Cardiac Arrhythmias, Pacing and Sudden Death (Cardiovascular Medicine)

 

Description:

 

This book provides up-to-date, user-friendly and comprehensive guidance on the evaluation, diagnosis, and medical and surgical treatment of cardiac arrhythmias. This ensures that that this title aids every trainee and practicising cardiologist, cardiac electrophysiologist, cardiac surgeon, vascular surgeon, diabetologist, cardiac radiologist and any physician who manages cardiac patients.  Cardiovascular Medicine: Cardiac Arrhythmias, Pacing and Sudden Death covers every aspect of cardiac arrhythmias, from cardiac signs and symptoms through imaging and the genetic basis for disease to surgery, interventions, treatment and preventive cardiology. This coverage is presented  with consistent chapter organization, clear design, and engaging text that includes user-friendly features such as tables, lists and treatment boxes.

 

Table of Contents:

Contributors

1: Basic Electrophysiology

Introduction

The Cardiac Action Potential

What Is an Action Potential? (AP)

How Is the Cardiac AP Generated?

Membrane Potential, Equilibrium Potential and Driving Force

Channel Gating

Stages of the Cardiac AP

Phase 4: the Resting Membrane Potential

Phase 0: The Rapid Upstroke

Phase 1: Early Repolarization

Phase 2: The AP Plateau

Phase 3: Repolarization

Contraction of Cardiac Myocytes

Ca2+-Induced Ca2+ Release

Excitation-Contraction Coupling

Automaticity: The Cardiac Pacemakers

The Membrane Clock Model

The Ca2+ Clock Model

Other Currents

Cardiac Conduction

Cell-Cell Coupling

Arrhythmogenesis

Abnormal Automaticity

Afterdepolarizations and Triggered Activity

Early Afterdepolarizations (EADs)

Delayed Afterdepolarizations (DADs)

Reentry

Anatomical Reentry

Functional Reentry

References

2: Pathophysiology of Atrial Fibrillation

Introduction

Conditions and Diseases That Affect AF Generation

Pathophysiology of AF Initiation: Triggers and Substrate

Pathophysiology of AF Maintenance: Atrial Electrical and Structural Remodeling

Atrial Electrical Remodeling

Atrial Structural Remodeling

Is There a “Vulnerable Window” for Development of AF in the Spectrum of Atrial Structural

Electrophysiological Mechanisms of AF: Focal and Reentry

References

3: Genomics of Cardiac Arrhythmias

DNA Variants

Conventional Approaches to Finding Genes in Familial Traits

Contemporary Approaches to Finding Trait Associated Genetic Variation

The Genome-Wide Association Study

Specific Arrhythmias: Atrial Fibrillation

Specific Arrhythmias: Sudden Cardiac Death

Specific Arrhythmias: Drug-Induced Torsades de Pointes

Antiarrhythmic Drug Pharmacogenetics

Summary and Cautionary Notes

References

4: Channelopathies: Clinical Presentation and Genetics

Long QT Syndrome (LQTS)

Clinical Presentation of LQTS

Genetic Basis and Genotype-Phenotype Correlations

Risk Stratification in LQTS

Brugada Syndrome (BrS)

Clinical Presentation of BrS

Genetic Basis and Genotype-Phenotype Correlations

Risk Stratification in BrS

Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT)

Clinical Presentation of CPVT

Genetic Basis and Genotype-Phenotype Correlations of CPVT

Risk Stratification in CPVT

References

5: Extended ECG Monitoring

Introduction

Recording Systems for Extended Rhythm Monitoring

Holter-ECG

External Cardiac Event Recorders

Implantable Cardiac Monitors (ICMs)

Clinical Applications of Non-invasive ECG Monitoring

Atrial Fibrillation and Cryptogenic Stroke

AF Burden Directing Medical or Invasive Management

Palpitations and Unknown Arrhythmia

Unexplained Syncope and Vasovagal Syncope

Screening for Ventricular Arrhythmia and Risk Assessment of Sudden Cardiac Death

References

6: Sudden Cardiac Death: Methods of Risk Prediction

Introduction

Genetics and Genomics

Left Ventricular Ejection Fraction

Resting Electrocardiogram (QRS and QT Intervals)

