读英文amp学心电周末复习篇Da
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(二)Selectiveforanyproceduresthatmaypromotebradycardia1.Generalanaesthesiawith:(1)secondorthirddegreeAVblock.(2)IntermittentAVblock.(3)BilateralBBBorbi-ortri-fascicularblock.2.Cardiacsurgery.(1)Aorticortricuspidsurgery.
(2)Ventricularseptaldefectclosure.
(3)Ostiumprimumrepair.
(4)Occasionally,coronaryangioplasty(usuallytorightcoronaryartery)
（二）可能加重心动过缓的择期手术1.全身麻醉伴有:（1）二度或三度房室阻滞。（2）间歇性房室阻滞。（3）双束支、双分支或三分支阻滞。2.心脏手术。（1）主动脉或三尖瓣手术。（2）室间隔缺损修补术。（3）原发孔型房间隔缺损修补。（4）冠状动脉成形术(通常右冠状动脉)。二、IndlicationsforapermanentpacemakerTheguidelineofACC/AHAforpacemakerimplantationrevisedinisausefulcriteriafortheindications.Theycanbedefinedasfollows.1、Third-degreeAVblockandadvancedAVblockwithfollowings.（1）Symptomaticbradycardiaorheartfailure.（2）Pause≥3.0secoranyescaperate40bpminawake.（3）AVjunctionalablation.（4）Postoperation，predictedun-resolvable.（5）Neuromusculardiseased.二、 性起搏器指征下列为美国心脏病协会年制定的起搏器植入指征。（一）一般适应症1.三度及高度房室阻滞。（1）症状性心动过缓或心力衰竭。（2）停搏≥3s或清醒状态下逸搏频率＜40/min时。（3）房室结消融。（4）术后预期难以恢复的。（5）神经肌肉病变。2、TypeIIsecond-degreeAVblockwithawideQRS.3、Bi-orTrifascicularblock.(1)Intermittentthird-degreeAVblock.(2)AlternatingBBB.4、Sinusnodedysfunctionwithsymptomaticbradycardia,pausesorchronotropicin
