晕厥定稿课件.ppt

Brignole M, Alboni P, Benditt D, et al. Guidelines on management (diagnosis and treatment) of syncope—Update 2004. Europace. 2004;6:467-537. The Reveal? Plus Insertable Loop Recorder system offers long-term, continuous, subcutaneous ECG monitoring and event-specific recording. This implantable device is designed to improve patient compliance with long-term AECG monitoring. The system includes an implanted loop recorder, a hand-held patient Activator, and a programmer with telemetry head that communicates noninvasively with the implanted device. When a patient experiences an episode, the device stores an ECG using the Activator or through the use of a auto-activating feature. The Reveal? Plus ILR can monitor continuously for up to 14 months. The probability of capturing an event is high—approximately 65-88%.1,2 The ECG captured during the episode may “reveal” the ECG during the patient’s episode or may allow the clinician to rule in or rule out arrhythmic causes. The stored ECG data is retrieved, viewed, and printed or saved to a disk, using a Medtronic 9790 programmer with a 9766 A or AL programmer head. The Reveal ILR can then be re-started for continued monitoring. 1. Krahn A, et al. Final results from a pilot study with an insertable loop recorder to determine the etiology of syncope in patients with negative noninvasive and invasive testing. Am J Cardiol, 1998;82:117-119. 2. Krahn A, Klein GJ, Yee R, Skanes AC. Randomized assessment of syncope trial. Conventional diagnostic testing versus a prolonged monitoring strategy. Circulation 2001;104:46-51 Three thousand years ago, Hippocrates already knew what we have learned from clinical studies to date – that recurrent episodes of syncope can be an indication of a serious, life-threatening disorder. 晕厥时心电图表现 心肌缺血 肺栓塞表现 不应用负性变频作用药物：窦率40bpm,窦停或窦房阻滞3s 高度房室传导阻滞 交替性左、右束支阻滞 快速性室上性心动过速，室速 起搏器工作异常 离子通道病（LQTS，Brugada) 标准12导心电图 动态心电图检测 常规 Holter 常规 ‘事件’ 记录仪 电话远程监测术 (MCOT) 植入式回路记录仪 (ILRs) 未来 结合 ECG / 血流动力学监测器 晕厥的