BOOK
Interatrial Block and Supraventricular Arrhythmias: Clinical Implications of Bayés’ Syndrome
(2017)
Additional Information
Book Details
Abstract
Bayés’ syndrome refers to the association between interatrial block and supraventricular arrhythmias—mainly the occurrence of atrial fibrillation. It is also a risk factor for cardio-embolic stroke. Rapid recognition by analyzing characteristic patterns in the surface ECG will help the physician to closely monitor the patient for atrial fibrillation and decide on anticoagulation therapy if the clinical risk of stroke is increased.
Interatrial blocks were described several decades ago; however, they are now gaining the attention of the medical community as a means of helping to identify patients at high risk of developing atrial fibrillation and/or cardio-embolic stroke.
I welcome all readers to navigate this book and to become familiar with this concept that is helping to renovate our models of predicting atrial fibrillation and stroke.
Interatrial Block and Supraventricular Arrhythmias: Clinical Implications of Bayés’ Syndrome, has been superbly edited by Adrian Baranchuk, an important clinical investigator of the syndrome. Baranchuk has thoughtfully and successfully pulled together the many threads of clinical research on the syndrome. This book will surely stimulate interest in what has been a largely neglected corner of cardiology. As a consequence of the outstanding work of Bayés, Baranchuk, and the authors who have contributed to this book, interatrial block is no longer a stepchild.
-Eugene Braunwald, MD
Boston, Massachusetts
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Cover | i | ||
| Title Page | v | ||
| Copyright | vi | ||
| Contents | vii | ||
| About the Authors | ix | ||
| Foreword | xiii | ||
| Preface | xvii | ||
| Chapter 1: The Long Journey to the Diagnosis of Interatrial Blocks: ECG-VCG Criteria | 1 | ||
| Introduction | 1 | ||
| Where Are the Interatrial Blocks Anatomically Located? | 3 | ||
| When Should an ECG Pattern Be Considered a Block? | 5 | ||
| How to Diagnose Interatrial Blocks | 5 | ||
| How to Measure the Duration of the P-Wave (ECG) and the P Loops (VCG)? | 6 | ||
| The ECG-VCG Diagnostic Criteria | 9 | ||
| Clinical Implications | 14 | ||
| Conclusions | 15 | ||
| References | 15 | ||
| Chapter 2: Normal Atrial Electrical Activity | 17 | ||
| Introduction | 17 | ||
| Normal P-Wave: Where Does It Come From? | 18 | ||
| Interatrial Routes: Anatomy and Function | 19 | ||
| Variability of Sinus Rhythm Origin and P-Wave Morphology | 22 | ||
| Atrial Geometry and Size as Determinants of P-Wave Morphology in Healthy Men | 23 | ||
| References | 24 | ||
| Chapter 3: Structure of the Bachmann’s Bundle | 27 | ||
| Introduction | 27 | ||
| Gross Anatomy of the Atria | 28 | ||
| Normal Atrial Myoarchitecture | 30 | ||
| The Gross Structure of the Bachmann’s Bundle and Its Extensions | 32 | ||
| Structural Myoarchitecture of the Bachmann’s Bundle | 38 | ||
| Bachmann’s Bundle and Its Vascularization | 40 | ||
| Conclusion | 41 | ||
| References | 41 | ||
| Chapter 4: Pathophysiology of the Interatrial Blocks | 43 | ||
| Introduction | 43 | ||
| Electrophysiological, Ultrastructural, and Anatomic Atrial Remodeling | 44 | ||
| How to Detect Atrial Fibrosis: From New Imaging Techniques to Old ECG Recordings | 46 | ||
| The Value of ECG/VCG in Understanding the Pathophysiology of IAB | 48 | ||
| Conclusions | 49 | ||
| References | 49 | ||
| Chapter 5: Contributions of Noncontact Mapping to the Understanding of Normal Atrial Activation | 51 | ||
| Introduction | 51 | ||
| Interatrial Activation | 51 | ||
| Clinical Significance of Advanced Interatrial Block (IAB) | 55 | ||
| Role of Advanced IAB as Risk Predictor of Atrial Fibrillation | 57 | ||
| Conclusion | 58 | ||
| References | 58 | ||
| Chapter 6: Contributions of Noncontact and Contact Mapping to the Understanding of Interatrial Block | 61 | ||
| Introduction | 61 | ||
| Noncontact Mapping to Record Interatrial Conduction During Sinus Rhythm and Atrial Pacing | 62 | ||
| Activation Mapping of Interatrial Block in Sinus Rhythm and Atrial Arrhythmias | 63 | ||
| Future Considerations | 64 | ||
| References | 65 | ||
| Chapter 7: Epidemiology of Interatrial Block | 67 | ||
| Introduction | 67 | ||
| Prevalence | 67 | ||
| Pathophysiology | 69 | ||
| Clinical Implications and Associated Conditions | 71 | ||
| Therapeutic Approaches | 75 | ||
| Conclusion | 76 | ||
| References | 77 | ||
| Chapter 8: Consensus Document on Interatrial Blocks: 2016 Update | 79 | ||
| Introduction | 79 | ||
| Classification of Blocks at the Atrial Level | 80 | ||
| Rules for IAB to Be Considered a Specific ECG Pattern | 80 | ||
