起搏器与临床心电生理200问

起搏器与临床心电生理200问

起搏器与临床心电生理200问

Brand: 北京大学医学出版社有限公司 Sold By: EM China
$31.18 In Stock
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起搏器与临床心电生理200问

起搏器与临床心电生理200问

$31.18

内容简介　　起搏与心电生理是心律失常诊治的重要方法。《起搏器与临床心电生理200问》以问答的形式，阐述了心律失常的介入诊治简史、原理、适应人群、手术过程及术后注意事项。《起搏器与临床心电生理200问》内容简明扼要，使基层医生、心血管内科中非心脏电生理专业的医生、其他专业的医生以及普通读者能够了解心律失常介入治疗的目的、适宜人群，使需要治疗的患者得到及时合理的治疗，明确手术后可能遇到的问题，并指导手术后的日常生活。
Product Details

内容简介
　　起搏与心电生理是心律失常诊治的重要方法。《起搏器与临床心电生理200问》以问答的形式，阐述了心律失常的介入诊治简史、原理、适应人群、手术过程及术后注意事项。《起搏器与临床心电生理200问》内容简明扼要，使基层医生、心血管内科中非心脏电生理专业的医生、其他专业的医生以及普通读者能够了解心律失常介入治疗的目的、适宜人群，使需要治疗的患者得到及时合理的治疗，明确手术后可能遇到的问题，并指导手术后的日常生活。
目　　录
部分 起搏器百问
1.正常的心脏是如何跳动的？
2.什么是心脏起搏器系统？
3.为什么会出现心律失常？
4.心律失常的常见症状有哪些？
5.什么是心律失常？心律失常的分类有哪些？
6.心脏起搏器（脉冲发生器）的发展简史是怎样的？
7.起搏电极导线的类型和发展简史是怎样的？
8.心脏起搏器的类型有哪些？
9.心脏起搏器是如何进行分类编码的？
10.起搏器电池的构成是怎样的？
11.哪些患者需要植入起搏器？
12.如何选择合适的起搏模式？
13.什么是单腔起搏器？其是如何工作的？
显示全部信息
在线试读
　　《起搏器与临床心电生理200问》：
　　心房颤动（房颤）是临床上常见的心律失常，大致可分为阵发性房颤和持续性房颤。由多种原因引起，其确切机制尚不清楚，可能与老年、心肌疾病、心脏或心肌结构异常有关。房颤时心房的心肌纤维颤动，心房肌电活动紊乱，记录到的心电信号幅度小，频率快（300～500次／分），整个（左、右）心房处于机械静止状态，无正常的收缩活动，因而心房内容易产生血栓，从而造成栓塞并发症。对于持续性永久性房颤的患者，当其心室频率缓慢或心室长时间停搏，产生症状，严重影响心脏功能和日常生活时，需安装起搏器治疗。由于自身心房已无功能，对电刺激无反应，故只能用心室起搏器治疗，包括VVI、VVIR或双心室起搏治疗。对于阵发性房颤患者，当伴有窦房结功能明显异常时，需安装起搏器治疗，通常应用带有自动模式转换（AMS）功能的DDD或DDDR起搏器。当房颤发生时，由于心房感知到高频事件，起搏器将自动把原来DDD模式改为DDI或VVI模式，目的是避免心室跟踪较高的心房频率，保持心室相对正常较慢的频率。目前多数DDD起搏器均带有AMS功能。有些特殊程控设计的起搏器，能够对房性早搏（有时是触发房颤的原因）进行特殊反应，包括以较快的频率起搏心房一段时间，以消除房性早搏造成的心房复极不均一，抑制心房异位兴奋灶，消除运动后心率骤减，预防房颤后早期复发，从而预防由房性早搏或其他原因引起的房颤的发生。31.哪些肥厚型心肌病患者可以采用起搏治疗？肥厚型心肌病患者当伴有左心室流出道梗阻，且同时存在有症状的房室传导阻滞或窦房结功能障碍，应安装DDD或DDDR起搏器。此外梗阻性肥厚型心肌病，药物治疗无效，症状明显，左心室流出道压力阶差明显增高（静息时 30rnmHg，或激发时 50mmHg）时，可考虑进行起搏器治疗。32.起搏器是如何治疗梗阻性肥厚型心肌病的？起搏器减低左心室流出道压力阶差的机制尚不完全清楚。目前认为，右心室心尖部起搏可提前激动右心室心尖部心肌，改变正常心室激动顺序，使室间隔激动和收缩延迟，由于局部节段性心肌的不同步性使左心室流出道的直径在收缩期增宽，同时减轻二尖瓣前瓣的前移而解除流出道的梗阻。小规模的随机临床研究也证实双腔起搏器及短房室间期可降低左心室流出道压力阶差，改善纽约心功能分级（NYHA）的级别。所以起搏器术后应适当缩短房室间期。由于缺乏大规模的前瞻性的随机临床试验资料，使此疾病的起搏适应证尚有争议。33.与起搏器植入手术相关的并发症有哪些？
　　起搏器植入手术与其他手术一样，都可能有意想不到的意外和并发症出现。与起搏器植入手术相关的并发症有以下几种。
　　（1）血肿形成：是起搏器植入手术常见的并发症之一。血肿形成可有局部肿胀、疼痛等表现。早期轻度血肿可采用局部砂袋加压止血，不主张引流以免增加不必要的感染机会。如局部压迫仍不能止血，应考虑尽早打开囊袋，寻找出血的血管，结扎止血。
　　（2）囊袋感染、溃破：其发生率为2%左右。起搏系统的感染应尽早发现和处理，如出现皮肤溃破，应尽可能移出已感染的起搏器和电极导线，以免感染扩散，久治不愈。
　　（3）心肌穿孔：发生率低于1%，心脏扩大、心脏壁薄、老年患者较易发生。一旦发生心肌穿孔，并出现心脏压塞症状，应行心包穿刺引流，必要时行开胸修补。
显示全部信息

