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Pacemakers and Implantable Defibrillators презентация
Содержание
- 1. Pacemakers and Implantable Defibrillators
- 3. Worldwide, > 250,000 permanent cardiac pacemakers
- 4. Pacemaker Temporary Permanent
- 5. Epicardial Endocardial
- 11. Temporary pacing Transcutaneous Transvenous
- 12. Transcutaneous pacing
- 13. Transvenous temporary pacing
- 14. Temporary pacemaker(2) Transvenous -Subclavian -Jugular - Femoral
- 15. Common Indications for Temporary Pacing Complete heart
- 16. Epicardial pacing
- 18. Permanent Pacemaker
- 19. Pacemaker Components Pulse generator Leads programmer
- 20. • Complete Heart Block or high
- 22. Pacing Sensing
- 23. Pacemaker Nomenclature
- 25. Atrial and ventricular pacing
- 27. Pacemaker interrogation and programming
- 28. Example 1 Ventricular sensed, ventricular paced Consistent
- 29. Example 2 Atrial sensed, ventricular paced Consistent
- 30. Example 4 Failure to Pace The Alan E. Lindsay ECG Learning Center ; http://medstat.med.utah.edu/kw/ecg/
- 31. Failure to capture
- 32. Complications Infection or erosion Hematoma Pneumothorax Lead dislodgment Lead malfunctions or fractures Electromagnetic interference
- 33. Reddy VY et al. N Engl J Med 2015;373:1125-1135. The Leadless LPacemaker.
- 34. Implantable Cardiac Defibrilator
- 36. Implantable Cardiac Defibrilator
- 37. Inventor of the ICD Michel Mirowski, M.D. 1924-1990
- 38. Indications 1. Cardiac arrest due to
- 40. Antitachycardia pacing
- 41. LV dysfunction EF < 30%
- 42. Subcutaneous defibrilator
- 43. External vest defibrilator
- 44. CLBBB
- 45. LV dysfunction + wide QRS
- 46. Cardiac resyncronization
- 49. ?
Worldwide, > 250,000 permanent cardiac pacemakers implanted each year. The primary role of cardiac pacing is to augment or replace the heart's intrinsic electrical system.
Слайд 3
Worldwide, > 250,000 permanent cardiac pacemakers implanted each year.
The primary
role of cardiac pacing is to augment or replace the heart's intrinsic electrical system.
Слайд 15Common Indications for Temporary Pacing
Complete heart block
Sinus bradycardia
Prior to the implant/replacement
of a permanent pacemaker
Acute myocardial infarction complicated by heart block
Temporary support of a patient after heart surgery
Acute myocardial infarction complicated by heart block
Temporary support of a patient after heart surgery
Слайд 20
• Complete Heart Block or high grade 2nd degree A-v block
•
Sick Sinus Syndrome
Common Indications for Implantable Cardiac Pacemaker
Слайд 21
Stimulate cardiac depolarization
Sense intrinsic cardiac function
Respond to increased metabolic demand by
providing rate responsive pacing
Provide diagnostic information stored by the pacemaker
Provide diagnostic information stored by the pacemaker
Most Pacemakers Perform Four Functions:
Слайд 28Example 1
Ventricular sensed, ventricular paced
Consistent with VVI
The Alan E. Lindsay ECG
Learning Center ; http://medstat.med.utah.edu/kw/ecg/
Слайд 29Example 2
Atrial sensed, ventricular paced
Consistent with DDD or VDD
The Alan E.
Lindsay ECG Learning Center ; http://medstat.med.utah.edu/kw/ecg/
Слайд 30Example 4
Failure to Pace
The Alan E. Lindsay ECG Learning Center ;
http://medstat.med.utah.edu/kw/ecg/
Слайд 32Complications
Infection or erosion
Hematoma
Pneumothorax
Lead dislodgment
Lead malfunctions or fractures
Electromagnetic interference
Слайд 38Indications
1. Cardiac arrest due to VF or VT not due
to a transient or reversible cause.
2. Spontaneous sustained VT in association with structural heart disease.
3. Syncope of undetermined origin with clinically relevant, hemodynamically significant sustained VT or VF induced at electrophysiologic study
4. Nonsustained VT in patients with coronary disease, prior myocardial infarction, LV dysfunction, and inducible VF or sustained VT at electrophysiologic study
5. Spontaneous sustained VT in patients without structural heart disease
2. Spontaneous sustained VT in association with structural heart disease.
3. Syncope of undetermined origin with clinically relevant, hemodynamically significant sustained VT or VF induced at electrophysiologic study
4. Nonsustained VT in patients with coronary disease, prior myocardial infarction, LV dysfunction, and inducible VF or sustained VT at electrophysiologic study
5. Spontaneous sustained VT in patients without structural heart disease
