Radiofrequency Catheter Ablation of Cardiac Arrhythmias Basic Concepts and Clinical Applications

by Huang, Shoei K. Stephen; Wiber, David J.

• ISBN13: 9780879934385
• ISBN10: 0879934387
• Edition: 2nd
• Format: Hardcover
• Copyright: 2000-06-08
• Publisher: Wiley-Blackwell

Summary

Since its inception in the mid-1980s, this therapeutic procedure has evolved to become an indispensable therapeutic modality in the treatment of arrhythmias. Now there is a "cure" without surgery. This text provides a comprehensive description of radiofrequency catheter ablation of cardiac arrhythmias from basic concepts of biophysics and pathophysiology of radiofrequency lesion formation to clinical application of the technique in every aspect of arrhythmia ablation. Each chapter provides an indepth review of the topic, including the most current information and references

Author Biography

Boaz Avitall, M.D., Ph.D., F.A.C.C.: Associate Professor of Medicine, Director, Electrophysiology Services, Section of Cardiology, Department of Medicine, University of Illinois at Chicago Helen Barold, M.D.: Clinical Cardiac Electrophysologist, JFK Medical Center, Atlantis, Florida S. Serge Barold, M.D.: Director of Research, North Broward Hospital District Electrophysiology Institute, Broward General Hospital, Fort Lauderdale, Florida Saroja Bharati, M.D., Ph.D.: Director, Maurice Lev Congenital Heart and Conduction System Center, The Heart Institute for Children, Christ Hospital and Medical Center, Oak Lawn, Illinois; Professor of Pathology, Rush Medical College, Rush-Presbyterian-St. Luke's Medical Center; Clinical Professor of Pathology, Finch University of Health Sciences/Chicago Medical School, North Chicago, Illinois Ulrika Birgersdottir-Green, M.D.: Division of Cardiology, Department of Medicine, University of California San Diego School of Medicine Alfred E. Buxton, M.D.: Professor, Cardiology Section, Department of Medicine, Temple University School of Medicine and Temple University Hospital, Philadelphia, Pennsylvania Hugh G. Calkins, M.D.: Director of the Arrhythmia Service and Cardiac Electrophysiology Laboratory, Johns Hopkins Hospital, Associate Professor of Medicine, Johns Hopkins University, Baltimore, Maryland Riccardo Cappato, M.D.: St. Georg Hospital, Hamburg, Germany Mau-Song Chang, M.D.: Professor of Medicine, National Yang-Ming University School of Medicine, and Director, Veterans General Hospital, Taipei, Taiwan Shih-Ann Chen, M.D.: Professor and Director of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, National Yang-Ming University School of Medicine, and Veterans General Hospital, Taipei, Taiwan Chern-En Chiang, M.D.: Associate Professor, Division of Cardiology, Department of Medicine, National Yang-Ming University, School of Medicine, and Veterans General Hospital, Taipei, Taiwan Jacques Clementy: Chef de service, Centre Hospitalier Universitaire de Bordeaux, Hopital Cardiologie du Haut-Leveque, Bordeaux, France Philip A. Cooke, M.B.B.S.: Fellow in Cardiac Electrophysiology, University of Chicago Robert F. Coyne, M.D.: Fellow in Cardiac Electrophysiology Allegheny University Hospitals, Philadelphia, Pennsylvania N.A. Mark Estes III, M.D.: Director, Cardiac Arrhythmia Service, New England Medical Center, Boston, Massachusetts Gregory K. Feld, M.D.: Director, Electrophysiology Program, Professor of Medicine, Division of