Additional Information
Book Details
Abstract
Clinically useful approaches for the effective diagnosis and ablation of arrhythmias.
The field of catheter ablation continues to advance with innovations in technology and a deeper understanding of the pathophysiology of arrhythmias. This comprehensive and unique book gives an inside look at leading electrophysiology labs throughout the world and provides the reader with practical knowledge and tips for ablation procedures directly from the experts themselves.
Each chapter highlights the practical knowledge of the expert author with a specific procedure.
In-depth "how-to" approaches are described for over 50 procedures, including ablations for supraventricular tachycardia, atrial fibrillation, and ventricular tachycardia.
"Hands-on" detail that helps translate new ideas and innovations into practice for the most state-of-the-art patient care.
A valuable reference for every electrophysiology lab to help differentiate diagnostic challenges.
Fully illustrated with over 165 videos and 475 figures.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Cover | Cover | ||
| Hands-On Ablation: The Experts’ Approach | iii | ||
| Copyright page | iv | ||
| CONTENTS | v | ||
| Contributors | xi | ||
| Foreword | xix | ||
| Preface | xxi | ||
| Abbreviations | xxiii | ||
| SECTION I: Ablation of Supraventricular Tachycardia | 1 | ||
| Chapter 1: How to Rapidly Diagnose Supraventricular Tachycardia (SVT) in the Electrophysiology Lab | 3 | ||
| Introduction | 3 | ||
| Preprocedure Planning | 3 | ||
| Vascular Access and Catheter Placement | 4 | ||
| Baseline Observations in the EP Lab | 4 | ||
| Tachycardia Characteristics | 6 | ||
| Pacing Maneuvers During Tachycardia | 7 | ||
| Conclusions | 9 | ||
| References | 9 | ||
| Chapter 2: How to Ablate Typical and Reverse Atrial Flutter | 11 | ||
| Introduction | 11 | ||
| Preprocedure Planning | 13 | ||
| Procedure | 13 | ||
| Ablation | 17 | ||
| Postprocedure Care | 21 | ||
| Procedural Complications | 21 | ||
| Conclusions | 21 | ||
| References | 22 | ||
| Chapter 3: How to Ablate Atrial Flutter Postsurgery | 23 | ||
| Introduction | 23 | ||
| Preprocedure Planning | 24 | ||
| Procedure | 24 | ||
| Postprocedure Care | 31 | ||
| Procedural Complications | 31 | ||
| Advantages and Limitations | 31 | ||
| Conclusions | 31 | ||
| References | 32 | ||
| Chapter 4: The Ablation of Atrial Tachycardia | 33 | ||
| Introduction | 33 | ||
| Focal Atrial Tachycardia | 33 | ||
| The Electrophysiological Study | 35 | ||
| References | 38 | ||
| Chapter 5: How to Ablate Atrial Tachycardias in Patients with Congenital Heart Disease | 39 | ||
| Introduction | 39 | ||
| Preprocedural Planning | 39 | ||
| Procedure | 41 | ||
| Postprocedure Care | 48 | ||
| Procedural Complications | 48 | ||
| Advantages and Limitations | 49 | ||
| Conclusions | 49 | ||
| References | 49 | ||
| Video Descriptions | 50 | ||
| Chapter 6: How to Perform Radiofrequency and Cryoablation Ablation for AV Nodal Reentrant Tachycardia | 51 | ||
| Introduction | 51 | ||
| Preprocedural Preparation | 51 | ||
| Procedure | 52 | ||
| Electrophysiological Testing andAssessment: Pathophysiology ofDual AV Nodal Pathways | 52 | ||
| Mapping and Diagnosis | 52 | ||
| Slow-Fast | 53 | ||
| Slow-Slow | 53 | ||
