Cardiology

The Clinical Cardiac Electrophysiology Handbook by Jason G. Andrade et al.

By Jason G. Andrade et al.

The medical Cardiac Electrophysiology instruction manual is a succinct presentation of the entire useful info that's had to comprehend the subtleties of cardiac electrophysiology and the administration of arrhythmias.

a spotlight at the tips on how to find out about the methods used to spot, diagnose, and deal with a wide diversity of cardiac rhythm disorders.

...with an knowing of the why make stronger the underlying primary and medical technology options forming the basisfor scientific electrophysiology decision-making.

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Extra resources for The Clinical Cardiac Electrophysiology Handbook

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Finally, the dilator and needle are gently withdrawn. • The transseptal sheath is then aspirated via the side arm (to ensure no air bubbles) and then connected to a continuously flushing pressure line. Dealing with the difficult transseptal „„ Anterior fossa • A fossa located closer to 3 o’clock rather than 4–5 o’clock confers a higher risk of aortic perforation. • Access may be safely facilitated by echocardiographic guidance. , from previous transseptal previous punctures). • Access may be facilitated by RF or two-part Endrys needle.

Score of <12% has 93% sensitivity and 75% specificity for successful ablation site. • Score of >12%–15% has 100% negative predictive value for successful ablation site, suggesting there is no utility to ablating at this location. Stim-QRS during pace mapping „„ Pacing in normal myocardium is associated with a Stim-QRS of <20–40 ms. • A Stim-QRS >40 ms is associated with a zone of slow conduction or a protected isthmus. „„ Stim-QRS can be used to map a protected isthmus in sinus rhythm and within ongoing VT.

Incremental Ventricular Pacing {{ Assess The presence (or absence) of retrograde atrial activation „„ The retrograde atrial activation sequence (concentric vs. eccentric) „„ The retrograde (VA) conduction time „„ The retrograde VA WCL • WCL is defined as CL where 1:1 retrograde conduction ceases. indb 43 01-02-2016 AM 10:11:36 44 Chapter 2: Electrophysiology Study and Maneuvers Decremental VA conduction • V2A2 > V1A1 with progressive increase in V2A2 with decreasing V1V2 Abnormal results include: „„ Eccentric atrial activation (right and left free wall APs) „„ Non-decremental VA conduction „„ VA jump due to: • Dual AVN physiology with a jump from the retrograde fast pathway to the slow pathway • Septal AP with a jump from AP to AVN conduction (AVNERP < APERP) Ventricular extra beats post-extrastimulus due to: „„ Bundle branch reentry • Retrograde right bundle branch block (RBBB) allows S2 to cross the septum and conduct retrograde via the left bundle and then anterograde down the right bundle, which has recovered conduction.

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