Shipping Overview: 

• Shipping: Standard Domestic Shipping within the United States charges USD 4.99. Standard International Shipping from United Kingdom, Germany and Japan to the United States charges 14.99. 

• Order Processing: Please allow 1-2 business days for order processing and preparation before shipment. 

• Domestic Shipping: Orders within the U.S. are shipped via USPS or FedEx, depending on the origin of the product. The average transit time is 3-7 business days. 

• International Shipping: Currently, we only ship within the USA. 

• Tracking Information: Every order is trackable. You will receive a tracking number once your order has been shipped. Products may be shipped from various global fulfillment centers.

Shipping Delays: 

Please note that shipping times may vary due to factors beyond our control, such as weather conditions, natural disasters, or peak holiday periods. While we strive to ensure timely delivery, the exact arrival time cannot be guaranteed and is managed by the shipping carrier.

Shipping Options:

  • Standard Delivery: Most orders are shipped within 3-7 business days. Larger items may utilize LTL shipping for safe handling.

  • Handling Time: We handle shipments on business days (Monday - Friday), with a preparation time of 1-2 days.

  • Additional Charges: Some items require additional shipping charges due to their size, weight, or special handling. These charges are specified on the product pages and are not eligible for shipping discounts.

  • Exclusions: Gift cards, packaging, taxes, and prior purchases do not count toward the minimum purchase requirement for free shipping. This offer is valid only for shipments to U.S. addresses, including Puerto Rico.

Delivery Details:

  • Estimates: Standard shipping within the US typically takes 3-7 business days. These are estimates and not guarantees.

  • Shipping Restrictions: We ship to all 50 states, Washington, DC, U.S. territories, and APO/FPO/DPO addresses. Shipping options vary based on the delivery address.

  • Remote Areas: Shipments to remote areas may incur additional charges or require pickup from a nearby shipping partner’s location.

Shipping Confirmation:

You will receive a shipping confirmation email with a tracking number as soon as your order is dispatched. If you do not receive this email immediately, please be assured that your items will arrive within the estimated delivery window provided at checkout.

