Table Of ContentHandbook of Cardiac
Electrophysiology
Handbook of Cardiac
Electrophysiology
Second Edition
Edited by
Andrea Natale
Oussama M. Wazni
Kalyanam Shivkumar
Francis E. Marchlinski
CRC Press
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CONTENTS
Preface ix
Acknowledgments x
Editors xi
Contributors xiv
SECTION I
Basic EP Laboratory Setup and Equipment
1 DEVICE LAB SET-UP 2
John Lopez and Mina K. Chung
2 ORGANIZATION OF THE ARRHYTHMIA LAB 6
Roy Chung and Oussama M. Wazni
3 HOLTER AND EVENT MONITOR LABORATORY SETUP 13
Roy Chung, Daniel Cantillon, and Mina K. Chung
SECTION II
Bradyarrhythmia
4 BRADYCARDIA 36
Shiv Bagga and Mandeep Bhargava
5 INDICATIONS FOR PERMANENT PACING AND CARDIAC
RESYNCHRONIZATION THERAPY 48
Shiv Bagga, J. David Burkhardt, and Mandeep Bhargava
SECTION III
Supraventricular Tachyarrhythmia
6 ATRIAL FLUTTER 68
Ayman A. Hussein and Oussama M. Wazni
7 ATRIAL FIBRILLATION 81
Rong Bai, Mohamed Salim, Luigi Di Biase, Robert Schweikert, and Walid Saliba
v
SECTION IV
Ventricular Tachyarrhythmia
8 GENETICALLY DETERMINED VENTRICULAR
ARRHYTHMIAS 94
Houman Khakpour and Jason S. Bradfield
9 IDIOPATHIC VENTRICULAR TACHYCARDIA 116
Jackson J. Liang and David S. Frankel
SECTION V
Syncope
10 SYNCOPE EVENTS, DEFINITIONS, CAUSES,
AND FEATURES 126
Subramanya Prasad, Oussama M. Wazni, Mina K. Chung, Kenneth Mayuga,
and Robert Schweikert
11 SYNCOPE MANAGEMENT FACILITIES 143
Subramanya Prasad, Robert Schweikert, Mina K. Chung, Kenneth Mayuga,
and Oussama M. Wazni
12 SYNCOPE MANAGEMENT AND DIAGNOSTIC TESTING 150
Subramanya Prasad, Oussama M. Wazni, Robert Schweikert, Kenneth Mayuga,
and Mina K. Chung
SECTION VI
Device Procedures
13 IMPLANTATION OF PACEMAKERS AND ICDs 164
Kushwin Rajamani, Michael P. Brunner, Oussama M. Wazni,
and Bruce L. Wilkoff
14 LEFT VENTRICULAR LEAD IMPLANTATION FOR
CARDIAC RESYNCHRONIZATION THERAPY 172
Kushwin Rajamani, Michael P. Brunner, Oussama M. Wazni,
and Bruce L. Wilkoff
15 EXTRACTION OF DEVICES 182
Oussama M. Wazni and Bruce L. Wilkoff
vi Contents
SECTION VII
Performing Basic EP Studies
16 VENOUS AND ARTERIAL ACCESS, EP CATHETERS,
POSITIONING OF CATHETERS 190
Ching Chi Keong, J. David Burkhardt, Thomas Dresing, and Andrea Natale
17 BASIC INTRACARDIAC INTERVALS 198
Duc H. Do and Noel G. Boyle
18 BASICS OF ELECTROPHYSIOLOGY STUDY 203
Jonathan R. Hoffman and Marmar Vaseghi
19 HEAD-UP TILT (HUT) TABLE TESTING 212
Subramanya Prasad, Amer Kadri, J. David Burkhardt, Thomas Dresing,
and Kenneth Mayuga
SECTION VIII
Catheter Ablation Techniques
20 ABLATION OF SVT (AVNRT AND AVRT) 224
Kushwin Rajamani and Patrick Tchou
21 MANAGEMENT AND ABLATION OF ATRIAL FLUTTER 238
Carola Gianni, Amin Al-Ahmad, and Andrea Natale
22 RADIOFREQUENCY ABLATION OF ATRIAL FIBRILLATION 261
Jorge Romero, Carola Gianni, Sanghamitra Mohanty, Chintan Trivedi,
Domenico G. Della Rocca, Andrea Natale, and Luigi Di Biase
23 VENTRICULAR ARRHYTHMIAS IN THE STRUCTURALLY
NORMAL HEART 272
Andres Enriquez and Fermin Garcia
24 CATHETER ABLATION OF VENTRICULAR FIBRILLATION
AND POLYMORPHIC VENTRICULAR TACHYCARDIA 289
Amin Al-Ahmad, Carola Gianni, and Andrea Natale
25 MAPPING AND CATHETER ABLATION OF
POSTMYOCARDIAL INFARCTION VENTRICULAR
TACHYCARDIA (VT): A SUBSTRATE-BASED APPROACH 300
Zaid Aziz and Roderick Tung
Contents vii
26 ARRHYTHMOGENIC RIGHT VENTRICULAR
CARDIOMYOPATHY 316
Daniele Muser and Pasquale Santangeli
27 NON-ISCHEMIC CARDIOMYOPATHY AND
VENTRICULAR ARRHYTHMIAS 335
Matthew C. Hyman and Gregory E. Supple
28 ULTRASOUND IN THE ELECTROPHYSIOLOGY LAB 352
Carola Gianni, Javier E. Sanchez, Domenico G. Della Rocca, Amin Al-Ahmad,
and Andrea Natale
29 LEFT ATRIAL APPENDAGE CLOSURE 364
Rodney P. Horton, Carola Gianni, and Andrea Natale
30 E CG FEATURES OF NORMAL HEART PVCs 385
Robert D. Schaller
31 EPICARDIAL ACCESS AND INDICATIONS 404
Jason S. Bradfield and Kalyanam Shivkumar
32 ECG-BASED ORIGIN OF ATRIAL FLUTTER 415
Decebal Gabriel Laţcu, Nadir Saoudi, and Francis E. Marchlinski
INDEX 431
viii Contents
PREFACE
This issue of the Handbook of Electrophysiology is a quick reference for EP fellows, allied
health professionals, and electrophysiologists on the state-of-the-art management of rhythm
disorders including discussions on how to set up an arrhythmia lab, different aspects of
the catheter ablation procedure for atrial and ventricular arrhythmia, techniques of device
implantation and lead extraction, and diagnostic testing and management of syncope.
The current edition also addresses the different aspects of ECG-based origin of atrial flutter,
indications for epicardial access, and ECG characteristics of normal heart PVCs. Lastly, the
handbook details on the indications, techniques, and benefits of left atrial appendage closure.
It was our privilege to have a team of world-renowned experts contributing the latest infor-
mation on the entire spectrum of EP knowledge in this handbook. We are confident that this
handbook will not only be relevant to all clinicians and allied health professionals involved
in the management of cardiac arrhythmia, but also will provide the readers an appreciation
of the complexity of procedures that are performed every day in the electrophysiology labs.
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