醫(yī)學(xué)D1-心臟生理解剖結(jié)構(gòu)和傳導(dǎo)路徑

Electrophysiology

電生理知識(shí)Training培訓(xùn)4/13/20241BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheterPositions培訓(xùn)內(nèi)容Theanatomyoftheheart

心臟解剖結(jié)構(gòu)Theelectricalconductionsystem

電傳導(dǎo)途徑TheEPprocedure電生理手術(shù)過(guò)程TheEPcatheter電生理導(dǎo)管簡(jiǎn)介TheBiosenseWebsterproductportfolioBW產(chǎn)品綜述4/13/20242BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheterPositions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4/13/20243BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheterPositionsAnatomyoftheHeartArrhythmias

位置

大小

心臟4/13/20244BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheterPositions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)脈弓下腔靜脈4/13/20245BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheterPositions4/13/20246BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheterPositions卵圓窩房間隔主動(dòng)脈界嵴4/13/20247BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheterPositions三尖瓣肺動(dòng)脈室間隔4/13/20248BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheterPositions二尖瓣4/13/20249BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheterPositions循環(huán)系統(tǒng)4/13/202410BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheterPositionsRightcoronaryartery

右冠posteriordescendingartery

后降支Leftcoronaryartery

左冠LAD

前降支Circumflexanditsmarginal

回旋支CORONARYCIRCULATION冠狀動(dòng)脈循環(huán)系統(tǒng)ARTERIALSUPPLY

動(dòng)脈血供4/13/202411BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheterPositions右冠左冠回旋支左心耳前降支4/13/202412BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheterPositions4/13/202413BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheterPositions4/13/202414BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheterPositions心臟解剖結(jié)構(gòu)右房右室左房左室冠狀竇右室心尖心尖高位右房升主動(dòng)脈右室流出道上腔靜脈下腔靜脈三尖瓣環(huán)4/13/202415BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheterPositions心臟傳導(dǎo)系統(tǒng)希氏束蒲氏纖維竇房節(jié)房室節(jié)4/13/202416BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheterPositionsAV心臟的電傳導(dǎo)系統(tǒng)CSSA

纖維瓣環(huán)RVLVRALATVMV4/13/202417BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheterPositionsAnatomyoftheHeartArrhythmiasBIOSENSEWEBSTERTRAINING4/13/202418BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheterPositions心肌細(xì)胞的電活動(dòng)周期4/13/202419BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheterPositions體表心電圖PQRSTSimplifiedECG4/13/202420BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheterPositionsAnatomyoftheHeartArrhythmiasBWTApr’024/13/202421BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheterPositionsPwave-AtrialDepolarisationQRSPRintervalSTsegmentTwave

PRIntervalQRSSTSegmentPT4/13/202422BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheterPositions4/13/202423BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheterPositionsPPwave-AtrialDepolarisationQRS-VentricularDepolarisationPRintervalSTsegmentTwave

PRIntervalQRSSTSegmentT4/13/202424BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheterPositions4/13/202425BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheterPositionsPQPRIntervalRSSTSegmentPwave

-AtrialDepolarisationQRS

-VentricularDepolarisation

PRinterval-timetakenfortheimpulsetobeconductedfromtheSAnodetojustbeforeventriculardepolarizationSTsegmentTwave

T4/13/202426BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheterPositions4/13/202427BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheterPositionsPPwave

-AtrialDepolarisationQRS

-VentricularDepolarisation

PRinterval-timetakenfortheimpulsetobeconductedfromtheSAnodetothePurkinjieSTsegment-BeginningofVentricularRepolarisationTwavePRIntervalQRSSTSegmentT4/13/202428BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheterPositionsPPwave

-AtrialDepolarisationQRS

-VentricularDepolarisation

PRinterval-timetakenfortheimpulsetobeconductedfromtheSAnodetothePurkinjieSTsegment-BeginningofVentricularRepolarisationTwave-VentricularRepolarisation(Recovery)

PRIntervalQRSSTSegmentT4/13/202429BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheterPositionsRepolarizationorRecovery4/13/202430BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheterPositions心電傳導(dǎo)路徑如何測(cè)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(hào)，并同其他部位的信號(hào)相比較。Standardvalues希氏束房室節(jié)竇房節(jié)ECG4/13/202431BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheterPositions如何到達(dá)這些傳導(dǎo)位置?利用電生理標(biāo)測(cè)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 CS4/13/202432BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheterPositions常規(guī)電生理標(biāo)測(cè)過(guò)程RAOLAOPA右室心尖電極冠狀竇電極希氏束電極高位右房電極4/13/202433BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheterPositionsX光透視圖（右前斜位）RAO4/13/202434BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheterPositionsLAOX光透視圖（左前斜位）4/13/202435BiosenseWebsterEPTraining2003PartAnatomy,ConductionSystem,andCatheter