电生理-心脏生理解剖结构和传导路径

1、8/30/2020,Slide 1,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,Electrophysiology电生理知识,Training 培训,8/30/2020,Slide 2,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 electric

2、al 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,8/30/2020,Slide 3,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,8/30/2020,Slide 4,Biosense Webster EP Train

3、ing 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,8/30/2020,Slide 5,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,8/3

4、0/2020,Slide 6,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,8/30/2020,Slide 7,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,卵圆窝,房间隔,主动脉,界嵴,8/30/2020,Slide 8,Biosense Webster EP Training 2003 Part Anatomy, Conduc

5、tion System, and Catheter Positions,三尖瓣,肺动脉,室间隔,8/30/2020,Slide 9,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,二尖瓣,8/30/2020,Slide 10,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,循环系统,8/30/2020,Slide 11,Biosens

6、e 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,8/30/2020,Slide 12,Biosense Webster EP Traini

7、ng 2003 Part Anatomy, Conduction System, and Catheter Positions,右冠,左冠,回旋支,左心耳,前降支,8/30/2020,Slide 13,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,8/30/2020,Slide 14,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,

8、8/30/2020,Slide 15,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,心脏解剖结构,三尖瓣环,8/30/2020,Slide 16,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,8/30/2020,Slide 17,Biosense Webster EP Trainin

9、g 2003 Part Anatomy, Conduction System, and Catheter Positions,AV,心脏的电传导系统,CS,8/30/2020,Slide 18,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,BIOSENSE WEBSTER TRAINING,8/30/2020,Slide 19,Biosense Web

10、ster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,心肌细胞的电活动周期,8/30/2020,Slide 20,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,体表心电图,P,Q,R,S,T,Simplified ECG,8/30/2020,Slide 21,Biosense Webster EP Training 2003 Part Anatomy, Cond

11、uction 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 Apr02,8/30/2020,Slide 22,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,BIOSENSE WEBSTER PRODUCT TRAINING,P wave - Atrial Depolarisation QRS PR interval ST seg

12、ment T wave,T,8/30/2020,Slide 23,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,BIOSENSE WEBSTER PRODUCT TRAINING,8/30/2020,Slide 24,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,BIOSENSE WEBSTER PRODUCT TRAINING,

13、P,P wave - Atrial Depolarisation QRS - Ventricular Depolarisation PR interval ST segment T wave,T,8/30/2020,Slide 25,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,BIOSENSE WEBSTER PRODUCT TRAINING,8/30/2020,Slide 26,Biosense Webster EP Training 2003 Part A

14、natomy, Conduction System, and Catheter Positions,BIOSENSE WEBSTER PRODUCT TRAINING,P,Q,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,8/30/2020,Sl

15、ide 27,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,BIOSENSE WEBSTER PRODUCT TRAINING,8/30/2020,Slide 28,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,BIOSENSE WEBSTER PRODUCT TRAINING,P,P wave - Atrial Depolari

16、sation 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,T,8/30/2020,Slide 29,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Position

17、s,BIOSENSE WEBSTER PRODUCT TRAINING,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),T,8/30/

18、2020,Slide 30,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,BIOSENSE WEBSTER PRODUCT TRAINING,Repolarization or Recovery,8/30/2020,Slide 31,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,

19、 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。,8/30/2020,Slide 32,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,8/30/2020,Slide 33,Biosense Webster EP Training 2003 Part Anatomy,

20、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,8/30/2020,Slide 34,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,X光透视图（右前斜位）,RAO,8/30/2020,Slide 35,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,LAO,X光透视图（左前斜位）,8/30/2020,Slide 36,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,典型心内心电图记