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ID:57234117
大小:17.08 MB
页数:156页
时间:2020-08-04
《心脏电生理及射频消融基础课件.ppt》由会员上传分享,免费在线阅读,更多相关内容在教育资源-天天文库。
1、电生理相关资料CardiacveinstenosisPTCAwith3.5mmballoonFinalresultModifiedSeldingertechniqueforpercutaneouscathetersheathintroductionSequenceofPWaveGenerationSinusNodeSAJunctionAtrium(Pwave)Non-visibleprocessontheEKGAVnode“Slowzone”IVCLeadIISUMMARYMechanismsofSVTAtrialTachycardiaA
2、VNRTAVRTFPSPDifferentialDiagnosisofNCTShortRPAVRTATSlow-SlowAVNRTLongRPATAtypicalAVNRTPJRTPburiedinQRSTypicalAVNRTATJETSUMMARYObtaina12leadECG.ThelocationofthePwavewilldictatethedifferentialdiagnosisIfhemodynamicallyunstable(chestpain,heartfailure,hypotension)-CARDIOVERSI
3、ONIfhemodynamicallystable-AVNODALAGENTLongtermtherapydependsonmechanismandcanbeconservative,pharmacologicorinvasiveEPstudyoftenneededfordefinitivecharacterizationofmechanismandcancuremostSVTswith90%successrateAVNRTAtrialflutter–sawtoothorpicketfenceAtrialflutterwithrapidr
4、esponseArrhythmias:SABlockPQRSTArrhythmias:AtrialFlutterStepstoreadingECGsWhatistherate?Bothatrialandventriculariftheyarenotthesame.Istherhythmregularorirregular?DothePwavesalllookthesame?IsthereaPwaveforeveryQRSandconverselyaQRSforeveryPwave?Areallthecomplexeswithinnorma
5、ltimelimits?Nametherhythmandanyabnormalities.RateLookatcomplexesina6-secondstripandcountthecomplexes;thatwillgiveyouaroughestimateofrateCountthenumberoflargeboxesbetweentwocomplexesanddivideinto300Countthenumberofsmallboxesbetweentwocomplexesanddivideinto1500Estimaterateb
6、ysequenceofnumbers(seenextslide)BundlebranchblocksLookattheQRSmorphologyinV1andV6AVNRTAcutetreatmentATPorVerapamilCardioversionifBPLongtermDrugs,verapamilorb-blockerEPSandRFAAVRTWPWorconcealedaccessorypathwayacuteandchronictreatmentsimilartoAVNRTavoidb-blockerandverapami
7、linknownWPWAtrialFlutterMarcoreentrantcircuitinRAterminatebycardioversionwithhighsuccessratepoorlycontrolledbymedicaltherapyEPS+RFA“Typicalisthmusdependentatrialflutter”isduetoamacroreentrantcircuitaroundthetricuspidvalveThisrhythmcanbestoppedbypacingandcuredwithablationE
8、mbolicriskmaybelessthaninfibrillation,butsamerecommendationsapplyElectrophysiologyII–Supraventri
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