心律失常发生机制及导管消融适应症课件（英文）.ppt

心律失常发生机制及导管消融适应症（Electrophysiological Mechanisms of Cardiac Arrhythmias and Indication of Radiofrequency Catheter Ablation);Indications for Radiofrequency Catheter Ablation;Risks and Complications With RF Ablation ;Arrhythmia Mechanisms ; Automatic tachycardia (AT, VT, AF) is identified by the presence of the following characteristics: Can be initiated by an isoproterenol infusion PES cannot initiate or terminate the tachycradia Can be gradually supressed with overdrive pacing, but then resumes with a gradual increase in the rate Can be terminated by propranolol These episodes have a “warm up” and/or “cool down phenomenon Cannot be terminated by adenosine, but transiently slows or suppresses, especially when it can be induced with isoproterenol ; Triggered activity (AT, VT, AF) is identified by the presence of the following characteristics: Triggered arrhythmias can be initiated with rapid pacing or exstrastimuli dependant on reaching a certain range of pacing cycle lengths No entrainment is observed, but overdrive suppression or termination occurs Delayed afterdepolarizations can be recorded near the origin using a monophasic action potential catheter before the onset, but not at sites remote from the tachycardia Is terminated by adenosine Rarely requires isoproterenol to induce it Is terminated by dipyridamole, propranolol, verapamil, edrophonium, Valsava maneuvers and carotid sinus pressure ; Microreentry (AT, AVNRT, VT)/Macroreentry (AT, AVRT, Atrial Flutter) is identified by the presence of the following characteristics: Can be reproducibly initiated and terminated by pacing and extrastimuli No delayed afterdepolarizations can be recorded using a monophasic action potential catheter Manifest and concealed entrainment observed while pacing during the tachycardia Frequently terminated by verapamil and adenosine, but adenosine usually has no effect The interval between the initiating premature beat and first beat