心脏起搏的适应症（英文版）.ppt

There are only two indications for pacing (excluding pacing for heart failure): 1- symptoms + slow HR 2- high risk of symptoms + slow HR developing in the future H.ELMAHY 2010 A: Bifascicular / trifascicular Block B: AV block C: Sinus node disease D:Neurally mediated syncope E: Post AVN ablation H.ELMAHY 2010 A: Symptoms such as syncope / presyncope B: bradyarrhythmia C: symptoms correlated to bradyarrhythmia D: symptoms not correlated to arrhythmia E: none of the above H.ELMAHY 2010 A: persistent 2nd degree Type II AV block B: transient 3rd degree block with LBBB C: Persistent 3rd degree block D: transient 2nd degree block with RBBB E: all of the above H.ELMAHY 2010 A: Functional class NYHA III-VI B: normal SR + wide QRS (150 msec) or wide QRS (120-149 msec) with evidence of mechanical dyssynchrony on echo C: on optimum medical therapy D: all of the above E: none of the above H.ELMAHY 2010 THANK YOU H.ELMAHY 2010 * Location of conduction abnormality is an important determinant of the likelihood and pace of progression of conduction system disease * RASH IS ERYTHEMA MIGRANS * Class IIb indication of PPM: Marked 1st degree AVB 300 msec in patients with LV dysfunction and symptoms of congestive heart failure in whom a shorter AV interval results in hemodynamic improvement, presumably by decreasing LA filling pressure. * Tachy-brady syn, intermittent sinus arrest with junctional escape beats at irregular intervals. Short episode of a. flutter is followed by almost 5 sec of asystole before a junctional escape rhythm resumes. This patient became presyncopal at this point. * * * * * Secondary prevention of SCD is defined as the prevention of an additional life-threatening event in survivors of sudden cardiac events or in patients with recurrent unstable rhythms. * * H.ELMAHY 2010 H.ELMAHY 2010 H.ELMAHY 2010 Dr. HOSSAM ELMAHY CARDIOLOGY SPECIALTY REGISTRAR ROYAL LANCASTER INFIRMARY Types of permanent pacing by indication Brady pacing- different indications