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Ngokuguga kwabantu kunye nokuqhubela phambili kokuxilongwa kwesifo se-cardiovascular and treatment, ukungaphumeleli kwentliziyo engapheliyo (ukungaphumeleli kwentliziyo) kuphela kwesifo se-cardiovascular disease esandayo kunye nokuxhaphaka.Inani labantu baseTshayina bezigulane ezingapheliyo zentliziyo ngo-2021 malunga ne-13.7 yezigidi, kulindeleke ukuba bafikelele kwi-16.14 yezigidi nge-2030, ukufa kwentliziyo kuya kufikelela kwi-1.934 yezigidi.

Ukungaphumeleli kwentliziyo kunye ne-fibrillation ye-atrial (AF) ihlala ihlala kunye.Ukuya kuthi ga kwi-50% yezigulane ezitsha zentliziyo zine-fibrillation ye-atrial;Phakathi kweemeko ezintsha ze-atrial fibrillation, phantse isinye kwisithathu sinokusilela kwentliziyo.Kunzima ukwahlula phakathi kwesizathu kunye nomphumo wokungaphumeleli kwentliziyo kunye ne-fibrillation ye-atrial, kodwa kwizigulane ezine-heart failure kunye ne-fibrillation ye-atrial, izifundo ezininzi zibonise ukuba ukuchithwa kwe-catheter kunciphisa kakhulu umngcipheko wokufa kunye nokungaphumeleli kwentliziyo yokufunda.Nangona kunjalo, akukho nanye kwezi zifundo ezibandakanya izigulane ezinokuphelelwa yintliziyo ekupheleni kunye ne-fibrillation ye-atrial, kwaye izikhokelo zamva nje malunga nokungaphumeleli kwentliziyo kunye nokukhupha i-ablation ziquka ukukhutshwa njengencomo yeKlasi yesi-II kwizigulane ezinoluphi na uhlobo lwe-fibrillation ye-atrial kunye nokunciphisa iqhekeza le-ejection, kanti i-amiodarone yiNgcebiso yeKlasi

Uphononongo lwe-CASTLE-AF, olupapashwe ngo-2018, lubonise ukuba kwizigulana ezine-fibrillation ye-atrial edityaniswe nokusilela kwentliziyo, i-catheter ablation inciphise kakhulu umngcipheko wokufa okubangelwa yiyo yonke kunye nokusilela kwentliziyo xa kuthelekiswa namayeza.Ukongezelela, inani lezifundo liye laqinisekisa izibonelelo ze-catheter ablation ekuphuculeni iimpawu, ukubuyisela ukuguqulwa kwentliziyo, kunye nokunciphisa umthwalo we-fibrillation ye-atrial.Nangona kunjalo, izigulane ezine-fibrillation ye-atrial edityaniswe nenqanaba lokugqibela lokungaphumeleli kwentliziyo zihlala zingabandakanywa kubantu abafundayo.Kwezi zi gulane, ukuthunyelwa ngexesha elifanelekileyo lokutshintshwa kwentliziyo okanye ukufakelwa kwesixhobo sokuncedisa i-ventricular yasekhohlo (LVAD) siyasebenza, kodwa kusekho ukungabikho kobungqina bezonyango obusekelwe kubungqina bokuba i-catheter ablation inokunciphisa ukufa kunye nokulibazisa ukufakwa kwe-LVAD ngelixa ulinde intliziyo. utyando.

Uphononongo lwe-CASTLE-HTx yayiziko elilodwa, ileyibhile evulekileyo, umphandi-uqalise uvavanyo olulawulwa ngokungahleliwe olusebenzayo oluphezulu.Uphononongo lwaqhutywa kwi-Herz- und Diabeteszentrum Nordrhein-Westfale, iziko lokuthumela uqhaqho lwentliziyo eJamani elenza malunga nama-80 oqhaqho ngonyaka.Iyonke izigulane ze-194 ezinenqanaba lokugqibela lokungaphumeleli kwentliziyo kunye neempawu ze-atrial fibrillation eziye zavavanywa ukuba zifanelekile ukutshintshwa kwentliziyo okanye ukufakelwa kwe-LVAD zabhaliswa ukusuka ngoNovemba 2020 ukuya kuMeyi ka-2022.Zonke izigulane zaye zahlelwa ngokwe-1: umlinganiselo we-1 wokufumana i-catheter ablation kunye neyeza eliqondiswe kwisikhokelo okanye ukufumana iyeza kuphela.Isiphelo esiphambili sasiyinxalenye yesizathu sokufa, ukufakelwa kwe-LVAD, okanye ukutshintshwa kwentliziyo engxamisekileyo.Iziphelo zesekondari zibandakanya zonke-izizathu zokufa, ukufakelwa kwe-LVAD, ukutshintshwa kwentliziyo engxamisekileyo, ukufa kwe-cardiovascular death, kunye noshintsho kwi-left ventricular ejection fraction (LVEF) kunye nomthwalo we-fibrillation ye-atrial kwi-6 kunye ne-12 iinyanga zokulandelelana.

NgoMeyi 2023 (unyaka omnye emva kokubhaliswa), iKomiti yokuHlola iDatha kunye noKhuseleko ifunyenwe kuhlalutyo lwexeshana ukuba iziganeko eziphambili zokuphela phakathi kwamaqela amabini zihluke kakhulu kwaye zinkulu kunokuba zilindelwe, ukuba iqela lokukhupha i-catheter lisebenza ngakumbi kwaye lithobela Umthetho we-Haybittle-Peto, kwaye wandulula ukuyekwa ngokukhawuleza kwerejimeni yechiza emiselweyo kuphononongo.Abaphandi bamkele isindululo sekomiti sokuguqula iprothokholi yophononongo ukucutha idatha yokulandelela kwisiphelo sokuqala ngoMeyi 15, 2023.

Ukutshintshwa kwentliziyo kunye nokufakelwa kwe-LVAD kubalulekile ekuphuculeni i-prognosis yezigulane ezinokuphelelwa yintliziyo ekupheleni kunye ne-fibrillation ye-atrial, nangona kunjalo, izibonelelo ezinqamlekileyo zomnikeli kunye nezinye izinto zinciphisa ukusetyenziswa kwazo ngokubanzi kwinqanaba elithile.Ngelixa silindele ukufakelwa kwentliziyo kunye ne-LVAD, yintoni enye esinokuyenza ukucothisa ukuqhubeka kwesi sifo ngaphambi kokuba ukufa kuqalise?Uphononongo lwe-CASTLE-HTx ngokungathandabuzekiyo lubaluleke kakhulu.Ayiqinisekisi ngakumbi iingenelo ze-catheter ablation kwizigulana ezine-AF ekhethekileyo, kodwa ikwabonelela ngendlela ethembisayo yokufikeleleka okuphezulu kwizigulane ezinokusilela kwentliziyo yokugqibela ezintsonkothileyo nge-AF.