Catheter Ablation of Cardiac Arrhythmias, 3e

759 Pages·2014·172.435 MB·English

by  Shoei K. Stephen Huang MD, John M. Miller MD FACR

THIRD EDITION
Catheter Ablation of
Cardiac Arrhythmias
Shoei K. Stephen Huang, MD
Chair Professor of Medicine
Tzu Chi University School of Medicine,
Director, Center of Cardiovascular Medicine
Taichung Tzu Chi General Hospital
Hualien, Taiwan;
Former Professor of Medicine with Tenure
Texas A&M University Health Science Center,
Former Director, Cardiac Electrophysiology and Pacing
Baylor-Scott & White Health
Temple, Texas
John M. Miller, MD
Professor of Medicine
Indiana University School of Medicine,
Director, Clinical Cardiac Electrophysiology
Indiana University Health
Indianapolis, Indiana
1600 John F. Kennedy Blvd.
Ste 1800
Philadelphia, PA 19103-2899
CATHETER ABLATION OF CARDIAC ARRHYTHMIAS ISBN: 978-0-323-24429-9
Copyright © 2015, 2011, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Notices
Knowledge and best practice in this field are constantly changing. As new research and experience
broaden our understanding, changes in research methods, professional practices, or medical
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Practitioners and researchers must always rely on their own experience and knowledge in
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Library of Congress Cataloging-in-Publication Data
Catheter ablation of cardiac arrhythmias (Huang)
Catheter ablation of cardiac arrhythmias / [edited by] Shoei K. Stephen Huang,
John M. Miller.—Third edition.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-0-323-24429-9 (hardcover : alk. paper)
I. Huang, Shoei K., editor. II. Miller, John M. (John Michael), 1954- , editor. III. Title.
[DNLM: 1. Arrhythmias, Cardiac—therapy. 2. Catheter Ablation—methods.
3. Tachycardia—therapy. WG 330]
RD598
617′.412—dc23
2014027631
Executive Content Strategist: Dolores Meloni
Senior Content Development Specialist: Joan Ryan
Publishing Services Manager: Catherine Jackson
Senior Project Manager: Rachel E. McMullen
Design Direction: Ellen Zanolle
Printed in Canada
Last digit is the print number: 9 8 7 6 5 4 3 2 1

DEDICATION
To my wife, Su-Mei, for all of her love, support, and patience; to my lovely children,
Priscilla and her husband, Alex; Melvin and his wife, Stacy; and Jessica, for their love
and encouragement; and to my grandson, Ethan, who fills my life with joy and happiness.
Shoei K. Stephen Huang, MD
To the love of my life, my dear Jeanne, and our wonderful children Rebekah, Jordan, and Jacob,
whose husband and father I am privileged to be, for their understanding and forbearance
during the writing and editing of this work.
John M. Miller, MD
iii
iv DEDICATION
SPECIAL DEDICATION TO THIRD EDITION— taken his place as one of the figures who come to mind
when people refer to the “days of the giants.” He was
MARK A. WOOD, MD
one of these in so many ways. Mark is sorely missed by
Mark Allen Wood departed this earthly existence May his friends and family but his legacy, example, and works
21, 2012, after an extended and valiant battle with cancer. live on.
His long and productive career and the dignity and tenac-
ity he showed to the end of his life remain an inspiration Shoei K. Stephen Huang, MD
for those of us fortunate enough to have known him, and
John M. Miller, MD
set him apart from many others.
Great clarity of thought and expression characterized
Mark’s interactions with colleagues. Many of us benefited
from his insights on a wide variety of topics. A rather
reserved man, in conversation, he rarely spoke of
himself—he was always more interested in what the other
person thought or was currently doing. He made a strong
impression on trainees as well as colleagues in the meticu-
lous care with which he approached everything in which
he was involved—his family life, patient care, research,
and teaching. An old-school educator, he invested heavily
in the currency of time and effort in the lives and careers
of his trainees. His legacy is impressive.
