Eminyakeni yakamuva, amawashi ahlakaniphile Bathathe isinyathelo kusukela ekubaleni izinyathelo kuya ekuqapheni inhliziyo eduzekuze kube sezingeni lokuba yingxoxo yezokwelapha mayelana nokuvimbela inhliziyo nemithambo yegazi. I-Atrial fibrillation, enye yezinkinga ezivame kakhulu ze-arrhythmias futhi ehlotshaniswa nohlangothi olubi kakhulu, isibe yimbangela yale mpikiswano.
Okusha Ukuhlolwa kwezokwelapha okwenziwe emhlabeni wangempela yi-Amsterdam UMC futhi kwanyatheliswa kumagazini we-JACC Lokhu kusikisela ukuthi i-Apple Watch ingadlala indima ebalulekile ekutholakaleni kwalesi sifo sokuqina kwemisipha, ikakhulukazi kubantu abadala kanye nalabo abanengozi ephezulu yemithambo yegazi, okuyisimo esivame kakhulu ezinhlelweni zezempilo zaseSpain naseYurophu.
Ukuhlolwa kwezokwelapha kwaseYurophu okunabantu abangu-437 abaneminyaka engaphezu kwengu-65 ubudala
Umsebenzi waklanywa njenge- isivivinyo somtholampilo esingahleliwe ngaphansi kwezimo zangempelaKunokuba yilabhorethri futhi kuseduze nalokho okwenzekayo ekuhlolweni kokunakekelwa okuyisisekelo noma kwezenhliziyo, abacwaningi baseDashi baqashe abantu abangu-437 abaneminyaka engu-65 nangaphezulu, bonke ababesengozini enkulu yokushaywa unhlangothi.
Abahlanganyeli bahlukaniswe ngamaqembu amabili: Abantu abangu-219 bathole i-Apple Watch futhi bacelwa ukuba bayigqoke cishe amahora angu-12 ngosuku.kanti abanye abangu-218 baqhubeka nokunakekelwa kwempilo okujwayelekile, ngokusekelwe ekuvakasheni okuhleliwe, ukubonisana lapho kudingeka kanye nokuhlolwa kwenhliziyo ngezikhathi ezithile.
Ukulandelela kwaqhubeka isikhathi eside izinyanga eziyisithupha ezigcwelePhakathi naleso sikhathi, iqembu elalinamawashi laliqapha cishe njalo ukushaya kwenhliziyo kanye nokushaya kwenhliziyo kusukela esihlakaleni, njengoba kuchaziwe. Ungakukala kanjani ukushaya kwenhliziyo yakho nge-Apple Watchkuyilapho iqembu lokulawula lithembele kuma-electrocardiogram kanye nama-scan enziwa ngendlela evamile lapho kuvela izimpawu noma kuhlelwa ukuhlolwa.
Ababhali baphawula ukuthi lolu cwaningo lune- usayizi wesampula omaphakathi kanye nobudala obumaphakathi obuseduze neminyaka engu-75Ngakho-ke, iziphetho zabo zibaluleke kakhulu kubantu asebekhulile kanye nalabo abasengozini enkulu yemithambo yegazi. Eqenjini elihlukile, izibalo zingahluka, yize izitayela ezijwayelekile kulindeleke ukuthi zihlale zifana.
Kutholakale i-fibrillation ye-atrial ephindwe kane nge-Apple Watch
Ngemva kwezinyanga eziyisithupha zokulandelela, imiphumela yadonsa ukunaka komphakathi wezifo zenhliziyo: eqenjini elalisebenzisa i-Apple Watch, kutholakale ukuthi i-fibrillation ye-atrial noma ezinye izimo ama-arrhythmia afanele ezigulini ezingu-21kuyilapho eqenjini elinokunakekelwa okuvamile kutholakale amacala amahlanu kuphela.
