Intracardiac electrophysiological examination

A clinically diagnosed complex arrhythmia and a traumatic means of guiding its treatment. The basic principle is to record the intracardiac electrical signals from the electrodes placed in different parts of the heart chamber through a multi-channel physiological instrument, analyze the principle, type and evaluation of the arrhythmia, and analyze the origin and location of the arrhythmia. Provide a basis for surgery or catheter ablation. Basic Information Specialist Category: Cardiovascular Examination Category: Other Examinations Applicable gender: whether men and women apply fasting: not fasting Tips: Obey the doctor's arrangements before the exam. Normal value Under the local anesthesia, the femoral vein and the subclavian vein were punctured, and the 2 to 4 pole lead was delivered to the coronary sinus, the high right atrium, the vicinity of the His bundle and the right ventricle. The atrial instrument can display and record the atrium (A) and His (His) and ventricular (V) waveforms. The His's beam diagram consists of A, H and V3 waveforms. A represents atrial excitatory activity, V represents ventricular excitation activity, H is excited by His bundle, and the distance between AH and HV has a normal range. Conduction block between the atrioventricular compartments. Electrical stimulation of the atrium and ventricle by an external stimulator can measure the electrophysiological characteristics of different parts of the heart and induce different types of arrhythmia. The atrioventricular block can be located according to the relationship of A, H and V. Diagnose and judge the mechanism of arrhythmia. Clinical significance The clinical application of intracardiac electrophysiological examination includes: 1 evaluation of sinus node function, which is helpful for clinically diagnosed sinus syndrome. Positioning of 2 compartments, indoor and indoor conduction block. 3 paroxysmal supraventricular tachycardia. 4-ventricular tachycardia. 5 screening for treatment of severe malignant ventricular arrhythmia drugs. 6 standard measurement position, non-medical treatment. Precautions Obey the doctor's arrangements before the examination. Inspection process The usual cardiac interventional disinfection, drape and anesthesia procedures are used. The Seldinger method was used to puncture the blood vessel into the electrode sheath. The coronary sinus electrode is approached through the left subclavian vein (via the right femoral vein when it is difficult), and the right ventricular electrode, the His bundle electrode, and the right atrium high electrode are routed through the right femoral vein. After the mapping electrode is in place, the intracardiac electrophysiological examination is performed: 1 The right atrial high electrode S1S2 is stimulated to determine the electrophysiological characteristics of the atrioventricular nodal pathway: the mode is transmitted to jump or induce AVNRT; 2 pairs of dominant bypass usually pass The coronary sinus electrode was measured at the bypass position, otherwise the right ventricular electrode S1S1 was scanned to check for the presence or absence of occult atrioventricular bypass. 3 The intracardiac electrophysiological diagnosis of tachycardia with the same or similar clinical symptoms was induced as much as possible.