心臟起搏器培訓(xùn)資料：起搏系統(tǒng)隨訪

1、Pacing System Follow-up 起搏系統(tǒng)隨訪 Evaluation sequence 1.Patients evaluation 2.Pacemaker interrogation 3.Measured and Diagnostic data 4.Capture threshold test 5.Sensing threshold test 6.Device optimization 7.Print final programming 評估順序 1.患者評估患者評估 2.起搏器詢問起搏器詢問 3.測得的數(shù)據(jù)和診斷數(shù)據(jù)測得的數(shù)據(jù)和診斷數(shù)據(jù) 4.奪獲閾值測試奪獲閾值測試 5.感知閾

2、值測試感知閾值測試 6.起搏器參數(shù)優(yōu)化起搏器參數(shù)優(yōu)化 7.打印最后程控報告打印最后程控報告 Evaluation sequence 1.Patients evaluation 2.Pacemaker interrogation 3.Measured and Diagnostic data 4.Capture threshold test 5.Sensing threshold test 6.Device optimization 7.Print final programming 評估順序 1.患者評估患者評估 2.起搏器詢問起搏器詢問 3.測得的數(shù)據(jù)和診斷數(shù)據(jù)測得的數(shù)據(jù)和診斷數(shù)據(jù) 4.奪獲閾

3、值測試奪獲閾值測試 5.感知閾值測試感知閾值測試 6.起搏器參數(shù)優(yōu)化起搏器參數(shù)優(yōu)化 7.打印最后程控報告打印最后程控報告 Patient Information 患者信息 Patient Notes 注意 fast ECG printout to check the pacemaker behaviour before. Choose and press here 在詢問之前，快速打印ECG，以檢查起搏器功能 選擇和選擇和 點擊 這里 Evaluation sequence 1.Patients evaluation 2.Pacemaker interrogation 3.Measured a

4、nd Diagnostic data 4.Capture threshold test 5.Sensing threshold test 6.Device optimization 7.Print final programming 評估順序 1.患者評估患者評估 2.起搏器詢問起搏器詢問 3.測得的數(shù)據(jù)和診斷數(shù)據(jù)測得的數(shù)據(jù)和診斷數(shù)據(jù) 4.奪獲閾值測試奪獲閾值測試 5.感知閾值測試感知閾值測試 6.起搏器參數(shù)優(yōu)化起搏器參數(shù)優(yōu)化 7.打印最后程控報告打印最后程控報告 Interrogate Device 詢問起搏器 Lead impedance ELT Fast V Rate / EGM Sum

5、mary Screen (FastPath) 導(dǎo)線阻抗 快心室率 / EGM 小結(jié)界面 (FastPath) Evaluation sequence 1.Patients evaluation 2.Pacemaker interrogation 3.Measured and Diagnostic data 4.Capture threshold test 5.Sensing threshold test 6.Device optimization 7.Print final programming 評估順序 1.患者評估患者評估 2.起搏器詢問起搏器詢問 3.測得的數(shù)據(jù)和診斷數(shù)據(jù)測得的數(shù)據(jù)和診

6、斷數(shù)據(jù) 4.奪獲閾值測試奪獲閾值測試 5.感知閾值測試感知閾值測試 6.起搏器參數(shù)優(yōu)化起搏器參數(shù)優(yōu)化 7.打印最后程控報告打印最后程控報告 Summary Screen (FastPath) 小結(jié)界面 (FastPath) Measured Data Careful analysis of measured data Leads impedance Less than 20% changes from one visit to the next 1200 : conduction failure Battery data Internal Impedance : information on

7、battery reserve 2-3 k : closer scheduled visits from ERI, it remains at least 3 months functioning Consumption: impact on PM longevity high consumption = early exhaustion 測得的數(shù)據(jù) 仔細分析測得的數(shù)據(jù) 導(dǎo)線阻抗 從一次隨訪至下一次隨訪，變化應(yīng)小于20% 1200 : 導(dǎo)線斷裂 電池數(shù)據(jù) 內(nèi)阻: 信息基于電池儲備 2-3 k: 縮短隨訪間隔縮短隨訪間隔 從ERI開始，還剩至少3個月電池容量 消耗: 影響起搏器壽命 高消耗 =

8、提前耗竭 Lets see Summary Screen again Summary screen is the first action automatically done, The next step is to check what has happened since the last followup Episodes Diagnostics Once you checked E & D, do tests (if necessary) 讓我們再看一下小結(jié)界面 小結(jié)界面是第一個自動完成的動作小結(jié)界面是第一個自動完成的動作 下一步是檢查從上一次隨訪至今發(fā)下一步是檢查從上一次隨訪至今發(fā)

9、 生了什么生了什么 發(fā)作發(fā)作 診斷診斷 一旦完成發(fā)作和診斷的檢查之后，一旦完成發(fā)作和診斷的檢查之后， 進行測試進行測試(如需要如需要) Lets navigate and press Episode Button 讓我們從導(dǎo)航條中點擊發(fā)作鍵 Episode Button 發(fā)作鍵 Episode Button Remember that always HVR trigger will be activated if any other trigger is activated 發(fā)作鍵 記住: 如果 任何其他 觸發(fā)器被 激活，那 么HVR觸 發(fā)器總是 處于打開 狀態(tài) Diagnostics 診斷

