文档介绍：一、适应证
房性心律失常
1)房颤和房扑复律时首选(I,A)
2)直流电复律强化药物治疗(IIa)
3)围外科手术期的房颤复律(IIa)
4)房颤+WPW(无血流动力学异常)(I,C)
伊布利特的临床应用
二、禁忌证
1. 急性心肌梗死或不稳定心绞痛
2. 严重充血性心力衰竭
3. 心室率<55次/分
4. 二度、三度房室阻滞
5. 低钾血症
6. 有尖端扭转型室速发作史
7. QTc≥440ms
8. 严重肝肾功能损害
伊布利特的临床应用
AVRT: Location Of Accessory Pathway In EP Lab
Precise location of the accessory pathway is determined by the rove catheter. Retrograde conduction over the AP is seen as a small spike between the V and A waves. These "Kent potentials" are so named because of the original denomination of accessory pathways as "Kent bundles," after the investigator Stanley Kent, who first proposed the existence of accessory AV connections.
AVRT: WPW: Initiation of AVRT
Supraventricular tachycardia
can be initiated by a closely coupled premature plex (PAC)
blocks in the accessory pathway
but conducts through the AV node
retrograde conduction via accessory pathway
inverted P wave produced by retrograde conduction visible in the inferior ECG leads
AVRT: WPW: 12-Lead ECG
The P wave produced by retrograde conduction during AV reentry tachycardia is inverted in the inferior ECG leads, since atrial depolarization begins in the lower right atrium and proceeds superiorly and leftward. Rapid retrograde conduction over the accessory pathway results in a short R-P interval, usually less than one-half of the R-R interval.
AVRT: Catheter Ablation Of Accessory Pathway
Radio frequency ablation of the accessory pathway is often indicated in patients with WPW who are at risk of sudden death due to atrial fibrillation with a rapid ventricular response via the bypass tract.
Note the disappearance of the pre-excitation delta wave in the QRS with catheter ablation.
AVRT: Catheter Ablation Of Accessory Pathway
Radio frequency ablation of the accessory pathway is often indicated in patients with WPW who are at risk of sudden death due to atrial fibrillation with a rapid ventricular response via the bypass tract.
Note the disappearance of the preexcitation delta wave in th