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第三篇 循环系统疾病

Jan 20, 2016

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第三篇 循环系统疾病. 第三章. 心律失常 ( Arrhythmia ). 张存泰. 学时数: 4 学时. 讲授目的和要求. 1. 掌握常见心律失常的病因、临床表现、心电图特征和治疗原则 2. 熟悉心律失常的分类、心电生理诊断方法和快速性心律失常的药物治疗 3. 了解心律失常的发病机制和射频消融治疗方法. 心脏传导系统. 心脏传导系统由特殊的心肌细胞组成,包括窦房结,结间束与房间束、房室结、希氏束、左、右束支以及末鞘浦肯野纤维网. 心律失常的定义. - PowerPoint PPT Presentation
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  • Arrhythmia4

  • 1.

    2.

    3.

  • 60%40%80%20%

  • 1 2 1 2reentry

  • reentry

  • 1. 2.

  • premature contraction

  • tachycardiaAVNRT AVRT

  • :

  • RFCA

  • 1Na+ aAPD bAPD cAPD-BK+CCB

  • ATP

    MgSO4

    KCl

  • premature beats

  • 1.P',P'-R>0.122.P'QRS3.atrial premature beats

  • 1.QRS,P',P'-R

  • ventricular premature beats 1.QRS,P2.

  • 1

  • 224 1. 5 2. 3. 4. T R on T

  • 3 - -

  • 100/PaVR>100/,100180/

  • P101160/ sinus tachycardia

  • atrial tachycardiaPP150200/

  • PPP-P

  • IAIC

  • paroxysmal supraventricular tachycardia490% AVNRT AVRT

  • AVN reentry tachycardia

  • IIIVHis dCS3,4 pCS2,3 mCS1,2 dRV

  • AV reentry tachycardia90%

  • IIIVHis dCS3,4 pCS2,3 mCS1,2 dABL dRV

  • 1. 2. ATP3. 4. 5. 6. RFCA

  • 1.P2.QRS160220/

  • atrial flutter 1.P,F().250400/2.2:14:1

  • atrial fibrillation 1. P,,,f,350 600/2. R-R

  • atrial fibrillation 1.P,F350600/2.R-R3.R-RQRS

  • RFCA

  • 1. paroxysmal48h3. permanent >6>110/

  • RFCA

  • INR 2.03.0300mg

  • QRSRFCA

  • ventricular tachycardia
  • QT

  • QRS0.12100250/PQRS

  • ventricular tachycardia 1.QRS150200/QRS0.122.QRSP

  • ventricular tachycardiaORS

  • MgSO4--BRFCAICD

  • ventricular flutter and ventricular fibrillationICD

  • P
  • AMI

  • P-PP(>2)P-PP-P

  • sick sinus syndrome,SSS

  • SSS

  • SSS
  • SSS Holter2mg iv, 15min2000ms

  • A-V blockAVBAVBAVB:AVB:

  • AMI

  • :P-R(P-R),>0.20AVB

  • : P-RQRS P-R

  • : P-RPQRS

  • 1.P-P,R-R2.PQRS(P-R)3.(P-P
  • 1. 2. 3. 4.

  • SSS22AVBRR

  • 1.2.3.4.5.6.7.