| Fast-Slow | 54 | ||
| Left-Sided Variant | 54 | ||
| Ablation | 54 | ||
| Anatomic Approach | 55 | ||
| Energy Application | 55 | ||
| Endpoints for Ablation | 56 | ||
| Efficacy | 56 | ||
| Complication | 56 | ||
| Postprocedural Care | 57 | ||
| Conclusions | 57 | ||
| References | 57 | ||
| Chapter 7: Ablation of Left-Lateral Accessory Pathways | 59 | ||
| Introduction | 59 | ||
| Preprocedural Planning | 59 | ||
| Procedure | 60 | ||
| Postprocedure Care | 63 | ||
| References | 63 | ||
| Chapter 8: Catheter Ablation of Accessory Pathways | 64 | ||
| Introduction | 64 | ||
| Catheter Mapping of Accessory Pathways | 64 | ||
| Catheter Ablation of APs | 67 | ||
| Epicardial Posteroseptal APs | 68 | ||
| References | 70 | ||
| Chapter 9: Right-Sided Accessory Pathways | 72 | ||
| Introduction | 72 | ||
| Classifications | 72 | ||
| General Considerations | 72 | ||
| Right Free-Wall Pathways | 72 | ||
| Anteroseptal Pathways | 74 | ||
| Midseptal Pathways | 75 | ||
| Posteroseptal Pathways | 75 | ||
| Mahaim Tachycardias | 76 | ||
| Permanent Junctional ReciprocatingTachycardia (PJRT) | 78 | ||
| New Techniques | 78 | ||
| How We Approach Right-Sided Pathways | 79 | ||
| References | 79 | ||
| Chapter 10: How to Diagnose, Map, and Ablate AVRT Due to Atriofascicular Conduction Fibers | 81 | ||
| Introduction | 81 | ||
| Surface Electrocardiogram | 81 | ||
| Electrophysiology Study | 82 | ||
| Techniques for Mapping and Ablation | 83 | ||
| Associated Findings | 83 | ||
| Conclusions | 84 | ||
| References | 84 | ||
| Chapter 11: How to Ablate Accessory Pathways in Patients with Ebstein’s Syndrome | 85 | ||
| Introduction | 85 | ||
| Anatomy of Ebstein’s Anomaly | 85 | ||
| Preprocedural Planning | 87 | ||
| Postprocedure Care | 93 | ||
| Procedural Complications | 94 | ||
| Advantages and Limitations | 94 | ||
| Conclusions | 94 | ||
| References | 94 | ||
| Video Description | 94 | ||
| SECTION II: Ablation of Atrial Fibrillation | 95 | ||
| Chapter 12: How to Perform a Transseptal Puncture | 97 | ||
| Introduction | 97 | ||
| Preprocedure Planning | 97 | ||
| Procedure | 97 | ||
| Postprocedure Care | 103 | ||
| Procedural Complications | 103 | ||
| Advantages and Limitations | 104 | ||
| Conclusions | 104 | ||
| References | 104 | ||
| Video Descriptions | 105 | ||
| Chapter 13: How to Utilize ICE for Optimal Safety and Efficacy with AF Ablation | 107 | ||
| Introduction | 107 | ||
| Preprocedure Planning | 107 | ||
| Procedural Imaging | 108 | ||
| Postprocedural Care | 116 | ||
| Procedural Complications | 117 | ||
| Advantages and Limitations | 117 | ||
| Conclusions | 118 | ||
| References | 118 | ||
| Video Descriptions | 118 | ||
| Chapter 14: How to Perform Pulmonary Vein Antrum Isolation for Atrial Fibrillation | 120 | ||
| Introduction | 120 | ||
| Preprocedural Planning | 120 | ||
| Procedure | 121 | ||
| Postprocedure Care | 126 | ||
| Procedural Complications | 127 | ||
| Advantages and Limitations | 127 | ||
| Conclusions | 127 | ||
| References | 128 | ||
| Video Descriptions | 128 | ||
| Chapter 15: How to Perform Circumferential Ablation for Atrial Fibrillation | 129 | ||
| Introduction | 129 | ||
| Technological Advances and New Tools | 129 | ||
| Remote Ablation | 131 | ||
| Catheter Ablation of Atrial Fibrillation | 132 | ||
