起搏器程控课件.ppt

Mode Switch Episodes This diagnostic is essentially the same as the Atrial High Rate Episodes Diagnostic, with the exception, of course, that it reports data on Mode Switches. Note the three top episodes. All of them reflect the fact that the mode switch occurred due to detection of atrial fibrillation (400 bpm). Note also that the patient was mode switched 5% of the time since the last follow-up (for a total of 404 times over the last 27 days). That would mean that each episode on average lasted longer than 1.5 hours (27 days X 24 hours divided by 404). If we exclude the short ones we see on this screen and others like them, we must conclude that some of the episodes lasted for hours, if not days. With such information in hand, the clinician might compare this data to ones gathered from a previous follow-up. Are the average times for the episodes getting shorter, longer, or do they remain about the same? If longer, has the patient exercised good drug compliance? If so, does the drug regimen need to be titrated? If shorter or about the same, nothing needs to be done at this time. Sinus Preference Episodes There are only 3 Intrinsic Episodes (no Search Episodes) displayed here. Note, however, that the patient was tracking the sinus due to the Sinus Preference operation 6% of the time. Since there are 672 hours in 28 days, we can calculate that the patient spent ~40 hours (one full work week) tracking the sinus, rather than using the sensor. One wonders what might be the number of hours would result if the Sinus Preference Zone was expanded to 15 bpm. Perhaps, the clinician might wish to expand the zone to 15 bpm and ask the patient to call in if any symptoms were to develop. We all know that the sinus node is the best sensor to follow, assuming there is no serious sinus incompetence. Since that seems to vary in this patient, the clinician may wish to make use of that knowledge and see if the patient might be able to track the sinus an even greater percentag