Management of cardiac arrhythmias

484 Pages·2011·9.12 MB·English

by  David J. Callans MD

Management of Cardiac Arrhythmias
Contemporary Cardiology
Christopher P. Cannon, MD
SERIES EDITOR
Annemarie M. Armani, MD
EXECUTIVEEDITOR
Forothertitlespublishedinthisseries,goto
http://www.springer.com/series/7677
Management of Cardiac
Arrhythmias
Edited by
Gan-Xin Yan, MD, PhD
Main Line Health Heart Center
Wynnewood, PA, USA
Peter R. Kowey, MD
Jefferson Medical College
Philadelphia, PA, USA
Editors
Gan-XinYan,MD,PhD PeterR.Kowey,MD
MainLineHealthHeartCenter JeffersonMedicalCollege
and Philadelphia,PA,USA
LankenauInstituteforMedicalResearch and
Wynnewood,PA,USA MainLineHealthHeartCenter
[email protected] Wynnewood,PA,USA
[email protected]
ISBN978-1-60761-160-8 e-ISBN978-1-60761-161-5
DOI10.1007/978-1-60761-161-5
SpringerNewYorkDordrechtHeidelbergLondon
LibraryofCongressControlNumber:2010934347
(cid:2)C SpringerScience+BusinessMedia,LLC2002,2011
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Preface
It is safe to say that few areas of medicine have moved faster than cardiac electrophysiology. In
three short decades, our field has grown from its infancy to a highly sophisticated subspecialty of
cardiology, complete with its own societies, scientific meetings, and board examination. Key to our
successes has been a progressively more in-depth understanding of pathophysiology from our basic
sciencelaboratories.Burgeoningknowledgehasbeenaccompaniedbyablitzkriegoftechnologythat
has allowed us to treat what used to be lethal rhythm disturbances and to improve the quality of life
of millions of people the world over. In 2010, we stand on the threshold of an even more impressive
leapforwardaswewrestlewithdefininghowthegeneticcodepredisposesto,orevencauses,cardiac
arrhythmias.
The price to pay for such rapid expansion of information is an ever-widening knowledge gap. It is
obviousthatpractitionerswhospendtheirtimecaringforpatientsfinditdifficulttokeepupwiththe
latestdevelopmentsinourfield.Thenumberofarticlesandjournalsthatcomeacrossourdesksevery
month is mind numbing. And few have the sophistication to understand the myriad of discoveries
that are unwrapped at each of our congresses. Clearly there is a need to have complex information
presentedinanefficientanduser-friendlyway.
We believe that condensed texts represent one of the best ways for colleagues to stay current. We
also think that there are individuals in our field, as in any endeavor, who are particularly skilled in
takingacomplexmassofinformation,condensingandformulatingit,andproducingastate-of-the-art
manuscript that makes clinical sense. Consequently, we agreed to recruit a stellar group of authors
and edit the text you are about to read. Its organization is standard, proceeding from basic science
to diagnostic and therapeutic techniques, before ending in a discussion of specific patient types and
syndromes. We added an historical perspective that should be particularly gratifying to our younger
readers.Sincethetimeframeofdevelopmentwasshort,theinformationisascurrentaspossibleand
should bring the interested readerup to speedrather quickly. We havetried to feature issuesthat will
beofcontinuinginterestinourfieldoverthenextfewyearsinordertoprovideaframeofreferencefor
journalreading.Finally,wehavekeptthelevelofsciencehightoappealtophysiciansandhealth-care
professionals,orthoseintraining,whohaveadeepinterestincardiacarrhythmias.
There are several we would like to acknowledge and thank, including our colleagues who helped
us with their knowledge and experience, our families who allowed us the time to write and edit, our
staffwhoprovidedtechnicalsupport,andtheresearchfoundationsandgrantingagenciesthatkeepus
afloat.Butmostofall,wethankourpatientswho,bytheircourageandperseverance,inspireustodig
deepersowecanultimatelyconquerthediseasesthatdisruptandendtheirlives.
Gan-XinYan,MD,PhD
PeterR.Kowey,MD
v

Acknowledgments
WewishtoacknowledgeMs.RoseWellandDrs.YingWuandXiaoqingQuanfortheirassistance
in editing this book. We also wish to acknowledge American Heart Association, the W.W. Smith
Charitable Trust, the Sharpe-Strumia Research Foundation, and the Albert M. Greenfield Foundation
fortheirgeneroussupportofourresearchandeducationincardiacelectrophysiology.
vii

Contents
Preface. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v
Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii
Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi
PartI Introduction
1 ManagementofVentricularArrhythmias:AnHistoricalPerspective . . . . . . . . . . . . 3
DavidJ.CallansandMarkE.Josephson
2 HistoryofSupraventricularTachycardia . . . . . . . . . . . . . . . . . . . . . . . . . . 17
YanfeiYang,EdmundC.Keung,andMelvinM.Scheinman
PartII CardiacElectrophysiology
3 IonicandCellularBasisforArrhythmogenesis . . . . . . . . . . . . . . . . . . . . . . . 41
CharlesAntzelevitchandGan-XinYan
4 GeneticandMolecularBasisofArrhythmias . . . . . . . . . . . . . . . . . . . . . . . . 65
ShaneB.RowanandDawoodDarbar
PartIII DiagnosticTesting
5 DiagnosisofArrhythmiaswithNon-invasiveTools . . . . . . . . . . . . . . . . . . . . . 89
ReneeM.Sullivan,WeiWeiLi,ArthurC.Kendig,andBrianOlshansky
6 ElectrophysiologyStudy:IndicationsandInterpretations . . . . . . . . . . . . . . . . . . 123
KarenE.ThomasandPeterJ.Zimetbaum
PartIV SpecificArrhythmias
7 SupraventricularArrhythmias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
KhalidAlmuti,BabakBozorgnia,andStevenA.Rothman
8 PharmacologicManagementofAtrialFibrillationandFlutter . . . . . . . . . . . . . . . 165
DeepakSaluja,KathleenHickey,andJamesA.Reiffel
9 CatheterAblationofAtrialFlutterandAtrialFibrillation. . . . . . . . . . . . . . . . . . 195
JosephE.MarineandHughCalkins
10 NonsustainedVentricularTachycardia. . . . . . . . . . . . . . . . . . . . . . . . . . . . 225
PeemLorvidhayaandAlfredE.Buxton
11 VentricularTachycardiaandFibrillation:PharmacologicTherapy . . . . . . . . . . . . . 243
GeraldV.NaccarelliandJohnField
12 AblationforVentricularTachycardia . . . . . . . . . . . . . . . . . . . . . . . . . . . . 257
DusanKocovic
13 IndicationsforImplantableCardioverter-Defibrillators . . . . . . . . . . . . . . . . . . . 283
GustavoLoperaandRobertJ.Myerburg
ix