![心脏电生理检查和射频消融-1_第1页](http://file4.renrendoc.com/view/29c268fa5159680a1b56673b1e6d1371/29c268fa5159680a1b56673b1e6d13711.gif)
![心脏电生理检查和射频消融-1_第2页](http://file4.renrendoc.com/view/29c268fa5159680a1b56673b1e6d1371/29c268fa5159680a1b56673b1e6d13712.gif)
![心脏电生理检查和射频消融-1_第3页](http://file4.renrendoc.com/view/29c268fa5159680a1b56673b1e6d1371/29c268fa5159680a1b56673b1e6d13713.gif)
![心脏电生理检查和射频消融-1_第4页](http://file4.renrendoc.com/view/29c268fa5159680a1b56673b1e6d1371/29c268fa5159680a1b56673b1e6d13714.gif)
![心脏电生理检查和射频消融-1_第5页](http://file4.renrendoc.com/view/29c268fa5159680a1b56673b1e6d1371/29c268fa5159680a1b56673b1e6d13715.gif)
版权说明:本文档由用户提供并上传,收益归属内容提供方,若内容存在侵权,请进行举报或认领
文档简介
1、心脏电生理检查和射频消融治疗快速心律失常-1长海医院心内科曹 江Cardiac Electrophysiology Cellular Cardiac Electrophysiology Experimental Cardiac Electrophysiology Clinical Cardiac Electrophysiology Clinical Cardiac Electrophysiology Clinical Cardiac Electrophysiology is a field within cardiology involves complicated technical pro
2、cedures to evaluate heart rhythms And provide appropriate treatment for rhythm disturbances Cardiac Electrophysiology Study EPS of the heart is a non-surgical analysis of the electrical conduction system (normal or abnormal) of the heart. involves placing cardiac electrode catheters within or near t
3、he heart to determine the characteristics of heart rhythm or arrhythmia EP studies may be helpful in: to diagnose the source of symptoms to evaluate the risk of future cardiac events to evaluate the effectiveness of medication in controlling an arrhythmia to evaluate the need for a permanent pacemak
4、er, an implantable cardioverter-defibrillator, or radiofrequency catheter ablation as a treatment for arrhythmia. Radiofrequency Catheter ablationRFCAA catheter procedure that uses electrical current to generate heat to destroy the fast irregular heartbeats心脏功能心脏功能心脏解剖心脏解剖心脏解剖心脏解剖心脏解剖心脏解剖心脏解剖心脏解剖心脏传
5、导系统心脏传导系统心脏传导系统心脏传导系统心脏X线解剖心脏X线解剖心脏X线解剖心脏X线解剖心脏电生理的历史心脏电生理的历史You can pick up a feather after rubbing amber with wool which were observed even in ancient Greece心脏电生理的历史公元前300年:亚里士多德发现电鳗的“震击”效应心脏电生理的历史William Gilbert (1544-1603) performed important early studies of electricity and magnetism. In De Mag
6、nete (1600), he was the first to describe the earths magnetic field and to postulate the relationship between electricity and magnetism. He introduced the term electricity into scientific discourse. 心脏电生理的历史Luigi Galvani, 1737-1798 Italian physicist and anatomist and was one of the first to investig
7、ate experimentally the phenomenon of what came to be named bioelectrogenesis. 心脏电生理的历史1791:Galvani discovers that electrical stimulation of a frogs heart leads to muscular contractionCarlo Matteucci 心脏电生理的历史心脏电生理的历史British physiologist Augustus D. Waller of St Marys Medical School, London publishes
8、the first human electrocardiogram. It is recorded with a capilliary electrometer from Thomas Goswell, a technician in the laboratory. Waller AD. A demonstration on man of electromotive changes accompanying the hearts beat. J Physiol (London) 1887;8:229-234 心脏电生理的历史心脏电生理的历史心脏电生理的历史心脏电生理的历史Einthoven 1
9、893年提出了心电图 Electrocardiogram的命名, 建立肢体导联发现心电图包括P, Q, R, S和 T波1903年研制成功弦线式心电图机研究了多种心脏疾病的心电图1924年荣获了诺贝尔医学奖Father of Electro-cardiographyECG Electrodes 1901Lead ILead IIECG Set心脏电生理的历史First Documentation of Ventricular Fibrillation In 1849: Hoffa, in Ludwigs laboratory, documented bizarre unregulated ac
10、tions of the ventricles when exposed directly to strong faradic or constant currents 心脏电生理的历史1900-1919S. Tawaras contribution to elucidation of conduction system of the mammalian heart 心脏电生理的历史In 1929 in a small hospital in Eberswald Germany Werner Forssmann, a young surgical resident, anesthetized
