心脏起搏器培训资料：起搏器随访

1、Pacemaker Follow-up 起搏器随访 Pacemaker Follow-up Goals and Check Lists Initial Interrogation Assess Function Patient Information Measured Data Magnet Information Diagnostics Testing Final Settings and Interrogation Transtelephonic Follow-up Note: Click once on an underlined topic to go directly to that

2、 section in the presentation 起搏器随访 目的和检查清单 开始询问 评估功能 患者信息 测得的数据 磁铁信息 诊断 测试 最后设置和询问 远程电话随访 注明：点击带下划线主题一次能够直接跳到本演示中相应的部分 Pacemaker Follow-up Goals and Check Lists 起搏器随访 目的和检查清单 Goal Of Follow-up Verify appropriate pacemaker operation Optimize pacemaker functions Document findings, changes and final se

3、ttings in order to provide appropriate patient management 随访目的 确认起搏器的工作状态是否正常 优化起搏器的工作模式 有效管理患者，包括提供备案文件、参数改 变及最后的设置 Problems in Follow-up Disease related System related Threshold and sensitivity changes Lead integrity Pacemaker mediated tachycardia Inappropriate upper rate/sensor responses Myopoten

4、tial Crosstalk or crosstalk inhibition 随访中的问题 相关疾病 相关系统 阈值和感知灵敏度改变 导线完整性 起搏器介导的心动过速 不恰当的上限频率/传感器反应 交叉感知或交叉抑制 Check List q Attach surface ECG leads with good skin prep q Check pacemaker implantation site q ECG rhythm-strip q Presenting q Magnet q Interrogate pacer for administrative data q Verify pac

5、emaker parameters 检查清单 q 做好皮肤准备，连接体表ECG导联 q 检查起搏器植入部位 q ECG走纸 q 当前 q 磁铁 q 询问起搏器 q 确认起搏器参数 Check List q Measured data from programmer q PRINT ORIGINAL SETTINGS q Read Diagnostics q Verify sensing and ensure adequate safety margin q Verify capture and ensure adequate safety margin 检查清单 q 从程控仪测得的数据 q 打

6、印原始设置 q 阅读诊断 q 确认感知和保证足够的安全范围 q 确认夺获和保证足够的安全范围 Check List q Myopotential test q Chest X-Ray q Prior to discharge q When symptoms dictate q Clinical assessment q Reprogram as indicated 检查清单 q 肌电干扰测试 q 胸部X线 q 出院前 q 有症状时 q 临床评价 q 根据指示重新程控 Pacemaker Follow-up Initial Interrogation 起搏器随访 初始询问 Initial Int

7、errogation Magnet must be removed from the telemetry wand before interrogation Except for Trilogy If you interrogate with the magnet in the wand the following message will appear “Remove magnet from the telemetry wand and try again.” 初始询问 在询问前，必须将磁铁从程控头上移走 除了Trilogy 如果你试图在磁铁存在时询问，下列信息将会 出现 “Remove m

8、agnet from the telemetry wand and try again.” Initial Interrogation Initial Interrogation provides current programmed setting The surface ECG and Markers will be transmitted automatically and assessment of current pacing and sensing function should be determined 初始询问 初始询问提供了当前程控的设置 体表心电图和标记会被自动传送，并且

9、应该判 断目前的起搏和感知效果 FastPath Summary Screen One touch to and from Summary Screen Direct link to capture and sense threshold testing Key Parameters Key Diagnostics Longevity Estimate Key Alerts Key Parameters Lead Analysis Capture and Sense Test Results Diagnostic Summary FastPath 汇总界面 从汇总界面，点击一个键 直接链接到感

10、知和阈值测试 主要参数 主要诊断 使用寿命估计 主要报警 主要参数 导线分析 夺获和感知测试结果 诊断小结 FastPath Summary Screen FastPath汇总界面 Initial Interrogation Basic Parameters 初始询问基本参数 Initial Interrogation Basic Parameters 初始询问基本参数 Initial Interrogation Extended Parameters 初始询问扩展参数 Initial Interrogation Sensor Parameters 初始询问传感器参数 Initial Inte

11、rrogation Patient Data 初始询问患者资料 Interrogate and retrieve Measured Data print-out results these will be your “Initial” values Initial Interrogation Print-out 询问和搜索测得询问和搜索测得 的数据，并打印的数据，并打印 结果结果 这些就是你的这些就是你的“ 初始初始”数据数据 初始询问打印输出 Pacemaker Follow-up Assess Function 起搏器随访 评价功能 Assess Current Pacemaker Fun

