Clinical Cardiac Pacing, Defibrillation and Resynchronization Therapy 4th Edition: Expert Consult Premium Edition - Enhanced Online Features and Print

1085 Pages·2011·161.93 MB·English

by  Kenneth A. Ellenbogen MD

Clinical Cardiac Pacing,
Defibrillation, and
Resynchronization Therapy
f o u r t h e d i t i o n
KENNETH A. ELLENBOGEN, MD
Kontos Professor of Medicine
Chairman, Division of Cardiology
Director, Clinical Electrophysiology Laboratory
Medical College of Virginia
Richmond, Virginia
G. NEAL KAY, MD
Professor, Department of Medicine
Director, Clinical Electrophysiology Section
The University of Alabama at Birmingham
Birmingham, Alabama
CHU-PAK LAU, MD
Director, Cardiac Health Heart Centre
Honorary Clinical Professor
Department of Medicine
University of Hong Kong
Queen Mary Hospital
Hong Kong, China
BRUCE L. WILKOFF, MD
Director, Cardiac Pacing and Tachyarrhythmia Devices
Robert and Suzanne Tomsich Department of Cardiovascular Medicine
Institute Medical Information Officer
Sydell and Arnold Miller Family Heart and Vascular Institute
Professor of Medicine
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University
Cleveland, Ohio
1600 John F. Kennedy Blvd.
Ste 1800
Philadelphia, PA 19103-2899
CLINICAL CARDIAC PACING, DEFIBRILLATION, AND 978-1-4377-1616-0
RESYNCHRONIZTION THERAPY
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Notices
Knowledge and best practice in this field are constantly changing. As new research and experience broaden
our understanding, changes in research methods, professional practices, or medical treatment may become
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Practitioners and researchers must always rely on their own experience and knowledge in evaluating and
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Library of Congress Cataloging-in-Publication Data
Clinical cardiac pacing, defibrillation, and resynchronization therapy / [edited by] Kenneth
A. Ellenbogen … [et al.].—4th ed.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-4377-1616-0 (hardcover : alk. paper) 1. Cardiac pacing. 2. Defibrillators.
I. Ellenbogen, Kenneth A.
[DNLM: 1. Cardiac Pacing, Artificial. 2. Cardiac Resynchronization Therapy. 3. Defibrillators,
Implantable. 4. Pacemaker, Artificial. WG 168]
RC684.P3C54 2011
617.4′120645—dc23
2011026279
Executive Publisher: Natasha Andjelkovic
Developmental Editor: Janice M. Gaillard
Publishing Services Manager: Patricia Tannian
Project Manager: Sarah Wunderly
Design Direction: Ellen Zanolle
Working together to grow
libraries in developing countries
Printed in United States of America www.elsevier.com | www.bookaid.org | www.sabre.org
Last digit is the print number: 9 8 7 6 5 4 3 2 1
To my wife and family,
Phyllis, Michael, Amy, and Bethany,
for their patience, support, and love.
To my parents, Roslyn and Leon,
who instilled in me a thirst for learning.
To my students, teachers, and colleagues,
who make each day an absolute delight.
KAE
To my teachers, colleagues, and students,
who have taught me about cardiac pacing.
I am also indebted to the many members of the industry
who have dedicated their professional careers
to the design and improvement of pacing technology.
These individuals have greatly improved
the therapy that clinicians can offer to their patients,
undoubtedly resulting in an improvement in their lives.
Perhaps most important, this book is dedicated
to my wife, Linda, for her patience
and understanding during its preparation.
GNK
To my wife and family, Carven, Yuk-Fai, and Yuk-Ming,
for their understanding, support, and love.
To my teachers, patients, and colleagues, who are my
source of inspiration and encouragement.
CPL
To my wife, Ellyn, children Jacob and Margaret,
Benjamin and Kara, Ephram and Kay
for their godly and inspirational patience and support.
To my grandchildren, Isabelle and Tobias,
for life, hope, and love.
To my parents, Harvey and Glenna,
for their unconditional love and insights.
To Yeshua, the Messiah, for His salvation,
and His sustaining covenant love.
And for the inspiration of His words in Proverbs 15:2:
“The tongue of the wise makes knowledge acceptable.”
May the words of this book prove to be wise and useful
to the student of cardiac pacing, defibrillation,
and heart failure device therapy.
BLW
CONTRIBUTORS
Amin Al-Ahmad, MD Mina K. Chung, MD
Assistant Professor Associate Professor of Medicine
Department of Cardiovascular Medicine Cleveland Clinic Lerner College of Medicine of Case Western Reserve
Stanford University School of Medicine University
Director, Cardiac Electrophysiology Laboratory Cleveland, Ohio
Stanford University Medical Center Imaging of Implantable Devices
Stanford, California
Timing Cycles of Implantable Devices Joshua M. Cooper, MD
Assistant Professor of Medicine
Angelo Auricchio, MD, PhD University of Pennsylvania
Professor of Cardiology Attending Cardiac Electrophysiologist
University of Magdeburg Hospital of the University of Pennsylvania
Magdeburg, Germany Philadelphia, Pennsylvania
Director, Clinical Electrophysiology Unit Engineering and Construction of Pacemaker and ICD Leads
Fondazione Cardiocentro Ticino
Lugano, Switzerland Ann M. Crespi, PhD
Basic Physiology and Hemodynamics of Cardiac Pacing Senior Principal Scientist
Department of Battery Research
Bryan Baranowski, MD Medtronic, Inc.
