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

By Jason G. Andrade et al.

The scientific Cardiac Electrophysiology guide is a succinct presentation of all of the useful info that's had to comprehend the subtleties of cardiac electrophysiology and the administration of arrhythmias.

a spotlight at the easy methods to know about the techniques used to spot, diagnose, and deal with a wide variety of cardiac rhythm disorders.

...with an realizing of the why toughen the underlying basic and medical technology strategies forming the basisfor medical electrophysiology decision-making.

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Presence of echo beats confirms tachycardia substrate. • Must be differentiated from intra-atrial reentry. ‡‡ True nodal echoes have midline caudo-cranial activation (His before HRA). ‡‡ VA timing of echoes should be consistent over many coupling intervals. „„ AV Nodal Echo Beat Using a stable drive train (S1), an extrastimulus (S2) is introduced and conducts anterogradely down the slow pathway and then back up the fast pathway. In this example, the impulse conducts back down the slow pathway, resulting in an echo beat before blocking retrogradely in the fast pathway.

1 mV is likely scar As the approach is less well validated, the map should include electrically silent areas, double potentials, and fractionation in order to delineate potential reentry circuits. indb 23 01-02-2016 AM 10:11:31 24 Chapter 1: Fundamentals Non-contact Substrate Mapping {{ Dynamic substrate mapping (DSM) algorithm: Uses a percentage of the peak negative chamber voltage Absolute cut-offs are not used because MEA reconstructed voltages can be affected by differences in chamber size and mass.

With an extrastimulus, there is block in the AP, resulting in anterograde conduction exclusively across the AVN. This impulse conducts down to the ventricle and returns to the atria via the now-recovered AP to complete the circuit (earliest A on the proximal CS). Programmed Ventricular Stimulation Background {{ Sudden cardiac death is most commonly due to ventricular arrhythmias (VT, VF). , previous MI). „„ Less common mechanisms include triggered activity and automaticity. Ventricular stimulation is indicated: „„ For evaluation of unexplained syncope in patients at risk of SCD „„ To study and characterize the VT in order to aid in ablation „„ {{ Principles {{ The technique employs increasingly aggressive programmed stimulation using multiple extrastimuli.

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