Electrophysiology of Arrhythmias : Practical Images for Diagnosis and Ablation.

Intro -- Preface -- 1. Bradycardias -- SINUS NODE FUNCTION -- SINUS NODE RECOVERY TIME -- SINO-ATRIAL CONDUCTION TIME -- INTRINSIC HEART RATE -- CAROTID SINUS MASSAGE -- AVN-HIS-PURKINJE AXIS -- AVN FUNCTION -- AVN REFRACTORY PERIODS -- WENCKEBACH CYCLE LENGTH -- HIS-PURKINJE FUNCTION -- PHYSIOLOGIC VERSUS PATHOLOGIC BLOCK -- ATROPINE OR ISOPROTERENOL -- PROCAINAMIDE -- LOCALIZING THE SITE OF AV BLOCK -- 12-LEAD ECG -- HIS BUNDLE RECORDINGS -- Intranodal Block -- Intrahisian Block -- Infrahisian Block -- UNUSUAL ELECTROPHYSIOLOGIC PHENOMENA -- PAROXYSMAL AV BLOCK -- BILATERAL BBB -- SUPERNORMALITY -- FATIGUE PHENOMENA -- INFRAHISIAN AV BLOCK DURING ATRIAL FIBRILLATION/FLUTTER -- PSEUDO AV BLOCK -- Nonpropagated His Bundle Extrasystoles -- Nodo-Fascicular/Ventricular Accessory Pathways -- Self-Perpetuating Cycle of Intranodal AV Block and Phase IV BBB -- REFERENCES -- 2. Mechanisms of Tachycardia -- MECHANISMS -- REENTRY -- Circuit -- Initiation -- Resetting and Entrainment -- Criteria of Transient Entrainment -- Termination -- ENHANCED AUTOMATICITY -- Initiation -- Resetting and Overdrive Suppression -- Termination -- TRIGGERED ACTIVITY -- Initiation -- Overdrive Acceleration -- Termination -- MAPPING -- ENTRAINMENT MAPPING -- First Criteria of Transient Entrainment versus Entrainment Mapping -- ACTIVATION MAPPING -- REFERENCES -- 3. Intracardiac Echocardiography -- TYPES OF ICE CATHETERS -- ICE VIEWS -- HOME VIEW -- LEFT ATRIUM -- RIGHT ATRIUM -- RIGHT VENTRICLE -- LEFT VENTRICLE -- ICE MONITORING -- REFERENCES -- 4. Transeptal Catheterization -- FOSSA OVALIS -- EMBRYOLOGY/ANATOMY -- TRANSEPTAL CATHETERIZATION -- EQUIPMENT -- AVOIDING CRITICAL STRUCTURES -- PULL-DOWN TECHNIQUE -- Pull-down -- Tenting -- The Puncture -- TD/TS Deployment -- PUNCTURE TYPES -- Double Transeptal Puncture -- Site-Selective Transeptal Puncture -- TROUBLESHOOTING.

FIRST PASS FAILURE -- DIFFERENT SEPTA -- REFERENCES -- 5. Narrow Complex Tachycardias -- ELECTROPHYSIOLOGIC FEATURES -- 12-LEAD ECG -- RP Interval -- P-Wave Morphology -- QRS Alternans -- NCT Rate -- ELECTROPHYSIOLOGIC STUDY -- VA Interval -- Atrial Activation Pattern -- AV Relationship -- Bundle Branch Block -- ZONES OF TRANSITION -- INITIATION -- Spontaneous -- Induced -- TERMINATION -- Spontaneous -- Induced -- PACING MANEUVERS FROM THE VENTRICLE (INVERSE RULE) -- DURING NSR (AV NODE VERSUS AP) -- Ventricular Extrastimulation (Retrograde RBBB) -- Differential RV Pacing -- Parahisian Pacing -- DURING NCT -- Diastolic VPDs -- Entrainment from the Ventricle -- PACING MANEUVERS FROM THE ATRIUM -- ΔAH VALUE -- VA LINKING (AT VERSUS AVNRT/ORT) -- AVNRT VERSUS JT -- VAGAL MANEUVERS -- UNUSUAL ELECTROPHYSIOLOGIC PHENOMENA -- NCT WITH AV DISSOCIATION -- DUAL ANTEGRADE RESPONSE TACHYCARDIA -- NARROW QRS VT -- REFERENCES -- 6. Long RP Tachycardias -- ELECTROPHYSIOLOGIC FEATURES -- PACING MANEUVERS -- His Refractory VPDs (Identifying Presence of a Decremental AP) -- Entrainment -- ABLATION -- SUMMARY -- UNUSUAL ELECTROPHYSIOLOGIC PHENOMENA -- CYCLE LENGTH ALTERNANS -- COUMEL'S LAW IN THE ATRIUM -- REFERENCES -- 7. Atrio-ventricular Nodal Reentrant Tachycardia -- DUAL AV NODE PHYSIOLOGY -- ECG MANIFESTATIONS OF DUAL AV NODE PHYSIOLOGY -- Dual Antegrade Response versus His Bundle Extrasystole -- ELECTROPHYSIOLOGIC STUDY -- ATRIO-VENTRICULAR NODAL REENTRANT TACHYCARDIA CIRCUIT -- ELECTROPHYSIOLOGIC FEATURES OF AVNRT -- 12-LEAD ECG -- ELECTROPHYSIOLOGIC STUDY -- AV Relationship -- Bundle Branch Block -- ZONES OF TRANSITION -- INITIATION -- TERMINATION -- PACING MANEUVERS FROM THE VENTRICLE -- DIASTOLIC VPDs -- Preexcitation Index -- HIS Refractory VPD ("V on H" Maneuver) -- ENTRAINMENT FROM THE VENTRICLE -- "AV" Response -- Post-pacing Interval (PPI) -- ΔHA Value.

