起搏器诊断与随访精要.ppt

* Phase II Sick Sinus Part II * The device looks for up to 10 seconds for a P-wave, then proceeds to look for up to 10sec for an R-wave. The 10 seconds test is over after one intrinsic event is measured baseline-to-peak that exceeds the programmed sensitivity. If a patient does not have intrinsic conduction within that 300ms interval, a P-wave value will be recorded and R-wave will display paced in (PDM) or N/R in (Insignia, PII, DII). Like the Vigor, if the test is repeated, (for example in VVI mode) in order to obtain an R-wave, the results from the second test will write over the initial P-wave. Phase II Sick Sinus Part II * With manual testing, the impedance test will report the Lead Impedance based on pacing amplitude and pulse width, current and energy at permanently programmed output settings for the leads in the pacemaker system. ?????will be displayed if measurements can’t be read or if A or V amplitude is programmed 5.5V. Output will need to be programmed to a lesser value in order to get a reading. With Daily Measurements, the Lead Impedance is done at 3.5V if programmed voltage is 3.5V, if pacing amplitude is between 3.6 5.0V the testing will be done at 5.0V, if amplitude is set at 5.1 – 6.5V the testing will be done at 6.5V. If the currently programmed pulse width is less than 0.4 msec, the pulse width will be set to 0.4 msec; otherwise, the pulse width for the test will be set to the currently programmed pulse width. This test is done in the triggered mode. This applies to both the commanded and automatic test (daily measurement tests). Pacing rate and Av Delay are not changed during this test. Measurement only occur in one chamber at a time. In the ventricle, triggered pacing will not occur on a PVC. “NR” is recorded if no impedance was measured. (The impedance is calculated by measuring the exponential droop from the leading edge of the pacing pulse to 0.35msec into the pacing pulse.) PDM family the impedance was measured at either 3.5, 5.0 or