Jasbir S. Sra Masood Akhtar - Practical electrophysiology

Practical Electrophysiology

Practical Electrophysiology

EDITORS

Jasbir S. Sra, MD, FACC, FHRS
University of Wisconsin School of Medicine and Public Health
Milwaukee, Wisconsin

Masood Akhtar, MD, FACC, MACP, FAHA, FHRS
University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin

ASSOCIATE EDITORS

Andrea Natale, MD, FACC, FHRS
Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas

David J. Wilber, MD
Loyola University of Chicago, Maywood, Illinois

2014 Jasbir S. Sra, Masood Akhtar, Andrea Natale, David Wilber

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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 reader's 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 publisher's 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.

To my wife Lori and my children whose understanding made this work possible. This book is dedicated to all those interested in advancing the field of electrophysiology.

Jasbir Sra, Milwaukee

Chapters

Cases

Section 2.1: ECGs, Syncope, Bradyarrhythmias, and Non-Invasive Testing

1. ECG Interpretation
Jasbir S. Sra, MD, Masood Akhtar, MD

2. Syncope and Suspected Sinus Node Dysfunction
Wayne Adkisson, MD, David G. Benditt, MD

3. Evaluating Transient Loss of Consciousness and Suspected Neurally Mediated Reflex Syncope
David G. Benditt, MD, Wayne Adkisson, MD

4. Noninvasive Testing for Sudden Cardiac Death
Ryan Cooley, MD

Section 2.2: Supraventricular Tachycardias

5. Diagnostic Pacing Maneuvers during Paroxysmal Supraventricular Tachycardia
Aman Chugh, MD and Fred Morady, MD

6. Narrow Complex Tachycardia with Features Suggesting Multiple Tachycardia Mechanisms the Importance of Electrophysiology Fundamentals
Indrajit Choudhuri, MD and Jasbir S. Sra, MD

7. Slow-Fast Atrioventricular Nodal Reentrant Tachycardia
Mohamed Djelmami-Hani, MD

8. Nonreentrant Atrioventricular Nodal Tachycardia
Atul Bhatia, MD

9. Atrioventricular Nodal Reentrant Tachycardia with 2:1 AV Block
Atul Bhatia, MD

10. Slow/Fast AVNRT: A Group of 3 Tachycardias
Warren M. Jackman, MD, Hiroshi Nakagawa, MD, PhD, Sunny Po, MD, PhD, Benjamin J. Scherlag, PhD, Karen J. Beckman, MD, Deborah Lockwood, BM, BCh, Adrian Dusa, MD, Stavros Stavrakis, MD, and Ralph Lazzara, MD

11. Atrial Tachycardia: Differential Diagnosis
Melvin M. Scheinman, MD

12. Atrial Tachycardia from above the Semilunar Valves
Ramprakash Balasundaram, MD and Calambur Narasimhan, MD

13. ECG Localization of Accessory Pathways
Nitish Badhwar, MD and Melvin Scheinman, MD

14. Permanent Junctional Reciprocating Tachycardia
George McDaniel, MD, MS and John P. DiMarco, MD, PhD

15. Targeted Ablation of the Noncoronary Cusp of Aortic Valve for Incessant Orthodromic Atrioventricular Reentrant Tachycardia
Ramprakash Balasundaram, MD, Hygriv Rao, MD, Samuel J. Asirvatham, MD, and Calambur Narasimhan, MD

16. CS-LV Accessory Connection or Epicardial Posteroseptal Accessory Pathway
Warren M. Jackman, MD, Hiroshi Nakagawa, MD, PhD, Sunny Po, MD, PhD, Benjamin J. Scherlag, PhD, Karen J. Beckman, MD, Deborah Lockwood, BM, BCh, Adrian Dusa, MD, Stavros Stavrakis, MD, and Ralph Lazzara, MD

17. Mahaim Pathway-Mediated Tachycardia
Patrick Tchou, MD, Mohamed Kanj, MD, and Mohamed Bassiouny, MD

18. Nodofascicular Pathway
Patrick Tchou, MD, Mohamed Kanj, MD, and Mohamed Bassiouny, MD

19. Preexcited Tachycardias: Differential Diagnosis, Mechanisms and Diagnostic Clues
Masood Akhtar, MD and Jasbir S. Sra, MD

Section 2.3: Atrial Flutter, Atrial Fibrillation

20. Typical Cavotricuspid Isthmus-Dependent Flutter
Dipen Shah, MD

21. Left Atrial Flutters after AF ablation
Jasbir S. Sra, MD

22. Targeting Complex Fractionated Atrial Electrograms to Eliminate Atrial Fibrillation
Hakan Oral, MD and Jos Jalife, MD

23. Techniques of Segmental Pulmonary Vein Isolation and Circumferential Pulmonary Vein Ablation during Sinus Rhythm and Atrial Fibrillation
Aman Chugh, MD and Fred Morady, MD

24. Exertional Dyspnea After Atrial Fibrillation Ablation
Brian D. Powell, MD and Douglas L. Packer, MD

25. Paroxysmal Atrial Fibrillation with Pulmonary Vein Triggers
Pasquale Santangeli, MD, Luigi Di Biase, MD, PhD, and Andrea Natale, MD

26. Identifying Extra Pulmonary Vein Triggers for AF Initiation
Luigi Di Biase, MD, PhD, Pasquale Santangeli, MD, and Andrea Natale, MD

27. Catheter Ablation for Long-Standing Persistent AF
Mlze Hocini, Ashok J. Shah, Shinsuke Miyazaki, Lena Rivard, Amir S. Jadidi, Daniel Scherr, Stephen B. Wilton, Laurent Roten, Patrizio Pascale, Michala Pedersen, Nicolas Derval, Sbastien Knecht, Frederic Sacher, Pierre Jas, and Michel Hassaguerre

28. Hybrid Ablation for Recurrent Left Atrial Fibrillation using Pericardioscopy and Transseptal Approach