起搏器随访程控.ppt

* * * * Student Notes Instructor Notes * * * Student Notes There are many acceptable ways to force pacing. Here are few for the given chamber: Atrial: Using AAI on a patient with AV conduction, increase the pacing rate to above the intrinsic rate Atrial: Using DDD on a patient without AV conduction, increase the pacing rate to above the intrinsic rate Ventricular: Using VVI, increase the pacing rate to above the intrinsic rate Ventricular: Using DDD, decrease the AV to below the intrinsic AV interval Periodically lowering the test value is automatically accomplished if you utilize the Auto Decrement feature on the Threshold Test screen. Instructor Notes Ask: What is the threshold? 1.25 V Set up a VIP-II and demo device with varying degrees of inappropriate outputs (i.e., an atrial pacing output of 2 V @ 0.4 ms, with an atrial threshold of 1.5 V @ 0.5 ms). Have each student perform an atrial and ventricular threshold test. Make sure that each participant can appropriately: Identify loss of atrial and ventricular capture Label the capture thresholds Recommend appropriate programming changes to pacing outputs, if necessary * * * Student Notes Instructor Notes * * Student Notes Instructor Notes * * Student Notes The periodic increase of the test value is automatic for most current pacemakers. Instructor Notes Set up a VIP-II and demo device with varying degrees of inappropriate sensitivity settings (i.e., an R-wave of 3 mV, with a ventricular sensitivity setting of 2.5 mV). Have each student perform a P- and R-wave sensing test. Make sure that each participant can appropriately: Identify loss of atrial and ventricular sensing Recommend appropriate programming changes to sensitivity, if necessary * * * * * * Another important task is symptom-rhythm correlation. The Arrhythmia Log Time date and time stamps the collected episodes, providing an easy way to compare a patient’s reported symptoms with collected events. * * * * * * 除了液体储留状态监测外，心衰管理报告还包括其他指标趋