ΔVA Value -- ONSET OF VENTRICULAR OVERDRIVE PACING -- PACING MANEUVERS FROM THE ATRIUM -- AVNRT VERSUS AT (VA LINKING) -- AVNRT VERSUS JT -- Atrial Overdrive Pacing -- Diastolic APDs -- UNUSUAL ELECTROPHYSIOLOGIC PHENOMENA -- CYCLE LENGTH ALTERNANS -- DUAL TACHYCARDIAS -- CTI/SVC BLOCK -- REFERENCES -- 8. Ablation of Atrio-ventricular Nodal Reentrant Tachycardia -- ANATOMY OF THE AV NODE -- ABLATION OF THE SLOW PATHWAY (RIGHT INFERIOR EXTENSION) -- SINUS RHYTHM MAPPING OF THE SLOW PATHWAY -- RETROGRADE MAPPING OF THE SLOW PATHWAY -- LEFT-SIDED ABLATION -- MONITORING DURING RF DELIVERY -- PROCEDURAL ENDPOINTS -- REFERENCES -- 9. Basic Evaluation of Accessory Pathways -- HALLMARKS OF MANIFEST PREEXCITATION -- 12-LEAD ECG -- ELECTROPHYSIOLOGIC STUDY -- AP LOCALIZATION -- 12-LEAD ECG -- Delta-Wave Axis -- P-Wave Axis -- ELECTROPHYSIOLOGIC STUDY -- Earliest Site of Ventricular Activation -- Earliest Site of Atrial Activation -- Accessory Pathway Potentials -- ELECTROPHYSIOLOGIC PROPERTIES OF THE AP -- ANTEGRADE AP ERP -- ANTEGRADE 1:1 CYCLE LENGTH -- RETROGRADE AP ERP -- RETROGRADE 1:1 CYCLE LENGTH -- RISK OF SUDDEN DEATH -- UNUSUAL ELECTROPHYSIOLOGIC PHENOMENA -- PHASE 4 BLOCK -- FATIGUE -- AUTOMATICITY -- SUPERNORMALITY -- LONGITUDINAL DISSOCIATION -- AV BLOCK -- REFERENCES -- 10. Orthodromic Reciprocating Tachycardia -- MECHANISM -- ELECTROPHYSIOLOGIC FEATURES -- 12-LEAD ECG -- ELECTROPHYSIOLOGIC STUDY -- AV Relationship -- Bundle Branch Block -- ZONES OF TRANSITION -- INITIATION -- Atrial Stimulation -- Ventricular Stimulation -- Bundle Branch Reentrant Beats ("V3 Response") -- TERMINATION -- Spontaneous -- Induced -- His Refractory VPD -- PACING MANEUVERS FROM THE VENTRICLE -- DIASTOLIC VPDs -- Preexcitation Index -- His Refractory VPD ("V on H" Maneuver) -- ENTRAINMENT FROM THE VENTRICLE -- Orthodromic Capture of the His Bundle -- "AV" Response.