12、ction Compare the Surface ECG to the Markers to determine appropriate pacing (capture) and sensing Make sure the patient and the pacemaker status match 评价当前起搏器功能 比较体表心电图和标记，确定起搏和感知是否 正常 确认患者和起搏器状态匹配 Markers 标记 P 心房感知 R 心室感知 A 心房起搏 V 心室起搏 心房感知心房感知 心室起搏心室起搏 Assess Current Pacemaker Function 评价当前起搏器功能

13、Assess Current Pacemaker Function 评价当前起搏器功能 IEGM IEGM Pacemaker Follow-up Patient Information 起搏器随访 患者信息 Patient Information Most modern pacemakers provide useful telemetered administrative data Pacemaker Model Number Serial Number Implant Date Lead Type Date last programmed 患者信息 现在，大多数起搏器提供有用的遥测管理数

14、据 起搏器型号 序列号 植入日期 导线类型 上次程控日期 Patient Information No guessing involved or reliance on incomplete records Useful for patients new to the clinic or lost to follow up Alerts physician to reprogramming by another facility 患者信息 不能猜测和依靠不完全的记录 对于前来诊所的新患者和失随访的患者有用 医生可用其他程控仪再程控 Patient Information 患者信息 Pacema

15、ker Follow-up Measured Data 起搏器随访 测得的数据 Measured Data Provides information on: Magnet Information Lead Status Battery Status 测得的数据 提供如下信息: 磁铁信息 导线状态 电池状态 Measured Data 测得的数据 Measured Data Dont forget to LOOK at the data 测得的数据 不要忘记看一下数据 Measured Data 测得的数据 心房阻抗心房阻抗 大于大于2500 Pacemaker Follow-up Magnet

16、 Information 起搏器随访 磁铁信息 Magnet Reponses Magnet application results in asynchronous pacing at magnet rate 98.6 PPM / 2.8 Volts = BOL 86.3 PPM / 2.5 Volts = ERI 65.7 PPM / 2.16 Volts = EOL Stepwise decrease AV Delay changes to 125 ms 磁铁反应 磁铁应用导致磁铁频率的非同步起搏 98.6 PPM / 2.8 V = BOL 86.3 PPM / 2.5 V = ERI

17、65.7 PPM / 2.16 V = EOL 逐步下降 AV间期改变至125ms Elective Replacement Indicator (ERI) ERI Indicators 86.3 PPM / 2.5 volts The base rate interval will increase by 100 ms Upon interrogation a display that ERI has been reached ERI nominally = 3 months battery life remaining Device should be replaced as soon a

18、s possible to ensure proper pacemaker function 选择性更换指示 (ERI) ERI指示 86.3 PPM / 2.5 V 基本频率间期增加100ms 在询问时，显示“ERI has been reached” ERI 默认值 = 剩余3个月电池寿命 应该尽可能快地更换起搏器，以确保正常的起 搏器功能 Pacemaker Follow-up Diagnostics 起搏器随访 诊断 Diagnostics A means of assessing past (since diagnostics last cleared), pacemaker per

19、formance 诊断 一种评价过去 (自上次诊断数据被清除以来)和 起搏器表现的方法 Identity ADxIntegrity ADxVerity ADx DR SRDR SRDR SR AF Suppression Histogram/Count X AT/AF Burden Trend/CounterX AT/AF Episode HistogramX AT/AF Episode LogX Long Term Threshold RecordXXXXXX AMS HistogramXXX AMS LogX Event HistogramXXXXXX Heart Rate Histogr

20、am/Counts XXXXXX Sensor Indicated HistogramXXXXXX Stored EGMsXXXX Stored EGM Trigger CounterXXXX Event RecordXXXXXX Event SnapshotsXXXX Prediction ModelXXXXXX Diagnostics Identity ADxIntegrity ADxVerity ADx DR SRDR SRDR SR AF Suppression 直方图/计数X AT/AF 负荷趋势/计数X AT/AF 发作直方图X AT/AF 发作日志X 长期阈值记录XXXXXX A

