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Adrian Baranchuk (ed.) - Interatrial Block and Supraventricular Arrhythmias: Clinical Implications of Bayes’ Syndrome

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Adrian Baranchuk (ed.) Interatrial Block and Supraventricular Arrhythmias: Clinical Implications of Bayes’ Syndrome
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Bays 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.
Foreword by Eugene Braunwald, MD:
Cardiologists are well acquainted with partial and complete blocks of conduction in the atrioventricular node, bundle of His, bundle branches, and within the ventricles. The prognostic implications and management of these blocks have been well described for decades. However, this has not been the case for blocks of interatrial conduction. While normal depolarization of the two atria and the bundle of myocardial fibers connecting them (Bachmann s bundle) were described early in the twentieth century, the recognition of blocks in interatrial conduction leading to delayed activation and contraction of the left atrium came much later, and until relatively recently have received little attention.
Professor Antoni Bays de Luna is a distinguished and highly respected Spanish cardiologist who is widely recognized as the leading figure in contemporary clinical electrocardiography. Among his many achievements is his work on interatrial conduction blocks, which he has pursued over almost four decades. Professor Bays has studied, investigated, described, and taught the cardiology community about this subject. In addition to providing rigorous criteria for the diagnosis and classification of the severity of these conduction blocks, he has recognized and emphasized their important association with supraventricular tachyarrhythmias. Quite appropriately, this syndrome of interatrial conduction blockade associated with these arrhythmias, most often atrial flutter or fibrillation, has been named the Bays Syndrome.
Professor Bays has stimulated research around the world on this syndrome. It has been learned that the syndrome occurs with increasing frequency in the elderly and may be caused by ischemia, produced most commonly by atherosclerotic obstruction of the right coronary artery, as well as by atrial distension and/or fibrosis. Importantly, the Bays syndrome appears to be a risk factor for cardio-embolic stroke. This has raised the possibility that preventive oral anticoagulant therapy, particularly with one of the newer oral anticoagulants, might be useful in patients with advanced interatrial block, even in the absence of clinically evident atrial fibrillation.
Interatrial Block and Supraventricular Arrhythmias: Clinical Implications of Bays 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 Bays, Baranchuk, and the authors who have contributed to this book, interatrial block is no longer a stepchild.
Eugene Braunwald, MD

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INTERATRIAL BLOCK AND SUPRAVENTRICULAR ARRHYTHMIAS CLINICAL IMPLICATIONS OF - photo 1
INTERATRIAL BLOCK AND SUPRAVENTRICULAR ARRHYTHMIAS: CLINICAL IMPLICATIONS OF BAYS SYNDROME
INTERATRIAL BLOCK AND SUPRAVENTRICULAR ARRHYTHMIAS: CLINICAL IMPLICATIONS OF BAYS SYNDROME

Adrian Baranchuk, MD, FACC, FRCPC, FCCS

Professor of Medicine (Tenure)

Head, Heart Rhythm Service

Queens University

Kingston, Ontario, Canada

2017 Adrian Baranchuk Cardiotext Publishing LLC 3405 W 44th Street - photo 2

2017 Adrian Baranchuk

Cardiotext Publishing, LLC

3405 W. 44th Street

Minneapolis, Minnesota 55410

USA

www.cardiotextpublishing.com

Any updates to this book may be found at: www.cardiotextpublishing.com/interatrial-block-and-supraventricular-arrhythmias

Comments, inquiries, and requests for bulk sales can be directed to the publisher at: .

All rights reserved. No part of this book may be reproduced in any form or by any means without the prior permission of the publisher.

All trademarks, service marks, and trade names used herein are the property of their respective owners and are used only to identify the products or services of those owners.

This book is intended for educational purposes and to further general scientific and medical knowledge, research, and understanding of the conditions and associated treatments discussed herein. This book is not intended to serve as and should not be relied upon as recommending or promoting any specific diagnosis or method of treatment for a particular condition or a particular patient. It is the readers responsibility to determine the proper steps for diagnosis and the proper course of treatment for any condition or patient, including suitable and appropriate tests, medications or medical devices to be used for or in conjunction with any diagnosis or treatment.

Due to ongoing research, discoveries, modifications to medicines, equipment and devices, and changes in government regulations, the information contained in this book may not reflect the latest standards, developments, guidelines, regulations, products or devices in the field. Readers are responsible for keeping up to date with the latest developments and are urged to review the latest instructions and warnings for any medicine, equipment or medical device. Readers should consult with a specialist or contact the vendor of any medicine or medical device where appropriate.

Except for the publishers website associated with this work, the publisher is not affiliated with and does not sponsor or endorse any websites, organizations or other sources of information referred to herein.

The publisher and the authors specifically disclaim any damage, liability, or loss incurred, directly or indirectly, from the use or application of any of the contents of this book.

