生理性起搏再定义课件.ppt

出厂值PAV=150ms Search AV+ 延长AV间期从60ms至210ms 16个周期后，AV间期又延长60ms，但仍不能搜索到VS 如患者的自身传导延迟或阻滞，Search AV+将重新开始AV间期延长 Search AV＋工作方式 紫色阴影部分 提示了在不同 心率组中， 因Search AV+功能打开而 搜索到的VS比例 Search AV＋工作方式 VS% Search AV+ OFF 0.2 % (Median) Search AV+ ON 95.9% (Median) Milasinovic et al. Heart Rhythm Vol. 1 No. 1 May Supplement 2004: 885 111 位具有1:1 AV传导的患者 Search AV＋显著降低起搏比例 Search AV+ 显著增加VS比例 38位患者随访2周至1月， Search AV+功能开启时 VS比例为71％，Search AV+ 功能关闭时VS比例 下降至2％，说明Search AV+ 可以增加71％的VS Difference in % Ventricular Pacing Number of Patients EnPules clinical study summary. Medtronic data on file. Search AV+ 显著增加VS比例 Dashed lines represent 95% confidence boundaries AV Hysteresis AV Search+ MVP AV Search Mean Vp Frequency Fixed AV Intervals Search AV+ 降低心室起搏比例 EnPulse 起搏器的 Search AV+功能的问世，使临床医生可以从起搏产品功能的不断完善中，充分体会到循证医学的深入研究对起搏行业的影响 总 结 Two long-term Danish Trials (Danish I8 and Danish II1) have documented the relationship between atrial-based pacing (AAI/R or DDD/R) and ventricular-based pacing and the relative risks for atrial fibrillation (AF) and heart failure (HF). This data supports the theory that VVI/R systems are worse for patient with respect to these risks and that pure AAI/R systems have inherent risks. The pros/cons of each mode of pacing operation is covered in a separate powerpoint presentation (MVP Comparative Analysis) that is available through your Medtronic Representative. Specifically the bullets documented on this slide outline the reduced risks for AF and HF but also note that a pure AAI/R system would require re-operation and placement of a ventricular lead if a patient develops complete AV block and/or develops bradycardia with the onset of AF (brady-tachy) syndrome. The focus on this slide is on relative risk for heart failure hospitalization in the DDDR group. Note that relative risk for heart failure hospitalization (HFH) cannot be decreased until the cumulative percent of ventricular pacing falls below the 40% mark. That is, ev