21、MS 直方图XXX AMS 日志X 事件直方图XXXXXX 心率直方图/计数 XXXXXX 传感器指示直方图XXXXXX 存储的EGMXXXX 存储的EGM触发计数XXXX 事件记录XXXXXX 事件快照XXXX 预测模型XXXXXX 诊断 Identity Integrity Affinity DR SRDR SRDR SR AF Suppression Histogram/Count X AT/AF Burden Trend/Counter AT/AF Episode Histogram AT/AF Episode Log Long Term Threshold RecordXXXXXX

22、AMS HistogramXXX AMS LogX Event HistogramXXXXXX Heart Rate Histogram/Counts XXXXXX Sensor Indicated HistogramXXXXXX Stored EGMsXX Stored EGM Trigger CounterXX Event RecordXXXXXX Event SnapshotsXXXX Prediction ModelXXXXXX Diagnostics Identity Integrity Affinity DR SRDR SRDR SR AF Suppression 直方图/计数X

23、AT/AF 负荷趋势/计数 AT/AF 发作直方图 AT/AF 发作日志 长期阈值记录XXXXXX AMS 直方图XXX AMS 日志X 事件直方图XXXXXX 心率直方图/计数 XXXXXX 传感器指示直方图XXXXXX 存储的EGMXX 存储的EGM触发计数XX 事件记录XXXXXX 事件快照XXXX 预测模型XXXXXX 诊断 Diagnostics AF Suppression Histogram Graphic representation of all paced and sensed events that have occurred while the algorithm is

24、 programmed ON 诊断AF Suppression直方图 图形表示该功能打开时发生的所有起搏和感知事件 Diagnostics AT/AF Burden Trend Graphical representation of weekly trends of the patients AT/AF episodes for 28 weeks Graphical representation of the weekly percentage of time the device was in AT/AF for 28 weeks Total percent of time in AT/AF

25、 Total AT/AF Episodes Date read and last cleared If more than 28 weeks are recorded by the device, the newest data overrides the oldest data. 诊断AT/AF负荷趋势 图形表示患者在28周内，AT/AF发作的每周趋 势 图形表示在28周内，起搏器在AT/AF状态的每 周时间百分比 AT/AF总的时间百分比 总AT/AF发作次数 读取日期和上次清除日期 如果起搏器的记录超过28周，新的数据会自动 覆盖旧的数据 Diagnostics AT/AF Burden

26、 Trend Identifies long-term trends for device or drug management Shows the patients atrial arrhythmia status 诊断AT/AF负荷趋势 确认长期趋势便于起搏器/药物管理 显示患者的房性心律失常状态 Diagnostics AT/AF Episode Histogram Provides a broad picture for speedy diagnosis of atrial tachyarrhythmias 诊断AT/AF发作直方图 为快速诊断房性快速心律失常提供一个宽的图片 Diag

27、nostics AT/AF Burden Event Counter Identifies long-term trend for device or drug management Provides specific tabular data on number of episodes and duration 诊断AT/AF负荷事件计数 确认长期趋势便于起搏器/药物管理 提供了具体的数据表格，包括发作次数和持续时间 Diagnostics AT/AF Episodes Log Provides detailed information on 32 AT/AF episodes (first

28、 16 and last 16) 诊断AT/AF发作日志 提供了32个AT/AF发作的详细信息 (前16个和最后16个) Diagnostics Long Term Threshold Record 诊断长期阈值记录 Diagnostics Long Term Threshold Record 诊断长期阈值记录 Diagnostics AMS Histogram 诊断AMS直方图 Diagnostics Auto Mode Switch Log 诊断AMS日志 Diagnostics Event Histogram 诊断事件直方图 评估窦房结和房评估窦房结和房 室结的功能，提室结的功能，提 供

29、调整参数的依供调整参数的依 据据 Diagnostics Heart Rate Histogram 诊断心率直方图 Diagnostics Heart Rate Histogram Count Data This Patient had Rest Rate enabled at 45 PPM 诊断心率直方图 计数数据 该患者的休息频率在45PPM时启动 Diagnostics Sensor Indicated Histogram 诊断传感器指示直方图 Diagnostics Stored EGM Triggers Advanced Hysteresis AT/AF Detection High

30、 Atrial Rate High Ventricular Rate AMS Entry AMS Exit PVCs PMT Termination Patient Activated (with Magnet) 诊断存储的EGM触发器 高级滞后 AT/AF检测 高心房率 高心室率 AMS启动 AMS终止 PVC PMT检测 患者激活的 (应用磁铁) Diagnostics Stored EGM Triggers 诊断存储的EGM触发器 Diagnostics Stored Electrograms 诊断储存的腔内心电图 Diagnostics Stored Electrograms 诊断储存