Ambulatory Electrocardiogram (Holter Recording of Ventricular Ectopy and Heart Rate Turbulence)

Exercise Electrocardiogram (NSVT and T-wave Alternans)

Signal Averaged Electrocardiography

Electrophysiology Study

Imaging: Assessing Scar Burden

Imaging: Assessing Sympathetic Denervation (MIBG)

Imaging: Assessing Sympathetic Denervation (Positron Emission Tomography)

Summary

References

7: Electrophysiologic Testing and Cardiac Mapping

Indications

Contraindications

Potential Complications

Electrophysiology Laboratory Requirements

Procedural Preparation

Vascular Access

Catheter Selection and Location

Basic EPS Protocol

Baseline Conduction Intervals

Assessment of Sinus Node Function

Programmed Stimulation

Evaluation of Refractoriness and Conduction

Induction of Tachycardia

Cardiac Mapping Techniques

Advanced Computerized Mapping

Three-Dimensional Electroanatomic Mapping Systems

Imaging Modalities for EPS and Ablation

Intracardiac Echocardiography

Summary

References

8: Antiarrhythmic Drug Management of Atrial Fibrillation

Introduction

Principles or Antiarrhythmic Drug Therapy for Maintaining Sinus Rhythm

Goals of Antiarrhythmic Drug Therapy

Pharmacologic Cardioversion of Atrial Fibrillation

Pill-in-the-Pocket Approach

Selection of an Antiarrhythmic Drug

Initiation of Antiarrhythmic Drug Therapy

Assessment of Rhythm Control

Comparative Efficacy of Antiarrhythmic Drugs

Beta-Blockers

Disopyramide

Propafenone and Flecainide

Sotalol

Dofetilide

Amiodarone

Dronedarone

Optimizing the Use of Antiarrhythmic Drugs: Special Situations

Shortening the Duration of Therapy

Postoperative Atrial Fibrillation

Proarrhythmia

Ablation

New Antiarrhythmic Drugs

Ranolazine

Budiodarone

Atrial Repolarisation Delaying Agents (ARDAs)

Small-Conductance Calcium-Activated Potassium Channels

References

9: Anticoagulants for Atrial Fibrillation

Introduction

Assessing Stroke and Bleeding Risks in Atrial Fibrillation

The CHADS2 Score

The CHA2DS2-VASc Score

The HAS-BLED Score

Oral Anticoagulants

Vitamin K Antagonists (VKA)

Non-vitamin K Antagonist Oral Anticoagulants (NOAC)

Management of Bleeding

Choosing Between VKA or NOAC?

Patient Values and Preferences

References

10: Cardiac Pacemakers

Introduction

Pacemaker Components

Pacing Nomenclature

Pacing Modes

Single or Dual-Chamber Asynchronous Pacing (AOO, VOO, DOO)

AAI(R) and VVI(R) Pacing Modes

DDD Pacing Mode

DDI Pacing Mode

VDI Pacing Mode

VDD Pacing Mode

Pacing Indications

Pacemaker Outpatient Follow-Up

Electrocardiogram Characteristics Based on Pacing Lead Location

P Wave Morphology

Morphology of QRS Complex

Biventricular Pacemakers

Other ECG Changes Related to Pacing Stimulation

Troubleshooting

Summary

References

11: Implantable and Wearable Defibrillator Therapy

Definition and Epidemiology of Sudden Cardiac Death

Mechanisms of SCD

Risk Stratification for SCD

Defibrillators, a Historical Perspective

Strategies for SCD Prevention

Primary Prevention of Sudden Cardiac Death: Ischemic Cardiomyopathy

Primary Prevention of Sudden Cardiac Death: Non-ischemic Cardiomyopathy

Secondary Prevention of Sudden Cardiac Death

Defibrillator Therapy for the Management of Heart Failure

The Subcutaneous Defibrillator (S-ICD)

The Wearable Defibrillator (LifeVest)

