06_CRT随访-成都(陈柯萍)推荐.pptVIP

CRT术前 CRT优化后 * IVD＝194-126=68 ms IVD＝154-126=28 ms CRT 优化 * CRT术前 优化后 * 小结－－如何提高CRT的疗效？ 术前：合理选择病人 失同步 术中：左室导线植入在理想的静脉 术后：AV和VV间期的优化 术后：合理的抗心衰药物治疗 术后：定期随访，及早发现问题，解决问题 左室失夺获 房性心律失常 室性心律失常 未纠正的心肌缺血 * 谢谢! * * What to say: “First we will review the programming considerations for CRT devices followed by an overview of CRT-D devices.” What to do: What to ask: * 一般情况下BNP来自于心房组织，循环中的水平较低，但在严重心脏疾病时，尤其在CRT患者中因严重的左心功能不全，心室作为BNP的重要来源，随着心力衰竭的加重循环中BNP的水平显著增高，BNP的测定可作为心力衰竭的血浆标志物，临床上用于心力衰竭的的诊断、危险分层、指导治疗及判断预后等。 * * * Each screen snap appears with a touch of the space bar.每张快照都可以通过点击Space bar得到 Feature Rationale: To help the clinician determine that biventricular pacing therapy is being delivered, the implanted device collects data during periods, or episodes, when ventricular sensing occurs.机制：当感知反应发生时，起搏器会收集整个期间或事件的相关数据，这有助于帮助医生判定发放了多少的双心室起搏。 Display indicates percent of time that extended periods of sensing have occurred. If ? 1%, then review episodes to determine what can be done to remedy the situation. 该图也会显示发生感知的时间段所占的百分比。如果大于等于1%，建议查看所有事件判定治疗这种情况我们能做什么。 Detailed information for the eight listed episodes includes the date and time of the episode, the episode duration, and the Sensor Rate at the time of episode onset. Each of the eight episodes can be opened to view a recorded strip of event markers covering the 36 events leading up to detection of the episode.八个列出的事件的细节包括了事件的时间日期，持续时间和事件开始时的传感器频率。这八个事件每个都能被打开并显示有导致该事件诊断成立的36个标记通道。 Note: The stored episodes have VP markers during biventricular pacing, while the LIVE monitor has BV markers. If VSR pacing occurs, only the VS markers will appear in the stored episodes, while the LIVE monitor will have VS markers closely followed by BV markers. 在实时监测时为BV标记，但储存的事件中却为VP标记。如果一个VSR反应发生，在储存的事件中只标记为VS，而实时监测时会先出现一个VS然后出现BV标记。 * Atrial and Ventricular High Rate Episodes:心房和心室高频事件 Shows information about episodes of abnormally high heart rate detected since the last patient session.记录上次随访以来被检测到的