无导线心脏起搏讲课.ppt

无导线起搏器的不足之处 目前所有无导线起搏器均为心室单腔起搏VVI(R) ,或双室起搏( 左室仅有超声能量传输方式) ，尚无传统的DDD 起搏模式，这可能导致房室失同步的非生理性起搏增加 经体表无线能量传输的最大不足在于能量的损耗, 能量利用率仅有0.03% ～ 0.07% 无导线起搏器临床应用刚起步，缺乏足够的临床证据证实其长期应用的真正利弊，需要今后大规模的临床研究。 由于除颤电极与普通起搏电极的结构与工作机制差异较大，目前无导线起搏技术尚不能应用于除颤。不过，全皮下植入式心脏转复除颤器系统( S-ICD)目前已得到临床应用。 Performance Time and/or Effort (funds) 生物医学科技发展 起搏器发展的未来趋势---无导线起搏器总结 现有起搏器 无导线起搏 生物起搏 1:医生以及整个行业已经为无导线起搏器努力了超过40年 2:这一设想现在可以变为现实 3:厂家能够提供更加可靠，稳定的产品 4:无导线起搏器是可实现的 5:无导线起搏器的前景是光明的 明天会更好！ 谢谢 我们熟悉的起搏系统 * Many pacemaker complications are, in actuality, lead complications. Acute lead dislodgement occurs in between 2.2% and 3.7% of all pacemaker patients. This may show up as an abrupt rise in pacing threshold, loss of capture, or sensing failure. Lead dislodgement requires surgical revision to correct. This places a burden on patients and their families, the clinical team, and the healthcare system. It also exposes the patient to the risks of a second surgical procedure. Pneumothorax occurs in 1.6% to 2.6% of pacemaker patients as a result of lead implantation and may lead to respiratory distress. About 80% of patients with lead-related pneumothorax will require chest intubation. Lead perforation is relatively uncommon, occurring in less than 1% of patients, but it may lead to serious complications, including life-threatening cardiac tamponade. Venous thrombosis is surprisingly common and may occur in half of pacemaker patients. It is typically asymptomatic. However, venous thrombosis may result in a clogged or block vein in 1% to 3% of cases. A common complication with transvenous leads is the lead itself. In the past five years, from 2% to 4% of patients have encountered an improperly functioning lead. The lead may experience an insulation breach, a conductor fracture, or exhibit some other problem. Dealing with damaged leads can be difficult and often requires a surgical intervention. Pocket complications are also common. Hematomas occur frequently as a result of pocket formation but most do no