BOOK
Ventricular Arrhythmias in Apparently Normal Hearts, An Issue of Cardiac Electrophysiology Clinics, E-Book
Frank M. Bogun | Thomas C. Crawford | Rakesh Latchamsetty
(2016)
Additional Information
Book Details
Abstract
This issue of the Cardiac Electrophysiology Clinics entitled “Ventricular Arrhythmias in Apparently Normal Hearts is being edited by Drs. Frank M. Bogun, Thomas Crawford, and Rakesh Latchamsetty. The issue will cover topics including, the mechanisms of ventricular arrhythmias, the role of genetic testing, papillary muscle arrhythmias, fascicular arrhythmias, exercised induced VT, VF, and SCD in the normal heart, and various management techniques.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Ventricular Arrhythmias in Apparently Normal Hearts\r | i | ||
| Copyright\r | ii | ||
| Contributors | iii | ||
| CONSULTING EDITORS | iii | ||
| EDITORS | iii | ||
| AUTHORS | iii | ||
| Contents | vii | ||
| Foreword: A Matter of Definition\r | vii | ||
| Preface: Ventricular Arrhythmias in Apparently Normal Hearts\r | vii | ||
| Premature Ventricular Complexes in Apparently Normal Hearts\r | vii | ||
| Role of Genetic Testing in Patients with Ventricular Arrhythmias in Apparently Normal Hearts\r | vii | ||
| Nonsustained Ventricular Tachycardia in the Normal Heart: Risk Stratification and Management\r | vii | ||
| Outflow Tract Premature Ventricular Contractions and Ventricular Tachycardia: The Typical and the Challenging\r | viii | ||
| Spectrum of Ventricular Arrhythmias Arising from Papillary Muscle in the Structurally Normal Heart\r | viii | ||
| Spectrum of Fascicular Arrhythmias\r | viii | ||
| Polymorphic Ventricular Tachycardia/Ventricular Fibrillation and Sudden Cardiac Death in the Normal Heart\r | viii | ||
| Exercise-induced Ventricular Tachycardia/Ventricular Fibrillation in the Normal Heart: Risk Stratification and Management\r | ix | ||
| Dynamics and Molecular Mechanisms of Ventricular Fibrillation in Structurally Normal Hearts\r | ix | ||
| Ventricular Arrhythmias in Apparently Normal Hearts: Who Needs an Implantable Cardiac Defibrillator?\r | ix | ||
| Sustained Ventricular Tachycardia in Apparently Normal Hearts: Ablation Should Be the First Step in Management\r | ix | ||
| Sustained Ventricular Tachycardia in Apparently Normal Hearts: Medical Therapy Should be the First Step in Management\r | x | ||
| CARDIAC ELECTROPHYSIOLOGY CLINICS\r | xi | ||
| FORTHCOMING ISSUES | xi | ||
| December 2016 | xi | ||
| March 2017 | xi | ||
| June 2017 | xi | ||
| RECENT ISSUES | xi | ||
| June 2016 | xi | ||
| March 2016 | xi | ||
| December 2015 | xi | ||
| Foreword:\rA Matter of Definition | xiii | ||
| Preface:\rVentricular Arrhythmias in Apparently Normal Hearts | xv | ||
| Premature Ventricular Complexes in Apparently Normal Hearts | 503 | ||
| Key points | 503 | ||
| PREMATURE VENTRICULAR COMPLEXES IN STRUCTURALLY NORMAL HEARTS: PRESENTATION AND DETECTION | 503 | ||
| Symptoms | 504 | ||
| Diagnostic Evaluation | 504 | ||
| HIGH-RISK FEATURES/MALIGNANT | 505 | ||
| PREMATURE VENTRICULAR COMPLEX–INDUCED VENTRICULAR FIBRILLATION | 505 | ||
| PREMATURE VENTRICULAR COMPLEX–INDUCED CARDIOMYOPATHY | 506 | ||
| Causes and Mechanism | 506 | ||
| Risk Factors and Prevalence | 506 | ||
| Treatment and Reversibility of Premature Ventricular Complex–Induced Cardiomyopathy | 506 | ||