Njengoba ihunyushwe yaba amaphesenti, iqembu elihlonyiswe nge-Apple Watch lafinyelela ku- izinga lokutholwa lisondele ku-9,6%uma kuqhathaniswa cishe no-2,3% eqenjini lokulawula. Lo mehluko wawubalulekile ngokwezibalo futhi usekela umqondo wokuthi Ukuqapha isikhathi eside okusekelwe esihlakaleni kwembula amacala amaningi engeziwe kunokuhlolwa okuvamile.
Kukhona idatha eyodwa ebaluleke kakhulu ekusebenzeni kwezokwelapha: kokuxilonga okungu-21 eqenjini elinewashi, nxazonke Ama-57% ahambelana nabantu abangenazo izimpawuLezi kwakuyiziguli ezazizizwa kahle, zingenazo izinhliziyo ezibuhlungu noma ukungakhululeki okusobala, futhi ezazingeke zifune usizo lwezokwelapha ngokwazo.
Eqenjini lokunakekelwa okujwayelekile isimo sasihluke kakhulu: abantu abahlanu abatholakale benalesi sifo Yebo, baveze izimpawu ezisobalaLokhu kugcizelela ukuthi, ngaphandle kokuqapha okuqhubekayo, kuvamile ukuthi kutholakale amacala asobala kakhulu kuphela, kuyilapho lawo angakhulumi engabonwa.
Kungani i-atrial fibrillation iphunyuka ekulawuleni okuvamile
I-arrhythmia okugxilwe kuyo kulolu hlobo locwaningo yi- i-fibrillation ye-atrialIsifo esivame kakhulu sokusebenza kwenhliziyo kubantu abadala. Kulesi simo, i-atria iyayeka ukufinyela ngendlela ehlelekile bese iqala ukuhamba ngokushesha nangokungahlelekile, ikhiqize ukushaya kwenhliziyo okungajwayelekile futhi okuvame ukushesha.
Odokotela benhliziyo bachaza ukuthi ingaphakathi le-atrium linayo imigoqo, imiphetho, kanye namaphakethe amancane lapho igazi lingahlala khonaUma udonga lwe-atrial luqhaqhazela kuphela futhi lungaphampi igazi ngempumelelo, ingozi yokwakheka kwamahlule egazi iyanda. Uma elinye lala mahlule lihamba liye ebuchosheni futhi livimbe umthambo, lingabangela isifo sohlangothi.
Imiphakathi yesayensi yaseYurophu neyaseMelika isikhumbuza ukuthi i-atrial fibrillation ingenza phinda ingozi yokushaywa yisifo sohlangothi ngamaphuzu amahlanuInkinga iwukuthi kuvame ukwenzeka ngezikhathi ezithile futhi, kumaphesenti amaningi eziguli, ngaphandle kwezimpawu ezicacile, noma ngokungakhululeki okungacacile kangangokuthi kubangelwa ubudala, ukucindezeleka, noma ukuntuleka kokuqina komzimba.
Uma umuntu ehlolwa i-electrocardiogram evamile ngokubonisana, uchwepheshe unokufinyelela kuphela ku- "isithombe" semizuzwana embalwa isigqi senhliziyo. Uma inhliziyo ishaya ngendlela evamile ngaleso sikhathi, ukuqoshwa kuzoba okulungile noma ngabe isiguli sihlushwa yiziqephu ze-atrial fibrillation ngezikhathi ezithile zosuku noma ebusuku; ngakho-ke, kuyalulekwa ukwengeza ukuqoshwa ngeziqondiso mayelana Indlela yokuthatha i-electrocardiogram nge-Apple Watch lapho kufaneleka khona.
Lokhu kuchaza ukuthi kungani, naphezu kokuhlolwa njalo, Iziguli eziningi azitholakali kuze kube yilapho kuvela inkinga. Kungaba njengokushaya kwenhliziyo. Yilapho kanye amadivayisi akwazi ukurekhoda i-pulse njalo amahora nezinsuku ngesikhathi angenza umehluko, yize kufanelekile ukukhumbula ukuthi imodi yamandla aphansi ingathinta lelo khono, njengoba ukuhlaziya ku-[okungacaci] kubonisa. imisebenzi ethintwa yimodi yamandla aphansi.
