Josephson’s Clinical Cardiac Electrophysiology

 

Description:

Widely regarded as the premier text in this complex field, Josephson’s Clinical Cardiac Electrophysiology, Seventh Edition, provides a thorough understanding of the mechanisms of cardiac arrhythmias and the therapeutic interventions used to treat them. Dr. David J. Callans, personally chosen and trained by Dr. Mark Josephson, provides expert clinical insights and superb illustrations that highlight proven approaches and methods. With its strong focus on physiologic investigation and its role in clinical decision making, this comprehensive text is a must-have reference for cardiology fellows, electrophysiologists, and others in the EP lab. 

 

Table of Contents:

 

Chapter 1: General Principles and Techniques of Electrophysiologic Investigation

THE ELECTROPHYSIOLOGY LABORATORY

Personnel

INTRACARDIAC SIGNAL RECORDING AND INTERPRETATION

Equipment

Electrode Catheters

Laboratory Organization

Recording and Stimulation Apparatus

CARDIAC CATHETERIZATION TECHNIQUE

Right Atrium

Left Atrium

Right Ventricle

Left Ventricle

His Bundle Electrogram

Transseptal Puncture

RISKS AND COMPLICATIONS

Significant Hemorrhage

Thromboembolism

Phlebitis

Arrhythmias

Complications of Left Ventricular Studies

Pericardial Effusion/Tamponade

INTERPRETATION OF ELECTROPHYSIOLOGY STUDIES

General Concepts

MEASUREMENT OF CONDUCTION INTERVALS

His Bundle Electrogram

Assessment of “H”-V Interval

Establishing Relationship of the His Bundle Deflection to Other Electrograms: Role of Catheter Position

Simultaneous Left-Sided and Right-Sided Recordings

His Bundle Pacing

A-H Interval

H-V Interval

Intra-atrial Conduction

Intraventricular Conduction

DESCRIPTION OF ELECTROGRAMS

Descriptive Characteristics

Quantitative Characteristics

Left Ventricular Endocardial Activation

PROGRAMMED STIMULATION

Incremental Pacing

Refractory Periods

Cycle Length Responsiveness of Refractory Periods

Dispersion of Refractoriness

Patterns of Response to Atrial Extrastimuli

Type I Response

Type II Response

Type III Response

The Atrium as a Limiting Factor in A-V Conduction

Patterns of Response to Ventricular Extrastimuli

Repetitive Ventricular Responses

Safety of Ventricular Stimulation

Comparison of Antegrade and Retrograde Conduction

Chapter 2: Sinus Node Function

ANATOMY AND CELLULAR ELECTROPHYSIOLOGY OF THE SINUS NODE

ELECTROCARDIOGRAPHIC FEATURES OF SINUS NODE DYSFUNCTION

Sinus Bradycardia

Sinoatrial Block and Sinus Arrest

Bradycardia-Tachycardia Syndrome

ELECTROCARDIOGRAPHIC MONITORING OF PATIENTS SUSPECTED OF HAVING SINUS NODE DYSFUNCTION

ASSESSMENT OF AUTONOMIC TONE

ELECTROPHYSIOLOGIC EVALUATION OF SINUS NODE FUNCTION

Sinoatrial Conduction Time

Sinus Node Electrogram

Sinoatrial Conduction Time in Patients with Sick Sinus Syndrome

Sinus Node Recovery Time

Effect of Atropine and Autonomic Blockade on Sinus Node Recovery Time in Normal Persons

Results Sinus Node Testing in Patients Suspected of Having Sinus Node Dysfunction