| TREATMENT OPTIONS FOR PREMATURE VENTRICULAR COMPLEX | 507 | ||
| Medical Therapies | 507 | ||
| β-Blockade and calcium channel blockade | 507 | ||
| Antiarrhythmic medications | 507 | ||
| Catheter Ablation | 508 | ||
| Indications | 508 | ||
| Techniques for ablation | 508 | ||
| Complications of ablation | 508 | ||
| Difficulties and limitations of ablation | 509 | ||
| Prognosis of right ventricular outflow tract ablation | 510 | ||
| Prognosis of premature ventricular complex–induced cardiomyopathy ablation | 510 | ||
| PROGNOSIS OF PREMATURE VENTRICULAR COMPLEX–INDUCED VENTRICULAR FIBRILLATION | 510 | ||
| SUMMARY | 511 | ||
| REFERENCES | 511 | ||
| Role of Genetic Testing in Patients with Ventricular Arrhythmias in Apparently Normal Hearts | 515 | ||
| Key points | 515 | ||
| INTRODUCTION | 515 | ||
| THE MECHANISM OF ELECTROPHYSIOLOGY AND ELECTROPHYSIOLOGIC ABNORMALITIES | 516 | ||
| MOLECULAR GENETICS OF LONG QT SYNDROME | 516 | ||
| The Role of Genetic Testing in Long QT Syndrome | 516 | ||
| BRUGADA SYNDROME | 517 | ||
| The Role of Genetic Testing in Brugada Syndrome | 517 | ||
| CATECHOLAMINERGIC POLYMORPHIC VENTRICULAR TACHYCARDIA | 517 | ||
| The Role of Genetic Testing in Catecholaminergic Polymorphic Ventricular Tachycardia | 520 | ||
| SHORT QT SYNDROME | 520 | ||
| IDIOPATHIC VENTRICULAR FIBRILLATION | 520 | ||
| CONDUCTION DISEASE | 520 | ||
| EARLY REPOLARIZATION SYNDROME | 520 | ||
| DISCUSSION: HOW TO JUDGE THE VARIANTS | 521 | ||
| REFERENCES | 521 | ||
| Nonsustained Ventricular Tachycardia in the Normal Heart | 525 | ||
| Key points | 525 | ||
| INTRODUCTION | 525 | ||
| APPROACH TO EVALUATION OF NONSUSTAINED VENTRICULAR TACHYCARDIA | 526 | ||
| Overview | 526 | ||
| Rule out conditions that may mimic ventricular tachycardia | 526 | ||
| Artifact | 527 | ||
| Paced rhythm | 527 | ||
| Supraventricular tachycardia with aberrancy | 528 | ||
| Differentiate monomorphic from polymorphic ventricular tachycardia | 529 | ||
| Further evaluation and therapy based on type of ventricular tachycardia and clinical circumstances | 530 | ||
| Evaluation of nonsustained polymorphic ventricular tachycardia | 530 | ||
| Evaluation of nonsustained monomorphic ventricular tachycardia | 534 | ||
| Idiopathic Ventricular Tachycardia | 535 | ||
| Outflow tract ventricular tachycardia | 535 | ||
| Malignant form of outflow tract ventricular tachycardia | 537 | ||
| Fascicular ventricular tachycardia | 537 | ||
| Papillary muscle ventricular tachycardia | 538 | ||
| Nonsustained ventricular tachycardia in patients with hypertension | 538 | ||
| Nonsustained ventricular tachycardia in athletes | 539 | ||
| Exercise-induced nonsustained ventricular tachycardia | 539 | ||
| SUMMARY | 540 | ||
| REFERENCES | 540 | ||
| Outflow Tract Premature Ventricular Contractions and Ventricular Tachycardia | 545 | ||
| Key points | 545 | ||
| INTRODUCTION | 545 | ||
| ANATOMY OF THE OUTFLOW TRACT | 546 | ||
| The Epicardial Outflow Tract | 546 | ||
| ELECTROCARDIOGRAM LOCALIZATION OF ORIGIN OF OUTFLOW TRACT ARRHYTHMIAS | 547 | ||
| ELECTROPHYSIOLOGIC TESTING AND MAPPING | 548 | ||
| ABLATION OF OUTFLOW TRACT VENTRICULAR ARRHYTHMIAS | 549 | ||
| Right Ventricular Outflow Tract | 549 | ||
| Aortic Root | 550 | ||
| Aortomitral Continuity | 550 | ||
