起搏器培训课件：Home Monitoring 家庭监测

1、1 Document Identifier Home Monitoring Launch by Yang Yu / August 20, 2008 Home Monitoring Launch Training Enalapril (ACE-inhibitor); Torem (diuretic);Aldactone (antihypertensive), Simva (statin for lipids) 2007.5.16植入：Lumax 300 HF-T（CRT-D） 68 Home Monitoring Launch by Yang Yu / August 20, 2008 69 Ho

2、me Monitoring Launch by Yang Yu / August 20, 2008 70 Home Monitoring Launch by Yang Yu / August 20, 2008 Periodic IEGM 18Feb2008: Stimulation in DDD-Mode : BIV with LV first Predetection Time (seconds) 71 Home Monitoring Launch by Yang Yu / August 20, 2008 Event report on 16Mar2008: atrial monitorin

3、g episode; AF burden; long atrial episode Predetection Time (seconds) 72 Home Monitoring Launch by Yang Yu / August 20, 2008 73 Home Monitoring Launch by Yang Yu / August 20, 2008 74 Home Monitoring Launch by Yang Yu / August 20, 2008 75 Home Monitoring Launch by Yang Yu / August 20, 2008 76 Home Mo

4、nitoring Launch by Yang Yu / August 20, 2008 77 Home Monitoring Launch by Yang Yu / August 20, 2008 2008.3.29病人被电话预约到医院随访，证实病人自3.15以 来一直持续发作房颤 而整个过程，病人是无症状的，病人完全不知晓 专家建议： 立即给予药物治疗Coumadin (warfarin) 预约4-6周后电转复 78 Home Monitoring Launch by Yang Yu / August 20, 2008 Benefit for this patient ! 早期发现无症状性

5、房颤（通常无症状性房颤只能在下次随访时 发现） 早期干预，降低心衰的危险 早期恢复窦性心律，降低导致持续性房颤的危险 适当抗凝治疗，降低脑中风的危险 79 Home Monitoring Launch by Yang Yu / August 20, 2008 Prevalence of atrial fibrillation 0.4% -1% in the general population increasing with age to 8% 80y median age of patients with AF is about 75y Incidence of atrial fibrill

6、ation increases from 0.1% age1.5% per year among women 2% in men older than 80 y in HF-patients, the 3-y incidence of AF was almost 10% Prognosis of atrial fibrillation increased long-term risk of stroke, HF and all-cause mortality mortality rate of patients with AF is 2x that of patients in sinus r

7、hythm rate of ischemic stroke among patients with AF averages 5% per year, 2 to 7 times that of people without AF AF responsible for 45% of all embolic strokes* * ACC/AHA/ESC Guidelines for the management of patients with atrial fibrillation; Europace 2006, Sept. (9):651-745. * Cerebroembolism Task

8、Force, Archives Neurology 1986; 43:71-84. 80 Home Monitoring Launch by Yang Yu / August 20, 2008 150,000台带家庭监护的设备被植入台带家庭监护的设备被植入 50个国家和地区在使用个国家和地区在使用 2500个植入中心个植入中心 2008 全球唯一的全球唯一的 服务中心服务中心 81 Home Monitoring Launch by Yang Yu / August 20, 2008 远程、无线 连续监测（病人、设备） 早期发现 增加了对病人的照顾 使病人更有安全感 有效分配医疗资源 减少医生的工作负荷 无需病人繁琐操作 Home Monitoring 带给我们：带给我们： 82 Home Monitoring Launch by Yang Yu / August 20, 2008 83 Home Monitoring Launch by Yang Yu / August 20, 2008 84 Home Monitoring