Order Modifications:

If you need to cancel or modify your order, please contact our customer support immediately.

Issues with Delivery:

If your order shows as delivered but you have not received it, please contact the shipping carrier directly to resolve the issue. For persistent problems, contact our customer service at cs@everymarket.com.

Customer Support:

Our team is available 24/7 to assist you with any questions or concerns regarding your order. We are committed to ensuring a smooth shopping experience.

Return & Refund Policy Overview

Please review our return and refund policies below to ensure a smooth transaction process.

Return Policy

  • Duration: You have 30 days from receiving your item to initiate a return.

  • Condition: Items must be unworn, unwashed, with original tags and packaging intact.

  • Shipping Costs: Customers are responsible for return shipping costs.

  • Packaging: Ensure returned items are well-packaged to avoid damage during transit.

  • Tracking: Use a trackable and insured shipping method as we are not liable for items lost or damaged on return.

  • Initiating a Return: Contact us at cs@everymarket.com to start your return. We will provide a return shipping label and instructions upon approval. Returns without prior approval will not be accepted.

How to Return

  • Method: Returns must be sent back by mail to the address provided in the return instructions.

Return Label

  • Defective Products: Return labels are provided for defective items.

  • Non-Defective Returns: Customers are responsible for obtaining their return shipping label.

Product Conditions for Return

  • Eligible Products: Returns are only accepted for items in new condition.

Nonreturnable Items

Certain items are not eligible for return:

  • Electronic devices after 30 days (e.g., computers, laptops, Kindles)

  • Gift cards, prepaid game cards

  • Perishable goods, live insects, some jewelry, some health and personal care items

  • Customized or personalized products

  • Items with special shipping restrictions

Refund Policy

  • Window: Eligible products may be returned within 30 days of delivery for a refund.

  • Refund Method: Refunds are processed to the original payment method or as store credit for items purchased with gift cards.

  • Processing Time: Refunds are processed within 3-5 business days after we receive the return; please allow additional time for shipping and bank processing.

Claims

Inspect your order upon arrival and report any defects, damages, or incorrect items immediately to allow us to address the issue. For claims, contact our support team with details of the issue.

Exchange Policy

For the quickest service, return your original item and place a new order for the desired product once your return is accepted.

Return Address

EveryMarket Customer Service 2101 E Terra Ln, O'Fallon, MO 63366

Customer Support

Available 24/7 for any questions or assistance needed:

  • Phone: +1 636-312-5925

  • Email: cs@everymarket.com

 

