d1心臟生理解剖結(jié)構(gòu)和傳導(dǎo)路徑

1、12/30/2020,Slide 1,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,Electrophysiology電生理知識,Training 培訓(xùn),12/30/2020,Slide 2,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,培訓(xùn)內(nèi)容,The anatomy of the heart 心臟解剖結(jié)構(gòu) The electr

2、ical conduction system 電傳導(dǎo)途徑 The EP procedure 電生理手術(shù)過程 The EP catheter 電生理導(dǎo)管簡介 The Biosense Webster product portfolio BW產(chǎn)品綜述,12/30/2020,Slide 3,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,電生理培訓(xùn)（一）,心臟解剖結(jié)構(gòu)、電傳導(dǎo)路徑 導(dǎo)管定位,12/30/2020,Slide 4,Biosense Webster EP T

3、raining 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,心臟,12/30/2020,Slide 5,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,左室,冠狀竇,右室,左房,右房,左下肺靜脈,左上肺靜脈,左上肺靜脈,左下肺靜脈,左室上腔靜脈,主動(dòng)脈弓,下腔靜

4、脈,12/30/2020,Slide 6,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,12/30/2020,Slide 7,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,卵圓窩,房間隔,主動(dòng)脈,界嵴,12/30/2020,Slide 8,Biosense Webster EP Training 2003 Part Anatomy

5、, Conduction System, and Catheter Positions,三尖瓣,肺動(dòng)脈,室間隔,12/30/2020,Slide 9,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,二尖瓣,12/30/2020,Slide 10,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,循環(huán)系統(tǒng),12/30/2020,Slide

6、 11,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 冠狀動(dòng)脈循環(huán)系統(tǒng),ARTERIAL SUPPLY 動(dòng)脈血供,12/30/2020,Slide 12,Biosense Webst

7、er EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,右冠,左冠,回旋支,左心耳,前降支,12/30/2020,Slide 13,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,12/30/2020,Slide 14,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Cathe

8、ter Positions,12/30/2020,Slide 15,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,心臟解剖結(jié)構(gòu),三尖瓣環(huán),12/30/2020,Slide 16,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,心臟傳導(dǎo)系統(tǒng),希氏束,蒲氏纖維,竇房節(jié),房室節(jié),12/30/2020,Slide 17,Biosense W

9、ebster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,AV,心臟的電傳導(dǎo)系統(tǒng),CS,12/30/2020,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,12/30/2020,Sl

10、ide 19,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,心肌細(xì)胞的電活動(dòng)周期,12/30/2020,Slide 20,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,體表心電圖,P,Q,R,S,T,Simplified ECG,12/30/2020,Slide 21,Biosense Webster EP Training 20

11、03 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 Apr02,12/30/2020,Slide 22,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,BIOSENSE WEBSTER PRODUCT TRAINING,P wave - Atrial Depolarisation

12、QRS PR interval ST segment T wave,T,12/30/2020,Slide 23,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,BIOSENSE WEBSTER PRODUCT TRAINING,12/30/2020,Slide 24,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,BIOSENSE W

13、EBSTER PRODUCT TRAINING,P,P wave - Atrial Depolarisation QRS - Ventricular Depolarisation PR interval ST segment T wave,T,12/30/2020,Slide 25,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,BIOSENSE WEBSTER PRODUCT TRAINING,12/30/2020,Slide 26,Biosense Webst

14、er EP Training 2003 Part Anatomy, 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 seg

15、ment T wave,T,12/30/2020,Slide 27,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,BIOSENSE WEBSTER PRODUCT TRAINING,12/30/2020,Slide 28,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,BIOSENSE WEBSTER PRODUCT TRAININ

16、G,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,T,12/30/2020,Slide 29,Biosense Webster EP Training 2003 Part Anatomy, Conduction

17、System, and Catheter Positions,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 Repo

18、larisation (Recovery),T,12/30/2020,Slide 30,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,BIOSENSE WEBSTER PRODUCT TRAINING,Repolarization or Recovery,12/30/2020,Slide 31,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Posit

19、ions,心電傳導(dǎo)路徑,如何測量這些時(shí)間距離 (PA, AH, HV)? 靠近相應(yīng)這些位置獲得其心內(nèi)心電信號，并同其他部位的信號相比較。,12/30/2020,Slide 32,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,如何到達(dá)這些傳導(dǎo)位置?,利用電生理標(biāo)測導(dǎo)管: 最早激動(dòng)位置: 竇房結(jié) HRA 希氏束電位： 希氏束 HBE 最晚電位： 心室心尖 RVA 左房電位/左室電位 冠狀竇 CS,12/30/2020,Slide 33,Biosense Webste

20、r EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,常規(guī)電生理標(biāo)測過程,RAO,LAO,PA,右室心尖電極,冠狀竇電極,希氏束電極,高位右房電極,12/30/2020,Slide 34,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,X光透視圖（右前斜位）,RAO,12/30/2020,Slide 35,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,LAO,X光透視圖（左前斜位）,12/30/2020,Slide 36,Biosense Webster EP Training 2003 Part Anatomy, Conduction System, and Catheter Positions,典型心內(nèi)心電圖記