It was our privilege to know and work with Mark for
several years on a variety of projects, including Catheter
Ablation of Cardiac Arrhythmias. His tireless efforts as
co-editor of the first two editions made this the superb
book it has been, and which we hope to maintain in the
current edition.
A physically tall man, Mark was never stooped by his
illness. As well as his overall strength of character, he has
CONTRIBUTORS
Amin Al-Ahmad, MD Eric Buch, MD
Texas Cardiac Arrhythmia Institute Assistant Professor of Medicine
St. David’s Medical Center University of California, Los Angeles
Austin, Texas Los Angeles, California
Jason Andrade, MD J. David Burkhardt, MD
Department of Medicine Texas Cardiac Arrhythmia Institute
Montreal Heart Institute St. David’s Medical Center
University of Montreal Austin, Texas
Montreal, Quebec, Canada;
Department of Medicine David J. Callans, MD
University of British Columbia Professor of Medicine, Cardiovascular Division
Vancouver, British Columbia, Canada University of Pennsylvania
Hospital of the University of Pennsylvania
Elad Anter, MD Philadelphia, Pennsylvania
Assitant Professor
The Harvard-Thorndike Electrophysiology Institute Huai-Ren Chang, MD, PhD
Beth Israel Deaconess Medical Center, Harvard Medical Assistant Professor of Medicine
School, School of Medicine
Boston, Massachusetts Tzu Chi University
Hualien, Taiwan
Rishi Arora, MD
Associate Professor of Medicine Shih-Lin Chang, MD
Director, Experimental Cardiac Electrophysiology Division of Cardiology
Northwestern University–Feinberg School of Medicine Department of Medicine
Chicago, Illinois National Yang-Ming University School of Medicine
Taipei Veterans General Hospital
Samuel J. Asirvatham, MD Taipei, Taiwan
Professor of Medicine and Pediatrics
Internal Medicine, Division of Cardiovascular Diseases Shih-Ann Chen, MD
Mayo Clinic Division of Cardiology
Rochester, Minnesota Department of Medicine
National Yang-Ming University School of Medicine
Javier E. Banchs, MD Taipei Veterans General Hospital
Penn State Heart and Vascular Institute Taipei, Taiwan
Milton S. Hershey Medical Center
Penn State University Peter Cheung, MD
Hershey, Pennsylvania Assistant Professor of Internal Medicine
The Texas A&M Health Science Center—College of
Mohamed Bassiouny, MD Medicine
Fellow, Department of Cardiovascular Medicine Baylor-Scott & White Health
Cleveland Clinic Temple, Texas
Cleveland, Ohio
Jason Chinitz, MD
Deepak Bhakta, MD Fellow, The Leona M. and Harry B. Helmsley
Associate Professor of Clinical Medicine Charitable Trust Center for Cardiac
Krannert Institute of Cardiology Electrophysiology
Indiana University School of Medicine Icahn School of Medicine at Mount Sinai
Indianapolis, Indiana New York, New York
Frank M. Bogun, MD Thomas C. Crawford, MD
Associate Professor of Medicine Assistant Professor of Medicine
Division of Cardiology Division of Cardiology
University of Michigan Health System University of Michigan Health System
Ann Arbor, Michigan Ann Arbor, Michigan
v
vi CONTRIBUTORS
Mithilesh K. Das, MD Evan Geidrimas, MD
Associate Professor of Clinical Medicine Cardiac Electrophysiologist
Krannert Institute of Cardiology Heart Rhythm Center, Baptist Hospital
Indiana University School of Medicine Pensacola, Florida
Indianapolis, Indiana
Edward P. Gerstenfeld, MD
Christopher V. DeSimone, MD, PhD Associate Professor of Medicine
Division of Cardiovascular Diseases Medicine/Cardiology