10、Automatic Mode Switch 自動模式轉(zhuǎn)換 AF Suppresion Diagnostic AF Suppresion診斷 AMS Histogram - April 2002 Thank you Dr Levine! AMS直方圖2002年4月 AMS Histogram - Jan 2003 Thank you Dr Levine! AMS直方圖2003年1月 AMS Histogram - July 2003 Thank you Dr Levine! AMS直方圖2003年7月 Evaluation sequence 1.Patients evaluation 2.Pac

11、emaker interrogation 3.Measured and Diagnostic data 4.Capture threshold test 5.Sensing threshold test 6.Device optimization 7.Print final programming 評估順序 1.患者評估患者評估 2.起搏器詢問起搏器詢問 3.測得的數(shù)據(jù)和診斷數(shù)據(jù)測得的數(shù)據(jù)和診斷數(shù)據(jù) 4.奪獲閾值測試奪獲閾值測試 5.感知閾值測試感知閾值測試 6.起搏器參數(shù)優(yōu)化起搏器參數(shù)優(yōu)化 7.打印最后程控報告打印最后程控報告 Back to FastPath Summary: Test 回

12、到FastPath小結(jié): 測試 Ventricular capture test 心室奪獲閾值測試 Ventricular capture test 心室奪獲閾值測試 Ventricular capture test 心室奪獲閾值測試 Ventricular capture test 心室奪獲閾值測試 Ventricular capture test 心室奪獲閾值測試 Ventricular Capture test 心室奪獲閾值測試 Ventricular Autocapture Setup 心室Autocapture設(shè)置 followup capability (Seeing is Bel

13、ieving) 隨訪能力 (眼見為實) Atrial capture 心房奪獲閾值測試 Atrial Capture Test New tests preset values in Victory Basic rate AV/PV delay Atrial pulse amplitude Cycles per Step 心房奪獲閾值測試 基本頻率 AV/PV間期 心房脈沖振幅 每步周期數(shù) 在Victory中新 的測試預(yù)設(shè)置值 Atrial Capture Test 心房奪獲閾值測試 Atrial Capture Test 心房奪獲閾值測試 Atrial Capture Test 心房奪獲閾值測

14、試 Evaluation sequence 1.Patients evaluation 2.Pacemaker interrogation 3.Measured and Diagnostic data 4.Capture threshold test 5.Sensing threshold test 6.Device optimization 7.Print final programming 評估順序 1.患者評估患者評估 2.起搏器詢問起搏器詢問 3.測得的數(shù)據(jù)和診斷數(shù)據(jù)測得的數(shù)據(jù)和診斷數(shù)據(jù) 4.奪獲閾值測試奪獲閾值測試 5.感知閾值測試感知閾值測試 6.起搏器參數(shù)優(yōu)化起搏器參數(shù)優(yōu)化 7.

15、打印最后程控報告打印最后程控報告 Back to the FastPath Summary 回到 FastPath小結(jié) Ventricular Sensing Threshold Intact AV conduction Increase AV / PV delay, and decrease the sensibility until loss of sensing. Event markers are very helpful. 心室感知閾值測試 伴完整AV傳導(dǎo) 增加AV/PV間期，降低敏感度，直至失感知 事件標記非常有用 Ventricular Sensing Threshold R-w

16、ave amplitude test Utilizes Sense Amplifier Filters 心室感知閾值測試 R波振幅測試 使用感知放大器和過濾器使用感知放大器和過濾器 followup capability (Seeing is Believing) 隨訪能力 (眼見為實) Atrial Sensing Threshold Non intact AV conduction 心房感知閾值測試 無完整AV傳導(dǎo) Atrial Sensing Threshold Intact AV conduction 心房感知閾值測試 伴完整AV傳導(dǎo) Atrial Sensing Threshold

17、P-wave amplitude test 心房感知閾值測試 P波振幅測試 Evaluation sequence 1.Patients evaluation 2.Pacemaker interrogation 3.Measured and Diagnostic data 4.Capture threshold test 5.Sensing threshold test 6.Device optimization 7.Print final programming 評估順序 1.患者評估患者評估 2.起搏器詢問起搏器詢問 3.測得的數(shù)據(jù)和診斷數(shù)據(jù)測得的數(shù)據(jù)和診斷數(shù)據(jù) 4.奪獲閾值測試奪獲閾值測

18、試 5.感知閾值測試感知閾值測試 6.起搏器參數(shù)優(yōu)化起搏器參數(shù)優(yōu)化 7.打印最后程控報告打印最后程控報告 Back to the FastPath Summary 回到FastPath小結(jié) Parameters 參數(shù) Parameters 參數(shù) Evaluation sequence 1.Patients evaluation 2.Pacemaker interrogation 3.Measured and Diagnostic data 4.Capture threshold test 5.Sensing threshold test 6.Device optimization 7.Prin

19、t final programming 評估順序 1.患者評估患者評估 2.起搏器詢問起搏器詢問 3.測得的數(shù)據(jù)和診斷數(shù)據(jù)測得的數(shù)據(jù)和診斷數(shù)據(jù) 4.奪獲閾值測試奪獲閾值測試 5.感知閾值測試感知閾值測試 6.起搏器參數(shù)優(yōu)化起搏器參數(shù)優(yōu)化 7.打印最后程控報告打印最后程控報告 .finally the Wrap up screen Go to wrap up screen and select the report you need. Summary Report Episodes Atrial Test result .最后Wrap-up概述 進入wrap-up概述界面，選擇需要打印的報告 小結(jié)報告 發(fā)作 測試報告 Wrap up Screen Wrap-up screen is a reminder screen where you can check all tasks done and essential information Remaining Longe