电风暴的评估和治疗武汉协对和医院张家明教学课件.pptVIP

电风暴的评估和治疗武汉协和医院 张家明 Examples of VF initiation by premature beats later found to originate from the right (top) or left (bottom) ventricle. The inferior panel is continuous Holter recording. In each case, the initiating beat is identical or similar to preceding isolated premature beat (*). Circulation. 2002，106(8):962-7 A, Premature beat originating from the left ventricular Purkinje system is indicated by a sharp potential (*), which also precedes activation during sinus rhythm. The second Purkinje discharge is not conducted to the ventricle. Circulation. 2002，106(8):962-7 B, The other morphologically distinct premature beats originating from the left ventricular Purkinje system (*) with different conduction times to local muscle. Circulation. 2002，106(8):962-7 Top, Initiation of VF during Holter recording. Bottom, In the same patient, run of premature beats originating from the left ventricular Purkinje system. Each QRS complex is morphologically different but preceded by a Purkinje potential (arrow) with a varying conduction time. Circulation. 2002，106(8):962-7 Left, ECG of patient 2 with AMI,VPB initiates VF , Right, ECG of patient 3 with AMI. Note changes in morphology of first and second VPBs during initiation of fast monomorphic VTs. Circulation. 2003;108:3011-6