内容简介
　　起搏与心电生理是心律失常诊治的重要方法。《起搏器与临床心电生理200问》以问答的形式，阐述了心律失常的介入诊治简史、原理、适应人群、手术过程及术后注意事项。《起搏器与临床心电生理200问》内容简明扼要，使基层医生、心血管内科中非心脏电生理专业的医生、其他专业的医生以及普通读者能够了解心律失常介入治疗的目的、适宜人群，使需要治疗的患者得到及时合理的治疗，明确手术后可能遇到的问题，并指导手术后的日常生活。
目　　录
部分 起搏器百问
1.正常的心脏是如何跳动的？
2.什么是心脏起搏器系统？
3.为什么会出现心律失常？
4.心律失常的常见症状有哪些？
5.什么是心律失常？心律失常的分类有哪些？
6.心脏起搏器（脉冲发生器）的发展简史是怎样的？
7.起搏电极导线的类型和发展简史是怎样的？
8.心脏起搏器的类型有哪些？
9.心脏起搏器是如何进行分类编码的？
10.起搏器电池的构成是怎样的？
11.哪些患者需要植入起搏器？
12.如何选择合适的起搏模式？
13.什么是单腔起搏器？其是如何工作的？
显示全部信息
在线试读
　　《起搏器与临床心电生理200问》：
　　心房颤动（房颤）是临床上常见的心律失常，大致可分为阵发性房颤和持续性房颤。由多种原因引起，其确切机制尚不清楚，可能与老年、心肌疾病、心脏或心肌结构异常有关。房颤时心房的心肌纤维颤动，心房肌电活动紊乱，记录到的心电信号幅度小，频率快（300～500次／分），整个（左、右）心房处于机械静止状态，无正常的收缩活动，因而心房内容易产生血栓，从而造成栓塞并发症。对于持续性永久性房颤的患者，当其心室频率缓慢或心室长时间停搏，产生症状，严重影响心脏功能和日常生活时，需安装起搏器治疗。由于自身心房已无功能，对电刺激无反应，故只能用心室起搏器治疗，包括VVI、VVIR或双心室起搏治疗。对于阵发性房颤患者，当伴有窦房结功能明显异常时，需安装起搏器治疗，通常应用带有自动模式转换（AMS）功能的DDD或DDDR起搏器。当房颤发生时，由于心房感知到高频事件，起搏器将自动把原来DDD模式改为DDI或VVI模式，目的是避免心室跟踪较高的心房频率，保持心室相对正常较慢的频率。目前多数DDD起搏器均带有AMS功能。有些特殊程控设计的起搏器，能够对房性早搏（有时是触发房颤的原因）进行特殊反应，包括以较快的频率起搏心房一段时间，以消除房性早搏造成的心房复极不均一，抑制心房异位兴奋灶，消除运动后心率骤减，预防房颤后早期复发，从而预防由房性早搏或其他原因引起的房颤的发生。31.哪些肥厚型心肌病患者可以采用起搏治疗？肥厚型心肌病患者当伴有左心室流出道梗阻，且同时存在有症状的房室传导阻滞或窦房结功能障碍，应安装DDD或DDDR起搏器。此外梗阻性肥厚型心肌病，药物治疗无效，症状明显，左心室流出道压力阶差明显增高（静息时 30rnmHg，或激发时 50mmHg）时，可考虑进行起搏器治疗。32.起搏器是如何治疗梗阻性肥厚型心肌病的？起搏器减低左心室流出道压力阶差的机制尚不完全清楚。目前认为，右心室心尖部起搏可提前激动右心室心尖部心肌，改变正常心室激动顺序，使室间隔激动和收缩延迟，由于局部节段性心肌的不同步性使左心室流出道的直径在收缩期增宽，同时减轻二尖瓣前瓣的前移而解除流出道的梗阻。小规模的随机临床研究也证实双腔起搏器及短房室间期可降低左心室流出道压力阶差，改善纽约心功能分级（NYHA）的级别。所以起搏器术后应适当缩短房室间期。由于缺乏大规模的前瞻性的随机临床试验资料，使此疾病的起搏适应证尚有争议。33.与起搏器植入手术相关的并发症有哪些？
　　起搏器植入手术与其他手术一样，都可能有意想不到的意外和并发症出现。与起搏器植入手术相关的并发症有以下几种。
　　（1）血肿形成：是起搏器植入手术常见的并发症之一。血肿形成可有局部肿胀、疼痛等表现。早期轻度血肿可采用局部砂袋加压止血，不主张引流以免增加不必要的感染机会。如局部压迫仍不能止血，应考虑尽早打开囊袋，寻找出血的血管，结扎止血。
　　（2）囊袋感染、溃破：其发生率为2%左右。起搏系统的感染应尽早发现和处理，如出现皮肤溃破，应尽可能移出已感染的起搏器和电极导线，以免感染扩散，久治不愈。
　　（3）心肌穿孔：发生率低于1%，心脏扩大、心脏壁薄、老年患者较易发生。一旦发生心肌穿孔，并出现心脏压塞症状，应行心包穿刺引流，必要时行开胸修补。
显示全部信息

Shipping Overview: 

• Shipping: Standard Domestic Shipping within the United States charges USD 4.99. Standard International Shipping from United Kingdom, Germany and Japan to the United States charges 14.99. 

• Order Processing: Please allow 1-2 business days for order processing and preparation before shipment. 

• Domestic Shipping: Orders within the U.S. are shipped via USPS or FedEx, depending on the origin of the product. The average transit time is 3-7 business days. 

• International Shipping: Currently, we only ship within the USA. 