EFFECT OF DRUGS ON SINUS NODE RECOVERY TIME AND SINOATRIAL CONDUCTION TIME

Digoxin

Propranolol

Calcium Channel Antagonists

Antiarrhythmic Agents

VAGAL HYPERSENSITIVITY (NEUROCIRCULATORY) SYNDROMES

THERAPEUTIC IMPLICATIONS

Chapter 3: Atrioventricular Conduction

ATRIUM

ANATOMY AND CELLULAR ELECTROPHYSIOLOGY OF THE ATRIOVENTRICULAR CONDUCTION AXIS

ATRIOVENTRICULAR NODE

HIS BUNDLE

INFRA-HIS CONDUCTION SYSTEM

PAROXYSMAL ATRIOVENTRICULAR BLOCK

VALUE OF INTRACARDIAC STUDIES IN THE EVALUATION OF ATRIOVENTRICULAR CONDUCTION DISTURBANCES

SUPPRESSION OF ATRIOVENTRICULAR CONDUCTION BY VENTRICULAR STIMULATION

THERAPEUTIC CONSIDERATIONS

Chapter 4: Intraventricular Conduction Disturbances

ANATOMY AND PHYSIOLOGY OF THE HIS-PURKINJE SYSTEM

DEFINITIONS

SITE OF “BLOCK” OR CONDUCTION DELAY DURING BUNDLE BRANCH BLOCK

Chronic Right Bundle Branch Block

Left Bundle Branch Block

Transient Bundle Branch Block

CLINICAL RELEVANCE OF INTRAVENTRICULAR CONDUCTION DISTURBANCES

Role of Electrophysiologic Studies in Predicting Risk of Heart Block

Methods to Identify Patients at Risk of Developing Atrioventricular Block

Alternating Bundle Branch Block

Syncope and Sudden Death in Patients with Bundle Branch Block

THERAPEUTIC IMPLICATIONS

Chapter 5: Miscellaneous Phenomena Related to Atrioventricular Conduction

CONCEALED CONDUCTION

GAP PHENOMENON

SUPERNORMAL CONDUCTION

Chapter 6: Ectopic Rhythms and Premature Depolarizations

ATRIAL DEPOLARIZATIONS

JUNCTIONAL (HIS BUNDLE OR ATRIOVENTRICULAR NODAL) DEPOLARIZATIONS

FASCICULAR DEPOLARIZATIONS

VENTRICULAR DEPOLARIZATIONS

Chapter 7: Supraventricular Tachycardias

MECHANISMS OF SUPRAVENTRICULAR TACHYCARDIA

METHODS OF EVALUATION

SUPRAVENTRICULAR TACHYCARDIA RESULTING FROM ATRIOVENTRICULAR NODAL REENTRY

Mechanisms of Initiation of Atrioventricular Nodal Reentry

Determinants for the Induction of Atrioventricular Nodal Reentry

Atrial Activation Sequence and the P-QRS Relationship During Supraventricular Tachycardia

Effect of Bundle Branch Block During Atrioventricular Nodal Reentrant Supraventricular Tachycardia

Requirement of the Atrium and Ventricle

Requirement of the Atrium in Atrioventricular Nodal Reentry Tachycardia

Responses to Stimulation During Atrioventricular Nodal Reentry Tachycardia—Role in Defining Atrial and Subnodal Participation

Role of Atrial Activation Patterns in Evaluating the Role of the Atrium

Requirement of Subnodal Structures in Atrioventricular Nodal Reentry Tachycardia

Role of Atrial or Ventricular Pacing in Analyzing Upper and Lower Final Common Pathways

Pharmacologic and Physiologic Maneuvers

SUPRAVENTRICULAR TACHYCARDIA RESULTING FROM CONCEALED ATRIOVENTRICULAR BYPASS TRACTS

Mechanism of Initiation

Atrial Activation Sequence and P-QRS Relationship During Supraventricular Tachycardia

Effect of Bundle Branch Block During Supraventricular Tachycardia Using Concealed Bypass Tracts

Requirement of Atrium and Ventricle During Supraventricular Tachycardia Using Concealed Bypass Tracts

Electrical Stimulation During Supraventricular Tachycardia Using a Concealed Bypass Tract

Effects of Pharmacologic and Physiologic Maneuvers During Supraventricular Tachycardia

SUPRAVENTRICULAR TACHYCARDIA RESULTING FROM FOCAL INTRA-ATRIAL OR SINUS NODE REENTRY

Mechanism of Initiation of Supraventricular Tachycardias Resulting From Intra-atrial Reentry

Atrial Activation Sequence and P-QRS Relationship During Supraventricular Tachycardias With Intra-atrial Reentry

