[医学]D1_心脏生理解剖结构和传导路径.ppt

Electrophysiology 电生理知识 Training 培训 Date1 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions 培训内容 The anatomy of the heart 心脏解剖结构 The electrical conduction system 电传导途径 The EP procedure 电生理手术过程 The EP catheter 电生理导管简介 The Biosense Webster product portfolio BW产品综述 Date2 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions 电生理培训（一） 心脏解剖结构、电传导路径 导管定位 Date3 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions A n a t o m y o f t h e H e a r t A r r h y t h m i a s 位置 大小 心脏 Date4 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions 左室 冠状窦 右室 左房 右房 左下肺静脉 左上肺静脉 左上肺静脉 左下肺静脉 左室上腔静脉 主动脉弓 下腔静脉 Date5 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions Date6 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions 卵圆窝 房间隔 主动脉 界嵴 Date7 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions 三尖 瓣 肺动脉 室间隔 Date8 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions 二尖瓣 Date9 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions 循环系统 Date10 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions Right coronary artery 右冠 posterior descending artery 后降支 Left coronary artery 左冠 LAD 前降支 Circumflex and its marginal 回旋支 CORONARY CIRCULATION 冠状动脉循环系统 ARTERIAL SUPPLY 动脉血供 Date11 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions 右冠 左冠 回旋支 左心耳 前降支 Date12 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions Date13 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions Date14 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions 心脏解剖结构 右房 右室 左房 左室 冠状窦 右室心尖 心尖 高位右房 升主动脉 右室流出道 上腔静脉 下腔静脉 三尖瓣环 Date15 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions 心脏传导系统 希氏束 蒲氏纤维 窦房节 房室节 Date16 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions AV 心脏的电传导系统 CS SA 纤维瓣环 RV LV RA LA TV MV Date17 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions A n a t o m y o f t h e H e a r t A r r h y t h m i a s Date18 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions 心肌细胞的电活动周期 Date19 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions 体表心电图 P Q R S T Simplified ECG Date20 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions A n a t o m y o f t h e H e a r t A r r h y t h m i a s BWT Apr02 Date21 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions P wave - Atrial Depolarisation QRS PR interval ST segment T wave PR Interval Q R S ST Segment P T Date22 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions Date23 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions P P wave - Atrial Depolarisation QRS - Ventricular Depolarisation PR interval ST segment T wave PR Interval Q R S ST Segment T Date24 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions Date25 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions P Q PR Interval R S ST Segment P wave - Atrial Depolarisation QRS - Ventricular Depolarisation PR interval - time taken for the impulse to be conducted from the SA node to just before ventricular depolarization ST segment T wave T Date26 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions Date27 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions P P wave - Atrial Depolarisation QRS - Ventricular Depolarisation PR interval - time taken for the impulse to be conducted from the SA node to the Purkinjie ST segment - Beginning of Ventricular Repolarisation T wave PR Interval Q R S ST Segment T Date28 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions P P wave - Atrial Depolarisation QRS - Ventricular Depolarisation PR interval - time taken for the impulse to be conducted from the SA node to the Purkinjie ST segment - Beginning of Ventricular Repolarisation T wave - Ventricular Repolarisation (Recovery) PR Interval Q R S ST Segment T Date29 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions Repolarization or Recovery Date30 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions 心电传导路径 如何测量这些时间 距离 (PA, AH, HV)? 靠近相应这些位置获得其 心内心电信号，并同其他 部位的信号相比较。 Standard values 希氏束 房室节 窦房节 ECG Date31 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions 如何到达这些传导位置? 利用电生理标测导管: 最早激动位置: 窦房结 HRA 希氏束电位： 希氏束 HBE 最晚电位： 心室心尖 RVA 左房电位/ 左室电位 冠状窦 CS Date32 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions 常规电生理标测过程 RAO LAO PA 右室心 尖电极 冠状窦 电极 希氏束 电极 高位右 房电极 Date33 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions X光透视图（右前斜位） RAO Date34 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions LAO X光透视图（左前斜位） Date35 Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positi