Cardiology, Department of Medicine, University of Californi-San Diego School of Medicine Peter L. Friedman, M.D., Ph.D.: Cape Cod Cardiovascular Associates, Hyannis, Massachusetts Gopal N. Gupta, B.S.: Section of Cardiology, Department of Medicine, University of Illinois at Chicago David Haines, M.D.: Professor of Internal Medicine, Division of Cardiology, Department of Medicine, University of Virginia, Charlottesville Michel Haissaguerre, M.D.: Professeur, Centre Hospitalier Universitaire de Bordeaux, Hopital Cardiologie du Haut-Leveque, France Ray W. Helms, B.S.E.: Section of Cardiology, Department of Medicine, University of Illinois at Chicago Meleze Hocini, M.D.: Centre Hospitalier Universitaire de Bordeaux, Hopital Cardiologie du Haut-Leveque, France Munther K. Homoud, M.D.: Co-director, Cardiac Electrophysiology and Pacemaker Lab, Cardiac Arrhythmia Service, New England Medical Center, Boston, Massachusetts Henry H. Hsia, M.D.: Associate, Cardiology Section, Department of Medicine, Temple University School of Medicine and Temple University Hospital, Philadelphia, Pennsylvania Shoei K. Stephen Huang, M.D.: Professor of Medicine, Associate Dean for International Affairs, Director, Laboratory Animal Center, National Taiwan University College of Medicine. Director, Cardiac Electrophysiology and Pacing Service, National Taiwan University Hospital, Taipei Pierre Jais: Practicien Hospitalier, Centre Hospitalier Universitaire de Bordeaux, Hopital Cardiologie du Haut-Leveque, France John Kall, M.D.: Assistant Professor of Medicine, University of Chicago Jonathan M. Kalman, M.B.B.S., Ph.D.: Section of Cardiac Electrophysiology, Department of Medicine and Cardiovascular, The Royal Melbourne Hospital, Parkville, Australia Martin R. Karch, M.D.: Deutsches Herzzentrum Muenchen, Abteilung Fuer Kardiologie/Elektrophysiologie, Germany G. Neal Kay, M.D.: Director, Clinical Electrophysiology Section, Division of Cardiovascular Disease, University of Alabama at Birmingham Dusan Kocovic, M.D.: Director, Electrophysiology Laboratory, Hospital of the University of Pennsylvania, Assistant Professor of Medicine, University of Pennsylvania School of Medicine, Philadelphia Karl-Heinz Kuck, M.D.: St. Georg Hospital, Hamburg, Germany Ling-Ping Lai, M.D.: Lecturer of Medicine, National Taiway University College of Medicine, Attending Staff, Cardiac Arrhythmias and Electrophysiology, National Taiwan University Hospital, Taipei Jonathan Langberg, M.D.: Professor, Emory University Hospital, Emory University School of Medicine, Division of Cardiology, Atlanta, Georgia Thomas Lavergne, M.D.: Hopital Broussais, Paris, France Randall J. Lee, M.D., Ph.D.: Section of Cardiac Electrophysiology, Department of Medicine and Cardiovascular Research Institute, University of California-San Francisco Shih-Huang Lee, M.D.: Associate Professor, Division of Cardiology, Department of Medicine, National Yang-Ming University, School of Medicine, and Director of Cardiac Electrophysiology, Shin-Kong Memorial Hospital, Taipei, Taiwan Michael D. Lesh, S.M., M.D.: Associate Professor of Medicine, Director, UCSF Atrial Arrhythmia Center, Department of Medicine, University of California-San Francisco Maurice Lev, M.D.: Professor of Pathology, Rush Medical College, Congenital Heart and Conduction System Center, The Heart Institute for Children, Palos Heights, Illinois Albert Lin, M.D.: Assistant