课件：起搏器功能及临床应用进展.ppt

Key Parameter History This diagnostic is found under the Patient Icon. It automatically records status of key parameters pertaining to the last 8 programming sessions. The clinician can quickly and easily see an at-a-glance history of programming changes. Tracking programming changes (whether performed manually or via the adaptive operations) may help the clinician determine the nature of a problem. For example, the Upper Tracking Rate was originally 120 ppm on 12/26, then changed to 140 ppm, left at that value, and is currently at 130 ppm. What sort of patient would need an upper tracking rate of 140 ppm? Why was it set to that rate and then lowered to 130 ppm? Should the clinician make certain that the patient is com-fortable tracking up to 130, since 140 ppm was apparently too high? Take a look at what the adaptive operations have done to the atrial and ventricular sensitivity settings, as well as to the ventricular outputs. One could conclude that the Acute Phase has ended and that the settings have started to adapt to lower values. Such adaptation is expected once the Acute Phase is completed. On the other hand, why did the output settings reach 5 V and 1.0 ms on January 7th? This should have triggered a High Threshold message in the Significant Events Window. Was a check performed at that time? Graphs and Tables - Diagnostics This screen provides an almost complete list of the automatic diagnostics with the exception of Rate Drop Response episodes (available only when turned on in the DDD or DDI modes). Note that the Capture Management Detail and the Sensitivity Detail (a subset of the Capture Management Detail diagnostic) are the default clinician-selected diagnostics. They are turned on at the end of a successful Implant Detection period. The remainder of this presentation will help you understand how to use these diagnostics to analyze the pacing system (the device, the lead, and the patient). AV Conduction Histogram Let’s assume that you ha