心律失常.ppt.ppt

Cardiac arrhythmia A cardiac arrhythmia is any abnormal heart rate or rhythm Tachycardia When conduction is normal and the rate is greater than 100bpm, then the rhythm is called sinus tachycardia. Bradycardia When conduction is normal and the rate is smaller than 60bpm, then the rhythm is called sinus bradycardia. Premature beats Premature Atrial Ectopics Premature Ventricular Ectopics Premature Junctional Premature Beat Atrial Ectopics The beat is caused by the premature contraction of a muscle within the atrial myocardium. 房性期前收缩 提前出现一个变异的P’波，QRS波一般不变形(室上性)，P’-R0.12s，代偿间歇常不完全。 Ventricular ectopics The beat is caused by the premature contraction of a muscle within the ventricular myocardium [maiEu5kB:diEm]n. 心肌( 层) 室性期前收缩 1. 提前出现的QRS-T波群，其前无相关P波； 2. 提前出现的QRS波形态异常，时限通常为0.12s或以上； 3. ST段、T波与QRS波群主波方向相反； 4. 期前收缩后可见一完全代偿间歇 Paroxysmal Tachycardia Supraventricular tachycardia Ventricular tachycardia 阵发性心动过速 阵发性心动过速(paroxysmal tachycardia)是一种阵发性快速而规律的异位心律，是由三个或三个以上连续发生的期前收缩形成，根据异位起搏点的部位，可分为房性、房室交界性和室性阵发性心动过速。由于房性与房室交界性阵发性心动过速在临床上常难以区别，故统称为室上性阵发性心动过速，简称室上速。 Supraventricular tachycardia Also termed atrial tachycardia, this is a normal morphology 【mC:5fClEdVi】 n.生物形tachycardia which is not driven by the SA node.The patient may feel dizzy,attack can last for a few beats or for many hours. 室上性：心率160-250次/分，节律规则 QRS波形态及时限正常 不容易辨认出P波 起止突然 Ventricular tachycardia Usually initiated by premature ventricular complexes 合成体ventricular tachycardia is continued by re-entry mechanisms. 室性：三个或三个以上连续并迅速出现的室性期前收缩 QRS波形态畸形，时限大于0.12秒，有继发ST-T改变，T波方向与QRS主波方向相反 心率140-220次/分，心律不规则 如出现P波，P波与QRS 波无关，出现房室分离现象 常可见到心室夺获或室性隔离波——是确诊室性心动过速的最重要依据 扑动与颤动 当自发性异位搏动的频率超过阵发性心动过速的范围时，形成扑动或颤动。根据异位搏动起源的部位不同，可分为心房扑动与颤动(atrial flutter and atrial fibrillation)；心室扑动与颤动(ventricular flutter and ventricular fibrillation)。心房颤动是仅次于期前收缩的常见心律失常，远较心房扑动多见。心室扑动与颤动是极危重的心律失常。 Atrial flutter Atrial flutter usually begins with a