• Tracking Information: Every order is trackable. You will receive a tracking number once your order has been shipped. Products may be shipped from various global fulfillment centers.

Shipping Delays: 

Please note that shipping times may vary due to factors beyond our control, such as weather conditions, natural disasters, or peak holiday periods. While we strive to ensure timely delivery, the exact arrival time cannot be guaranteed and is managed by the shipping carrier.

Shipping Options:

  • Standard Delivery: Most orders are shipped within 3-7 business days. Larger items may utilize LTL shipping for safe handling.

  • Handling Time: We handle shipments on business days (Monday - Friday), with a preparation time of 1-2 days.

  • Additional Charges: Some items require additional shipping charges due to their size, weight, or special handling. These charges are specified on the product pages and are not eligible for shipping discounts.

  • Exclusions: Gift cards, packaging, taxes, and prior purchases do not count toward the minimum purchase requirement for free shipping. This offer is valid only for shipments to U.S. addresses, including Puerto Rico.

Delivery Details:

  • Estimates: Standard shipping within the US typically takes 3-7 business days. These are estimates and not guarantees.

  • Shipping Restrictions: We ship to all 50 states, Washington, DC, U.S. territories, and APO/FPO/DPO addresses. Shipping options vary based on the delivery address.

  • Remote Areas: Shipments to remote areas may incur additional charges or require pickup from a nearby shipping partner’s location.

Shipping Confirmation:

You will receive a shipping confirmation email with a tracking number as soon as your order is dispatched. If you do not receive this email immediately, please be assured that your items will arrive within the estimated delivery window provided at checkout.

Order Modifications:

If you need to cancel or modify your order, please contact our customer support immediately.

Issues with Delivery:

If your order shows as delivered but you have not received it, please contact the shipping carrier directly to resolve the issue. For persistent problems, contact our customer service at cs@everymarket.com.

Customer Support:

Our team is available 24/7 to assist you with any questions or concerns regarding your order. We are committed to ensuring a smooth shopping experience.

Return & Refund Policy Overview

Please review our return and refund policies below to ensure a smooth transaction process.

Return Policy

  • Duration: You have 30 days from receiving your item to initiate a return.

  • Condition: Items must be unworn, unwashed, with original tags and packaging intact.

  • Shipping Costs: Customers are responsible for return shipping costs.

  • Packaging: Ensure returned items are well-packaged to avoid damage during transit.

  • Tracking: Use a trackable and insured shipping method as we are not liable for items lost or damaged on return.

  • Initiating a Return: Contact us at cs@everymarket.com to start your return. We will provide a return shipping label and instructions upon approval. Returns without prior approval will not be accepted.

How to Return

  • Method: Returns must be sent back by mail to the address provided in the return instructions.

Return Label

  • Defective Products: Return labels are provided for defective items.

  • Non-Defective Returns: Customers are responsible for obtaining their return shipping label.

Product Conditions for Return

  • Eligible Products: Returns are only accepted for items in new condition.

Nonreturnable Items

Certain items are not eligible for return:

  • Electronic devices after 30 days (e.g., computers, laptops, Kindles)

  • Gift cards, prepaid game cards

  • Perishable goods, live insects, some jewelry, some health and personal care items

  • Customized or personalized products

  • Items with special shipping restrictions

Refund Policy

  • Window: Eligible products may be returned within 30 days of delivery for a refund.

  • Refund Method: Refunds are processed to the original payment method or as store credit for items purchased with gift cards.

  • Processing Time: Refunds are processed within 3-5 business days after we receive the return; please allow additional time for shipping and bank processing.

Claims

Inspect your order upon arrival and report any defects, damages, or incorrect items immediately to allow us to address the issue. For claims, contact our support team with details of the issue.

Exchange Policy

For the quickest service, return your original item and place a new order for the desired product once your return is accepted.

Return Address

EveryMarket Customer Service 2101 E Terra Ln, O'Fallon, MO 63366

Customer Support

Available 24/7 for any questions or assistance needed:

  • Phone: +1 636-312-5925

  • Email: cs@everymarket.com

 

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