D1_心脏生理解剖结构和传导路径.ppt

1 6 2020 Slide1 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions Electrophysiology电生理知识 Training培训 1 6 2020 Slide2 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions 培训内容 Theanatomyoftheheart心脏解剖结构Theelectricalconductionsystem电传导途径TheEPprocedure电生理手术过程TheEPcatheter电生理导管简介TheBiosenseWebsterproductportfolioBW产品综述 1 6 2020 Slide3 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions 电生理培训 一 心脏解剖结构 电传导路径导管定位 1 6 2020 Slide4 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions AnatomyoftheHeart Arrhythmias 位置 大小 心脏 1 6 2020 Slide5 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions 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 1 6 2020 Slide6 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions 1 6 2020 Slide7 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions 卵圆窝 房间隔 主动脉 界嵴 1 6 2020 Slide8 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions 三尖瓣 肺动脉 室间隔 1 6 2020 Slide9 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions 二尖瓣 1 6 2020 Slide10 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions 循环系统 1 6 2020 Slide11 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions Rightcoronaryartery右冠posteriordescendingartery后降支Leftcoronaryartery左冠LAD前降支Circumflexanditsmarginal回旋支 CORONARYCIRCULATION冠状动脉循环系统 ARTERIALSUPPLY动脉血供 1 6 2020 Slide12 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions 右冠 左冠 回旋支 左心耳 前降支 1 6 2020 Slide13 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions 1 6 2020 Slide14 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions 1 6 2020 Slide15 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions 心脏解剖结构 三尖瓣环 1 6 2020 Slide16 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions 心脏传导系统 希氏束 蒲氏纤维 窦房节 房室节 1 6 2020 Slide17 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions AV 心脏的电传导系统 CS 1 6 2020 Slide18 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions AnatomyoftheHeart Arrhythmias BIOSENSEWEBSTERTRAINING 1 6 2020 Slide19 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions 心肌细胞的电活动周期 1 6 2020 Slide20 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions 体表心电图 P Q R S T SimplifiedECG 1 6 2020 Slide21 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions AnatomyoftheHeart Arrhythmias BWTApr 02 1 6 2020 Slide22 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions BIOSENSEWEBSTERPRODUCTTRAINING Pwave AtrialDepolarisationQRSPRintervalSTsegmentTwave T 1 6 2020 Slide23 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions BIOSENSEWEBSTERPRODUCTTRAINING 1 6 2020 Slide24 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions BIOSENSEWEBSTERPRODUCTTRAINING P Pwave AtrialDepolarisationQRS VentricularDepolarisationPRintervalSTsegmentTwave T 1 6 2020 Slide25 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions BIOSENSEWEBSTERPRODUCTTRAINING 1 6 2020 Slide26 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions BIOSENSEWEBSTERPRODUCTTRAINING P Q Pwave AtrialDepolarisationQRS VentricularDepolarisationPRinterval timetakenfortheimpulsetobeconductedfromtheSAnodetojustbeforeventriculardepolarizationSTsegmentTwave T 1 6 2020 Slide27 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions BIOSENSEWEBSTERPRODUCTTRAINING 1 6 2020 Slide28 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions BIOSENSEWEBSTERPRODUCTTRAINING P Pwave AtrialDepolarisationQRS VentricularDepolarisationPRinterval timetakenfortheimpulsetobeconductedfromtheSAnodetothePurkinjieSTsegment BeginningofVentricularRepolarisationTwave T 1 6 2020 Slide29 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions BIOSENSEWEBSTERPRODUCTTRAINING P Pwave AtrialDepolarisationQRS VentricularDepolarisationPRinterval timetakenfortheimpulsetobeconductedfromtheSAnodetothePurkinjieSTsegment BeginningofVentricularRepolarisationTwave VentricularRepolarisation Recovery T 1 6 2020 Slide30 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions BIOSENSEWEBSTERPRODUCTTRAINING RepolarizationorRecovery 1 6 2020 Slide31 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions 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 1 6 2020 Slide32 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions 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 1 6 2020 Slide33 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions 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 1 6 2020 Slide34 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions X光透视图 右前斜位 RAO 1 6 2020 Slide35 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions LAO X光透视图 左前斜位 1 6 2020 Slide36 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions 典型心内心电图记录 SurfaceECG HRA HBE CS RVA 1 6 2020 Slide37 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions BIOSENSEWEBSTERPRODUCTTRAINING 导管放置 1 6 2020 Slide38 BiosenseWebsterEPTraining2003PartAnatomy ConductionSystem andCatheterPositions A 波 H 波 V 波 BIOSENSEWEBSTERPRODUCTTRAINING 1 6 202