Professor of Medicine, University of Chicago, Illinois James C. Lin, Ph.D.: Professor, Department of Electrical Engineering and Computer Science and Department of Bioengineering, University of Illinois at Chicago Jiunn-Lee Lin, M.D.: Associate Professor of Medicine, National Taiwan University College of Medicine, Director, Cardiac Electrophysiology Laboratory, National Taiwan University Hospital, Taipei Mahadevappa Mahesh, M.D.: Chief Physicist, Johns Hopkins Hospital, Research Associate, Johns Hopkins University, Baltimore, Maryland J. Michael Mangrum, M.D.: Division of Cardiology, Department of Medicine, University of Virginia, Charlottesville Frank Marchlinski, M.D.: Professor of Medicine, Director, Cardiac Electrophysiology, University of Pennsylvania Health System Ali A. Mehdirad, M.D.: Cardiac Electrophysiologist, Mercy Cardiology Corporation, St. Louis, Missouri Fernando Mera, M.D.: Fellow in Electrophysiology, Carlyle Fraser Heart Center, Emory University School of Medicine, Division of Cardiology, Atlanta, Georgia William M. Miles, M.D.: Southwest Florida Heart Group, Fort Myers John Miller, M.D.: Cardiology Section, Department of Medicine, Temple University School of Medicine and Temple University Hospital, Philadelphia, Pennsylvania Michael M. Mollerus, M.D.: Division of Cardiology, Department of Medicine, University of California San Diego School of Medicine Larry Nair, M.D.: Fellow in Cardiac Electrophysiology, Duke University Medical Center Sunil Nath, M.D.: Colorado Springs Cardiologists, Colorado Jeffrey Olgin, M.D.: Assistant Professor of Medicine, Krannert Institute of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis Feifan Ouyang, M.D.: St. Georg Hospital, Hamburg, Germany Franz X. Roithinger, M.D.: Universitaetsklinik Fuer Innere Medizin, Klinische Abteilung Fuer Kardiologie, Innsbruck, Austria Lawrence Rosenthal, M.D.: Assistant Professor of Medicine, Associate Director of the Electrophysiology Laboratory, University of Massachusetts Medical Center, Worcester Steven A. Rothman, M.D.: Associate, Cardiology Section, Department of Medicine, Temple University School of Medicine and Temple University Hospital, Philadelphia, Pennsylvania Michael Schluter, Ph.D.: St. Georg Hospital, Hamburg, Germany Dipen C. Shah: Centre Hospitalier Universitaire de Bordeaux, Hopital Cardiologie du Haut-Leveque, France Hossein Shenasa, M.D.: Department of Medicine, Division of Cardiology, Duke University Medical Center, Durham, North Carolina Jerold S. Shinbane, M.D.: Heart Place, Dallas, Texas Grant Simons, M.D.: Department of Medicine, Division of Cardiology, Duke University Medical Center, Durham, North Carolina William Stevenson, M.D.: Cardiology Department, Brigham and Women's Hospital, Boston, Massachusetts S. Adam Strickberger, M.D.: Division of Cardiology, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor John F. Swartz, M.D.: Cardiology of Tulsa, Inc., Oklahoma Ching-Tai Tai, M.D.: Associate Professor, Division of Cardiology, Department of Medicine, National Yang-Ming University, School of Medicine, and Veterans General Hospital, Taipei, Taiwan Yasuhiro Taniguchi, M.D.: International Fellow in Electrophysiology, Gunma University School of Medicine, Gunma, Japan Gregg W. Taylor, M.D.: University of Alabama at Birmingham, Alabama Patrick Tchou, M.D.: Head, Section of Cardiac Electrophysiology and Pacing, Department of