1、胡延生胡延生 主任医师主任医师尤溪县总医院尤溪县总医院 12345678910111213Nonconducted PACs Slowing The Heart Rate1415161718192021222324252627Atrial Flutter With 2:1 AV Conduction282930When unsure of the mechanism of a supraventricular tachycardia,carotid sinus massage may help make the diagnosis.In this example,carotid sinus m
2、assage causes marked AV block which permits easy recognition of the rapid,regular atrial flutter waves.313233343536类别类别定义定义初发房颤初发房颤First diagnosed AFFirst diagnosed AF首次出现首次出现 ,无论房颤持续时间或是否存在,无论房颤持续时间或是否存在AFAF相关症状及严重程度相关症状及严重程度 阵发性房颤阵发性房颤Paroxysmal AFParoxysmal AF具有自限性;虽然最长可持续具有自限性;虽然最长可持续7 7天,但通常在天,
3、但通常在4848小时内终止小时内终止持续性房颤持续性房颤Persistent AFPersistent AFAFAF发作持续超过发作持续超过7 7天或需要使用药物或直流心天或需要使用药物或直流心脏电复律(脏电复律(DCCDCC)来转复)来转复长时间持续性房颤长时间持续性房颤Long-standing persistent AFLong-standing persistent AF当决定采取心律控制策略时,当决定采取心律控制策略时,AFAF已持续已持续1 1年或年或更长时间更长时间永久性房颤永久性房颤Permanent AFPermanent AF患者与医生已接受患者与医生已接受AFAF的存在,
4、不再进行心律的存在,不再进行心律控制干预控制干预37383940A PAC Initiates Paroxsymal Atrial Fibrillation41Pulmonary Vein Isolation for Atrial Fibrillation in Patients With Paroxysmal Atrial Fibrillation and Prolonged Sinus PauseConclusion:Prolonged sinus pauses after paroxysmal AF may result from depressed sinus node functio
5、n,which can be eliminated by curative ablation of AF.(Int Heart J 2007;48:247-252)Case Reports424344454647484950515253 5455房室结内折返性心动过速房室结内折返性心动过速(AVNRT)机制:房室结内双径路机制:房室结内双径路 :慢径前传:慢径前传 :快径逆传:快径逆传565758596061WPW Diagram62636465666768697071病因病因临床表现临床表现:症状:症状:心悸、心绞痛。体格检查:体格检查:室性期前收缩后出现较长的停 歇,S2减弱,仅听到S1。7273 74Compensatory vs.Non-compensatory Pauses 75767778798081828384858687888990919293 94959697 导管消融治疗快速型心律失常导管消融治疗快速型心律失常 心脏起搏植入装置心脏起搏植入装置 心律失常治疗领域最具革命性心律失常治疗领域最具革命性 的贡献!的贡献!9899