单腔时间间期XXXX.pptxVIP

;;;83bpm;45bpm;心脏起搏器的基本設計原理;Hyman 在1932年设计制作了一台 由发条驱动的电脉冲发生器 ;第一台植入式起搏器的制造者工程师 Rune Elmqvist;;现代植入式心脏起搏器;;;VOO 心室起搏、无心房感知、无心室感知 VVI 心室起搏、心室感知抑制 VVT 心室起搏、心室感知触发V脉冲 VVIR 心室起搏、心室感知抑制、频率应答 AOO 心房起搏、无心房感知、无心室感知 AAI 心房起搏、心房感知抑制 AAT 心房起搏、心房感知触发A脉冲 AAIR 心房起搏、心房感知抑制、频率应答;;可程控参数;;低???频率的应用;VVI 模式;;不应期 ;不应期的应用;感知到T波;;;;;;;单腔滞后的心电图特征;Hysteresis;Basic rate 70;Hysteresis;噪声转换;噪声干扰问题 ;噪声转换的心电图特征;;;;;;Mode VVI;;补充知识;VVI导致房颤可能与下列因素有关;补充知识;;;;;Mode AAI;;; “On the basis of the evidence indicating that ventricular pacing is associated with a higher incidence of AF in patients with sinus node dysfunction, a patient who has a history of AF and needs a pacemaker for bradycardia should receive a physiological pacemaker (dual chamber or atrial) rather than a single-chamber ventricular pacemaker. For patients who need a dual-chamber pacemaker, efforts should be made to program the device to minimize the amount of ventricular pacing when AV conduction is intact by extending the AV delay, programming the device to a non atrial tracking mode such as DDIR, or implanting a device with an algorithm that minimizes ventricular pacing.”;;;;生理性起搏;三个要素;房室顺序收缩的重要性;丧失房室顺序的后果-起搏器综合征;基于心房起搏的优势;三个要素;正常心脏的起搏顺序;正常心脏左右心室同时激动，然而30%的 心衰右室先激动，然后左室激动， 导致心脏工作效率下降;;双心室起搏电极放置位置;起搏治疗心衰人体示意图;左侧图片是植入后3天胸片， 右侧是植入后3个月的图片 注意：心脏明显缩小;植入前后心电图变化;;;MP3 Key Messages;Key MP3 Pillars;;单腔时间间期;;;;;谢谢您的聆听！