| CPVA Procedure | 132 | ||
| Conclusion | 138 | ||
| References | 138 | ||
| Chapter 16: How to Perform Ablation of Atrial Fibrillation by Targeting Complex Fractionated Atrial Electrograms | 139 | ||
| Introduction | 139 | ||
| Preprocedural Planning | 139 | ||
| Procedure | 140 | ||
| CFAE Mapping and Ablation | 142 | ||
| Postprocedure Care | 144 | ||
| Follow-Up | 144 | ||
| Advantages and Limitations | 144 | ||
| Conclusions | 145 | ||
| References | 146 | ||
| Video Descriptions | 146 | ||
| Chapter 17: How to Ablate Long-Standing Persistent Atrial Fibrillation Using a Stepwise Approach (The Bordeaux Approach) | 147 | ||
| Introduction | 147 | ||
| Preprocedural Planning | 147 | ||
| Procedural Aspects | 148 | ||
| Atrial Fibrillation Ablation | 149 | ||
| Postprocedural Care | 155 | ||
| Procedural Complications | 157 | ||
| Procedural Outcomes | 157 | ||
| Conclusion | 157 | ||
| References | 157 | ||
| Chapter 18: How to Ablate Long-Standing Persistent Atrial Fibrillation Using a Stepwise Approach (The Natale Approach) | 159 | ||
| Introduction | 159 | ||
| Preprocedural Management | 159 | ||
| Anesthesia Protocol | 160 | ||
| Instrumentation forElectrophysiological Study | 160 | ||
| PVAI and Isolation of the SVC | 161 | ||
| Other Targets | 163 | ||
| Considerations for Patients Presentingfor Repeat Procedure | 165 | ||
| Postprocedural Care and Follow-Up | 165 | ||
| References | 166 | ||
| Video Descriptions | 166 | ||
| Chapter 19: How to Use Balloon Cryoablation for Ablation of Atrial Fibrillation | 167 | ||
| Introduction | 167 | ||
| Preprocedure Planning | 167 | ||
| Procedure | 168 | ||
| Postprocedure Care | 170 | ||
| Procedural Complications | 172 | ||
| Advantages and Limitations | 172 | ||
| Conclusions | 173 | ||
| References | 173 | ||
| Video Descriptions | 174 | ||
| Chapter 20: How to Perform Pulmonary Vein Isolation Using Laser Catheter Ablation | 175 | ||
| Background | 175 | ||
| Left Atrium Access and BalloonDeployment | 176 | ||
| Laser Ablation | 178 | ||
| Checking for PVI | 180 | ||
| Summary | 181 | ||
| References | 181 | ||
| Video Descriptions | 181 | ||
| Chapter 21: The Combined Surgical/Endocardial Ablation Procedure for Atrial Fibrillation | 182 | ||
| The Thoracoscopic Surgical Procedure | 182 | ||
| The Transdiaphragmatic SurgicalProcedure | 183 | ||
| The Endocardial Procedure | 185 | ||
| Discussion | 185 | ||
| References | 188 | ||
| Chapter 22: How to Perform a Hybrid Surgical Epicardial and Catheter Endocardial Ablation for Atrial Fibrillation | 189 | ||
| Introduction | 189 | ||
| Procedure Goal and Summary | 189 | ||
| Patient Selection | 190 | ||
| Performing the LAMP HybridAF Procedure | 190 | ||
| Postprocedure Care | 198 | ||
| Procedural Complications | 200 | ||
| Conclusions | 201 | ||
| Acknowledgments | 201 | ||
| References | 201 | ||
| Video Descriptions | 201 | ||
| Chapter 23: How to Ablate the Vein of Marshall | 202 | ||
| Introduction | 202 | ||
| The Anatomy of Ligament of Marshall | 202 | ||
| Electrophysiological Characteristicsof the MB | 203 | ||
| Methods of Marshall Bundle Mapping | 205 | ||
| Marshall Bundle Ablation | 207 | ||
| Additional Implications for CommonlyPerformed AF Ablation Procedures | 208 | ||
| References | 208 | ||