| Epicardial and Perivenous Foci | 550 | ||
| THE CHALLENGING CASES | 551 | ||
| OUTCOMES AND COMPLICATIONS OF CATHETER ABLATION FOR OUTFLOW TRACT ARRHYTHMIAS | 551 | ||
| SUMMARY | 552 | ||
| REFERENCES | 552 | ||
| Spectrum of Ventricular Arrhythmias Arising from Papillary Muscle in the Structurally Normal Heart | 555 | ||
| Key points | 555 | ||
| INTRODUCTION | 555 | ||
| ANATOMIC CORRELATION AND PHYSIOLOGIC CONSIDERATION | 556 | ||
| CLINICAL MANIFESTATIONS | 556 | ||
| DIFFERENTIAL DIAGNOSIS | 556 | ||
| Electrocardiography | 557 | ||
| Imaging | 557 | ||
| Electrophysiologic Characteristics | 558 | ||
| TREATMENT AND PROGNOSIS | 558 | ||
| Catheter Ablation Techniques | 559 | ||
| Efficacy of Ablation | 562 | ||
| MALIGNANT VENTRICULAR ARRHYTHMIAS | 562 | ||
| Maintaining Circuits for Ventricular Fibrillation | 562 | ||
| Ventricular Fibrillation Triggered by Papillary Premature Ventricular Contractions | 563 | ||
| Malignant Mitral Valve Prolapse Syndrome | 563 | ||
| SUMMARY | 563 | ||
| ACKNOWLEDGMENTS | 563 | ||
| SUPPLEMENTARY DATA | 563 | ||
| REFERENCES | 563 | ||
| Spectrum of Fascicular Arrhythmias | 567 | ||
| Key points | 567 | ||
| INTRODUCTION | 567 | ||
| Historical Background | 567 | ||
| Mechanisms of Fascicular Arrhythmias | 569 | ||
| Clinical Presentation of Fascicular Arrhythmias | 569 | ||
| Intrafascicular Reentry | 569 | ||
| Ablation of Intrafascicular Reentrant Ventricular Tachycardia | 572 | ||
| Upper Septal–Dependent Interfascicular Reentry | 572 | ||
| Ablation of Upper Septal or Interfascicular Ventricular Tachycardia | 576 | ||
| Focal Mechanism of Fascicular Arrhythmias | 576 | ||
| Ablation of Focal Fascicular Arrhythmias | 578 | ||
| SUMMARY | 578 | ||
| REFERENCES | 578 | ||
| Polymorphic Ventricular Tachycardia/Ventricular Fibrillation and Sudden Cardiac Death in the Normal Heart | 581 | ||
| Key points | 581 | ||
| INTRODUCTION | 581 | ||
| OVERVIEW OF MANAGEMENT | 582 | ||
| MAPPING AND ABLATION OF POLYMORPHIC VENTRICULAR TACHYCARDIA/VENTRICULAR FIBRILLATION | 582 | ||
| Idiopathic Ventricular Fibrillation | 582 | ||
| Purkinje arborization | 583 | ||
| Characteristics of culprit premature ventricular ectopic beats | 583 | ||
| Outcome of ablation | 584 | ||
| Long QT Syndrome | 585 | ||
| Brugada Syndrome | 585 | ||
| Catecholaminergic Polymorphic Ventricular Tachycardia | 586 | ||
| Short QT Syndrome | 586 | ||
| Abnormal Early Repolarization Syndrome | 587 | ||
| LATEST INSIGHTS FROM NONINVASIVE MAPPING OF CLINICAL POLYMORPHIC VENTRICULAR TACHYCARDIA/VENTRICULAR FIBRILLATION | 588 | ||
| REFERENCES | 590 | ||
| Exercise-induced Ventricular Tachycardia/Ventricular Fibrillation in the Normal Heart | 593 | ||
| Key points | 593 | ||
| INTRODUCTION | 593 | ||
| ARRHYTHMOGENIC EFFECTS OF EXERCISE | 594 | ||
| IDIOPATHIC MONOMORPHIC VENTRICULAR TACHYCARDIA | 594 | ||
| RISK STRATIFICATION AND MANAGEMENT | 595 | ||
| MALIGNANT ARRHYTHMOGENIC RIGHT VENTRICULAR CARDIOMYOPATHY VERSUS BENIGN RIGHT VENTRICULAR OUTFLOW TRACT VENTRICULAR TACHYCARDIA | 596 | ||
| EXERCISE-INDUCED VENTRICULAR TACHYCARDIA AND BRUGADA SYNDROME | 597 | ||
| EXERCISE-INDUCED POLYMORPHIC VENTRICULAR TACHYCARDIA | 597 | ||
| SUMMARY/DISCUSSION | 598 | ||
| REFERENCES | 598 | ||
| Dynamics and Molecular Mechanisms of Ventricular Fibrillation in Structurally Normal Hearts | 601 | ||