Cardiology, Cleveland Clinic Foundation, Ohio George Van Hare, M.D.: Medical Director, Pediatric Arrhythmia Center, Pediatric Cardiology, Lucille Packard Children's Hospital, Stanford University, Palo Alto, California Ismail Vergara, M.D.: Department of Medicine, Division of Cardiology, Duke University Medical Center, Durham, North Carolina Alan B. Wagshal, M.D.: Department of Cardiology, Soroka Hospital, Beer-Sheva, Israel Edward P. Walsh, M.D.: Chief, Electrophysiology Division, Department of Cardiology, Children's Hospital, Boston, Massachusetts Paul J. Wang, M.D.: Associate Director, Cardiac Electrophysiology and Pacemaker Lab, Cardiac Arrhythmia Service, New England Medical Center, Boston, Massachusetts Ming-Shien Wen, M.D.: Associate Professor of Medicine, Chang Gung Medical College, Attending Cardiologist, Chang Gung Memorial Hospital, Taipei, Taiwan J. Marcus Wharton, M.D.: Department of Medicine, Division of Cardiology, Duke University Medical Center, Durham, North Carolina David Wilber, M.D.: Professor of Medicine, Director of Clinical Electrophysiology, University of Chicago, Illinois Mark A. Wood, M.D.: Associate Professor of Medicine, Division of Cardiology, Medical College of Virginia, Richmond Delon Wu, M.D., F.A.C.C.: Professor of Medicine and Chancellor, Chang Gung Medical College, Attending Cardiologist, Chang Gung Memorial Hospital, Taipei, Taiwan San-Jou Yeh, M.D.: Professor of Medicine, Chang Gung Medical College, Attending Cardiologist, Chang Gung Memorial Hospital, Taipei, Taiwan Adam Zivin, M.D.: Division of Cardiology, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor

Table of Contents

Dedication	iii
Foreword	iv
Preface	v
Contributors	vii
Part I: Fundamental Aspects of Radiofrequency Energy Applications
Historical Aspects of Radiofrequency Energy Applications	3	(10)
Shoei K. Stephen Huang
Jiunn-Lee Lin
Biophysics of Radiofrequency Ablation	13	(12)
James C. Lin
Pathophysiology of Lesion Formation by Radiofrequency Catheter Ablation	25	(22)
Sunil Nath
David Haines
Determinants of Radiofrequency-Induced Lesion Size	47	(34)
Boaz Avitall
Ray W. Helms
Pathological Observations of Radiofrequency Catheter Ablation of Cardiac Tissue	81	(22)
Saroja Bharati
Maurice Lev
Temperature Monitoring Versus Impedance Monitoring During Radiofrequency Catheter Ablation	103	(12)
Adam Zivin
S. Adam Strickberger
Part II: Radiofrequency Ablation of Atrial Tachycardia and Flutter
Ablation of Ectopic Atrial Tachycardia in Young Patients	115	(24)
Edward P. Walsh
Ablation of Atrial Tachycardia in Adults	139	(26)
Marcus Wharton
Hossein Shenasa
Helen Barold
Grant Simons
Ismael Vergara
Ablation of Inappropriate Sinus Tachycardia	165	(10)
Michael D. Lesh
Martin R. Karch
Jonathan Kalman
Franz X. Roithinger
Randall J. Lee
Jerold S. Shinbane
Ablation of Atrial Tachycardia within the Triangle of Koch	175	(10)
Ling-Ping Lai
Jiunn-Lee Lin
Shoei K. Stephen Huang
Ablation of Reentrant Atrial Tachycardia Associated with Structural Heart Disease	185	(24)
George Van Hare
Ablation of Typical Clockwise and Counterclockwise Flutter	209	(24)
Gregory K. Feld
Ulrika Birgersdottir-Green
Michael E. Mollerus
Ablation of Atypical Atrial Flutter	233	(24)
John G. Kall
David J. Wilber
Role of Anatomic Structures and Barriers in the Ablation of Atrial Tachycardia and Flutter	257	(24)
Jeffrey Olgin
Michael D. Lesh
Part III: Radiofrequency Catheter Ablation for Control of Atrial Fibrillation
