EnRhythm Implantation and Follow-up Training EnRhythm植入和随访注意事项.ppt

June 2004, UC200500470EN * 2007-11-23钟幼民 EnRhythm主要针对房性心动过速的管理 MVP：尽量减少不必要的右室起搏 有对AT/AF的干预程序：PMOP、APP、ARS，干预触发机制 AT/AF患者心室率控制：MS、空白期房扑搜索、VRP/CAFR 相对规整、较低频率的AT进行ATP治疗，终止AT 心脏指南针监测：尽早发现房颤、发现房颤触发因素、指导药物的调整、评估中风风险和疗效。 * Enrhythm会一直记录数据，在植入前也会，所以为了避免干扰，在植入后要初始化数据（把之前的事件清除） 模式程控为DDD,为了医生在手术植入后能看到起搏，帮助医生了解电极放置的情况。 为了保障感知的精确，电极固定为双极，无法修改，所以，必须是双极电极。 * 如果心房导线放置在靠近三尖瓣的位置，如心房电压很大的时候可能会刺激心室。那ATP治疗时会有危险。 * 在手术过程中也会记录数据。 * 在急性期过后电极稳定了才考虑打开房性心律失常治疗。 * This Cardiac Compass Trend is an example patient with sinus node dysfunction. Note the high daily burden of atrial tachyarrhythmias recorded during the first month of follow-up post-implant. The associated ventricular rate during AT/AF highlights that the patient had little or no rate-control. This patient was initially programmed to a non-MVP mode. AT the patient’s one month follow-up an MVP mode was programmed ON (noted by the “P” on the annotations lines at the top) and you will note a dramatic drop in ventricular pacing to near 0%. The results in this example are unique to this patient. Patient results may vary. Details of recorded information: Rhythm-control assessment (AT/AF daily burden) – Vertical lines reflect cumulative daily time spent in AT/AF as defined by the programmed detection zone(s). Rate-control assessment (V. Rate during AT/AF) – Vertical lines reflect average-to-max V. rate measured during recorded AT/AF episodes. Average V. rate computed as total time in the episode (from onset to termination) divided by the number of V-V intervals. Max V. rate computed as the fasted RR Median (where RR median is the 7th fastest of previous 12 V-V intervals). Reduction of unnecessary V-pacing (%Pacing/day) – Plots daily cumulative percentage of both atrial and ventricular pacing. Patients with <40% VP have reduced risks for HF hospitalization and incidence of AF1,3. Heart Failure Status Indicators (Bottom 3 Trends) Avg. V. Rate – Day rate measured between 8 am and 8 pm. Night rate measured between 12 am and 4 am. Calculated