| Chapter 24: Diagnosis and Ablation of Atrial Tachycardias Arising in the Context of Atrial Fibrillation Ablation | 210 | ||
| Introduction | 210 | ||
| Incidence of Atrial Tachycardia after AFAblation | 210 | ||
| Classification of Atrial Tachycardia | 211 | ||
| Mechanisms of Atrial Tachycardia | 211 | ||
| Drug Therapy | 211 | ||
| Locations of Atrial Tachycardia Circuits | 211 | ||
| Diagnosis | 212 | ||
| Catheter Ablation | 216 | ||
| Procedural Outcome and Prognosis | 218 | ||
| Prevention of AT | 218 | ||
| Conclusion | 218 | ||
| References | 218 | ||
| Chapter 25: How to Perform 3-Dimensional Entrainment Mapping to Treat Post–AF Ablation Atrial Tachycardia/AFL | 220 | ||
| Introduction | 220 | ||
| Preprocedural Planning | 220 | ||
| Procedure | 220 | ||
| Mapping | 222 | ||
| Postprocedure Care | 224 | ||
| Procedural Complications | 226 | ||
| Advantages and Limitations | 226 | ||
| Conclusion | 226 | ||
| References | 226 | ||
| Video Descriptions | 226 | ||
| Chapter 26: Catheter Ablation of Autonomic Ganglionated Plexi in Patients with Atrial Fibrillation | 227 | ||
| Introduction | 227 | ||
| Localization of LA Ganglionated Plexi byEndocardial High-Frequency Stimulation | 229 | ||
| Catheter Ablation of LAGanglionated Plexi | 230 | ||
| References | 232 | ||
| Chapter 27: How to Use Electroanatomic Mapping to Rapidly Diagnose and Treat Post–AF Ablation Atrial Tachycardia and Flutter | 234 | ||
| Introduction | 234 | ||
| Preprocedure Planning | 234 | ||
| Mapping and Ablation of Postablation AT | 235 | ||
| LA Macroreentrant AT s | 237 | ||
| Postprocedure Care | 245 | ||
| Procedural Outcomes | 246 | ||
| Advantages and Limitations ofActivation Mapping | 246 | ||
| Conclusions | 246 | ||
| References | 247 | ||
| Chapter 28: How to Utilize Frequency Analysis to Aid in Atrial Fibrillation Ablation | 248 | ||
| Introduction | 248 | ||
| Preprocedural Planning: TechnologicalConsiderations | 248 | ||
| Clinical Perspective | 255 | ||
| Limitations | 256 | ||
| Conclusions | 256 | ||
| References | 257 | ||
| Video Descriptions | 258 | ||
| Chapter 29: Utilization of the Hansen Robotic Catheter Navigation System: The Austin Approach | 259 | ||
| Introduction | 259 | ||
| Background | 259 | ||
| Description of the Hansen System | 260 | ||
| Transseptal Access | 262 | ||
| Ablation Lesion Sets | 264 | ||
| References | 265 | ||
| Video Descriptions | 266 | ||
| Chapter 30: How to Perform Atrial Fibrillation Ablation Using Remote Magnetic Navigation | 267 | ||
| Introduction | 267 | ||
| Preprocedural Planning | 267 | ||
| Procedure | 268 | ||
| Postprocedure Care | 272 | ||
| Follow-Up | 273 | ||
| Procedural Complications | 273 | ||
| Advantages and Limitations | 273 | ||
| Conclusion | 273 | ||
| References | 274 | ||
| Video Descriptions | 274 | ||
| Chapter 31: How to Perform Accurate Image Registration with Electroanatomic Mapping Systems | 275 | ||
| Introduction | 275 | ||
| Preprocedural Planning | 276 | ||
| Procedure | 276 | ||
| Factors Affecting Integration Error | 278 | ||
| Postprocedure Care | 279 | ||
| Procedural Complications | 279 | ||
| Advantages and Limitations | 279 | ||
| Conclusions | 279 | ||
| References | 280 | ||
| Section III: Ablation of Ventricular Tachycardia | 281 | ||