31、的腔内心电图 Diagnostics Event Record 诊断事件记录 Diagnostics Event Record 诊断事件记录 Diagnostics Event Record 诊断事件记录 Diagnostics Event Record Expanded View 诊断事件记录扩展界面 Diagnostics Event Snapshots 诊断事件快照 磁铁触发的磁铁触发的 事件记录事件记录 最多记录最多记录5次，次， 以后先入先出以后先入先出 Diagnostics Event Snapshots Magnet Response 诊断事件快照 磁铁反应 必须把Magnet

32、 Response功能设 置为 Snapshot+Batt.， 才能打开该功能 Diagnostics Event Snapshots 诊断事件快照 Diagnostics Prediction Model 诊断预测模型 Pacemaker Follow-up Testing 起搏器随访 测试 Testing Sensing and Capture testing should be performed to insure adequate safety margins are programmed The order of testing may be determined by the p

33、resenting rhythm Two tests can be performed without reprogramming in a dual chamber device The number of tests available are pacemaker model dependent 测试 需进行感知和阈值测试，以确保足够的安全范 围可被程控 测试的顺序应该由当前的节律决定 在双腔起搏器中，两个测试可以在不重新程 控的情况下完成 能够完成的测试数目和起搏器型号有关 Capture Test Decrease Voltage until loss of capture occur

34、s. Then increase until 100% capture is regained This is the Capture Threshold 阈值测试 降低电压直到失夺获 再增加电压，直到重新100%夺获 这就是夺获阈值 Capture Test In our devices we have three types of capture testing Semi-automatic Automatic Ventricle only Device Specific Vario Device Specific REMEMBER In order to determine the ca

35、pture threshold you MUST be pacing 阈值测试 在我们的起搏器中有3种阈值测试 半自动 自动的 仅心室 起搏器特有的 Vario 起搏器特有的 记住: 为了测试夺获阈值，你必须使脉冲发生 期处于起搏状态 Temporary Programming 临时程控 取消临取消临 时程控时程控 Temporary Programming Discontinue Temporary Programming by: Pressing the Cancel Temporary Button Pressing the Permanent Program Button Removi

36、ng wand A prompt appears to either “Restore” or “Cancel” 临时程控 通过如下步骤停止临时程控: 点击“Cancel Temporary”键 点击“Permanent Program”键 移去程控头 一个 “Restore” 或者 “Cancel”的提示会出现 Ventricular Capture Test 心室夺获阈值测试 Ventricular Capture Test 心室夺获阈值测试 Ventricular Capture Test 心室夺获阈值测试 Ventricular Capture Test with AV Nodal B

37、lock 心室夺获阈值测试 伴AV阻滞 Ventricular Capture Test with AV Nodal Block 心室夺获阈值测试 伴AV阻滞 Ventricular Capture Test with Intact AV Node 心室夺获阈值测试 伴AV完好 Ventricular Capture Test with Intact AV Node 心室夺获阈值测试 伴AV完好 Ventricular Capture Test with Intact AV Node 心室夺获阈值测试 伴AV完好 Atrial Capture Test 心房夺获阈值测试 Atrial Capt

38、ure Test 心房夺获阈值测试 Atrial Capture Test 心房夺获阈值测试 Atrial Capture Test with Intact AV Node 心房夺获阈值测试 伴AV完好 Atrial Capture Test with Intact AV Node 心房夺获阈值测试 伴AV完好 Atrial Capture Test with Intact AV Node 心房夺获阈值测试 伴AV完好 Atrial Capture Test with AV Nodal Block 心房夺获阈值测试 伴AV阻滞 Capture Test Sometimes 4 Cycles i

39、s Not Enough 夺获阈值测试 有时4个心动周期是不够的 Capture Safety Margin Once the Capture Threshold has been determined The rule of thumb is to multiply the voltage by: 2 if the system is chronic 3 to 5 times if the system is acute Remember changing pacing polarity may have an affect on the Capture Threshold 夺获安全范围 一

40、旦夺获阈值被确认 凭经验的做法是把阈值乘以: 2，如果系统是慢性的（但建议不低于2.4V ) 3-5倍，如果系统是急性的（但建议不低于 2.4V ) 记住: 改变起搏极性可能会影响阈值 Energy 能量 Output VoltageLead ImpedancePulse Width (mS)Energy Amperes 10.005000.50 100 7.505000.5056 5.005000.5025 2.505000.506 5.002500.5050 5.005000.5025 5.007500.5017 5.0010000.5013 5.005001.0050 5.005000.

