除颤起搏器的临床应用课件

1、除颤起搏器的临床应用1 除颤起搏器的临床应用 除颤起搏器的临床应用2 Contents 除颤起搏器的临床应用3 History of ICDs 除颤起搏器的临床应用4 Pioneer of ICD Technology 除颤起搏器的临床应用5 1985 - First approved ICD Ventak is a trademark of Cardiac Pacemakers, Inc. 除颤起搏器的临床应用6 The next milestone for ICDs Pectoral implants approved by the FDA in 1995 More comfortable

2、 for patients Faster implants Smaller but just as powerful as older devices 除颤起搏器的临床应用7 “Active Can” Technology Traditional System RV-Can 除颤起搏器的临床应用8 Evolution of ICD Technology 19911995 The First ICDs Featured Epicardial Leads Transvenous Leads and Advanced Therapy Increase Effectiveness of ICD The

3、rapy Pectoral ICDs Reduce Costs and Increase Surgical Ease 1985 除颤起搏器的临床应用9 “Dual Chamber” ICDs 除颤起搏器的临床应用10 Basic Functions of ICD 除颤起搏器的临床应用11 How it works 除颤起搏器的临床应用12 Auto-Adjusting Sensitivity Post-sensed sensitivity adjustment Post-paced sensitivity adjustment Programmed sensitivity Post-pace

4、blanking Marker Channel Telemetry V PACE V PACE V SENSE V PACE V SENSE Rectified EGM Changing Threshold Post-PacePost-Sense 10 x 4.5x 0.3 mV 除颤起搏器的临床应用13 Three Zone Detection 除颤起搏器的临床应用14 VT Detection VFFVTVT Detection Status:ONOFFON Interval (ms):320400 Initial NID:12/1612 Sensitivity (mV):0.3 VT C

5、ounter Value:123456789101112 200 ms V S V S V S V S V S T S T S T S T S T S T S T S T S T S T S T S T D 除颤起搏器的临床应用15 VF Detection 除颤起搏器的临床应用16 FVT Detection via VF Counter T F T F 121110987654321 T F T F T F T F T F T F T F T F T F T F V S V S V S V S V S LOOKBACK WINDOW (8 INTERVALS BEFORE NID) 除颤起

6、搏器的临床应用17 FVT Detection via VT Counter 121110987654321 LOOKBACK WINDOW (8 INTERVALS BEFORE NID) V S V S V S T S T S T S T S T S T S T S T S T S T F T S T F VF Counter: 除颤起搏器的临床应用18 Increased VT Detection Specificity Sinus Tachycardia Atrial Tachycardia Atrial Flutter Atrial Fibrillation Morphology X

7、 X X X Onset X Stability X 除颤起搏器的临床应用19 Therapies 除颤起搏器的临床应用20 Burst 除颤起搏器的临床应用21 Ramp 除颤起搏器的临床应用22 Ramp+ 除颤起搏器的临床应用23 ICD Indications, who gets one or not Gregoratos G. J Am Coll Cardiol. 1998;31:1175-1209. 除颤起搏器的临床应用24 1998 Class I Indications for ICD Therapy Gregoratos G. J Am Coll Cardiol. 1998;

8、31:1175-1209. 除颤起搏器的临床应用25 1998 Class II Indications Gregoratos G. J Am Coll Cardiol. 1998;31:1175-1209. 除颤起搏器的临床应用26 1998 Class II Indications (cont.) Gregoratos G. J Am Coll Cardiol. 1998;31:1175-1209. 除颤起搏器的临床应用27 1998 Class III Indications Gregoratos G. J Am Coll Cardiol. 1998;31:1175-1209. 除颤起搏器