Risk of arrhythmia and sudden death

429 Pages·2001·7.12 MB·English

by  Marek Malik

Risk of Arrhythmia
and
Sudden Death
Edited by
Marek Malik
BMJ Books
Risk of Arrhythmia and
Sudden Death
To my parents
Risk of Arrhythmia and
Sudden Death
Edited by
Marek Malik
Professor of Cardiac Electrophysiology
St George’s Hospital Medical School, London, UK
©BMJ Books 2001
BMJ Books is an imprint of the BMJ Publishing Group
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any
form or by any means, electronic, mechanical, photocopying, recording and/or otherwise, without the prior written
permission of the publishers.
First published in 2001
by BMJ Books, BMA House, Tavistock Square,
London WC1H 9JR
www.bmjbooks.com
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
ISBN 0-7279-1581-9
Typeset by Phoenix Photosetting, Chatham, Kent
Printed and bound by Creative Print and Design Ltd
Contents
Contributors ix
Preface xiii
Abbreviations xv
Part I: Problem and methodology
1 Clinical goals of risk stratification 3
Roberto Elosua, Josep Guindo, Xavier Viñolas, Antonio Martinez-Rubio,
Toni Bayés-Genis and Antoni Bayés de Luna
2 Definition of arrhythmic risk 10
Steen Z Abildstrom, Christian Torp-Pedersen and Lars Køber
3 Statistical methods for risk-stratification studies 19
Timothy R Church
4 Step-wise risk-stratification strategies 29
Stefan H Hohnloser
5 Risk-stratification studies for prospective trial design 37
Marek Malik
Part II: Techniques of risk assessment
6 Basic clinical assessment 49
Branco Mautner
7 Left ventricular ejection fraction and wall motion score 57
Steen Z Abildstrom, Christian Torp-Pedersen and Lars Køber
8 Risk assessment: the 12-lead electrocardiogram 65
Rory Childers
9 Electrophysiological study for risk stratification of cardiac patients 98
Velislav Batchvarov
10 QT dispersion 117
Velislav Batchvarov and Marek Malik
v
Risk of Arrhythmia and Sudden Death
11 Electrocardiographic assessment of myocardial ischaemia
(with a note on the ischaemia–arrhythmia connection) 135
Shlomo Stern
12 Exercise electrocardiography for the assessment of arrhythmias 144
Michael Cusack and Simon Redwood
13 Analysis of monophasic action potentials 155
Peter Taggart and Peter Sutton
14 Ventricular signal averaged electrocardiography 167
Piotr Kulakowski
15 Signal averaged P wave 180
Antonio Michelucci, Luigi Padeletti, Andrea Colella, Maria Cristina Porciani,
Paolo Pieragnoli, Alessandro Costoli and Gian Franco Gensini
16 Non-invasive investigation of Wedensky modulation 187
Katerina Hnatkova and Marek Malik
17 Ambulatory electrocardiography: use in arrhythmia risk assessment 194
Morrison Hodges and James J Bailey
18 Event loop recorders and implantable monitors 202
Mark L Brown
19 Basic autonomic tests 209
Federico Lombardi
20 Heart rate assessment and monitoring 213
Xavier Copie, Olivier Piot, Thomas Lavergne, Louis Guize and
Jean-Yves Le Heuzey
21 Heart rate variability 221
Robert E Kleiger and Phyllis K Stein
22 Baroreflex sensitivity 234
Maria Teresa La Rovere, Andrea Mortara and Gian Domenico Pinna
23 Heart rate turbulence 242
Georg Schmidt
24 T wave dynamicity 249
Pierre Maison Blanche and Philippe Coumel
25 Repolarisation alternans 256
Daniel M Bloomfield and Richard J Cohen
26 Social and psychosocial influences on sudden cardiac death, ventricular
arrhythmia and cardiac autonomic function 266
Harry Hemingway
vi
Contents
Part III: Clinical studies of risk assessment
27 Risk stratification after myocardial infarction 287
Yee Guan Yap
28 Ventricular arrhythmias in chronic heart failure 297
Steven Lindsay and Jim Nolan
29 Ventricular arrhythmias in hypertrophic cardiomyopathy 309
Gang Yi and William J McKenna
30 Ventricular arrhythmias in apparently healthy athletes 316
Francesco Furlanello, Fredrick Fernando, Amedeo Galassi and
Annalisa Bertoldi
31 Paroxysmal atrial fibrillation 325
Johan EP Waktare
32 Persistent atrial fibrillation 336
Joseph T Dell’Orfano and Gerald V Naccarelli
33 Permanent atrial fibrillation 348
Isabelle C Van Gelder and Harry JGM Crijns
34 Arrhythmias associated with the long QT syndrome 353
Peter J Schwartz
35 Arrhythmia associated with other cardiac diseases 360
Patrick Lam and Paul Schweitzer
36 Arrhythmias associated with non-cardiac disease 365
Josef Kautzner
Part IV: Antiarrhythmic trials
37 Antiarrhythmic device trials 379
Arthur J Moss
38 Recent antiarrhythmic drug trials 389
Michiel J Janse
Index 395
vii

Contributors
Steen Z Abildstrom Richard J Cohen
Department of Cardiology, Gentofte University Hospital, Whitaker Professor, Harvard University–Massachusetts
Copenhagen, Denmark Institute of Technology, Division of Health Sciences and
Technology, Massachusetts, USA
James J Bailey
Center for Information Technology, National Institutes of Andrea Colella
Health, Bethesda, Maryland, USA Istituto di Clinica Medica e Cardiologia, Università di
Firenze, Florence, Italy
Velislav Batchvarov
Xavier Copie
Department of Cardiological Sciences, St George’s
Department of Cardiology, Broussais Hospital, Paris,
Hospital Medical School, London, UK
France
Antoni Bayés de Luna
Alessandro Costoli
Departamento de Cardiología, Hospital de la Santa Creu i
Istituto di Clinica Medica e Cardiologia, Università di
Sant Pau, Barcelona, Spain
Firenze, Florence, Italy
Toni Bayés-Genis
Philippe Coumel
Fellow, Mayo Clinic, Rochester, Minnesota, USA
Hôpital Lariboisière, Paris, France
Annalisa Bertoldi
Harry JGM Crijns
Department of Cardiology, S. Chiara Hospital, Trento, Italy
Department of Cardiology, Thoraxcenter, University
Hospital Groningen, Groningen, The Netherlands
Daniel M Bloomfield
Assistant Professor of Medicine, Division of Cardiology,
Michael Cusack
College of Physicians and Surgeons, Columbia University,
Clinical Research Fellow, Department of Cardiology,
USA
Rayne Institute, St Thomas’ Hospital, London, UK
Mark L Brown Joseph T Dell’Orfano
Staff Scientist, Tachyarrhythmia Research Department, Department of Medicine, Division of Cardiology, The
Atrial Fibrillation Research Group, Medtronic, State University of New York at Stony Brook, Stony
Minneapolis, Minnesota, USA Brook, New York, USA
Rory Childers Roberto Elosua
Professor of Medicine, Section of Cardiology, University Unidad de Lípidos y Epidemiología Cardiovascular,
of Chicago Medical Centre, Chicago, USA Instituto Municipal de Investigación Médica, Barcelona,
Spain
Timothy R Church
Division of Environmental and Occupational Health, Fredrick Fernando
School of Public Health, University of Minnesota, Sports Science Institute, Italian National Olympic
Minneapolis, Minnesota, USA Committee, Rome, Italy
ix