| Chapter 32: How to Localize Ventricular Tachycardia Using a 12-Lead ECG | 283 | ||
| Introduction | 283 | ||
| Bundle Branch Reentrant VentricularTachycardia | 283 | ||
| Ventricular Tachycardia in Patients withCoronary Artery Disease | 284 | ||
| Idiopathic Ventricular Tachycardias | 285 | ||
| ECG Characteristics of EpicardialVentricular Tachycardias | 289 | ||
| Conclusion | 289 | ||
| References | 290 | ||
| Chapter 33: How to Diagnose and Ablate Ventricular Tachycardia from the Outflow Tract and Aortic Cusps | 292 | ||
| Introduction | 292 | ||
| Preprocedural Planning | 292 | ||
| Procedure | 293 | ||
| Postprocedural Care | 299 | ||
| Procedural Complications | 300 | ||
| Conclusions | 300 | ||
| References | 300 | ||
| Chapter 34: How to Diagnose and Ablate Fascicular Ventricular Tachycardia | 302 | ||
| Introduction | 302 | ||
| Preprocedural Planning | 302 | ||
| Postprocedure Care | 308 | ||
| Procedural Complications | 311 | ||
| Advantages and Limitations | 311 | ||
| Conclusions | 311 | ||
| References | 311 | ||
| Chapter 35: How to Map and Ablate Hemodynamically Tolerated Ventricular Tachycardias | 313 | ||
| Introduction | 313 | ||
| Preprocedure Planning | 313 | ||
| Procedure | 314 | ||
| Substrate Mapping | 316 | ||
| Mapping During HemodynamicallyStable VT | 318 | ||
| Ablation | 326 | ||
| Postprocedure Care | 328 | ||
| Follow-up | 328 | ||
| Procedural Complications | 328 | ||
| Conclusion | 328 | ||
| References | 328 | ||
| Chapter 36: How to Map and Ablate Unstable Ventricular Tachycardia: The University of Pennsylvania Approach | 331 | ||
| Introduction | 331 | ||
| Preprocedural Planning | 331 | ||
| Procedure | 332 | ||
| Epicardial Mapping | 336 | ||
| Ablation | 337 | ||
| Postprocedure Care | 338 | ||
| Follow-up | 338 | ||
| Repeat Ablations | 338 | ||
| Procedural Complications | 339 | ||
| Conclusions | 339 | ||
| References | 339 | ||
| Chapter 37: How to Map and Ablate Unstable Ventricular Tachycardia: The Brigham Approach | 341 | ||
| Introduction | 341 | ||
| Preprocedural Planning | 341 | ||
| Procedure | 342 | ||
| Ablation | 346 | ||
| Postprocedure Care | 347 | ||
| Procedural Complications | 348 | ||
| Advantages and Limitations | 348 | ||
| Conclusions | 348 | ||
| Video Descriptions | 349 | ||
| Chapter 38: How to Map and Ablate Ventricular Tachycardia Using Delayed Potential in Sinus Rhythm. | 350 | ||
| Introduction | 350 | ||
| Preprocedural Planning | 351 | ||
| Procedure | 351 | ||
| Postprocedure Care | 356 | ||
| Advantages and Limitations | 357 | ||
| Conclusions | 358 | ||
| References | 358 | ||
| Video Descriptions | 359 | ||
| Chapter 39: How to Utilize Electroanatomical Mapping to Identify Critical Channels for Ventricular Tachycardia Ablation | 360 | ||
| Introduction | 360 | ||
| Preprocedural Planning | 360 | ||
| Procedure | 361 | ||
| Postprocedure Care | 370 | ||
| Procedural Complications | 370 | ||
| Limitations | 370 | ||
| Summary | 371 | ||
| References | 372 | ||
| Chapter 40: How to Use Noncontact Mapping for Catheter Ablation of Ventricular Tachycardia | 373 | ||
| Introduction | 373 | ||
| Preprocedural Planning | 373 | ||
| Anesthesia and Hemodynamic Support | 374 | ||
| Procedure | 374 | ||
| Postprocedure Care | 380 | ||
| Procedural Complications | 381 | ||
| Advantages and Limitations | 381 | ||