Associate Staff Minneapolis, Minnesota
Section of Cardiac Pacing and Electrophysiology Power Systems for Implantable Pacemakers, Cardioverters, and
Heart and Vascular Institute Defibrillators
Cleveland Clinic
Cleveland, Ohio George H. Crossley III, MD
Imaging of Implantable Devices Clinical Professor of Medicine
University of Tennessee College of Medicine
Gust Bardy, MD Chief, Cardiac Services
Clinical Professor of Medicine Baptist Hospital
University of Washington Nashville, Tennessee
Director, Seattle Institute for Cardiac Research Pacemaker, Defibrillator, and Lead Codes, and Headers
Seattle, Washington
Subcutaneous Implantable Cardioverter-Defibrillators J. Kevin Donahue, MD
Associate Professor
Peter H. Belott, MD, FACC, FHRS Department of Medicine, Biomedical Engineering, Physiology &
Director of Electrophysiology Biophysics
Sharp Grossmont Hospital Case Western Reserve University
La Mesa, California Clinical Cardiac Electrophysiologist
Permanent Pacemaker and Implantable Cardioverter-Defibrillator The MetroHealth System
Implantation Cleveland, Ohio
The Biologic Pacemaker
Janneke Berecki-Gisolf, MD, PhD
Senior Research Fellow Derek J. Dosdall, PhD
Monash University Accident Research Centre Assistant Professor
Melbourne, Victoria, Australia Department of Internal Medicine
Pacing in Neurally Mediated Syncope Syndromes Division of Cardiology
University of Utah School of Medicine
Paola Berne, MD Adjunct Assistant Professor
Senior Fellow Department of Bioengineering
Department of Cardiology University of Utah
Electrophysiology Section Adjunct Assistant Professor
Thorax Institute Department of Animal, Dairy, and Veterinary Sciences
Hospital Clínic de Barcelona Utah State University
Barcelona, Spain Salt Lake City, Utah
ICD Therapy in Channelopathies Cardiac Electrical Stimulation
Josep Brugada, MD, PhD, FESC Kenneth A. Ellenbogen, MD
Professor of Medicine Kontos Professor of Medicine
Barcelona University Chairman, Division of Cardiology
Medical Director, Hospital Clínic de Barcelona Director, Clinical Electrophysiology Laboratory
Barcelona, Spain Medical College of Virginia
ICD Therapy in Channelopathies Richmond, Virginia
Pacing for Atrioventricular Conduction System Disease; Interventional
Techniques for Device Implantation
vii
viii Contributors
Andrew E. Epstein, MD, FAHA, FACC, FHRS Margaret Hood, MBChB
Professor of Medicine Cardiologist
University of Pennsylvania Auckland City Hospital
Chief, Cardiology Section Auckland, New Zealand
Philadelphia VA Medical Center Subcutaneous Implantable Cardioverter-Defibrillators
Philadelphia, Pennsylvania
Troubleshooting of Implantable Cardioverter-Defibrillators Henry H. Hsia, MD
Associate Professor of Medicine
Laurence M. Epstein, MD Stanford University School of Medicine
Associate Professor of Medicine Associate Director, Electrophysiology Laboratory
Harvard Medical School Stanford University Medical Center
Chief, Arrhythmia Service Stanford, California
Director, Electrophysiology and Pacing Laboratory Timing Cycles of Implantable Devices
Brigham and Women’s Hospital
Boston, Massachusetts Raymond E. Ideker, MD, PhD
Engineering and Construction of Pacemaker and ICD Leads Jeanne V. Marks Professor of Medicine
Professor
Derek V. Exner, MD, MPH, FRCPC, FACC, FHRS Departments of Biomedical Engineering and Physiology
Professor University of Alabama at Birmingham
University of Calgary Birmingham, Alabama
Canada Research Chair, Cardiovascular Clinical Trials Principles of Defibrillation: From Cellular Physiology to Fields and
Medical Director, Arrhythmia Program Waveforms
Libin Cardiovascular Institute of Alberta
Calgary, Alberta, Canada Carsten W. Israel, MD
Clinical Trials of Defibrillator Therapy Associate Professor of Medicine and Cardiology
Department of Cardiology
Jeffrey M. Gillberg, MSEE Division of Electrophysiology
Research Director J. W. Goethe University
Bakken Fellow Frankfurt, Germany
Medtronic, Inc. Chief of Cardiology
Minneapolis, Minnesota Evangelical Hospital Bielefeld
Sensing and Detection Bielefeld, Germany
Clinical Trials of Atrial and Ventricular Pacing Modes
Anne M. Gillis, MD, FRCPC
Professor of Medicine Bharat K. Kantharia, MD, FRCP, FAHA, FACC, FESC, FHRS
University of Calgary Professor of Medicine
Calgary, Alberta, Canada Director, Cardiac Electrophysiology Training Program
