Josephson's Clinical Cardiac Electrophysiology

Author: Mark Josephson, MD
Publisher: Lippincott Williams & Wilkins
Publication Date: 2016
ISBN 10: 1451187416
ISBN 13: 9781451187410
eISBN: 9781496326614
Edition: 5th


Turn to this updated, classic text for a thorough understanding of the mechanisms of cardiac arrhythmias and the therapeutic interventions used to treat them. Josephson's Clinical Cardiac Electrophysiology, 5th Edition delivers Dr. Mark Josephson's unparalleled guidance on the electrophysiologic methodology required to define the mechanism and site of origin of arrhythmias - enabling you to choose the safest and most effective therapy for each patient. Features:* Get comprehensive coverage of mechanisms, clinical implications, and limitations of current therapeutic interventions, including drugs, and catheter and surgical ablation.* Gain a better visual understanding thanks to more than 1,100 illustrations (over 100 are new!), an increased number of 3-D color anatomical mapping images, ECG examples, photographs of equipment, and procedural diagrams.* Stay up to date with information on new technologies of ablation and pitfalls of interpreting data; innovative new catheters; new drug information; and new tables summarizing SVT and VT criteria.* Benefit from Dr. Josephson's decades of experience as "the father of clinical cardiac electrophysiology," and learn from his proven approaches and methods in this challenging area.Now with the print edition, enjoy the bundled interactive eBook edition, offering tablet, smartphone, or online access to:* Complete content with enhanced navigation.* Powerful search tools and smart navigation cross-links that pull results from content in the book, your notes, and even the web.* Cross-linked pages, references, and more for easy navigation.* Highlighting tool for easier reference of key content throughout the text.* Ability to take and share notes with friends and colleagues.* Quick reference tabbing to save your favorite content for future use.

Table of Contents

Front Matter

  • Foreword: Historical Perspectives
  • Preface
  • Acknowledgments

CHAPTER 1: Electrophysiologic Investigation: Technical Aspects

  • Personnel
  • Equipment
  • Cardiac Catheterization Technique
  • Risks and Complications
  • Artifacts
  • References

CHAPTER 2: Electrophysiologic Investigation: General Concepts

  • Introduction
  • Electrogram Recordings
  • Measurement of Conduction Intervals
  • Description of Electrograms
  • Programmed Stimulation
  • References

CHAPTER 3: Sinus Node Function

  • Introduction
  • Electrocardiographic Features of Sinus Node Dysfunction
  • Electrocardiographic Monitoring of Patients Suspected of Having Sinus Node Dysfunction
  • Assessment of Autonomic Tone
  • Electrophysiologic Evaluation of Sinus Node Function
  • Effect of Drugs on Sinus Node Recovery Time and Sinoatrial Conduction Time
  • Vagal Hypersensitivity (Neurocirculatory) Syndromes
  • Therapeutic Implications
  • References

CHAPTER 4: Atrioventricular Conduction

  • Introduction
  • Atrium
  • Atrioventricular Node
  • His Bundle
  • Infra-His Conduction System
  • Paroxysmal A-V Block
  • Value of Intracardiac Studies in the Evaluation of A-V Conduction Disturbances
  • Suppression of A-V Conduction by Ventricular Stimulation
  • Therapeutic Considerations
  • References

CHAPTER 5: Intraventricular Conduction Disturbances

  • Introduction
  • Definitions
  • Site of “Block” or Conduction Delay During Bundle Branch Block
  • Clinical Relevance of Intraventricular Conduction Disturbances
  • Therapeutic Implications
  • References

CHAPTER 6: Miscellaneous Phenomena Related to Atrioventricular Conduction

  • Introduction
  • Concealed Conduction
  • Gap Phenomenon
  • Supernormality
  • References

CHAPTER 7: Ectopic Rhythms and Premature Depolarizations

  • Introduction
  • Atrial Depolarizations
  • Junctional (His Bundle or A-V Nodal) Depolarizations
  • Fascicular Depolarizations
  • Ventricular Depolarizations
  • References

CHAPTER 8: Supraventricular Tachycardias

  • Introduction
  • Mechanisms of Supraventricular Tachycardia
  • Methods of Evaluation
  • Supraventricular Tachycardia Resulting from Atrioventricular Nodal Reentry
  • Supraventricular Tachycardia Resulting from Concealed Atrioventricular Bypass Tracts
  • Supraventricular Tachycardia Resulting from Intra-Atrial or Sinus Node Reentry
  • Automatic Atrial Tachycardia
  • Atrial Tachycardia Due to Triggered Activity
  • Distinguishing Atrial Tachycardia from AVNRT And AVRT
  • Multiple SVT Mechanisms in Individual Patients
  • Overview
  • References

CHAPTER 9: Atrial Flutter and Fibrillation

  • Introduction
  • Electrophysiologic and Anatomic Substrates of Macroreentrant Atrial Tachycardia (Typical and Atypical Atrial Flutter) and Fibrillation
  • Atrial Flutter
  • Atrial Fibrillation
  • Summary
  • References

CHAPTER 10: Preexcitation Syndromes

  • Introduction
  • Atrioventricular Bypass Tracts
  • Electrophysiologic Properties of A-V Bypass Tracts
  • Electrophysiologic Evaluation in Patients with Wolff–Parkinson–White Syndrome
  • Mode of Initiation of Tachycardias
  • Orthodromic Tachycardia
  • Preexcited Tachycardias
  • Atrial Fibrillation
  • Localization of The Bypass Tract
  • Relation of Local Ventricular Electrograms to Delta Wave
  • Pacing from Multiple Atrial Sites
  • Retrograde Atrial Activation
  • Effect of Bundle Branch Block During Orthodromic Tachycardia
  • Direct Recording of Bypass Tract Potentials
  • Role of The Bypass Tract in Genesis of Arrhythmias
  • Determination of The Antegrade Refractory Period of The Bypass Tract
  • Intermittent Preexcitation
  • Effect of Antiarrhythmic Agents on Preexcitation
  • Exercise Testing in Wolff–Parkinson–White Syndrome
  • Determination of The Antegrade Refractory Period of The Bypass Tract by Programmed Stimulation
  • Termination of Orthodromic Tachycardia
  • Atrioventricular Nodal “Bypass Tracts”—The Lown–Ganong–Levine Syndrome
  • Accessory Pathways with Anterograde Decremental Conduction and Fasciculoventricular Pathways
  • References

CHAPTER 11: Recurrent Ventricular Tachycardia

  • Introduction
  • Definitions of Ventricular Tachycardias
  • Diagnosis of Ventricular Tachycardia
  • Pathophysiologic Substrate for Ventricular Tachyarrhythmias
  • Mechanisms of Ventricular Tachycardia
  • Effect of Drugs on Ventricular Tachycardia
  • Localization of The Site of Origin of Ventricular Tachycardia
  • Ventricular Stimulation in Miscellaneous Disorders
  • References

CHAPTER 12: Evaluation of Antiarrhythmic Agents

  • Introduction
  • Classification of Antiarrhythmic Agents
  • Evaluation of Electrophysiologic Effects of Drugs in Humans
  • Selection of Antiarrhythmic Drug Therapy for Reentrant Tachycardias
  • References

CHAPTER 13: Catheter and Surgical Ablation in the Therapy of Arrhythmias

  • Introduction
  • Biophysics of Current Ablation Techniques
  • Control of Supraventricular Arrhythmias by Ablative Techniques
  • Control of Ventricular Arrhythmias by Ablative Techniques
  • Conclusion
  • References