Complete Atrioventricular Junction Ablation for Control of Symptomatic Drug-Resistant Atrial Fibrillation	281	(8)
Shoei K. Stephen Huang
Ling-Ping Lai
Jiunn-Lee Lin
Modification of Atrioventricular Conduction for Control of Symptomatic Drug-Resistant Atrial Fibrillation	289	(16)
Shih-Ann Chen
Shih-Huang Lee
Mau-Song Chang
Ablation of Paroxysmal Atrial Fibrillation: What and How to Target	305	(22)
Michele Hassaggierre
Pierre Jais
Dipen C. Shah
Thomas Lavergne
Meleze Hocini
S. Serge Barold
Jacques Clementy
Experimental Studies of Catheter-Based Linear Lesions for Ablation of Atrial Fibrillation	327	(40)
Boaz Avitall
Ray W. Helms
Gopal N. Gupta
New Catheter Technologies for Ablation of Atrial Fibrillation	367	(20)
J. Michael Mangrum
David Haines
Part IV: Radiofrequency Catheter Ablation of Atrioventricular Nodal Reentrant Tachycardia
Evolving Concepts of Atrioventricular Nodal Reentrant Tachycardia: Insights into the Anatomy and Physiology	387	(28)
Delon Wu
Yasuhiro Taniguchi
Ming-Shien Wen
Ablation of Atrioventricular Nodal Reentrant Tachycardia with the Anterior Approach: Is It Obsolete in the Year 2000?	415	(8)
Ling-Ping Lai
Jiunn-Lee Lin
Shoei K. Stephen Huang
Ablation of Atrioventricular Nodal Reentrant Tachycardia with the Posterior Approach	423	(42)
Gregg W. Taylor
G. Neal Kay
Part V: Radiofrequency Catheter Ablation of Accessory Pathways
Ablation of Right Free-Wall Accessory Pathways	465	(30)
William M. Miles
Ablation of Posteroseptal Accessory Pathways	495	(14)
Shin-Ann Chen
Chern-En Chiang
Ching-Tai Tai
Mau-Song Chang
Ablation of Left Free-Wall Accessory Pathways	509	(32)
Mark A. Wood
John F. Swartz
Ablation of Anteroseptal and Midseptal Accessory Pathways	541	(18)
Michael Schluter
Riccardo Cappato
Feifan Ouyang
Karl-Heinz Kuck
Ablation of Mahaim Fibers	559	(20)
John Miller
Steven A. Rothman
Henry H. Hsia
Alfred E. Buxton
Ablation of Multiple Accessory Pathways	579	(22)
Munther K. Homoud
N.A. Mark Estes III
Paul J. Wang
Part VI: Radiofrequency Catheter Ablation of Ventricular Tachycardia
Ablation of Idiopathic Left Ventricular Tachycardia	601	(20)
Delon Wu
Ming-Shien Wen
San-Jou Yeh
Ablation of Idiopathic Right Ventricular Tachycardia	621	(32)
David J. Wilber
Catheter Ablation of Bundle Branch Reentrant Ventricular Tachycardia	653	(16)
Ali A. Mehdirad
Patrick Tchou
Ablation of Ventricular Tachycardia Late After Myocardial Infarction: Techniques for Localizing Target Sites	669	(36)
William G. Stevenson
Dusan Kocovic
Peter L. Friedman
Ablation of Ventricular Tachycardia Associated with Nonischemic Structural Heart Disease	705	(32)
Robert F. Coyne
Frank Marchlinski
Part VII: Miscellaneous Topics
Complications Associated with Radiofrequency Catheter Ablation	737	(10)
Albert C. Lin
David J. Wilber
Cooled Radiofrequency Ablation	747	(14)
J. Marcus Wharton
Carlton Nibley
Larry Nau
Electroanatomic Imaging as a Guide for Catheter Ablation	761	(32)
David J. Wilber
Philip C. Cooke
John G. Kall
Radiation Exposure During Radiofrequency Catheter Ablation Procedures	793	(12)
Hugh G. Calkins
Lawrence Rosenthal
Mahadevappa Mahesh
Follow-Up Evaluation of Patients After Radiofrequency Catheter Ablation	805	(32)
Alan B. Wagshal
Shoei K. Stephen Huang
Future Perspective of Radiofrequency Catheter Ablation: New Electrode Designs and Mapping Techniques	837	(14)
Fernando Mera
Jonathan Langberg
Index	851	(18)
Color Plate	869