References

12: Atrial Fibrillation Ablation

Introduction

Basis for Pulmonary Vein Isolation

Pulmonary Vein Anatomy and Signals Assessment

Assessing PV Potentials

Techniques and Results of PVI

Pulmonary Veins Reconnection

Maximizing Durable Pulmonary Vein Isolation

Complex Fractionated Atrial Electrograms

Linear Ablation

Roof Line

Mitral Line

Role of Non-PV Sources

Ganglion Plexi Modification

Focal Impulse and Rotor Modulation

Balloon Based Technology

Cryoballoon

Laser-Balloon Ablation

Complications

Risk Factor Modification

References

13: Ventricular Tachycardia Ablation

Introduction

Technical Aspects of Catheter Ablation

Radiofrequency Ablation

Alternative Energy Sources

Access Considerations

Initial Considerations and Pre-procedural Workup for Patients Presenting with VT

Complications of Catheter Ablation

Patients with Structurally Normal Hearts

Outflow Tract Arrhythmias

Other Idiopathic Ventricular Arrhythmias

Sustained Monomorphic VT in Structural Heart Disease

Sustained Monomorphic VT due to Scar-­Related Reentry

Ablation in Specific Disease

Ischemic Heart Disease

Dilated Cardiomyopathy

Arrhythmogenic RV Cardiomyopathy (ARVC)

Cardiac Sarcoidosis

Hypertrophic Cardiomyopathy

Repaired Congenital Heart Disease

Purkinje-Related Monomorphic VTs

Catheter Ablation for Polymorphic VT and Ventricular Fibrillation (VF)

Summary

References

14: Supraventricular Tachycardia

Supraventricular Tachycardia

Clinical Presentation

Obtaining Symptom Rhythm Correlation

Patterns of Presentation

Presentation in the Emergency Department with Ongoing Tachycardia

Presentation to an Out Patient Clinic with Symptoms Suggestive of SVT

A Patient with Prior Documented SVT Presenting for Consultation and Management

SVT with Pronged QRS Duration/Wide Complex SVT

Mechanisms of SVT

Atrial Tachycardia

AV Nodal Reentrant Tachycardia

Atrioventricular Reciprocating Tachycardia

Junctional Tachycardia

ECG

P Wave Morphology

Ratio of P Waves to QRS

Timing of P Wave to QRS

Initiation, Termination, and Cycle Length Variation

VT vs. SVT with Aberrancy

Bystander Pre-excitation

Accessory Pathways and Sudden Cardiac Death

Wide Complex Tachycardia with Accessory Pathways

“Concealed” Bypass Tracts

References

15: Clinical Management of Atrial Fibrillation

Introduction

Assessment of the Patient with AF

Choice of Rate Vs. Rhythm Control

Approach to Rate Control

Approach to Rhythm Control

Approach to Stroke Prevention

References

16: Ventricular Tachycardia and Fibrillation in Patients with Structural Heart Disease

Epidemiology

VT/VF as the Mechanism of SCD

Coronary Heart Disease

Pathophysiology: Acute Ischemia

Transient Ischemia and the Onset on Myocardial Infarction

Reperfusion After Transient Ischemia

Enhanced Automaticity and Accelerated Ventricular Rhythms Shortly After Onset of Myocardial Infa

VT/VF During the First 48 h After the Onset of Myocardial Infarction

Cardiac Arrest During Early Convalescence

Electrophysiologic Mechanisms

Onset of VT/VF

Treatment of VT

VT/VF in Patients with Nonischemic Cardiomyopathy

Dilated Cardiomyopathy

Pathophysiology

Predictors of VT/VF and SCD in Patients with DCM

Therapy to Prevent and Treat VT/VF in Patients with DCM

Special Populations

Alcoholic Cardiomyopathy

Left Ventricular Non-compaction (LVNC)

Amyloid

Sarcoid Cardiomyopathy

References

17: Ventricular Arrhythmias in the Absence of Structural Heart Disease

Introduction

Monomorphic VT in the Absence of Apparent SHD

Classification

Diagnostic Evaluation

General Approach

Repetitive Monomorphic VT

Epidemiology and Clinical Features

Site of Origin

Electrocardiographic Features

Electrophysiologic Features

Prognosis

Medical Therapy

Radiofrequency Ablation

Idiopathic Left Ventricular Tachycardia (ILVT)

Clinical Features

Site of Origin

Electrocardiographic Features

Electrophysiologic Features

Treatment of ILVT

Polimorphic VT and VF in the Absence of Apparent SHD

Congenital Long QT Syndrome (LQTS)

