心脏起搏器植入方法—培训课件.pptVIP

* 导线现在进入到心房。例图显示了导线放置在心耳。它是典型的心房导线放置的部位。非创伤性的J型导线往往用于这种放置。 * This slide shows atrial lead placement. The atrial lead is typically positioned in the atrial appendage. * 该图所示的是透视下同一型号的J型导线在成型之前的影像。 导线进入心耳的通道、比我们通常估计的稍微低一点。当典型的往返摆动被观察到时，导线就被植入正确的位置。 一般大概在5点钟的位置允许导线进入右心耳。 * Fluoroscopy is used to view lead placement. In general, the leads pass through the venous system with ease. Some manipulation is typically required to move the tip (1) across the bicuspid valve and/or (2) position the tip in the atrium. A stylet is often used to facilitate lead maneuvering. * * 检查一下缝合的紧密性。我们经常使用袖翼固定导线的两端。 再检查一下导线和起搏器壳的插入连接。事实上这些在植入时已经完成了，但是在您缝合囊袋前仍要再看一下。 * Welcome to Indications and Mode Selection, a course module in CorePace. The Indications and Mode Selection module addresses established and new indication for pacemaker implantation. It also provides guidance in choosing the appropriate mode for optimal pacing therapy. * We will start by discussing normal impulse fomation and then move into common conduction disturbances. As abnormal conduction is discussed we will correlate the AHA/ACC guidelines for pacemaker implantation related to that particular rhythm. * Part of understanding timing intervals requires an acquaintance with milliseconds. Many healthcare professionals are accustomed to measuring intervals in seconds. Timing intervals in pacing, however, are always measured in milliseconds. The exception to this is lower and upper rates, which are usually expressed in beats per minute/bpm. The graphic above shows intervals in milliseconds of a normal sinus beat. The entire graph represents 1000 milliseconds or one second of time. The smallest box on the ECG represents 40 milliseconds or .04 seconds. The medium box represents 200 milliseconds or .2 seconds. * The way to convert bpm to milliseconds is to divide the rate into 60,000 (the number of milliseconds in one minute). Converting an interval in milliseconds to a rate in bpm is done by dividing 60,000 by the m