| Key points | 601 | ||
| INTRODUCTION | 601 | ||
| MODERN CONCEPTS ON VENTRICULAR FIBRILLATION MECHANISMS | 602 | ||
| FIBRILLATORY CONDUCTION | 602 | ||
| SCALING LAW OF VENTRICULAR FIBRILLATION FREQUENCY | 603 | ||
| THE GUINEA PIG HEART MODEL OF VENTRICULAR FIBRILLATION | 603 | ||
| ACTION POTENTIAL DURATION ABBREVIATION AND RAPID ROTATION FREQUENCY | 604 | ||
| AN IONIC MECHANISM FOR STABLE ROTORS AND VENTRICULAR FIBRILLATION | 605 | ||
| MOUSE GENETICS, INWARD RECTIFIER POTASSIUM CURRENT AND VENTRICULAR FIBRILLATION | 606 | ||
| MOLECULAR MECHANISMS THAT CONTROL VENTRICULAR FIBRILLATION FREQUENCY | 608 | ||
| SUMMARY | 610 | ||
| REFERENCES | 610 | ||
| Ventricular Arrhythmias in Apparently Normal Hearts | 613 | ||
| Key points | 613 | ||
| INTRODUCTION | 613 | ||
| PREVALENCE OF MALIGNANT VENTRICULAR ARRHYTHMIAS AND POTENTIAL IMPLANTABLE CARDIAC DEFIBRILLATOR BURDEN | 614 | ||
| PROPOSED MECHANISM FOR MALIGNANT ARRHYTHMIAS | 614 | ||
| RISK FACTORS FOR MALIGNANT VENTRICULAR ARRHYTHMIAS | 615 | ||
| History of Aborted Sudden Death or Syncope | 616 | ||
| Shorter Coupling Interval of the First or Second Premature Ventricular Complex Beat | 616 | ||
| Shorter CL | 616 | ||
| QRS Duration of Ventricular Tachycardia | 616 | ||
| Prematurity Index | 616 | ||
| Disorganized Morphology | 616 | ||
| CANDIDATES FOR IMPLANTABLE CARDIAC DEFIBRILLATOR THERAPY | 616 | ||
| Survivors of Cardiac Arrest: Implantable Cardiac Defibrillator or Ablation? | 616 | ||
| History of Syncope and Nonsustained Ventricular Tachycardia | 618 | ||
| Asymptomatic with Nonsustained Ventricular Tachycardia with Malignant Electrocardiogram Criteria | 618 | ||
| Premature Ventricular Complex–Induced Cardiomyopathy and Implantable Cardiac Defibrillators | 618 | ||
| Influence of a Mixed Substrate on Implantable Cardiac Defibrillator Therapy | 619 | ||
| SUGGESTED APPROACH TO IMPLANTABLE CARDIAC DEFIBRILLATOR RISK STRATIFICATION | 619 | ||
| SUMMARY | 620 | ||
| REFERENCES | 620 | ||
| Sustained Ventricular Tachycardia in Apparently Normal Hearts | 623 | ||
| Key points | 623 | ||
| COMMON TYPES OF VENTRICULAR TACHYCARDIA IN STRUCTURALLY NORMAL | 624 | ||
| THE CASE AGAINST IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR AS FIRST-LINE THERAPY | 625 | ||
| THE CASE AGAINST ANTIARRHYTHMIC MEDICATIONS AS FIRST-LINE THERAPY | 626 | ||
| EXTRAPOLATION OF DATA IN STRUCTURAL HEART DISEASE | 627 | ||
| PATIENTS WITH INAPPARENT OR “CONCEALED” STRUCTURAL HEART DISEASE | 627 | ||
| SUMMARY | 628 | ||
| REFERENCES | 629 | ||
| Sustained Ventricular Tachycardia in Apparently Normal Hearts | 631 | ||
| Key points | 631 | ||
| INTRODUCTION | 631 | ||
| CURRENT GUIDELINES | 631 | ||
| IDIOPATHIC VENTRICULAR TACHYCARDIA HAS A FAVORABLE PROGNOSIS | 632 | ||
| MEDICAL THERAPIES FOR IDIOPATHIC VENTRICULAR TACHYCARDIA ARE REASONABLY EFFECTIVE | 633 | ||
| MEDICAL THERAPIES ARE SAFE | 633 | ||
| CATHETER ABLATION FOR MANY FORMS OF IDIOPATHIC VENTRICULAR TACHYCARDIA IS INEFFECTIVE | 633 | ||
| THERE ARE REAL RISKS WITH CATHETER ABLATION | 634 | ||
| CHOOSING MEDICAL THERAPIES AS A FIRST-LINE STRATEGY FOR IDIOPATHIC VENTRICULAR TACHYCARDIA DOES NOT MEAN ELIMINATING THE RO ... | 636 | ||
| APPARENT EXCEPTIONS TO THE RULE | 636 | ||
| SUMMARY | 636 | ||
| REFERENCES | 636 |