41、7538 5.005000.5025 5.005000.2513 Energy Doubling Voltage causes 4 times increase in energy Doubling PW causes 2 times increased in energy Higher Impedance results in Less current drain=less energy 输出电压导线阻抗脉宽 (ms)能量 A 10.005000.50 100 7.505000.5056 5.005000.5025 2.505000.506 5.002500.5050 5.005000.50

42、25 5.007500.5017 5.0010000.5013 5.005001.0050 5.005000.7538 5.005000.5025 5.005000.2513 能量 电压翻倍导致能 量呈4倍增加 脉宽翻倍导致能 量呈2倍增加 高阻抗导致电流 减少=能量减少 AutoCapture Pacing Systems Ventricular Threshold Test Only available in AutoCapture Pacing Systems Devices Evoked Response Sensitivity Threshold Testing may need t

43、o be done prior to the Automatic Testing AutoCapture起搏系统 心室阈值测试 仅在AutoCapture起搏系统中 在自动夺获阈值测试之前，必须完成ER感知灵 敏度测试 Ventricular Evoked Response Sensitivity Test Measures Evoked Response and Lead Polarization signal Recommends Evoked Response (E/R) sensitivity setting Calculates the safety margin between E

44、/R sensitivity and polarization signal Recommends if Ventricular AutoCapture Pacing Systems safety margins are acceptable ER感知灵敏度测试 测量ER波和导线极化信号 建议的ER感知灵敏度设置 计算ER感知灵敏度和导线极化信号之间的安全 范围 如果心室AutoCapture 起搏系统安全范围可 接受，则建议打开 Ventricular Evoked Response Sensitivity Test 心室ER感知灵敏度测试 Ventricular Evoked Respon

45、se Sensitivity Test 心室ER感知灵敏度测试 Ventricular Evoked Response Sensitivity Test 心室ER感知灵敏度测试 Ventricular Evoked Response Sensitivity Test 心室ER感知灵敏度测试 Ventricular Evoked Response Sensitivity Test 心室ER感知灵敏度测试 AutoCapture Pacing Systems Ventricular Threshold Test Threshold search algorithm is identical to

46、the Automatic Threshold Search algorithm A 0.25 V working margin is applied to the threshold value as final setting During test AV delay set to 50 ms PV delay set to 25 ms AutoCapture 起搏系统 心室阈值测试 阈值搜索运算法则和自动阈值搜索运算法则是 一样的 在阈值上加0.25V作为最后的设置 在测试期间 AV间期设置为50ms PV间期设置为25ms AutoCapture Pacing Systems Vent

47、ricular Threshold Test AutoCapture起搏系统 心室阈值测试 AutoCapture Pacing Systems Ventricular Threshold Test AutoCapture起搏系统 心室阈值测试 AutoCapture Pacing Systems Ventricular Threshold Test AutoCapture起搏系统 心室阈值测试 AutoCapture Pacing Systems Ventricular Threshold Test AutoCapture起搏系统 心室阈值测试 AutoCapture Pacing Syst

48、ems Ventricular Threshold Test AutoCapture起搏系统 心室阈值测试 Sensing Threshold Tests The sensitivity number is increased until loss of sensing is seen Then the sensitivity number is decreased until sensing is regained This is the Sensing Threshold 感知阈值测试 提高感知灵敏度数值，直到感知丧失 然后，降低感知灵敏度数值，直到重新100% 感知 这就是感知阈值 Se

49、nsing Threshold Tests St. Jude Medical pacemakers have two types of sensing tests Semi-automatic Automatic Device Specific REMEMBER In order to determine the sensing threshold you MUST be sensing 感知阈值测试 SJM起搏器使用两种感知阈值测试 半自动 自动 起搏器特有的 记住: 为了得到感知阈值，你必须使脉冲发生 器处于抑制状态，让患者自身心律出现 Atrial Sense Test 心房感知测试 A

50、trial Sense Test 心房感知测试 Atrial Sense Test 心房感知测试 Atrial Sense Test with AV Nodal Block 心房感知测试 伴AV阻滞 Atrial Sense Test with AV Nodal Block 心房感知测试 伴AV阻滞 Atrial Sense Test Example of how the IEGM may help to determine sensing 心房感知测试 举例: IEGM 帮助确定感知 Atrial Sense Test with Intact AV Node (Pseudofusion) 心

