现代起搏器对房性心律失常的诊断、治疗及预防.ppt

通过SOS AF临床我们得知 AF负荷阈值 是评判AF负荷与中风风险相关联的重要标准。AF负荷超过一小时，患者发生中风风险几率极大提高。 AF负荷是对缺血性中风风险的独立预测因子，结果显示AF负荷达到6小时，风险为1.17(95% CI: 1.01-1.36) ，12小时为1.37 (95% CI: 1.01-1.85). SOS AF临床研究并没有仅观察前3个月，而是在整个随访期间都对AF负荷进行记录。这种方式可以更加直接观察到6个月是患者达到最大AF负荷的中位数。 * 心房Reactive ATP 会持续监测AT/AF，尤其针对较长事件，找寻机会重新开启ATP治疗方案以达到终止AT/AF事件的效果。同时，针对发生节律改变或者设定时间，会持续的发放不同的ATP治疗方案。 The Atrial Reactive ATP parameters of Rhythm Change and Time Interval can be programmed from the AT/AF Detection and Therapies window accessed from the Parameters icon. Details of operation on these two parameters are included in subsequent slides. * 当依据节律变化的ReactiveATP程控为打开，器械会自动检测在心房心律失常事件中以下的变化： 规律性的改变(观察时间间期) 2. 时间间期的改变(频率) Depending upon the number of detection “Zones” programmed (1-zone or 2-zones), the device will automatically subdivide these zones into a series of more narrow bins. One series of bins is used for regular atrial rhythms and the other for irregular atrial rhythms. Each bin is supplied with its own set of the atrial ATP therapies programmed (Rx1, Rx2 and/or Rx3). When single-zone (1-zone) detection is programmed, all sequences of Rx1, Rx2 and Rx3 are available within each sub-bin. If two-zone detection is used (Fast AT/AF, AT/AF), each of these two zones has its own unique set of ATP therapies assigned to it. The Fast AT/AF zone will get only one set of ATP therapies (there are no sub-bins). In the example on this slide, the Fast AT/AF Zone was programmed at 200 ms. All sequences of Rx1, Rx2 and Rx3 would be available only once for any tachyarrhythmias that have a cycle length of 100-200 ms. However, for any tachyarrhythmias that are slower than 200 ms, the Rx1, Rx2 and Rx3 sequences could be attempted multiple times depending whether the arrhythmia shifts in cycle length or regularity (i.e., shifts from bin-to-bin).  Example of Rhythm Change ATP Delivery for One-Zone Detection: AT/AF detected as “regular” with a cycle length of 200 ms. Device delivers all 8 sequences of programmed Rx1 (Ramp) – assumin