文档介绍：烦恼有何惧怕，既然躲不掉，就调好心态与它共存。心向阳光，何惧风霜。 茫茫人海你我相遇就是缘分，欢迎下载！
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IMPLANTABLE DEVICE FOR THE TREATMENT OF ATRIAL FIBsociated with increased vagal tone and braycardia
Supress ectopic atrial beats
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The Mode Selection Trial
Number of patients: More than 2000 patients with the SSS
Two groups: ventricular pacemaker,dual-chamber pacemaker
The primary end points: mortality,stroke
Result: no difference with respect to the primary end point;50% decrease in the likehood of a first episode of atrial fibillation and a reduction in kisk of progression to chronic atrial fibillation with dual-chamber pacing
Press release of NASP,Natick,Mass,May,2001
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Alternative single-site and dual-site atrial paceng
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房间传导阻滞（Interartrial Conduction Block）
一般人群房间传导阻滞发生1%，缓—速综合征患者发生率32%
诊断标准：右房与左房间传导超过100ms
体表心电图：
P波增宽
P波时限≥120ms
Ⅰ导联P波常有明显切迹，切迹间双峰间距＞
Ⅱ、Ⅲ 导联P波双向，先负后正
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Synchronized atrial activation
Usual single-site of atrial pacing:
interatrial septum
coronary sinus
Bachmann’bundle
……
Dual-site of atrial pcing
the right atrial appendage
interatrial septum
Dual-atrial pacing
the right atrial appendage
coronary sinus
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Patients in whom the the atrial lead was placed at Bachmann’budle or on the interatrial septum had a lower incidence of parxymal and chronic atrial fibrillation than those in whom the lead was posisioned in the traditional right atrial appendage.
Bailin SJ,et ,2001;142:1047-55
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双房同步起搏
双心房＋右心室起搏，是三腔人工心脏起搏器的一种。
用于防治与房间传导阻滞有关的某些快速性房性心律失常
冠状窦起搏的最佳位电多选择在冠状窦中部
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双房同步起搏方式
单腔起搏器：仅有房间传导阻滞及快速房性心律失常，选用双极AAT方式
双腔DDD起搏器：同时合并缓慢性心律失常或房室传导阻滞，选用DDD(R）方式
Chorus 6234或7034（ela corp）：
AAT(房间水平)+DDD（房室间水平）
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Overdrive atrial pacing
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The mechanism of overdrive atrial pacing
The atrial pacing predominate over the intrinsic atrial activity to reduce the initiation of atrial fibrillation
Supresses prema