na farko a tsakanin ƙungiyoyin biyu sun bambanta sosai kuma sun fi yadda ake tsammani, cewa rukunin catheter ya kasance mafi inganci kuma yana bin bin doka. Dokar Haybittle-Peto, kuma ya ba da shawarar dakatar da tsarin maganin da aka tsara a cikin binciken.Masu binciken sun karɓi shawarar kwamitin don gyara ƙa'idar binciken don rarraba bayanan biyo baya don farkon ƙarshen Mayu 15, 2023.

Ciwon zuciya da LVAD dasawa suna da mahimmanci don inganta yanayin marasa lafiya tare da raunin zuciya na ƙarshen zamani tare da fibrillation na atrial, duk da haka, ƙayyadaddun albarkatun mai ba da gudummawa da sauran abubuwan da ke iyakance aikace-aikacen su mai yawa har zuwa wani lokaci.Yayin jiran dashen zuciya da LVAD, menene kuma zamu iya yi don rage ci gaban cutar kafin mutuwa ta fara?Binciken CASTLE-HTx babu shakka yana da ma'ana mai girma.Ba wai kawai yana ƙara tabbatar da fa'idodin ablation na catheter ga marasa lafiya tare da AF na musamman ba, har ma yana ba da kyakkyawar hanyar samun dama ga marasa lafiya tare da raunin zuciya na ƙarshen zamani mai rikitarwa tare da AF.