人工心脏起搏器课件幻灯片.pptVIP

* CorePace Module 4: Troubleshooting A poor connection at the connector block can result in a lack of output, which can prevent the pacemaker from delivering a pacing pulse. In addition to lead dislodgment, lead perforation should be considered with acute implants as a potential cause of noncapture. Battery depletion can result in a lack of output, which can prevent the pacemaker from delivering a pacing pulse. At generator replacement procedures, (and sometimes at initial implants) the pacemaker pocket may be malformed or too large to accommodate the pacemaker. Air can get trapped in the pocket which, with unipolar devices, will not allow appropriate grounding. No output can result. Circuit failure梞ore commonly referred to as 損acemaker malfunction敆is very rare. * CorePace Module 4: Troubleshooting Pseudomalfunctions should be ruled out as the cause(s) of an anomalous ECG strip before corrective measures are taken. * CorePace Module 4: Troubleshooting Each of these device features has an impact on pacing rates. These rate changes will appear on an ECG strip. * CorePace Module 4: Troubleshooting The Elective replacement indicator (ERI) is designed to alert the clinician at least three months before the battery voltage drops to a level at which noncapture or inconsistent pacing would result. The end of life (EOL) indication is designed to give the patient and physician adequate time to replace the device. Battery depletion may necessitate a mode switch prior to battery failure. For example, the mode may be switched from DDD to VVI or from DOO to VOO. * CorePace Module 4: Troubleshooting Having completed the troubleshooting module, you should have a better understanding of identifying pacemaker system anomalies and the steps used to resolve them. 原 因 灵敏度设置不当 导线移位 导线故障： 绝缘破裂；导体断裂 导线成熟(电极头端的纤维化） 原信号改变 感知不良 电极脱位 是最常见的并发症之一 发生率为2％～8％ 其中90％发生在一周内 表现为起搏或/和感知失灵 早期脱位发生在术24～ 48h，晚期脱位可发生于术后一个月,应及早复位 感知灵敏度设置 导线故障 连接器连接不良 受到干扰 过分感知 原因 1、导线移位 2、输出低 3、导线成熟 4、连接器连