Mayo Clinic University of California
Rochester, Minnesota San Francisco, California
Sanjay Dixit, MD Mario D. Gonzalez, MD
Associate Professor Professor of Medicine
Medicine, Cardiovascular Division Director, Clinical Electrophysiology
Hospital of The University of Pennsylvania, Penn State Heart and Vascular Institute
Director, Cardiac Electrophysiology Milton S. Hershey Medical Center
Cardiology-Medicine Penn State University
Philadelphia Veterans Affairs Medical Center Hershey, Pennsylvania
Philadelphia, Pennsylvania
David E. Haines, MD
Luigi Di Biase, MD William Beaumont Hospital
Texas Cardiac Arrhythmia Institute Division of Cardiology
St. David’s Medical Center Royal Oak, Michigan
Austin, Texas
Haris M. Haqqani, MBBS(Hons), PhD
Shephal K. Doshi, MD Senior Lecturer
Director, Cardiac Electrophysiology School of Medicine
Pacific Heart Institute The University of Queensland;
St. John’s Health Center Senior Consultant Electrophysiologist
Santa Monica, California Cardiology
The Prince Charles Hospital
Marc Dubuc, MD Brisbane, Queensland, Australia
Electrophysiology Service
Department of Medicine Satoshi Higa, MD, PhD
Montreal Heart Institute Director of Cardiac Electrophysiology and Pacing
University of Montreal Laboratory
Montreal, Quebec, Canada Division of Cardiovascular Medicine
Makiminato Central Hospital
Srinivas R. Dukkipati, MD Okinawa, Japan
Assistant Professor of Medicine
Co-Director, Cardiac Arrhythmia Service Rodney P. Horton, MD
The Leona M. and Harry B. Helmsley Charitable Trust Adjunct Professor of Biomedical Engineering
Center for Cardiac Electrophysiology Texas Cardiac Arrhythmia Institute
Icahn School of Medicine at Mount Sinai Cockrell School of Engineering
New York, New York University of Texas
Austin, Texas;
James R. Edgerton, MD Adjunct Assistant Professor of Cardiology
The Heart Hospital University of Texas Health Sciences Center
Baylor Regional Medical Center at Plano San Antonio, Texas
Plano, Texas;
Cardiopulmonary Research Science and Technology Patrick Hranitzky, MD
Institute Texas Cardiac Arrhythmia Institute
Dallas, Texas St. David’s Medical Center
Austin, Texas
Gregory K. Feld, MD
Professor Medicine Jen-Che Hsieh, MD
University of California, San Diego Assitant Professor of Medicine
Director, Electrophysiology Program School of Medicine
San Diego Medical Center Tzu Chi University
La Jolla, California Hualien, Taiwan
CONTRIBUTORS vii
Yu-Feng Hu, MD George J. Klein, MD
Division of Cardiology Professor of Medicine
Department of Medicine University of Western Ontario
National Yang-Ming University School of Medicine London, Ontario, Canada
Taipei Veterans General Hospital
Taipei, Taiwan Jacob S. Koruth, MD
Assistant Professor of Medicine,
Shoei K. Stephen Huang, MD Director, Experimental Electrophysiology Laboratory
Chair Professor of Medicine The Leona M. and Harry B. Helmsley Charitable Trust
Tzu Chi University School of Medicine, Center for Cardiac Electrophysiology
Director, Center of Cardiovascular Medicine Icahn School of Medicine at Mount Sinai
Taichung Tzu Chi General Hospital New York, New York
Hualien, Taiwan;
Former Professor of Medicine with Tenure Andrew D. Krahn, MD
Texas A&M University Health Science Center, Professor, Division of Cardiology
Former Director, Cardiac Electrophysiology and Pacing London Health Sciences Centre
Baylor-Scott & White Health London, Ontario, Canada
Temple, Texas
David E. Krummen, MD
Mathew D. Hutchinson, MD Associate Professor of Medicine
