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Motnje ritma

Motnje ritma. Novosti pri napravah. način stimulacije mesto stimulacije delež stimulacije elektrode ICD, CRT. Način stimulacije. DDD/R Stimulation is better than as VVI/R 4,5,6 Reduced risk to develop AF Reduced risk for HF hospitalization

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Motnje ritma

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  1. Motnje ritma

  2. Novosti pri napravah • način stimulacije • mesto stimulacije • delež stimulacije • elektrode • ICD, CRT

  3. Način stimulacije • DDD/R Stimulation is better than as VVI/R4,5,6 • Reduced risk to develop AF • Reduced risk for HF hospitalization • “Functional” AAI/R Stimulation is better than DDD/R 1,6

  4. Mesto stimulacije in kontraktilnost IntrinsicActivation RV-ApexStimulation EF 47% EF 58% Coutesy of Dr. Burri, Genf

  5. Normal Myocardium RVA Paced: Myofibrillar Disarray KarpawichAHJ 1990;119:1077 RVA Pacing: Histology

  6. 40 50 60 70 80 LV Performance and Peak dp/dt (Max and Min) LV pressure (mm Hg) Max LV dP/dt max 1 5 0 0 1 4 0 0 NSR 80 * 1 3 0 0 1 2 0 0 60 1 1 0 0 RVA Pace 1 0 0 0 40 NSR RVP - 1 0 0 0 - 1 1 0 0 20 - 1 2 0 0 * - 1 3 0 0 0 - 1 4 0 0 LV dP/dt min LV volume (ml) - 1 5 0 0 Peschar JACC 2003 Prinzen PACE 2002

  7. Najboljša mesta za stimulacijo • apeks sistemskega prekata (levega) • srednji del septuma RV • stimuliranje prekatov z več elektrodami (CRT) • biventrikularno • večmestno

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