心律失常发生机制及导管消融适应症(英文).pptVIP

心律失常发生机制及导管消融适应症（Electrophysiological Mechanisms of Cardiac Arrhythmias and Indication of Radiofrequency Catheter Ablation) Indications for Radiofrequency Catheter Ablation Wolff-Parkinson-White Syndrome (WPW) Atrioventricular Nodal Reentrant Tachycardia (AVNRT) Atrial Flutter Atrial Fibrillation (AF) Ventricular Tachycardia (VT) Atrial Tachycardia (AT) Others Risks and Complications With RF Ablation Hypotension - secondary to drugs or vagal reaction Vascular injury Ischemia/Infarction Venous/ Arterial Thrombosis Cardiac perforation Damage to the AV conduction system Life threatening arrhythmias Arrhythmia Mechanisms Automaticity Triggered Activity Reentry Arrhythmia Mechanisms Arrhythmia Mechanisms Arrhythmia Mechanisms Sequence of the Flow in a Typical EP Study Preparation of the Patient Insertion of sheaths and Electrode catheters Basic EPS study to get the basic data Induction of the Arrhythmia Diagnosis of the Arrhythmia Ablation of the Arrhythmia (if indicated) Confirmation of Therapy Success WPW WPW tachycardia circuits Bypass Tract Locations Bypass Tract Locations Types of Accessory Pathways Types of Accessory Pathways Preexcitation Syndromes Wolff - Parkinson - White “Mahaim” Fibers - now separated into: Atriofascicular Nodoventricular Nodofascicular Fasciculoventricular Wolff, Parkinson and White,and their Syndrome Published in American Heart Journal in August, 1930 findings on 11 patients with a syndrome of signs and symptoms Clinical significance May confuse physicians Delta Wave may be interpreted as an infarct Marked preexcitation in atrial tachycardias may look like VT Pt has paroxysms of SVT May bypass the protective nature of the AV node and expose the ventricles to extremely high heart rates. Diagnosis and Localization Surface lead evaluation Understanding Bundle Branch Block “Patterns” as applied to interpreting Delta Wave polarity Delta Wave Polarity interpretation The use of algorithms for evaluating preexcited 12 leads Funct