Requirement of the Atrium and Ventricles and Influence of Bundle Branch Block on Supraventricular Tachycardia Resulting From Intra-atrial Reentry

Effects of Stimulation During Supraventricular Tachycardias Resulting From Intra-atrial Reentry

Physiologic and Pharmacologic Maneuvers During Supraventricular Tachycardias Resulting From Intra-atrial Reentry

AUTOMATIC ATRIAL TACHYCARDIA

ATRIAL TACHYCARDIA DUE TO TRIGGERED ACTIVITY

DISTINGUISHING ATRIAL TACHYCARDIA FROM ATRIOVENTRICULAR NODAL REENTRY TACHYCARDIA AND ATRIOVENTRICULAR REENTRY TACHYCARDIA

MULTIPLE SUPRAVENTRICULAR TACHYCARDIA MECHANISMS IN INDIVIDUAL PATIENTS

OVERVIEW

Chapter 8: Preexcitation Syndromes

ATRIOVENTRICULAR BYPASS TRACTS

ELECTROPHYSIOLOGIC PROPERTIES OF ATRIOVENTRICULAR BYPASS TRACTS

ELECTROPHYSIOLOGIC EVALUATION IN PATIENTS WITH WOLFF-PARKINSON-WHITE SYNDROME

Diagnosis of an Atrioventricular Bypass Tract

MODE OF INITIATION OF TACHYCARDIAS

ORTHODROMIC TACHYCARDIA

PREEXCITED TACHYCARDIAS

ATRIAL FIBRILLATION

LOCALIZATION OF THE BYPASS TRACT

RELATION OF LOCAL VENTRICULAR ELECTROGRAMS TO DELTA WAVE

PACING FROM MULTIPLE ATRIAL SITES

RETROGRADE ATRIAL ACTIVATION

EFFECT OF BUNDLE BRANCH BLOCK DURING ORTHODROMIC TACHYCARDIA

DIRECT RECORDING OF BYPASS TRACT POTENTIALS

ROLE OF THE BYPASS TRACT IN GENESIS OF ARRHYTHMIAS

DETERMINATION OF THE ANTEGRADE REFRACTORY PERIOD OF THE BYPASS TRACT

INTERMITTENT PREEXCITATION

EFFECT OF ANTIARRHYTHMIC AGENTS ON PREEXCITATION

EXERCISE TESTING IN WOLFF-PARKINSON-WHITE SYNDROME

DETERMINATION OF THE ANTEGRADE REFRACTORY PERIOD OF THE BYPASS TRACT BY PROGRAMMED STIMULATION

TERMINATION OF ORTHODROMIC TACHYCARDIA

MULTIPLE BYPASS TRACTS

ATRIOVENTRICULAR NODAL “BYPASS TRACTS”—LOWN-GANONG-LEVINE SYNDROME

Electrophysiologic Properties

Atrial Pacing

Response to Atrial Premature Depolarizations

Ventriculoatrial Conduction

Response to Pharmacologic and Physiologic Maneuvers

Role of the Bypass Tract in Arrhythmias

Therapeutic Implications

ACCESSORY PATHWAYS WITH ANTEROGRADE DECREMENTAL CONDUCTION AND FASCICULOVENTRICULAR PATHWAYS

Slowly Conducting Accessory Pathways

Electrophysiologic Manifestations

Atriofascicular and Long Atrioventricular Bypass Tracts

Short Slowly Conducting Atrioventricular Bypass Tracts

Nodofascicular and Nodoventricular Bypass Tracts

Tachycardias Associated With Atriofascicular, Slowly Conducting Atrioventricular, Nodofascicular, and Nodoventricular Bypass Tracts

Therapeutic Implications

Fasciculoventricular Bypass Tracts

Chapter 9: Atrial Flutter and Fibrillation

ELECTROPHYSIOLOGIC AND ANATOMIC SUBSTRATES OF MACRO-REENTRANT ATRIAL TACHYCARDIA AND FIBRILLATION

Conduction Defects in Patients With Atrial Fibrillation and Flutter

Atrial Refractoriness

Atrial Vulnerability

Modern Studies of the Electrophysiologic and Anatomic Substrate of Atrial Fibrillation

