Amin Al-Ahmad - Hands-On Ablation: The Experts’ Approach

THE EXPERTS APPROACH

SECOND
EDITION

EDITORS

AMIN AL-AHMADMD

Texas Cardiac Arrhythmia Institute at St. Davids Medical Center, Austin, Texas

DAVID J. CALLANSMD

University of Pennsylvania Health System, Philadelphia, Pennsylvania

HENRY H. HSIAMD

University of California, San Francisco, San Francisco, California

ANDREA NATALEMD

Texas Cardiac Arrhythmia Institute at St. Davids Medical Center, Austin, Texas

OSCAR OSEROFFMD

Bazterrica Clinic, Buenos Aires, Argentina

PAUL J. WANGMD

Stanford University, Stanford, California

Second edition

2013, 2017 Amin Al-Ahmad, David J. Callans, Henry H. Hsia, Andrea Natale, Oscar Oseroff, Paul J. Wang

First edition published 2013. Second edition 2017

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/hands-on-ablation-2nd-edition

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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.

Library of Congress Control Number: 2017937019

ISBN: 978-1-942909-17-0

eISBN: 978-1-942909-19-4

Printed in the United States of America

To Rola, Maya, Dana, and Mohammad, for the constant love and support.

Amin Al-Ahmad

I am dedicating this book to the memory of my great mentor and friend Mark Josephson.

David J. Callans

To my family, for their continuous support and guidance; to my parents, for their encouragement and illumination.

Henry H. Hsia

To my lovely wife Marina and our beautiful daughters Veronica and Eleonora.

Andrea Natale

To my loving wife Solange, my sons Pablo and Martin, my parents, and my brother, for their endless understanding and support.

Oscar Oseroff

To my lovely wife Gloria, my wonderful daughters Margaret and Katie, and the memory of my parents, Samuel and Lillian.

Paul Wang

Contributors

Amin Al-Ahmad, MD, FACC, FHRS, CCDS

Cardiac Electrophysiologist, Texas Cardiac Arrhythmia Institute at St. Davids Medical Center, Austin, Texas

David J. Callans, MD, FHRS, FAHA, FACC

Professor of Medicine, Perelman School of Medicine; Associate Director of Electrophysiology, University of Pennsylvania Health System, Philadelphia, Pennsylvania

Henry H. Hsia, MD, FACC, FHRS

Health Science Professor of Medicine, University of California, San Francisco; Chief, Arrhythmia Service, VA Medical Center, San Francisco, California

Andrea Natale, MD, FACC, FHRS, FESC

Executive Medical Director, Texas Cardiac Arrhythmia Institute at St. Davids Medical Center, Austin, Texas; Consulting Professor, Division of Cardiology, Stanford University, Palo Alto, California; Clinical Professor of Medicine, Case Western Reserve University, Cleveland, Ohio; Director, Interventional Electrophysiology, Scripps Clinic, San Diego, California; Senior Clinical Director, EP Services, California Pacific Medical Center, San Francisco, California

Oscar Oseroff, MD, FHRS

Chief of Pacing and Electrophysiology, Electrophysiology Department, Bazterrica Clinic, Buenos Aires, Argentina

Paul J. Wang, MD, FACC, FHRS, FAHA

Professor, Cardiovascular Medicine and Bioengineering (by courtesy); Director, Cardiac Arrhythmia Service, Stanford University School of Medicine, Stanford, California

Mohamed Aljaabari, MBBS, FACC

Attending Cardiac Electrophysiologist, Mafraq Hospital, Abu Dhabi, United Arab Emirates

Jess Almendral, MD, PhD, FESC

Unidad de Electrofisiologa Cardaca y Arritmologa Clnica, Grupo Hospital de Madrid, Universidad CEU- San Pablo, Madrid, Spain

Arash Aryana, MS, MD, FACC, FHRS

Vice Chair, Department of Cardiology and Cardiovascular Surgery, Mercy General Hospital, Dignity Health Heart and Vascular Institute, Sacramento, California

Donita Atkins, RN

Division of Cardiovascular Diseases, Cardiovascular Research Institute, University of Kansas Hospital and Medical Center, Kansas City, Kansas

Zaid Aziz, MD

Assistant Professor of Medicine, Section of Cardiology, The University of Chicago School of Medicine, Center for Arrhythmia Care, Chicago, Illinois

Nitish Badhwar, MD, FACC, FHRS

Director, Cardiac Electrophysiology Training Program; Associate Chief, Cardiac Electrophysiology, Medicine/ Cardiology, University of California, San Francisco, San Francisco, California

Tina Baykaner, MD

Senior Fellow, Department of MedicineCardiovascular Medicine, Stanford University School of Medicine, Stanford, California

Victor Bazan, MD, PhD

Consultant Physician, Electrophysiology Unit, Cardiology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

Jason S. Bradfield, MD, FACC, FHRS

Assistant Professor of Medicine; Director, Specialized Program for Ventricular Tachycardia, UCLA Cardiac Arrhythmia Center, David Geffen School of Medicine at UCLA, Los Angeles, California

J. David Burkhardt, MD, FACC, FHRS