心脏电生理检查和射频消融治心脏电生理检查和射频消融治疗快速心律失常疗快速心律失常-1-1长海医院心内科曹江CardiacElectrophysiology•CellularCardiacElectrophysiology•ExperimentalCardiacElectrophysiology•ClinicalCardiacElectrophysiologyClinicalCardiacElectrophysiology•ClinicalCardiacElectrophysiologyisafieldwithincardiology•involvescomplicatedtechnicalprocedurestoevaluateheartrhythms•AndprovideappropriatetreatmentforrhythmdisturbancesCardiacElectrophysiologyStudy•EPSoftheheartisanon-surgicalanalysisoftheelectricalconductionsystem(normalorabnormal)oftheheart.•involvesplacingcardiacelectrodecatheterswithinornearthehearttodeterminethecharacteristicsofheartrhythmorarrhythmiaEPstudiesmaybehelpfulin:•todiagnosethesourceofsymptoms•toevaluatetheriskoffuturecardiacevents•toevaluatetheeffectivenessofmedicationincontrollinganarrhythmia•toevaluatetheneedforapermanentpacemaker,animplantablecardioverter-defibrillator,orradiofrequencycatheterablationasatreatmentforarrhythmia.RadiofrequencyCatheterablation•RFCA–Acatheterprocedurethatuseselectricalcurrenttogenerateheattodestroythefastirregularheartbeats心脏功能心脏功能心脏解剖心脏解剖心脏解剖心脏解剖心脏解剖心脏解剖心脏解剖心脏传导系统心脏传导系统心脏传导系统心脏传导系统心脏X线解剖心脏X线解剖心脏X线解剖心脏X线解剖心脏电生理的历史心脏电生理的历史YoucanpickupafeatherafterrubbingamberwithwoolwhichwereobservedeveninancientGreece心脏电生理的历史公元前300年：亚里士多德发现电鳗的“震击”效应心脏电生理的历史WilliamGilbert(1544-1603)performedimportantearlystudiesofelectricityandmagnetism.InDeMagnete(1600),hewasthefirsttodescribetheearth'smagneticfieldandtopostulatetherelationshipbetweenelectricityandmagnetism.Heintroducedthetermelectricityintoscientificdiscourse.心脏电生理的历史LuigiGalvani,1737-1798Italianphysicistandanatomistandwasoneofthefirsttoinvestigateexperimentallythephenomenonofwhatcametobenamed"bioelectrogenesis".心脏电生理的历史1791:Galvanidiscoversthatelectricalstimulationofafrog'sheartleadstomuscularcontractionCarloMatteucci心脏电生理的历史心脏电生理的历史BritishphysiologistAugustusD.WallerofStMary'sMedicalSchool,Londonpublishesthefirsthumanelectrocardiogram.ItisrecordedwithacapilliaryelectrometerfromThomasGoswell,atechnicianinthelaboratory.WallerAD.Ademonstrationonmanofelectromotivechangesaccompanyingtheheart'sbeat.JPhysiol(London)1887;8:229-234心脏电生理的历史心脏电生理的历史心脏电生理的历史心脏电生理的历史•Einthoven–1893年提出了心电图‘Electrocardiogram’的命名,建立肢体导联–发现心电图包括P,Q,R,S和T波–1903年研制成功弦线式心电图机–研究了多种心脏疾病的心电图–1924年荣获了诺贝尔医学奖FatherofElectro-cardiographyECGElectrodes1901LeadILeadIIECGSet心脏电生理的历史•FirstDocumentationofVentricularFibrillationIn1849:Hoffa,inLudwig'slaboratory,documentedbizarreunregulatedactionsoftheventricleswhenexposeddirectlytostrongfaradicorconstantcurrents心脏电生理的历史•1900-1919–S.Tawara’scontributiontoelucidationofconductionsystemofthemammalianheart心脏电生理的历史In1929inasmallhospitalinEberswaldGermanyWernerForssmann,ayoungsurgicalresident,anesthetizedhisownelbow,insertedacatheterinhisantecubitalveinand,catheterdanglingfromhisarm,proceededtoabasementx-rayroomwherehedocumentedthecatheter'spositioninhisrightatrium?provingthatacathetercouldbeinsertedsafelyintoahumanheart.心脏电生理的历史•The1930s–Bundle-BranchBlockwithShortP-RtypeI...