I-Apple Watch: I-PPG, i-ECG, kanye nokuqapha okuqhubekayo okusekelwe esihlakaleni
Ukuzibophezela kwe-Apple empilweni yenhliziyo kuthathe igxathu elikhulu ngo-2018 ngokufika kwe- I-Apple WatchSeries 4Imodeli yokuqala yokuhlanganisa uhlelo lokusebenza lwe-electrocardiogram (ECG) kanye nezaziso ze-heart rhythm ezingajwayelekile. Kusukela ngaleso sikhathi, kuye kwaqongelela amacala amaningi abantu abaxwayiswa yiwashi ngenkinga eyaqinisekiswa kamuva ehhovisi likadokotela.
Idivayisi ihlanganisa ubuchwepheshe obubili ngokuyinhloko: I-Photoplethysmography (PPG) kanye ne-ECG ene-lead eyodwaI-PPG isebenzisa inzwa yokukhanya ngemuva kwewashi ukuze ilinganise njalo izinga lokushaya kwenhliziyo futhi ithole amaphethini okushaya kwenhliziyo angalingani nesigqi esijwayelekile; indlela i-ECG esebenza ngayo eSpain ichazwa ezihlokweni ezifana nalezi Iwashi le-Apple le-ECG eSpain.
Uma i-algorithm ibona ukungalingani okuphindaphindiwe, iwashi lingakha isaziso sesigqi esingajwayelekile esingaba khonaNgakolunye uhlangothi, umsebenzi we-ECG uvumela umsebenzisi ukuthola ukuqoshwa okulula ngokubeka umunwe emqheleni wedijithali imizuzwana embalwa; lokhu kulandelela, yize kungaphelele njenge-electrocardiogram yezokwelapha enama-lead angu-12, kuyasiza ekuboneni i-fibrillation ye-atrial ezimweni eziningi.
Uma kuqhathaniswa nezinhlelo zokuqapha zendabuko, njengeziqaphi ze-Holter ezine ama-electrode okunamathelayo kanye nedivayisi yangaphandle enkulu Ngokungafani neziqaphi zokushaya kwenhliziyo ezifakwayo, amawashi ahlakaniphile anenzuzo yokuhlanganiswa nokuphila kwansuku zonke ngaphandle kokuphazamiseka okuningi. Iningi labasebenzisi liwagqoka amahora amaningi ngosuku ngaphandle kokucabanga kakhulu ngakho, okuyinto kwandisa kakhulu amathuba "okubamba" isiqephu esingahleliwe.
Abacwaningi base-Amsterdam UMC bagcizelela ukuthi amadivayisi akwazi ukuqopha ukushaya kwenhliziyo kanye nomsebenzi kagesi wenhliziyo asevele ekhona, kodwa Bekunokuntuleka kwezifundo eziqinile ezindaweni zangempela ezihlole ukusebenza kwayo njengethuluzi lokuhlola. ezixukwini ezisengozini enkulu. Lolu cwaningo luhlose ukugcwalisa ingxenye yalelo gebe ngedatha elinganisekayo.
Ukuxilongwa okwengeziwe… kanye nenani elikhulu lezinto ezingelona iqiniso
Ngaphandle komehluko ocacile enanini lamacala aqinisekisiwe, ukuhlaziywa okuningiliziwe komsebenzi kukhombisa ukuthi i-Apple Watch Akuyona ithuluzi elipheleleCishe ingxenye yezexwayiso ezikhiqizwe yiwashi ngesikhathi sokuqapha kwavela ukuthi ziyiziphazamiso ezingamanga, okungukuthi, izexwayiso zesigqi esingajwayelekile ezathi kamuva azaqinisekiswa njenge-atrial fibrillation noma enye i-arrhythmia ebalulekile emtholampilo.