Assistant Professor of Medicine Department of Medicine
Cardiovascular Division University of California, San Diego
University of Pennsylvania San Diego, California
Philadelphia, Pennsylvania
Nirusha Lachman, PhD
Rahul Jain, MD Department of Anatomy
Senior Electrophysiology Fellow College of Medicine
Krannert Institute of Cardiology Mayo Clinic
Indiana University School of Medicine Rochester, Minnesota
Indianapolis, Indiana
Gautam G. Lalani, MD
Gautham Kalahasty, MD Fellow
Assistant Professor of Medicine (Cardiology) Department of Medicine
Virginia Commonwealth University Medical Center University of California, San Diego
Richmond, Virginia San Diego, California
Jonathan M. Kalman, MBBS, PhD Bruce B. Lerman, MD
Director of Cardiac Electrophysiology Professor of Medicine and Chief, Division of
Cardiology Cardiology,
Royal Melbourne Hospital Director of the Cardiac Electrophysiology Laboratory
Melbourne,Victoria, Australia Cornell University Medical Center-New York
Presbyterian Hospital
Mohamed Kanj, MD New York, New York
Fellow, Department of Cardiovascular Medicine
Cleveland Clinic Jackson J. Liang, DO
Cleveland, Ohio Department of Internal Medicine
Mayo Clinic
G. Neal Kay, MD Rochester, Minnesota
Professor Emeritus
University of Alabama at Birmingham Yenn-Jiang Lin, MD
Birmingham, Alabama Division of Cardiology
Department of Medicine
Paul Khairy, MD, PhD National Yang-Ming University School of Medicine
Boston Adult Congenital Heart (BACH) Service Taipei Veterans General Hospital
Department of Cardiology Taipei, Taiwan
Boston Children’s Hospital
Boston, Massachusetts
viii CONTRIBUTORS
Li-Wei Lo, MD Akihiro Nogami, MD, PhD
Division of Cardiology Professor
Department of Medicine Cardiovascular Division
National Yang-Ming University School of Medicine University of Tsukuba,
Taipei Veterans General Hospital Tsukuba, Ibaraki, Japan
Taipei, Taiwan
Amit Noheria, MBBS, SM
Steven M. Markowitz, MD Division of Cardiovascular Diseases
Professor of Medicine, Division of Cardiology Mayo Clinic
Cornell University Medical Center—New York Rochester, Minnesota
Presbyterian Hospital
New York, New York Nicholas Olson, MD
Fellow
Thomas McGarry, MD Department of Medicine
Fellow, Department of Medicine University of California, San Diego
University of California, San Diego San Diego, California
La Jolla, California
Mark O’Neill, DPhil
John M. Miller, MD Consultant Cardiologist and Professor in Clinical
Professor of Medicine Cardiac Electrophysiology
Indiana University School of Medicine, Divisions of Imaging Sciences and Biomedical
Director, Clinical Cardiac Electrophysiology Engineering and Cardiovascular Medicine
Indiana University Health St. Thomas’ Hospital
Indianapolis, Indiana London, United Kingdom
Marc A. Miller, MD Hakan Oral, MD
Assistant Professor of Medicine Professor of Internal Medicine
The Leona M. and Harry B. Helmsley Charitable Trust Internal Medicine
Center for Cardiac Electrophysiology University of Michigan,
Icahn School of Medicine at Mount Sinai Director
New York, New York Cardiac Arrhythmia Service,
Frederick G.L. Huetwell Professor of Cardiovascular
Joseph B. Morton, MBBS Medicine
Department of Cardiology Cardiovascular Medicine
Royal Melbourne Hospital University of Michigan
Melbourne, Victoria, Australia Ann Arbor, Michigan
Sudip Nanda, MD Thomas Paul, MD
Division of Cardiovascular Diseases Professor
Mayo Clinic Pediatric Cardiology and Intensive Care Medicine
