心脏起搏器并发症和故障的处理夏岳.pptVIP

谢谢 A Medtronic Technical Services Story: The EGM on this slide reflects that of a patient who was receiving heat diathermy to the back. Due to the strength of the electrical heat waves in some heat diathermy machines, it is not a recommended treatment for patients with pacemakers or defibrillators, as it will likely interfere with device sensing. However, the location of the treatment should be considered if this is a mandatory treatment. Some treatments below the waist can be tested with a programmer for interference. Treatments above the waist, however, are not recommended. Problem: 60 cycle interference. Possible Symptoms: Over-detection. Patient will likely not be symptomatic prior to therapy. Acute/Chronic: Either Definitive Diagnostics: Episode records, Patient Interview. Reproducible? Note: Noise present in both Atrial and Ventricular EGMs is suggestive of external interference. If, however, noise is discovered only on one lead, the possibility of a lead fracture should be investigated. Some common sources of EMI that may interfere with proper ICD function are listed on this slide. Patients with an ICD are asked to avoid high intensity electromagnetic fields. Large TV or radio transmitting towers and transmission power lines carrying more than 100,000 volts are likely to interfere with the defibrillator. Areas for the general public are safe, however, patients should avoid areas that have restricted access, such as: Broadcasting antennas of AM, FM, short-wave radio, and TV stations; and power plants, large generators, transmission lines, and transmission buildings Using chain saws and heavy electrical equipment is also not recommended as they may interfere with how a defibrillator works. If a patient experiences dizziness, a feeling of rapid or irregular heartbeats (palpitations), or an extra shock caused by interference from equipment, they should be instructed to simply move further away from the source. The defibrillator will immediately r