Ngokombono wezempilo, lokhu kusho ukuthi umthwalo womsebenzi owengeziwe wokubonisana kanye nokuhlolwa okwengeziwe ukucacisa ukuthi ngabe kunenkinga yangempela noma cha. Kungabangela ukukhathazeka kwabanye abasebenzisi, okuthi, lapho bethola isexwayiso senhliziyo ewashini labo, ngokwemvelo bakhathazeke futhi baxhumane nodokotela wabo; kulezi zimo, kuyasiza ukukhumbula iziqondiso kanye Amathiphu e-Apple Watch ezisiza ekuchazeni izexwayiso.
Kodwa-ke, ochwepheshe baveza ukuthi ngale kwalokhu kukhathazeka okungenzeka kanye nesikhathi esichithwa ukususa i-pathology, Akukho miphumela emibi eqondile ehlobene nezixwayiso ebonwe.Ngokwezobuchwepheshe, ubuchwepheshe buyathuthuka ekuzweleni — buthola amacala amaningi angaba khona — kodwa bulahlekelwa ukucaca okuthile.
Ezinhlelweni zokunakekelwa kwempilo ezinesidingo esikhulu, njengoba kunjalo engxenyeni enkulu yaseYurophu kanye nasesimisweni sokunakekelwa kwempilo somphakathi saseSpain, lesi simo sivula impikiswano mayelana nokuthi kanjani Hlanganisa izaziso ezivela kuma-smartwatches ngendlela ehlelekile kumasekethe okuhamba nge-bypass kanye nokuxilonga, ukugwema kokubili ukugcwala okungadingekile kanye nokwehliswa kwezixwayiso ezibalulekile.
Abalobi balolu cwaningo bagcizelela ukuthi, yize iwashi lingabona ngokunembile amaphethini ahambisana ne-atrial fibrillation, Ukuqinisekiswa kokuxilonga kufanele kwenziwe njalo endaweni yezokwelapha.ngamarekhodi ekhwalithi ephezulu kanye nokuhlolwa kobungcweti. Ngakho-ke i-Apple Watch ihloselwe njengohlelo lokuxwayisa kusenesikhathi, hhayi njengokufaka esikhundleni sokuxilongwa okusemthethweni.
Umthelela ongaba khona ezindlekweni zesifo sohlangothi kanye nokunakekelwa kwempilo eYurophu
Udokotela wenhliziyo UMichel Winter, e-Amsterdam UMC, ifingqa ububanzi bale miphumela ngokugqamisa ukuthi ukusetshenziswa kwamawashi ahlakaniphile ane-PPG kanye ne-ECG kusiza odokotela ukuthola ama-arrhythmia kubantu ababengazi nhlobo inkinga yabo, ukusheshisa inqubo yokuxilonga nokuvumela ukungenelela kwangaphambi kwesikhathi.
Uma i-atrial fibrillation iqinisekiswa, enye yezindlela eziyinhloko zokuvimbela isifo sohlangothi ukunqunywa kwemithi. ukwelashwa kwama-anticoagulant Ezigulini ezisengozini enkulu, i-anticoagulant isetshenziselwa ukunciphisa ukwakheka kwamahlule. Kodwa-ke, izifundo ezahlukahlukene zomhlaba wonke zibonisa ukuthi cishe ingxenye yalabo okufanele basebenzise ama-anticoagulant abawasebenzisi, ngokuvamile ngenxa yokungatholakali kokuxilongwa.
Uma abantu abaningi—kufaka phakathi iziguli ezingenazo izimpawu—bengatholakala ezigabeni zokuqala, ochwepheshe bangakwazi qala ukwelashwa kokuvimbela kusenesikhathi futhi kuncishiswe amathuba okuba nesifo sohlangothi esihlobene ne-atrial fibrillation. Inzuzo ingaba kabili: ikhwalithi yokuphila ethuthukisiwe yeziguli kanye ukuncishiswa kwezindleko ezihambisana nokulaliswa esibhedlela, imiphumela kanye nokuvuselelwaIzifundo kanye nokuhlaziywa kokuthi i-Apple Watch ingathonya kanjani ukuvimbela izehlakalo zenhliziyo nakho kuhlole lo mthelela wezomnotho kanye nowezokwelapha, njengoba kuxoxwe ngakho ezihlokweni ezikhuluma ukuvimbela ukuhlaselwa yinhliziyo.
