北大人民医院心脏起搏器基础与临床研讨班课件 07Single Chamber Timing .ppt

Single Chamber Timing 单腔时间间期 Single Chamber Timing Sensing and Pacemaker Inhibition Capture Fusion and Pseudofusion Single-chamber Timing Cycles Rate Hysteresis Single-chamber Modes Single-chamber Troubleshooting 单腔时间间期 单腔时间间期 频率滞后 感知和起搏器抑制 夺获 融合波和假性融合波 单腔模式 单腔Troubleshooting Surface and Intracardiac 体表和腔内心电图 Surface and IEGM 体表 ECG和 IEGM Pacing Interval / Pacing Rate The rate at which the pacemaker will pace if the patient does not have their own rhythm Expressed in either PPM or ms Your pacing Interval is your programmed Base Rate (Also known as Pacing Rate, Lower Rate Limit) 起搏频率/起搏间期 如果患者没有自身节律，起搏器将起搏的频率 用PPM或ms表示 起搏间期就是程控的基本频率间期 (也被称为起搏频率、下限频率) Base Rate 60ppm Pacing Intervals 起搏间期 Rate Hysteresis By lowering the pacing rate, allows for intrinsic rate to drop to below the Hysteresis Rate before pacing will occur On the surface ECG, looks likes a separate rate for pacing and sensing The purpose of Hysteresis is to promote intrinsic conduction 频率滞后 通过降低起搏频率，允许自身心率在发生起搏前降至滞后频率 在体表ECG上，看上去像有一个分开的起搏和感知频率 滞后的目的是促进自身传导 Hysteresis 滞后 Single Chamber Hysteresis 单腔滞后 Timing Cycles Refractory period A programmable period of time that starts with pacing or sensing This period of time has two components: Absolute Refractory Period Relative or Noise Sampling Period 时间间期 不应期 从起搏或感知开始的一个可程控的时间周期 该时间有两个部分组成 绝对不应期 相对不应期或噪音采样期 Timing Cycles Absolute Refractory Period The pacemaker cannot see during this time The sense amplifier is totally shut off 时间间期 绝对不应期 该时间内，起搏器不能看到任何信号 感知放大器被完全关闭 Relative Refractory Period The device sees electrical activity but doesn’t respond 相对不应期 起搏器能看见电活动，但不会做出反应 Clinical Application of Refractory Periods Programmer AAI mode “A. Refractory” (nominal 275 ms) Used to blank far-field event in DDD mode (PVAB) Atrial Absolute Refractory period is programmable in AAI/R and AAT/R modes only VVI mode “Ventricular Refractory” (nominal 250 ms) Used to prevent oversensing of T-waves 相对不应期的临床应用