| Conclusions | 384 | ||
| References | 384 | ||
| Video Descriptions | 384 | ||
| Chapter 41: How to Use ICE to Aid in Catheter Ablation of Ventricular Tachycardia | 385 | ||
| Introduction | 385 | ||
| Preprocedural Planning | 386 | ||
| Procedure | 387 | ||
| Postprocedure Care | 395 | ||
| Procedural Complications | 395 | ||
| Advantages and Limitations | 397 | ||
| Conclusions | 397 | ||
| References | 397 | ||
| Video Descriptions | 398 | ||
| Chapter 42: How to Perform an Epicardial Access | 399 | ||
| Introduction | 399 | ||
| Before Scheduling the PericardialSpace Access | 399 | ||
| Preventing Complications | 400 | ||
| How to Manage Pericardial AccessComplications | 405 | ||
| Conclusion | 406 | ||
| References | 406 | ||
| Video Descriptions | 406 | ||
| Chapter 43: Transcoronary Ethanol Ablation for Ventricular Tachycardia | 407 | ||
| Introduction | 407 | ||
| Preprocedural Preparation | 408 | ||
| Intraoperative Requirements | 409 | ||
| Procedure | 409 | ||
| Complications and Safety | 411 | ||
| Conclusions | 413 | ||
| References | 413 | ||
| Chapter 44: How to Perform Epicardial Ablation in Postcardiac Surgery Patients | 414 | ||
| Introduction | 414 | ||
| Preprocedural Planning | 416 | ||
| Complications | 417 | ||
| Conclusion | 418 | ||
| References | 418 | ||
| Chapter 45: How to Perform Endocardial/Epicardial Ventricular Tachycardia Ablation | 419 | ||
| Introduction | 419 | ||
| Preprocedure Planning | 419 | ||
| Procedure | 420 | ||
| Follow-up | 426 | ||
| Advantages and Limitations | 426 | ||
| Conclusion | 426 | ||
| References | 426 | ||
| Video Descriptions | 427 | ||
| Chapter 46: How to Ablate Ventricular Fibrillation Arising from the Structurally Normal Heart | 428 | ||
| Introduction | 428 | ||
| Preprocedural Planning of VF Ablation | 428 | ||
| Procedure | 429 | ||
| Follow-up After VF Ablation | 432 | ||
| Procedural and Clinical Outcome | 432 | ||
| Conclusion | 434 | ||
| References | 434 | ||
| Chapter 47: How to Ablate Ventricular Tachycardia in Patients with Congenital Heart Disease | 435 | ||
| Introduction | 435 | ||
| Preprocedural Planning | 435 | ||
| Procedure | 438 | ||
| Postprocedure Care | 446 | ||
| Procedural Complications | 447 | ||
| Advantages and Limitations | 447 | ||
| Conclusions | 447 | ||
| References | 448 | ||
| Video Descriptions | 449 | ||
| Chapter 48: Catheter Ablation of Ventricular Tachycardia in Sarcoidosis / Hypertrophic Cardiomyopathy | 450 | ||
| Introduction | 450 | ||
| Hypertrophic Cardiomyopathy | 452 | ||
| Summary | 460 | ||
| References | 460 | ||
| Chapter 49: How to Ablate Ventricular Tachycardia in Patients with Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia | 462 | ||
| Introduction | 462 | ||
| Preprocedural Planning | 463 | ||
| Ablation Procedure | 464 | ||
| Procedural Complications | 468 | ||
| Postprocedure Care | 468 | ||
| Conclusions | 469 | ||
| References | 470 | ||
| Video Descriptions | 470 | ||
| Chapter 50: How to Perform Hybrid VT Ablation in the Operating Room | 471 | ||
| Introduction | 471 | ||
| Indications for Surgical Ablation | 472 | ||
| Surgical EP Room Setting | 473 | ||
| Different Approaches | 474 | ||
| Conclusions | 483 | ||
| References | 483 | ||
| Index | 487 | ||
| Back Cover | 497 | ||
| Blank Page | Cover |