ELECTROPHYSIOLOGIC MECHANISMS OF ATRIAL FIBRILLATION

Mapping During Atrial Fibrillation

Stimulation During Atrial Fibrillation

Relationship Between Atrial Flutter and Fibrillation

ELECTROPHYSIOLOGIC MECHANISMS OF ATRIAL FLUTTER

Induction of Atrial Flutter

Activation Mapping and Programmed Stimulation During Flutter

Characterization of the Reentrant Circuit in Atrial Flutter

Termination of Atrial Flutter

Effects of Pharmacologic Agents on Reentrant Atrial Flutter

Atrioventricular Conduction During Flutter

SUMMARY

Chapter 10: Recurrent Ventricular Tachycardia

DEFINITIONS OF VENTRICULAR TACHYCARDIAS

Morphology

Duration

CLASSIFICATION OF VENTRICULAR TACHYCARDIA QRS COMPLEXES

DIAGNOSIS OF VENTRICULAR TACHYCARDIA

Use of His Bundle Recordings in Diagnosing Ventricular Tachycardia

Limitations of His Bundle Recordings for the Diagnosis of Ventricular Tachycardia

PATHOPHYSIOLOGIC SUBSTRATE FOR VENTRICULAR TACHYARRHYTHMIAS

Anatomic Substrate

Electrophysiologic Substrate

Classic Studies

New Concepts

MECHANISMS OF VENTRICULAR TACHYCARDIA

Initiation of Ventricular Tachycardias

Protocol of Programmed Stimulation

Number of Extrastimuli

Influence of Drive Cycle Length

Multiple Sites of Stimulation

Role of Increasing Current

Initiation of Sustained Uniform Ventricular Tachycardia

Relationship of Coupling Intervals and Cycle Length Initiating Tachycardia to the Onset of Ventricular Tachycardia and the Initial Ventricular Tachycardia Cycle Length

Relationship of Stimulation Site to Initiation of Ventricular Tachycardia

Relationship of Initiation of Ventricular Tachycardia to Conduction Delay, Block, and/or Continuous Activity

Role of the His-Purkinje System in Initiating and Maintaining Sustained Uniform Ventricular Tachycardia

Initiation of Polymorphic Ventricular Tachycardia-Ventricular Fibrillation

Initiation of Polymorphic Ventricular Tachycardia-Ventricular Fibrillation With Normal QT Intervals

Initiation of Polymorphic Ventricular Tachycardia-Ventricular Fibrillation in the Presence of Long QT Intervals

Mechanism of QRS Morphology in Polymorphic Ventricular Tachycardia

Initiation of Monomorphic Nonsustained Ventricular Tachycardia

Response of Sustained Uniform Ventricular Tachycardia to Stimulation

Protocol for Stimulation During Sustained Ventricular Tachycardia

Manifest and Concealed Perpetuation of Ventricular Tachycardia

Resetting of Ventricular Tachycardia

Return Cycle Versus Ventricular Tachycardia Cycle Length

Resetting With Fusion

Site Specificity of Resetting

Resetting Response Curves

Entrainment of Ventricular Tachycardia

Termination of Sustained Ventricular Tachycardia

Mechanism of Termination and Relationship to Resetting Phenomena

Modification of Factors Influencing Termination of Ventricular Tachycardia

EFFECT OF DRUGS ON VENTRICULAR TACHYCARDIA

Localization of the Site of Origin of Ventricular Tachycardia

General Methods of Catheter Mapping

Acquisition and Interpretation of Activation Mapping During Ventricular Tachycardia

Continuous Activity and Diastolic Bridging

Role of Programmed Stimulation in Identifying the Critical Sites in a Reentrant Circuit

Relationship of Mapping Data to Heart Disease

Multiple Ventricular Tachycardia Morphologies: Relationship to Site of Origin

Validation of Catheter Mapping

Sinus Rhythm Mapping

Relationship of QRS Morphologies to Sites of Origin of Tachycardias

Relationship of QRS Patterns of Sites of Origin of Ventricular Tachycardia

Role of Pace Mapping in Determining the Site of Origin of Ventricular Tachycardia

