起搏器程控随访准备讲课用2015-3-18解答.pptVIP

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. Pacemaker wenchebach:起搏器文氏现象 如果此值较高，提示可能MTR（最大跟踪频率）过低 变时性功能不良 DUSISLOG n=105, BSC MV+XL A dual sensor combination and optimization provides an additional benefit only in a selected population with an advanced atrial chronotropic disease. ADEPT n=872, MDT MV+XL(?) Kappa 400 rate modulation is ineffective in improving the functional status or quality of life of patients LIFE n=1256, BSC MV+XL a BS programed empirically restores chronotropic response more favorably than an XL sensor programed nominally. APPROPRIATE: Assessment of Proper Physiologic Response with Rate Adaptive Pacing Driven by Minute Ventilation or Accelerometer evaluate the MV sensor compared with the XL sensor for superiority in improving functional capacity as measured by peak VO2 in pacemaker patients that are chronotropically incompetent N~1,000 RESET: The Restoration of Chronotropic CompEtence in Heart Failure PatientS with Normal Ejection FracTion assessing the effect of rate adaptive pacing on peak VO2 and quality of life in patients with symptomatic mild to moderate heart failure with preserved ejection fraction and chronotropic impairment N~400 J. of Cardiovasc. Trans. Res. 2011,4:21 J Card Fail. 2010,16:17 * 患者植入半年后入院随访，随访过程中发现在9月3号记录了2个心率失常事件 12:36分：A-tachy事件 12:39分：V-tachy事件 与患者沟通后，得知9月3号患者正在打麻将，突然发生一阵眩晕感觉 备注：Magnet：患者自己触发的心电图存储 ATR：模式转换 SBR：频率骤降反应 临床案例分析 打开EGM发现(快速心房事件) 频率增快，房室1:1下传 心房频率增快先于心室频率 房速 A通道 V通道