起搏器培训课件：心脏装置基础知识.pptVIP

* Student Notes学员注释 When the first human implants occurred in the late 1980’s, the ICD devices were quite large, required major surgery (thoracotomy with multiple incisions, usually under general anesthesia), long hospital stays, and the device longevity averaged about 18 months. Therefore, ICDs were reserved only for the highest risk patients: Those who survived 2 or more SCD events. Post-operative length of stay averaged about a week. Therapy was delivered via large defibrillation patches that were sutured directly to the epicardium. 第一台人体ICD的植入是在1980年晚期，当时ICD的体积相当巨大，需要大手术完成（数个切口，开胸手术，通常需要全麻），住院时间长，装置的平均使用寿命在18个月左右。因此ICD治疗仅限于最高危的患者：即从两次或更多次心源性猝死中存活的 患者。术后住院时间大约需要1周。通过直接缝合在心外膜上的除颤垫片来发放治疗。 Instructor Notes教员注释 * Student Notes学员注释 Today’s devices are implanted pectorally, either subcutaneously or sub-muscularly, under local anesthesia and conscious sedation in most patients. Most are approached transvenously with few complications (perioperative mortality 1%). Unlike past practice, ICDs are now a first-line of therapy for VT/VF patients. Today’s ICDs offer many programmable therapy options with single or dual chamber therapy available. Battery longevity is now up to 9 years. 当今装置在胸部植入，无论是皮下还是胸肌下，在大多数病人中采用局麻和保持意识的镇静。大多数通过静脉完成，并发症很少（围手术期死亡率低于1%）。同以往的观念不同，ICD现在成为室速/室颤患者的一线治疗。当今的ICD无论是单腔还是双腔治疗均可提供许多可程控的治疗选项。电池使用寿命现在可以达到9年。 Instructor Notes教员注释 * Student Notes学员注释 Instructor Notes教员注释 * Student Notes学员注释 Instructor Notes教员注释 Auto-animated slide自动动态幻灯 Click for answers点击可见答案 Also use this slide to review ECG rhythm and intervals. 同时使用该幻灯片回顾心电图节律和间期 Ask: What device system (if any) is the patient likely to get? 提问：这个病人最有可能装何种装置？ Answer: High-power CRT 答案：高能量CRT * Student Notes学员注释 Instructor Notes教员注释 Auto-animated slide自动动态幻灯 Click for answers点击可见答案 Point out anatomical landmarks指出解剖结构标记 Ask: Could this be the previous patient’s chest x-ray? 提问：这会是前述患者的胸片吗？ Answer: Yes, we see an RV lead with RV and SVC coils, and atrial pacing lead, and an LV pacing lead.