UWinter ngokwakhe uveza ukuthi, emaqenjini akhethwe kakhulu, asengozini enkulu njengalawo afakiwe esivivinyweni, Ukuncipha kwezinkinga kunganciphisa izindleko zokuqala zewashi.Leli phuzu libaluleke kakhulu ezinhlelweni zezempilo zomphakathi njengezaseSpain, lapho noma yikuphi ukutshalwa kwezimali kwezobuchwepheshe kumele kuqinisekiswe umthelela wako empilweni nasekuzinzeni komnotho.
Kusho ukuthini lokhu kubasebenzisi eSpain nakwamanye amazwe aseYurophu?
Kubantu bonke, ikakhulukazi labo asebevele besebenzisa i-Apple Watch noma elinye iwashi elihlakaniphile elinokuqapha izinga lokushaya kwenhliziyo, umyalezo oyisisekelo ukuthi idivayisi ingaba yithuluzi elibalulekile. umsizi othakazelisayo wokuqapha izinga lokushaya kwenhliziyoKodwa-ke, akufanele kubhekwe njengokungena esikhundleni sokuhlolwa kwezokwelapha noma ukuhlolwa okunqunywe uchwepheshe.
Uma iwashi linikeza izixwayiso eziphindaphindwayo ngesigqi esingajwayelekile noma liqopha ukulandelwa kwe-ECG okungavamile, into efanelekile okufanele yenziwe. Xhumana nohlelo lwezempilo bese ucela ukuhlolwa okugcwele., esikhundleni sokuthembela ekuchazeni okunikezwa uhlelo lokusebenza ngokwalo, noma ngabe i-algorithm ithuthuke kangakanani.
Ngesikhathi esifanayo, kungcono ukugwema okuphambene nalokho: i-Apple Watch engenazo izexwayiso. Akuqinisekisi ngokuphelele ukuthi ayikho inkinga yenhliziyo.Ikakhulukazi uma uzwa ukushaya kwenhliziyo okukhulu, isiyezi, ukuphelelwa umoya, ubuhlungu besifuba, noma ukuquleka. Kulezi zimo, isincomo sisalokhu siwukuthi uthintane nochwepheshe wezempilo, kungakhathaliseki ukuthi isikrini sibonisani.
Imiphakathi yesayensi yaseYurophu isikhumbuza ukuthi lawa mawashi kufanele aqondwe njengalawo amathuluzi ahambisanayo ngaphakathi kwesu lokuvimbela inhliziyoUkusebenziseka kwazo kwangempela kuzoncika endleleni ezihlanganiswa ngayo ezindleleni zokunakekelwa, ukuqeqeshwa kochwepheshe neziguli, kanye nekhono lokuhlunga nokubeka phambili ulwazi ezilukhiqizayo.
Ngobufakazi obunikezwe yisilingo se-Amsterdam UMC kanye nezinye izifundo ezibuyekezwe ontanga, umqondo wokuthi i-Apple Watch kanye namadivayisi afanayo angadlala indima ebalulekile ku- ukutholwa kusenesikhathi kwe-atrial fibrillation kanye nokunciphisa ingozi yokushaywa yisifo sohlangothiLokhu kuyiqiniso ikakhulukazi kubantu asebekhulile nalabo abanezici eziyingozi. Kusazobonakala ukuthi lokhu kuzohumusha kanjani eziqondisweni zezokwelapha kanye nokuhleleka kokunakekelwa eSpain nakwamanye amazwe aseYurophu, kodwa zonke izinkomba zithi isihlakala siba yindawo entsha yokuqapha impilo yenhliziyo.