51、房感知测试 伴AV完好(假性融合波) Atrial Sense Test with Intact AV Node (Pseudofusion) 心房感知测试 伴AV完好(假性融合波) Atrial Sense Test Sometimes 4 Cycles is Not Enough 心房感知测试 有时4个心动周期是不够的 Atrial Sense Test Sometimes we dont pace because of loss of sensing 心房感知测试 有时感知丧失，但并没有起搏 Ventricular Sense Test 心室感知测试 Ventricular Sense

52、Test 心室感知测试 Ventricular Sense Test 心室感知测试 Ventricular Sense Test 心室感知测试 Ventricular Sense Test with Intact AV Node 心室感知测试 伴AV完好 Ventricular Sense Test with Intact AV Node 心室感知测试 伴AV完好 Ventricular Sense Test Ventricular Sense Testing CANNOT be done if the patient does not have an R-wave Sometimes tem

53、porarily going from a DDD to VVI mode will elicit a R-wave 心室感知测试 如果患者没有R波，则不能进行心室感知测试 有时候临时从 DDD改为VVI 模式，会引出一 个R波 Sensitivity Safety Margin Once the Sensing Threshold has been determined The rule of thumb is to take half that value and program as a safety margin Ventricular sensitivity usually 2.0

54、- 3.0 mV Atrial sensitivity usually 0.5 - 1.0 mV Remember changing the sensing polarity may be beneficial in reducing a sensing threshold 感知安全范围 一旦感知阈值被确定 凭经验做法是取这个值的一半，将其程控为安 全范围 心室感知灵敏度通常是 2.0 - 3.0 mV 心房感知灵敏度通常是 0.5 - 1.0 mV 记住: 改变感知极性可能会引起感知阈值降低 Automatic Sensitivity Test Automatic P- and R-wave

55、 Measurement Tests Automatically measures the P or R-wave and recommends a safety margin Not available in the Trilogy and Affinity families 自动感知灵敏度测试 自动测量P波和R波 自动测量P波和R波，并建议一个安全范围 在Trilogy 和Affinity系列中不适用 P-wave Measurement Test P波测量 P-wave Measurement Test P波测量 P-wave Measurement Test P波测量 心房建议值 P波

56、高度 安全范围 P-wave Measurement Test P波测量 P-wave Measurement Test P波测量 P-wave Measurement Test P波测量 R-wave Measurement Test R波测量 R-wave Measurement Test R波测量 R-wave Measurement Test R波测量 R-wave Measurement Test R波测量 R-wave Measurement Test R波测量 R-wave Measurement Test R波测量 R-wave Measurement Test R波测量 R-

57、wave Measurement Test R波测量 R-wave Measurement Test R波测量 Measure Threshold Follow-up Check Sensing Check Diagnostics Measure Impedance Interrogate 测量阈值测量阈值 随访 检查感知检查感知 检查诊断检查诊断 测量阻抗测量阻抗 询问询问 Pacemaker Follow-up Final Settings Final Interrogation 起搏器随访 最后设置 最后询问 Final Programmed Settings Review origin

58、al settings and make adjustments per Physician orders as indicated by your evaluation- Print final settings and compare to original- Verify changes made Keep printout for patient chart and give one to patient 最后设置 回顾最初的设置，并且根据医生的要求做出 调整 打印最后设置，并且和最初的比较确认做 出的改变 在患者的病案中保留一份打印结果，并留一 份给患者 Final Interrog

59、ation Programmed Parameters 最后询问 程控参数 Final Interrogation Patient and Measured Data 最后询问 患者资料和测得的数据 Final Interrogation Test Results 最后询问 测试结果 Document Document Document 文档 文档 文档 A Quicker Way Automated Follow-up In Trilogy and earlier product called Custom Report Allows the user to conduct a comple

60、te follow- up examination with the touch of a single button, “Start Protocol” Specific Protocol identified for each family of pacemakers 较快的方法 自动随访 在Trilogy 和更早的产品中被称作用户报告 使用户可以点击一个键“Start Protocol”，就能 完成一次完整地随访 为每个起搏器系列定制专门的随访过程 Pacemaker Follow-up Transtelephonic Follow-up 起搏器随访 远程电话随访 Pacemaker F