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 |
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iii | |
Foreword |
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iv | |
Preface |
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v | |
Contributors |
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vii | |
Part I: Fundamental Aspects of Radiofrequency Energy Applications |
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Historical Aspects of Radiofrequency Energy Applications |
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3 | (10) |
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Biophysics of Radiofrequency Ablation |
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13 | (12) |
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Pathophysiology of Lesion Formation by Radiofrequency Catheter Ablation |
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25 | (22) |
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Determinants of Radiofrequency-Induced Lesion Size |
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47 | (34) |
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Pathological Observations of Radiofrequency Catheter Ablation of Cardiac Tissue |
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81 | (22) |
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Temperature Monitoring Versus Impedance Monitoring During Radiofrequency Catheter Ablation |
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103 | (12) |
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Part II: Radiofrequency Ablation of Atrial Tachycardia and Flutter |
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Ablation of Ectopic Atrial Tachycardia in Young Patients |
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115 | (24) |
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Ablation of Atrial Tachycardia in Adults |
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139 | (26) |
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Ablation of Inappropriate Sinus Tachycardia |
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165 | (10) |
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Ablation of Atrial Tachycardia within the Triangle of Koch |
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175 | (10) |
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Ablation of Reentrant Atrial Tachycardia Associated with Structural Heart Disease |
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185 | (24) |
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Ablation of Typical Clockwise and Counterclockwise Flutter |
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209 | (24) |
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Ulrika Birgersdottir-Green |
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Ablation of Atypical Atrial Flutter |
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233 | (24) |
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Role of Anatomic Structures and Barriers in the Ablation of Atrial Tachycardia and Flutter |
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257 | (24) |
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Part III: Radiofrequency Catheter Ablation for Control of Atrial Fibrillation |
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Complete Atrioventricular Junction Ablation for Control of Symptomatic Drug-Resistant Atrial Fibrillation |
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281 | (8) |
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Modification of Atrioventricular Conduction for Control of Symptomatic Drug-Resistant Atrial Fibrillation |
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289 | (16) |
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Ablation of Paroxysmal Atrial Fibrillation: What and How to Target |
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305 | (22) |
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Experimental Studies of Catheter-Based Linear Lesions for Ablation of Atrial Fibrillation |
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327 | (40) |
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New Catheter Technologies for Ablation of Atrial Fibrillation |
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367 | (20) |
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Part IV: Radiofrequency Catheter Ablation of Atrioventricular Nodal Reentrant Tachycardia |
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Evolving Concepts of Atrioventricular Nodal Reentrant Tachycardia: Insights into the Anatomy and Physiology |
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387 | (28) |
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Ablation of Atrioventricular Nodal Reentrant Tachycardia with the Anterior Approach: Is It Obsolete in the Year 2000? |
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415 | (8) |
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Ablation of Atrioventricular Nodal Reentrant Tachycardia with the Posterior Approach |
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423 | (42) |
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Part V: Radiofrequency Catheter Ablation of Accessory Pathways |
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Ablation of Right Free-Wall Accessory Pathways |
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465 | (30) |
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Ablation of Posteroseptal Accessory Pathways |
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495 | (14) |
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Ablation of Left Free-Wall Accessory Pathways |
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509 | (32) |
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Ablation of Anteroseptal and Midseptal Accessory Pathways |
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541 | (18) |
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Ablation of Mahaim Fibers |
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559 | (20) |
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Ablation of Multiple Accessory Pathways |
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579 | (22) |
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Part VI: Radiofrequency Catheter Ablation of Ventricular Tachycardia |
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Ablation of Idiopathic Left Ventricular Tachycardia |
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601 | (20) |
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Ablation of Idiopathic Right Ventricular Tachycardia |
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621 | (32) |
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Catheter Ablation of Bundle Branch Reentrant Ventricular Tachycardia |
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653 | (16) |
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Ablation of Ventricular Tachycardia Late After Myocardial Infarction: Techniques for Localizing Target Sites |
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669 | (36) |
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Ablation of Ventricular Tachycardia Associated with Nonischemic Structural Heart Disease |
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705 | (32) |
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Part VII: Miscellaneous Topics |
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Complications Associated with Radiofrequency Catheter Ablation |
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737 | (10) |
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Cooled Radiofrequency Ablation |
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747 | (14) |
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Electroanatomic Imaging as a Guide for Catheter Ablation |
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761 | (32) |
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Radiation Exposure During Radiofrequency Catheter Ablation Procedures |
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793 | (12) |
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Follow-Up Evaluation of Patients After Radiofrequency Catheter Ablation |
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805 | (32) |
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Future Perspective of Radiofrequency Catheter Ablation: New Electrode Designs and Mapping Techniques |
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837 | (14) |
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Index |
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851 | (18) |
Color Plate |
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869 | |