Rochester, Minnesota Georg-August-University Medical Center
Göttingen, Germany
Sanjiv M. Narayan, MD, PhD
Professor of Medicine Basilios Petrellis, MD
Department of Medicine Consultant, Arrhythmia Service
University of California, San Diego University of Toronto
San Diego, California St. Michael’s Hospital
Toronto, Ontario, Canada
Andrea Natale, MD
Executive Medical Director Vivek Y. Reddy, MD
Texas Cardiac Arrhythmia Institute The Helmsley Trust Professor of Medicine
St. David’s Medical Center Director, Cardiac Arrhythmia Service
Austin, Texas The Leona M. and Harry B. Helmsley Charitable Trust
Center for Cardiac Electrophysiology
Ashley M. Nisbet, MBChB, PhD Icahn School of Medicine at Mount Sinai
Department of Cardiology New York, New York
Royal Melbourne Hospital
Melbourne, Victoria, Australia
CONTRIBUTORS ix
Jaime Rivera, MD Hiroshi Tada, MD, PhD
Director of Cardiac Electrophysiology Professor
Instituto Nacional de Ciencias Médicas y Nutrición Department of Cardiovascular Medicine, Faculty of
Hospital Médica Sur Medical Sciences
Mexico City, Mexico University of Fukui
Yoshida-gun, Japan
Kurt C. Roberts-Thomson, MD
Department of Cardiology Yasuaki Tanaka, MD
Royal Melbourne Hospital Visiting Assistant Professor
Melbourne, Victoria, Australia University of California, San Francisco
San Francisco, California
Raphael Rosso, MD
Head of the Atrial Fibrillation Service Taresh Taneja, MD
Department of Cardiology Cardiac Electrophysiology TPMG, North Valley
Tel Aviv Sourasky Medical Center Sacramento, California
Tel Aviv, Israel
Patrick J. Tchou, MD
Javier Sanchez, MD Department of Cardiovascular Medicine
Texas Cardiac Arrhythmia Institute Cleveland Clinic
St. David’s Medical Center Cleveland, Ohio
Austin, Texas
Andrew W. Teh, MD
Pasquale Santangeli, MD Department of Cardiology
Fellow, Cardiovascular Division Royal Melbourne Hospital
Hospital of the University of Pennsylvania Melbourne, Victoria, Australia
Philadelphia, Pennsylvania
John K. Triedman, MD
J. Philip Saul, MD Professor of Pediatrics
Professor and Chair, Department of Pediatrics Harvard Medical School
Associate Dean for Pediatric and Transitional Health Boston, Massachusetts
The Ohio State University,
Physician-in-Chief, Nationwide Children’s Hospital Wen-Chin Tsai, MD, PhD
CEO, Pediatric Academic Association Assistant Professor of Medicine
Columbus, Ohio School of Medicine, Tzu Chi University
Division of Cardiology
Amir Schricker, MD Tzu-Chi General Hospital
Fellow Hualien, Taiwan
Department of Medicine
University of California, San Diego Roderick Tung, MD
San Diego, California Assistant Professor of Medicine
Cardiology
Richard K. Shepard, AB, MD University of California, Los Angeles
Associate Professor of Medicine Los Angeles, California
Internal Medicine
Virginia Commonwealth University John Whitaker, MB ChB
Richmond, Virginia Cardiology Specialty Trainee
Cardiovascular Directorate, Department of Cardiology
Kalyanam Shivkumar, MD, PhD St. Thomas’ Hospital
Director, UCLA Cardiac Arrhythmia Center London, United Kingdom
Professor of Medicine & Radiology
UCLA Health System Mark A. Wood, MD†
Los Angeles, California Former Professor of Internal Medicine
Virginia Commonwealth University
Allan C. Skanes, MD Richmond, Virginia
Associate Professor of Medicine
Western University,
†Deceased.
Director, Electrophysiology Laboratory
London Health Sciences Centre
University Hospital
London, Ontario, Canada