VENTRICULAR STIMULATION IN MISCELLANEOUS DISORDERS

Chapter 11: Catheter and Surgical Ablation in the Therapy of Arrhythmias

BIOPHYSICS OF CURRENT ABLATION TECHNIQUES

Direct Current Ablation

Irreversible Electroporation (Pulsed Electrical Field Ablation)

Radiofrequency Energy

Enhancements of Radiofrequency Ablation

Laser Ablation

Cryoablation

Ultrasound

Radioablation

CONTROL OF SUPRAVENTRICULAR ARRHYTHMIAS BY ABLATIVE TECHNIQUES

Ablation of Atrioventricular Bypass Tracts and Variants of Preexcitation

Anatomic Considerations

Localization of Bypass Tracts

Electrocardiographic Localization

Intracardiac Localization

Catheter Ablation of Bypass Tracts

Ablation of Preexcitation Variants

Complications of Accessory Pathway Ablation Procedures

Ablation of the Atrioventricular Junction for Ventricular Rate Control During Atrial Tachyarrhythmias

Catheter Ablation Techniques to Treat Atrioventricular Nodal Tachycardia

Anatomic Considerations

Historical Concepts to Development of Present Therapy

Junctional Tachycardia

Surgical and Catheter Ablation Techniques to Manage Other Atrial Arrhythmias

Ablation of Focal Atrial Tachycardia

Anatomic Considerations

Electrocardiographic Considerations

Ablation of Typical Atrial Flutter and Other Macroreentrant Atrial Arrhythmias

Anatomic Considerations

Electrocardiographic Considerations

Surgical and Catheter-Based Ablative Techniques for Treatment of Atrial Fibrillation

Anatomic Considerations

Pulmonary Vein Triggers and Atrial Fibrillation

Role of linear lesions to the atrial roof and/or mitral annulus

Ablation of complex fractionated electrograms

Stepwise ablation (ablation to termination of persistent atrial fibrillation)

Additional Ablation After Pulmonary Vein Isolation

Ablation/modification of the autonomic nervous system for control of atrial fibrillation

Posterior Wall Isolation

Left Atrial Appendage Ablation/Excision

Epicardial Ablation

Substrate Ablation Targeting Areas of Fibrosis

Focal Impulse and Rotor Modulation for Ablation of Atrial Fibrillation

Vein of Marshall Ethanol Infusion

Hybrid Ablation

Additional Ablation After Pulmonary Vein Isolation: Summary

CONTROL OF VENTRICULAR ARRHYTHMIAS BY ABLATIVE TECHNIQUES

Anatomic Considerations

Electrocardiographic Considerations

Historical Considerations

Mapping Techniques for Ventricular Tachycardia

Activation Mapping

Pace Mapping

Entrainment Mapping

Substrate Mapping

Anatomic Ablation

Channel-Based Ablation

Late Potential–Based Ablation

Additional Procedures After Failed Catheter Ablation

Catheter Ablation of Ventricular Tachycardia Associated With Coronary Artery Disease

Ablation of Unstable Ventricular Tachycardias

Role of Catheter Ablation in the Treatment of Ventricular Tachycardia Associated With Nonischemic Left Ventricular Cardiomyopathy

Role of Catheter Ablation in the Treatment of Ventricular Tachycardia Associated With Right Ventricular Cardiomyopathy

The Role of Catheter Mapping and Ablation of Ventricular Fibrillation

The Role of Catheter Mapping and Ablation of Idiopathic Ventricular Tachycardias

Catheter Ablation of Miscellaneous Ventricular Tachycardias

Intraoperative Mapping and Surgical Ablation of Ventricular Tachycardias

Intraoperative Mapping Techniques for Ventricular Tachycardia

Surgical Treatment for Ventricular Tachyarrhythmias

Results of Surgery

Ventricular Tachycardia Unassociated With Coronary Artery Disease

CONCLUSION

Appendix: Case Studies

Index

 

An aparitie	12 ian 2024
Autor	Dr. David Callans
Dimensiuni	213 x 276 mm
Editura	LWW
Format	Hardcover
ISBN	9781975201166
Limba	Engleza
Nr pag	976
Versiune digitala	DA