Post-pacing Interval -- ΔHA Value -- ΔVA Value -- ONSET OF VENTRICULAR OVERDRIVE PACING -- PACING MANEUVERS FROM THE ATRIUM -- ORT VERSUS AT (VA LINKING) -- UNUSUAL ELECTROPHYSIOLOGIC PHENOMENA -- CYCLE LENGTH ALTERNANS -- QRS ALTERNANS -- CTI/MITRAL ISTHMUS/SVC BLOCK -- REFERENCES -- 11. Unusual Types of Accessory Pathways -- MULTIPLE APs -- 12-LEAD ECG -- ELECTROPHYSIOLOGIC STUDY -- PERMANENT FORM OF JUNCTIONAL RECIPROCATING TACHYCARDIA -- ELECTROPHYSIOLOGIC FEATURES -- 12-lead ECG -- Electrophysiologic Study -- ZONES OF TRANSITION -- Initiation -- Termination -- PACING MANEUVERS FROM THE VENTRICLE -- His Refractory VPD -- Entrainment from the Ventricle -- Onset of Ventricular Overdrive Pacing -- ACCESSORY PATHWAYS ORIGINATING/INSERTING INTO THE AV NODE-HIS-PURKINJE SYSTEM -- NODO-FASCICULAR/NODO-VENTRICULAR AP -- Electrophysiologic Features -- AV Block -- Orthodromic NFRT -- Antidromic NFRT -- AVNRT with Manifest/Concealed Bystander NF AP -- ATRIO-FASCICULAR AP (OR LONG ATRIO-VENTRICULAR AP) -- Electrophysiologic Features -- Antidromic AFRT -- FASCICULO-VENTRICULAR AP -- Electrophysiologic Features -- UNUSUAL ELECTROPHYSIOLOGIC PHENOMENA -- DOUBLE TACHYCARDIA (ORT AND AVNRT) -- REFERENCES -- 12. Ablation of Accessory Pathways -- CLASSIC ATRIO-VENTRICULAR ACCESSORY PATHWAYS (BUNDLE OF KENT) -- MAPPING -- Antegrade -- Retrograde -- ABLATION -- SPECIFIC LOCATIONS -- Right versus Left versus CS Posteroseptal -- Parahisian versus NCC -- ATYPICAL ACCESSORY PATHWAYS -- PERMANENT FORM OF JUNCTIONAL RECIPROCATING TACHYCARDIA -- MAHAIM FIBERS -- REFERENCES -- 13. Atrial Tachycardia -- 12-LEAD ECG -- SPECIFIC P-WAVE MORPHOLOGIES -- Sinus-Like Morphology -- Atypical AVNRT-Like Morphology -- Biphasic (Negative-Positive) Morphology -- Concordance -- ELECTROPHYSIOLOGIC FEATURES -- AV RELATIONSHIP -- BUNDLE BRANCH BLOCK -- ZONES OF TRANSITION.

PACING MANEUVERS FROM THE VENTRICLE ("AAV" RESPONSE) -- PACING MANEUVERS FROM THE ATRIUM (ABSENCE OF VA LINKING) -- MAPPING AND ABLATION -- FOCAL ATRIAL TACHYCARDIA -- Activation Mapping -- Pacemapping -- Atrial Overdrive Pacing -- MACROREENTRANT ATRIAL TACHYCARDIA -- Pacemapping -- Entrainment Mapping -- Nonpropagated Extrastimulus -- UNUSUAL ELECTROPHYSIOLOGIC PHENOMENA -- REFERENCES -- 14. Atrial Flutter -- ANATOMY OF THE CAVO-TRICUSPID ISTHMUS -- CTI-DEPENDENT ATRIAL FLUTTER -- CIRCUIT -- ELECTROPHYSIOLOGIC FEATURES -- 12-Lead ECG -- Electrophysiologic Study -- CTI DEPENDENCY -- MAPPING AND ABLATION OF THE CTI -- MAPPING -- During Atrial Flutter -- During NSR -- GAP MAPPING -- DIFFICULT CTI ABLATION -- PROCEDURAL ENDPOINTS -- WIDELY SPACED DOUBLE POTENTIALS -- ATRIAL ACTIVATION/ELECTROGRAM POLARITY REVERSAL -- POSITIVE TERMINAL P-WAVE FORCES -- DIFFERENTIAL ATRIAL PACING -- UNUSUAL ELECTROPHYSIOLOGIC PHENOMENA -- DOUBLE WAVE REENTRY -- LOWER LOOP REENTRY -- INTRA-ISTHMUS REENTRY -- TRANSPLANT FLUTTER -- LONGITUDINAL DISSOCIATION OF THE CTI -- UNUSUAL ATRIO-VENTRICULAR CONDUCTION RATIOS -- 1:1 AV Conduction -- Alternating Wenckebach -- REFERENCES -- 15. Atrial Fibrillation -- PATHOPHYSIOLOGY -- FOCAL TRIGGERS -- ARRHYTHMOGENIC SUBSTRATE -- MODULATING FACTORS -- ATRIAL FIBRILLATION ABLATION -- FOCAL TRIGGERS -- Radiofrequency Ablation -- Cryoablation -- SUBSTRATE MODIFICATION -- Electrogram-Based Ablation -- Linear Lesions -- Mechanistic-Based Ablation -- MODULATING FACTORS -- Vagal Denervation -- TAILORED APPROACH -- ENDPOINTS -- POST-ABLATION LEFT ATRIAL FLUTTER/TACHYCARDIA -- REFERENCES -- 16. Sinus Node and Atrio-ventricular Junction Modification/Ablation -- SINO-ATRIAL NODE AND AV NODE-HIS BUNDLE AXIS -- SINO-ATRIAL NODE MODIFICATION -- ATRIO-VENTRICULAR JUNCTION MODIFICATION/ABLATION -- RIGHT-SIDED APPROACH -- Direct Compact AV Node Ablation.

Electrical Isolation of the AV Node.

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