Epidemiology

Clinical Manifestations

Diagnosis

Treatment

Brugada Syndrome

Pathogenesis

Clinical Features

ECG Patterns

Diagnosis

Diagnostic Testing and Risk Stratification

Treatment

Catecholaminergic Polymorphic Ventricular Tachycardia

Early Repolarization

References

18: Bradyarrhythmias/Heart Blocks

Introduction

The Sinus Node-Related Bradycardias

Patterns of Sinus Node Dysfunction

Chronotropic Incompetence

Sinus Arrest

Sinus Node Exit Block

Causes of Sinus Node Dysfunction

Sinus Node Disease (Sick Sinus Syndrome)

The AV Conduction System-Related Bradycardias

Patterns of AV Block

First-Degree AV Block

Second-Degree AV Block

Third-Degree AV Block

Incomplete His-Purkinje System Blocks

Causes of AV Node Dysfunction

Congenital Heart Block

Lyme Disease

Cardiac Sarcoidosis

AV Block Associated with Ischemic Heart Disease

Causes of His-Purkinje System Dysfunction

Symptoms of the Bradycardias

Treatment of the Bradycardias

References

19: Syncope and Risk of Sudden Death

Introduction

Assessment

Initial Assessment

Determining the Etiology

Assessment of Mortality/Life-Threatening Risk

Assessment of Long-Term Risk

Longer-Term Risk

Shorter-Term and Immediate Risk (7–30 days)

Risk of Recurrence

Specific Cardiac Conditions

Ischemic Cardiomyopathy

Non-ischemic Cardiomyopathy

Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC)

Hypertrophic Cardiomyopathy (HCM)

Long QT Syndrome (LQTS)

Brugada Syndrome

Impact on Healthcare Costs

References

20: Management of Ventricular Arrhtyhmias in Nonischemic Cardiomyopathic Syndromes

Dilated Cardiomyopathy

Hypertrophic Cardiomyopathy

Sarcoidosis

Chagas Disease

Left Ventricular Non-compaction Cardiomyopathy

Peripartum Cardiomyopathy (PPCM)

Takotsubo Cardiomyopathy

Fabry’s Disease

Arrhythmogenic Right Ventricular Dysplasia

Risk Stratification

PVC Mediated Cardiomyopathy

References

21: Arrhythmias in Congenital Heart Disease

Introduction

Tachycardias in CHD

Accessory Pathways

Atrioventricular Nodal Reentrant Tachycardia, and Twin AV Nodes

Intraatrial Reentrant Tachycardia

Atrial Fibrillation

Ventricular Tachycardia

Bradycardia in CHD

Sinoatrial Node Dysfunction

Atrioventricular Block in CHD

Summary

References

22: Arrhythmias in Special Populations

Arrhythmias in Pregnancy

Mechanisms

Supraventricular Tachycardia

Wolff-Parkinson-White and Preexcitation

Atrial Fibrillation and Flutter

Ventricular Tachycardia

Arrhythmias in Athletes

The Athletic Heart

Sinus Node Dysfunction

Atrioventricular Node Dysfunction

Supraventricular Tachycardia

Atrial Fibrillation/Flutter

Premature Ventricular Contractions

Hypertrophic Cardiomyopathy

Commotio Cordis

Anomalous Coronary Arteries

Arrhythmogenic Right Ventricular Dysplasia

Catecholaminergic Polymorphic Ventricular Tachycardia

Idiopathic Ventricular Tachycardia

Long QT Syndromes

Short QT Syndrome

Brugada Syndrome

Arrhythmias Following Heart Transplant

Sinus Bradycardia and Conduction System Disease

Atrial Fibrillation

Atrial Flutter

Ventricular Arrhythmias

Sudden Cardiac Death

Post-operative Arrhythmias

Bradycardias

Supraventricular Arrhythmias

Atrial Fibrillation/Flutter

Ventricular Arrhythmias

References

Index

 

An aparitie	18 Sept. 2017
Autor	Peter Kowey, Jonathan P. Piccini , Gerald Naccarelli , James A. Reiffel
Dimensiuni	21.59 x 2.54 x 27.94 cm
Editura	Springer
Format	Hardcover
ISBN	9783319579986
Limba	Engleza
Nr pag	306