起搏器及相关图片—培训课件.pptVIP

* INSYNC的适应症 * * INSYNC实验的结果之一，QRS波变窄。 * 同上图的实验结果之二，射血分数增加。 * * INSYNC刺激仪，目前最有效的心力衰竭抢救设备。 * GEMIIDR------当今体积最小，功能最强的双腔除颤器，它能保护病人避免意外休克，拥有奔腾II芯片二倍的晶体管数目，而体积却只有寻呼机一般大小。 * * * * 心动周期始于窦房结，除极波传向右左心室，刺激心房收缩。 Initiation of the cardiac cycle normally begins with at the SA node. A resulting wave of depolarization passes through the right and left atria, which stimulates atrial contraction. * 心率的改变对老年人尤为重要，因为他们甚至在日常活动中都需要动用心率储备。 Heart rate variability is especially important for nearly all elderly patients since they rely on heart rate reserves even during normal daily activities. * Impulses in a patient with diseased heart tissue may be: Intermittent Irregular Not generated at all At an inappropriate rate for the patient抯 metabolic demand. Block can occur at any point Within the SA node, AV node, His bundle or distal conduction system. * 能够随着活动而增加心率是很重要的(变时性功能)。起搏器和起搏方式应该选择能跟踪窦房结随着活动而增强心率，或者，如果窦房结有变时性功能不全，选择有传感器驱动的频率应答起搏器。 It is important to be able to able to increase heart rate with activity (chronotropic competence). The pacemaker and mode selected should provide the ability to increase rate with activity either by 搕racking?the sinus node or, if the sinus node is not chronotropically competent, by providing the rate response via a sensor. * 心肌收缩与房室顺序收缩对增加心输出量的潜力比较少，心率的增加最重要。所以对变时性功能不全的患者装频率适应性起搏器很重要。 * 说明起搏器的工作原理，适应症(BRADY，TACHY) * The modern pacemaker supports heart function in the following ways: Provides effective and consistent cardiac depolarization Prevents unnecessary pacing by sensing cardiac activity Increases rate to meet increased metabolic demand Provides information about how the patient抯 heart and the implanted pacemaker are functioning 说明起搏器的功能 * * 现在的起搏器大多采用锂-碘电池。电池技术在不断进步。美敦力有自己的研发部门研究开发更有效的电源。微处理器控制感知、输出、遥测和诊断电路。 Lithium-iodine is the most commonly used power source for todays pacemakers. Battery technology is advancing everyday. Medtronic has our own RD division to develop more efficient power source. Microprocessors (both ROM and RAM)