双腔起搏器程控随访模板.ppt

* * * Student Notes Instructor Notes * * * As device technology has evolved many features in implantable devices have become automatic. In addition enhanced diagnostic data in devices has allowed the clinician to spend less time on issues related to device management and to focus more on patient management. * 心房率直方图、心室率直方图、AV传导直方图、心率直方图前后对比 及心脏指南针（节律、频率、起搏监测、中风风险、心功能监测） 基础心律的管理、AT/AF的管理、心衰的管理 * * * 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, even if a physician is able to reduce %VP from 85% down to 45%, the patients relative risk for heart failure hospitalization would still remain the same. A patient’s risk for HFH is not affected until %VP falls below the 40% mark. Below 40% VP, for each 10% increase in cumulative percent pacing, there is an associated 54% relative increase in risk in HFH. Bottom line: Novel algorithms or pacing modes that attempt to reduce cumulative %VP, should strive to reduce the percent VP below the 40% mark. If they are unable to show this type of reduction, the relative risk for HFH is unaffected. * * The measurements are made across the thorax from noon until 5pm, during the study, this time period gave the best correlation between measured impedance and patient fluid status. Measurements are enabled after VF detection is enabled for the first time and cannot be reset. Between noon and 5 pm, an impedance is measured every 20 minutes, all of these measurements are averaged together to arrive at one Daily impedance value. By averaging many impedances together to arrive at one Daily value, the effect of respiration and position are minimized on the Daily impedance measurement. Also, by averaging many values together the resolution of the system is approximately 1 ohm. * Enpulse Versa Adapta 中都有6个月的CardiacCompass EEnR