11、his own elbow, inserted a catheter in his antecubital vein and, catheter dangling from his arm, proceeded to a basement x-ray room where he documented the catheters position in his right atrium ?proving that a catheter could be inserted safely into a human heart. 心脏电生理的历史 The 1930s Bundle-Branch Blo
12、ck with Short P-R type Interval in Healthy Young People Prone to Paroxysmal Tachycardia 心脏电生理的历史The Ventricular Vulnerable Period In 1940 Wiggers and Wegria established beyond doubt the existence of the ventricular vulnerable period by elegant experiments that confirmed previous less striking observ
13、ations. 心脏电生理的历史Treatment of Unexpected Cardiac Arrest by External Electric Stimulation of the Heart 心脏电生理的历史On July 16, 1958 the transvenous catheter electrode was introduced, with fluoroscopy, via the basilic vein into the right ventricular outflow tract, in a patient with fixed complete heart blo
14、ck 心脏电生理的历史1970s 电生理检查和治疗真正起步的年代Ventricular Fibrillation: A Possible Mechanism of Sudden Death in Patients with WPW Syndrome 心脏电生理的历史His bundle activity during the spontaneous and stimulated onset of SVT Initiation and Termination of Ventricular Tachycardia 心脏电生理的历史Overdrive pacing in the WPW syndro
15、me Epicardial Mapping in Ventricular Tachycardia 心脏电生理的历史1980s: 电生理检查和治疗发展的年代 Catheter Ablation of the A-V Junction by DC Energy in Man of open heart心脏电生理的历史Catheter Induced Ablation of the A-V Junction in Man in 1981 at Moffitt Hospital 心脏电生理的历史1990s: 心脏电生理检查和治疗走向辉煌和成熟Transvenous Implantable Defibr
16、illator 心脏电生理的历史导管射频消融(RFCA)ELECTROPHYSIOLOGY: CARDIAC CELLS2 Types of Cells: Electrical & Myocardial Electrical Cells impulse formation & conductionEC distributed evenly along the conduction system of the heart. They possess THREE specific properties.*Automaticity- ability to initiate an impulse sp
17、ontaneously & continuously*Excitability ability to be electrically stimulated *Conductivity-ability to transmit an impulse from one cell to another in an orderly manner * Myocardial Cells form thin muscular layer of atrial wall & the thicker wall of the ventricle.Contractility ability of cell to sho
18、rten & lengthen its muscle fibers respond mechanically to an impulseExtensibility- cell to stretchDEPOLARIZATION & REPOLARIZATIONCardiac Action PotentialIon Channel Diffusion心肌细胞的动作电位静息电位 K平衡电位Nernst方程计算 Em=61.51og(Co/Ci)Em=61.51og(4/140) =-90毫伏“0”相 外来刺激Na+渗入细胞阈电位(-60mV)除极作用形成R波升支心肌细胞的动作电位“0”相 -55mV时,慢钠通道开放,Ca+缓慢内流-10mV氯通道开放,Cl-内流形成R波升支心肌细胞的动作电位“1”相 快Na+通道失活Cl-快速内流-10mV氯通道失活形成R波降支心肌细胞的动作电位“2”相 Ca+内流和K+外渗抵消,形成平台相当于ST段“1”、“2”相交界点相当于J点心肌细胞
温馨提示
- 1. 本站所有资源如无特殊说明,都需要本地电脑安装OFFICE2007和PDF阅读器。图纸软件为CAD,CAXA,PROE,UG,SolidWorks等.压缩文件请下载最新的WinRAR软件解压。
- 2. 本站的文档不包含任何第三方提供的附件图纸等,如果需要附件,请联系上传者。文件的所有权益归上传用户所有。
- 3. 本站RAR压缩包中若带图纸,网页内容里面会有图纸预览,若没有图纸预览就没有图纸。
- 4. 未经权益所有人同意不得将文件中的内容挪作商业或盈利用途。
- 5. 人人文库网仅提供信息存储空间,仅对用户上传内容的表现方式做保护处理,对用户上传分享的文档内容本身不做任何修改或编辑,并不能对任何下载内容负责。
- 6. 下载文件中如有侵权或不适当内容,请与我们联系,我们立即纠正。
- 7. 本站不保证下载资源的准确性、安全性和完整性, 同时也不承担用户因使用这些下载资源对自己和他人造成任何形式的伤害或损失。
最新文档
- 中职教育三年级上学期装备制造大类《充电头的逆向建模》教学课件
- 中职教育二年级上学期英语《Listening and Speaking》教学课件
- 2024年广西电力行业职工职业技能大赛电工(配电带电作业)赛项理论考试题库-上(单选题)
- (初级)航空油料特设维修员(五级)理论考试题库-下(判断题)
- 校园安全知识竞赛试题
- 保安防灾测试试卷及答案
- 中班科学《“小流星”》活动教案
- 中班教案《有趣的昆虫》
- -电影中专属角色音乐对人物形象塑造的作用-以漫威英雄电影为例
- TSG G0002-2010 锅炉节能技术监督管理规程第1号修改单
- 初中英语-How I Learned to Learn English教学课件设计
- 《电力电子技术》课程思政教学案例(一等奖)
- 结构化工作法:让目标高效落地完美达成
- 学校励志教育系列资料-985博导桂海潮案例读书可以改变命运++主题班会
- 2020-2021学年英语外研版(2019)选择性必修第一册学案:Unit 2 第四课时 Writing-描写一次经历含解析
- 【字帖】英语字母衡水体书写字帖
- 【知识点解析】知识梳理-等差数列与一次函数的关系
- 手机上怎么做电子版读后感
- 论文写作100问知到章节答案智慧树2023年中国石油大学(华东)
- 学校管理工作存在的问题及整改方案5篇
- 新版临床输血指南
评论
0/150
提交评论