Case 14

Case presentations focus on mapping techniques, diagnosis, and proper catheter placement for successful ablation of arrhythmias. This case focuses on wide complex tachycardia, automatic tachycardia, and reentrant tachycardia.

Case 9

Case presentations focus on mapping techniques, diagnosis, and proper catheter placement for successful ablation of arrhythmias. This case focuses on microbubbles on imaging, intracardiac ultrasonography, thrombi, and vessel perforation and dissection.

Case 8

Case presentations focus on mapping techniques, diagnosis, and proper catheter placement for successful ablation of arrhythmias. This chapter focuses on bundle branch block, accessory bypass tract, and preexcitation.

Case 3

Case presentations focus on mapping techniques, diagnosis, and proper catheter placement for successful ablation of arrhythmias. This case focuses on wide QRS tachycardia, atrial activation, and near-field and far-field potentials.

Catheter Ablation and Device Therapy in Congenital Heart Disease

Arrhythmias in adult CHD patients represent the leading cause of morbidity and hospitalization, resulting in a major increase in ablation and device-related procedures in these patients. These procedures are often complex, not only because of underlying congenital anatomic variations but also because of the effects of prior surgical repair that can modify the arrhythmic substrate leading to an increased likelihood of multiple types of arrhythmias, even in the same patient. To optimize both success and safety with these procedures, the electrophysiologist must be thoroughly familiar with the underlying cardiac anatomy, prior cardiac surgical history, and known variants of both the pathology and surgical techniques. The purpose of this chapter is to outline the salient concepts and principles pertinent to arrhythmia and device management in patients with CHD.

Antiarrhythmic Drug Therapy: Understanding Options for the Ablationist

Antiarrhythmic agents play an important role in the management of cardiac arrhythmias as both primary and hybrid therapy. The essential goals of antiarrhythmic therapy are termination of an ongoing arrhythmia, prevention of arrhythmia recurrence, or both. Antiarrhythmic drugs help control arrhythmias but also may cause them. Therefore, selection of an effective yet safe medication may be challenging. The challenge arises from factors intrinsic to the patient, the disease condition, or the drug itself. These factors include variability in the pathophysiologic substrate, arrhythmia mechanisms, clinical presentation, prognostic implications, drug disposition, and response. Patients with arrhythmia comprise a highly heterogeneous patient population, with variable comorbid conditions and concomitant drug use.

Introduction to the Electrophysiology Manual: Fluoroscopic Views, Electrograms, and Relevant Anatomy

The purpose of this chapter is to familiarize the reader with the typical fluoroscopic views and electrograms used throughout this book. First, the rationale for the particular views used and the standard electrogram display format are introduced. The discussion then continues to the important fluoroscopic landmarks relevant to the arrhythmias encountered in the electrophysiology laboratory. These landmarks are discussed in the context of the electrograms obtained from mapping these sites and their importance from an anatomic and ablation standpoint. The first topics are the common fluoroscopic and anatomic principles relevant to the electrophysiology laboratory; then the specific differences in catheter use and electrograms obtained from the standard fluoroscopic catheter position in supraventricular tachycardia, atrial flutter, atrial fibrillation, and ventricular tachycardia; and finally some unusual positions and congenital variants.

Case 19

Case presentations focus on mapping techniques, diagnosis, and proper catheter placement for successful ablation of arrhythmias. This case focuses on incessant atrial tachycardia, ablative therapy, premature ventricular contraction, and isolation procedures.

Case 15

Case presentations focus on mapping techniques, diagnosis, and proper catheter placement for successful ablation of arrhythmias. This case focuses on the adult with a history of congenital heart disease, tachypalpitations, atrial fibrillation, and atrial flutter.

Case 4

Case presentations focus on mapping techniques, diagnosis, and proper catheter placement for successful ablation of arrhythmias. This case focuses on atrial fibrillation treated with ablation.