Confirmation-plus_CHN-医学产品ppt课件

Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Confirmation+,Confirmation+,1,2,Protecta,SmartShock,组成,6,个特有的减少电击的算法,RV,电极导线完整性组合,电极导线噪音识别和报警,电极导线完整性报警,提高,SVT,识别,PR Logic,+Wavelet,双腔和三腔装置,SVT limit nominally in the VF zone,减少,T,波过感知引起的电击,T,波识别,减少非持续性,VT,的电击,Confirmation+,2Protecta SmartShock 组成6个特,3,Confirmation+,临床需求,:,患者有时受到不必要的电击是因为被诊断的心律失常在充电结束前终止了，或,CE,后终止但出现,PVCs,3Confirmation+临床需求:,4,Confirmation+,临床需求,:,患者有时受到不必要的电击是因为被诊断的心律失常在充电结束前终止了，或,CE,后终止但出现,PVCs,Marquis,之前：,充电中不看，,CE,后才,Confirmation,（,TDI+60,）,Maquis,Protecta,之前：,无,ATP During Charging,，充电中,&CE,后,Confirmation,（,TDI+60,）,打开,ATP During Charging,，充电中不看，,CE,后才,Confirmation,（,TDI+60,）,Only R1&NID,4Confirmation+临床需求:Marquis之前：,5,Case#5:EnTrust,DR,5Case#5:EnTrust DR,6,终止的事件,/NSVT,引起的不必要电击,Case5,解决方案,:,提高,VT,区,设置,ATP before charging,局限性,?,如果有较慢的,VT,史，,可能不识别,FVT,如果没有及时被,ATP,终止，患者可能因,此,出现症状,6终止的事件/NSVT引起的不必要电击Case5解决方案:,6,7,增加电击发放的特异性,依据所,检测心律失常的周长,评价节律是“继续”或“终止”,更好地识别在充电时心动过速被,ATP,终止或自动终止并放弃电击,避免在充电结束时由于单个,PVC,或单个快速事件导致的不恰当电击,Confirmation+:,解决方案,7增加电击发放的特异性 Confirmation+:解决,8,Case#5:EnTrust,DR,8Case#5:EnTrust DR,9,有效吗,?,ATPDC,Aborted,9有效吗?ATPDCAborted,10,目前装置运行,Current Confirmation Interval=TDI+60 ms,420 ms=360 ms+60,Confirmation+,EnTrust,Case,10目前装置运行Current Confirmation I,11,Abort,Protecta Confirmation Interval=Rhythm Cycle length+60 ms,310 ms=,250 ms,+60 ms,Protecta,装置运行,Confirmation+,VT zone programmed ON at 360 ms(Old CI=420 ms),Rhythm cycle length=250 ms,Shock would be aborted with Protecta,Confirmation Interval=250 ms+60=310 ms Intervals after ATP During Charging used in confirmation,11AbortProtecta Confirmation I,12,Protecta,装置运行,Confirmation+,应用稳定性计算区分多形性和单形性,:,如果应用于心室平均数的最小和最大间期,50ms,认为节律是多形性的,.,如果应用于心室平均数的最小和最大间期,50ms,认为节律是单形性的,12Protecta 装置运行Confirmation+,13,运行比较,Confirmation+,如果基于节律的,Confirmation Interval,在,VF,区且是多形的,:FDI+60 ms,CI:320 ms+60 ms=380 ms,13运行比较Confirmation+如果基于节律的Con,14,运行比较,Confirmation+,心律失常频率在,VT,区,:,14运行比较Confirmation+心律失常频率在VT区,15,Protecta,装置运行,Confirmation+,这些变化允许应用于更多情况,:,VF Rx1,在一个事件中可以放弃多次,Confirmation,和,delivery,算法是相同的，独立,ATP During Charging,15Protecta 装置运行Confirmation+,16,其他变化,Item,Current,Definition,Protecta,Definition,再识别时,Confirmation,再识别时的治疗不确认,如果初始治疗放弃，装置进行再识别，再识别时,Rx1,被确认,再识别时,Rx2-Rx6,不确认,在,ATP During the Charge,充电中的,Confirmation,不可用,只有充电结束后的间期被考虑,可用,将发放,ATP During Charging,后的间期应用于,confirmation,过程,.,Confirmation+,16其他变化ItemCurrent DefinitionPr,17,用户界面和诊断,用户可程控的,可程控,ON/OFF,出厂值,ON,没有新的诊断数据,在事件数据中标注放弃的治疗,(,同现有的装置,),Confirmation+,17用户界面和诊断用户可程控的 Confirmation+,18,Case#5:,Protecta,SmartShock,Confirmation+,18Case#5:Protecta SmartShoc,19,Case#5:Protecta,Performance,无不恰当电击,!,即使有,PVC,19Case#5:Protecta Performan,20,Confirmation+,Rx1 confirmed during redetection,Abort#1,Abort#2,20Confirmation+Rx1 confirmed,21,减少,对自动终止节律的电击,Confirmation+(,根据节律同步,),更好识别在充电时被,ATP,终止的或自动终止的心动过速，并放弃治疗,避免在充电结束时由于单个,PVC,或单个快速事件导致的不恰当电击,Confirmation+,Modify determination of persisting arrhythmia based on intrinsic detected rate vs.programmed lower therapy rate(sync interval),CONFIRMATION,在,ATP During Charging,后可用,Confirmation,21减少对自动终止节律的电击Confirmation+(,22,Knowledge Check,22Knowledge Check,23,问题,有了,Confirmation+,在通过,ATP During Charging,终止,FVT,案例中没有电击发放,即使有,PVCs:,True,False,答案,23问题有了Confirmation+在通过ATP D,Poster:Poole JE,et al.Analysis of ICD Shock Electrograms in the SCD-HeFT Trial.Heart,Rhythm Society Conference.2004.,Fewer Shocks.Greater Living.,ONLY PROTECTA,!,Poster:Poole JE,et al.Anal,24,