Unless otherwise stated, all figures and tables in this book are used courtesy of the authors.

Cover image courtesy of Elsevier Espaa. Baranchuk A. and Bays-Gens A. Bays Syndrome. Rev Esp Cardiol. 2016;69(4):439. Copyright 2016 Sociedad Espaola de Cardiologa. Published by Elsevier Espaa, S.L.U. All rights reserved.

Library of Congress Control Number: 2016956978

ISBN: 978-1-942909-15-6

eISBN: 978-1-942909-16-3

Printed in the United States of America

About the Authors
Editor

Adrian Baranchuk, MD, FACC, FRCPC, FCCS

Professor of Medicine (Tenure), Head, Heart Rhythm Service, Queens University, Kingston, Ontario, Canada

Contributors

Bryce Alexander, BSc

Division of Cardiology, Kingston General Hospital, Queens University, Kingston, Ontario, Canada

Antoni Bays de Luna, MD, PhD

Hospital de la Santa Creu i Sant Pau, Cardiovascular Research Center, CSIC-ICCC, Barcelona, Spain

Antoni Bays-Gens, MD

Hospital Germans Trias i Pujol Universitat Autnoma de Barcelona, Badalona, Barcelona, Spain

Jos Angel Cabrera, MD

Hospital Universitario Quirn-Madrid, European University of Madrid, Madrid, Spain

Lovely Chhabra, MD

Department of Cardiovascular Medicine, Heartland Regional Medical Center, Marion, Illinois, United States

Diego Conde, MD

Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina

Francisco G. Coso, MD

Cardiology Department, Hospital Universitario de Getafe, Madrid;
Cardiology Department, Universidad Europea de Madrid, Madrid, Spain

Iwona Cygankiewicz, MD, PhD

Department of Electrocardiology, Medical University of Lodz, Sterling Regional Center for Heart Diseases, Lodz, Poland

Jean-Claude Daubert, MD

Facult de Mdecine, Universit Rennes 1, Rennes, France

Andres Enriquez, MD

Cardiovascular Division, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States

Luis Alberto Escobar Robledo, MD

Hospital de la Santa Creu i Sant Pau, Cardiovascular Research Center, CSIC-ICCC, Barcelona, Spain

Ignacio Fernndez-Lozano, MD

Hospital Puerta de Hierro, Majadahonda, Madrid, Spain

Eusebio Garca Izquierdo, MD

Hospital Puerta de Hierro, Majadahonda, Madrid, Spain

Javier Garca-Niebla, RN

Servicios Sanitarios del Area de Salud de El Hierro, Valle del Golfo Health Center, Canary Islands, Spain

Arun Gautam, MD

Department of Medicine, Hartford Hospital, University of Connecticut School of Medicine, Hartford, Connecticut, United States

Benedict M. Glover, MD, FESC

Division of Cardiology, Queens University, Kingston, Ontario, Canada

Shreyas Gowdar, MD

Department of Cardiovascular Medicine, Hartford Hospital, University of Connecticut School of Medicine, Hartford, Connecticut, United States

Martin Green, MD, FRCPC

Clinical Cardiac Electrophysiology, University of Ottawa Heart Institute, Ottawa, Canada

Diego Jimnez Sanchez, MD

Hospital Puerta de Hierro, Majadahonda, Madrid, Spain

Robert Lemery, MD, FRCPC, FESC, FHRS

Clinical Cardiac Electrophysiology, University of Ottawa Heart Institute, Ottawa, Canada

Philippe Mabo, MD

Facult de Mdecine, Universit Rennes 1; Cardiology and Vascular Diseases Division, Rennes University Hospital, Rennes, France

Marco Marano, MD

Hemodialysis Unit, Maria Rosaria Clinic, Pompeii, Italy

Manuel Martnez-Sells, MD

Hospital General Universitario Gregorio Maran, Universidad Europea y Universidad Complutense, Madrid, Spain

Raphal Martins, MD, PhD

Facult de Mdecine, Universit Rennes 1; Cardiology and Vascular Diseases Division, Rennes University Hospital, Rennes, France

Albert Mass van-Roessel, MD

Hospital de la Santa Creu i Sant Pau, Cardiovascular Research Center, CSIC-ICCC, Barcelona, Spain

Pyotr G. Platonov, MD, PhD, FHRS, FESC

Arrhythmia Clinic, Skne University Hospital; Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden

Fariha Sadiq Ali, MD

Division of Cardiology, Kingston General Hospital, Queens University, Kingston, Ontario, Canada

Damin Snchez-Quintana, MD

Department of Anatomy and Cell Biology, Faculty of Medicine, University of Extremadura, Badajoz, Spain

David H. Spodick, MD, DSc

Department of Cardiovascular Medicine, Saint Vincent Hospital, University of Massachusetts Medical School, Worcester, Massachusetts, United States

Larisa G. Tereshchenko,

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