ICD程控基础感知与识别.pptx

ICD程控基础 (一)感知与识别内容一般特性感知：心电信号的记录识别：心律失常的诊断治疗：Monitor only, ATP, Shock起搏功能：AV Search+, RMS, BTR程控随访ICD导线一般特性VITALITY 2TELIGEN30, 35 cc11 mm82, 90 g31 J (stored energy)31.5 cc9.9 mm72 g41 J (stored energy)寿命起搏比例VITALITY2 VRT175VITALITY2 DRT165VITALITY2 EL VRT177VITALITY2 EL DRT167TELIGEN VRF102TELIGENDRF1100%15%6.68.98.650%100%5.37.17.0VITALITY: 900?. 60 min-1 LRL, and ventricular and atrial settings of 2.5 V pacing pulse amplitude and 0.4 ms pacing pulse width. Projected longevity is calculated at 6 to 14 maximum energy charging cycles per year (6 at BOL and 14 at MOL2 until ERI) which includes automatic capacitor/battery management and high energy charges, and 3-channel EGM Onset On.Teligen : 900?. For RF-enabled models, assumes ZIP telemetry use for 1 hour at implant time and for 20 minutes during each quarterly follow-up. Assumes standard use of the LATITUDE Communicator as follows: Daily Device Check on, Weekly Device Alert on, weekly scheduled remote follow ups, and quarterly patient-initiated interrogations.Teligen单腔 12.7年Teligen双腔 11.1年Analysis of aggregate LATITUDE Patient Management system data from?over 67,000 patients as of? August 19th 2011Teligen ICD长寿的理由锂锰电池技术，容量大（1.7Ah），充电时间平稳能耗低，更省电集成电路由3块优化为2块，节能30%EGM记录耗电量：4-5天/年最大能量放电一次：19天电池寿命减少右室起搏技术：AVS+ (400ms)，模式回转，频率滞后…Safety Core ?: Teligen保证 ICD的除颤和起搏功能，为患者保驾护航Safety Core ? 安全核 独特的ICD硬件解决方案当ICD电路的CPU（中央处理器）出现不可修复的错误的时候，激活备用的安全模式，以保证针对VF提供挽救生命的除颤治疗和基本的心动过缓起搏功能，直至装置更换。当安全模式激活，ICD会每6个小时发出16次报警声，医生可通过远程监测了解此情形的发生。ICD存在自检纠错程序，能持续检测并纠正装置本身的软件错误或异常情况内容一般特性感知：心电信号的记录滤波频率：带通 (band pass)自动增益控制： AGC (automatic gain control)噪音处理：动态噪音算法(DNA, dynamic noise algorithm)不应期：智能感知 (Smart Sensing)识别：心律失常的诊断治疗：Monitor only, ATP, Shock起搏功能：AV Search+, RMS, BTR程控随访ICD导线滤波VITALITY 2TELIGENINSIGNIABand Pass（带通）21 – 171 Hz20 – 85 Hz25 – 81 Hz在1570例不适当放电事件中，因T波过感知引起者仅2例（0.1%）1病例报告显示换用波科ICD后，T波过感知消失2,3Ellenbogen Clinical Cardiac Pacing, Defibrillation and Resynchronization Therapy, 4th 20111 PACE 2012: in press2 J Cardiovasc Electrophy