| The ECG-VCG Diagnostic Criteria of Advanced IAB (A-IAB) | 81 | ||
| Unanswered Questions: The Challenges Ahead | 84 | ||
| Conclusions | 85 | ||
| References | 85 | ||
| Chapter 9: Interatrial Block and Supraventricular Arrhythmias: Bayés’ Syndrome | 89 | ||
| Introduction | 89 | ||
| Identification of the Syndrome | 90 | ||
| Importance of Contributing to Predict AF Integrating the ECG Within the Risk Model | 92 | ||
| Brief Summary on the Importance of Detecting AF | 93 | ||
| References | 94 | ||
| Chapter 10: Correlation of Interatrial Block with Left Atrial Enlargement and P-Wave Terminal Force | 97 | ||
| Introduction and Definitions | 97 | ||
| Correlation of Interatrial Block with P-Wave Terminal Force | 98 | ||
| Correlation of IAB with Left Atrial Enlargement | 103 | ||
| Summary | 104 | ||
| References | 104 | ||
| Chapter 11: Interatrial Block and Stroke | 107 | ||
| Introduction | 107 | ||
| Methods | 107 | ||
| Definition of IAB | 108 | ||
| Etiopathogenesis | 108 | ||
| Data and Discussion | 109 | ||
| Therapeutic Interventions for IAB | 112 | ||
| Conclusion | 112 | ||
| References | 113 | ||
| Chapter 12: Interatrial Block as a Predictor of Atrial Fibrillation | 117 | ||
| Introduction | 117 | ||
| Pathophysiological Considerations | 118 | ||
| General Population | 119 | ||
| Post Catheter Ablation of Atrial Fibrillation and Flutter | 119 | ||
| Post Cardioversion of Atrial Fibrillation | 121 | ||
| Cardiomyopathies | 121 | ||
| After Cardiac Surgery | 122 | ||
| Conclusion | 123 | ||
| References | 123 | ||
| Chapter 13: Interatrial Block as a Predictor of Post-CABG Atrial Fibrillation | 125 | ||
| Introduction | 125 | ||
| Atrial Fibrillation Following Cardiac Surgery | 126 | ||
| Interatrial Block Is Not a Predictor of Post-CABG Atrial Fibrillation | 126 | ||
| P-Wave Morphology and PCAF | 127 | ||
| Conclusion | 128 | ||
| References | 128 | ||
| Chapter 14: Interatrial Block in Octogenarians and Up | 129 | ||
| Introduction | 129 | ||
| References | 134 | ||
| Chapter 15: Interatrial Block in Hemodialysis Patients | 137 | ||
| Introduction | 137 | ||
| Recent Insight on Uremic Cardiomyopathy | 138 | ||
| IAB as a Sign of Uremic Cardiomyopathy | 138 | ||
| Literature Review | 139 | ||
| Prevalence of IAB in Hemodialysis Patients | 139 | ||
| Pathophysiology of IAB in Hemodialysis Patients | 139 | ||
| Clinical Implications of IAB in the Hemodialysis Population | 140 | ||
| Advanced IAB (and Bayés’ Syndrome) in Hemodialysis Population | 140 | ||
| Renal Replacement Therapies and P-Wave Changes | 142 | ||
| Conclusions | 142 | ||
| References | 142 | ||
| Chapter 16: Interatrial Block in Severe Heart Failure and the Impact of Cardiac Resynchronization Therapy | 145 | ||
| Introduction | 145 | ||
| Congestive Heart Failure and Atrial Fibrillation: Cause and Effect | 145 | ||
| Predicting Atrial Fibrillation in Heart Failure: Role of Advanced Interatrial Block | 147 | ||
| Reverse Structural Remodeling of the Left Ventricle and Left Atrium: Role of Cardiac Resynchronization Therapy | 149 | ||
| Conclusion | 151 | ||
| References | 151 | ||
| Chapter 17: Interatrial Block in Patients with Sleep Apnea and the Impact of CPAP | 155 | ||
| Introduction | 155 | ||
| The Link Between OSA and AF | 156 | ||
| The Prevalence of IAB in Patients with Moderate to Severe OSA | 157 | ||
| Reverse Atrial Electrical Remodeling Induced by CPAP | 158 | ||
| Conclusion | 159 | ||
| References | 159 | ||
| Chapter 18: Progressive Interatrial Block | 161 | ||
| Introduction | 161 | ||
| Pathophysiology of the Atrial Conduction | 162 | ||
| Progressive IAB and Progressive Interatrial Remodeling | 164 | ||
| Reversal of Progressive Atrial Remodeling | 166 | ||
| Post-Atrial Fibrillation Cardioversion | 166 | ||
| Post-Atrial Fibrillation Catheter Ablation | 167 | ||
| Post-Mitral Valve Commissurotomy | 167 | ||
| Post-Cardiac Resynchronization Therapy | 167 | ||
| Post-Continuous Positive Airway Pressure in Obstructive Sleep Apnea | 168 | ||
| Conclusion | 168 | ||
| References | 168 | ||
| Chapter 19: Atrial Resynchronization by Biatrial Pacing: Is This a Solution? | 171 | ||
| Introduction | 171 | ||
| Technical Aspects (Chronic Implants) | 172 | ||
| Antiarrhythmic Properties | 174 | ||
| Hemodynamic Effects | 177 | ||
| Conclusion | 179 | ||
| References | 180 | ||
| Chapter 20: The Future (and Challenge) of Treating Interatrial Block in the 21st Century | 183 | ||
| Introduction | 183 | ||
| Should We Prevent Atrial Arrhythmias in These Patients? | 184 | ||
| Should We Consider Anticoagulation in Patients Without Evidence of Atrial Fibrillation or Atrial Flutter? | 186 | ||
| References | 189 | ||
| Index | 191 |