Pacing for Sinus Node Disease The University of Texas-Health Science Center at Houston
Director, Cardiac Electrophysiology Laboratories
Andrew A. Grace, MBChB, PhD Heart and Vascular Institute–Memorial Hermann Hospital
Research Group Head Houston, Texas
University of Cambridge Approach to Pulse Generator Changes
Consultant Cardiologist
Papworth Hospital Karoly Kaszala, MD, PhD
Cambridge, United Kingdom Assistant Professor of Cardiology
Subcutaneous Implantable Cardioverter-Defibrillators Virginia Commonwealth University School of Medicine
Director, Cardiac Electrophysiology
Henry Halperin, MD, MA Hunter Holmes McGuire VAMC
Carver Professor of Medicine Richmond, Virginia
Johns Hopkins School of Medicine Electromagnetic Interference and CIEDs
Baltimore, Maryland
Electromagnetic Interference and CIEDs G. Neal Kay, MD
Professor of Medicine
Haris M. Haqqani, MBBS(Hons), PhD Director, Cardiac Electrophysiology Section
Senior Lecturer Division of Cardiovascular Disease
School of Medicine University of Alabama at Birmingham
The University of Queensland Birmingham, Alabama
Consultant Electrophysiologist Cardiac Electrical Stimulation
The Prince Charles Hospital
Brisbane, Queensland, Australia Paul Khairy, MD, PhD, FRCPC
Engineering and Construction of Pacemaker and ICD Leads Associate Professor
Department of Medicine
David Hayes, MD University of Montreal
Medical Director, Affiliated Practice Network Canada Research Chair, Electrophysiology and Adult Congenital
Mayo Clinic Heart Disease
Mayo College of Medicine Director, Montreal Heart Institute Adult Congenital Center
Rochester, Minnesota Montreal, Quebec, Canada
Ethical Issues Sensing and Detection
Contributors ix
Daniel B. Kramer Mark J. Niebauer, MD, PhD
Teaching Fellow in Medicine Assistant Professor
Harvard Medical School Cleveland Clinic Lerner College of Medicine of Case Western Reserve
Beth Israel Deaconess Medical Center University
Boston, Massachusetts Staff Physician
Guidelines for Managing Pacemaker and Implantable Defibrillator Cleveland Clinic
Advisories Cleveland, Ohio
Defibrillation Testing, Implant Testing, And Relation to Empiric ICD
Steven P. Kutalek, MD Programming
Associate Professor of Medicine
Director, Cardiac Electrophysiology Marco V. Perez, MD
Associate Chief, Division of Cardiology Clinical Instructor
Drexel University College of Medicine Stanford University School of Medicine
Philadelphia, Pennsylvania Stanford University Medical Center
Approach to Pulse Generator Changes Stanford, California
Timing Cycles of Implantable Devices
Rachel Lampert, MD
Associate Professor Robert Andrew Pickett, MD
Yale University School of Medicine Physician
Attending Physician St. Thomas Research Institute
Yale New Haven Hospital St. Thomas Heart at Baptist Hospital
New Haven, Connecticut Nashville, Tennessee
Ethical Issues Pacemaker, Defibrillator, and Lead Codes, and Headers
Chu-Pak Lau, MD Stephen M. Pogwizd, MD
Director, Cardiac Health Heart Centre Featheringill Endowed Professor in Cardiac Arrhythmia Research
Honorary Clinical Professor Professor of Medicine, Physiology & Biophysics, and Biomedical
Department of Medicine Engineering
University of Hong Kong Director, Center for Cardiovascular Biology
Queen Mary Hospital Associate Director, Cardiac Rhythm Management Laboratory
Hong Kong, China University of Alabama at Birmingham
Implantable Sensors for Rate Adaptation and Hemodynamic Birmingham, Alabama
Monitoring; Leadless Pacing Concepts Principles of Defibrillation: From Cellular Physiology to Fields and
Waveforms
Kathy L. Lee, MBBS, FRCP, FACC
Honorary Clinical Assistant Professor Frits W. Prinzen, PhD
Medical School Professor of Physiology
University of Hong Kong Maastricht University
Hong Kong, China Maastricht, the Netherlands
Leadless Pacing Concepts Basic Physiology and Hemodynamics of Cardiac Pacing
Charles J. Love, MD François Regoli, MD, PhD
Professor of Medicine Attending Physician, Cardiologist
Director, Cardiac Rhythm Device Services Fondazione Cardiocentro Ticino
Division of Cardiovascular Medicine Lugano, Switzerland
The Ohio State University Medical Center Basic Physiology and Hemodynamics of Cardiac Pacing
Columbus, Ohio
Pacemaker Troubleshooting and Follow-up Dwight W. Reynolds, MD
Professor of Medicine
William H. Maisel, MD, MPH Chief, Cardiovascular Section
Associate Professor of Medicine University of Oklahoma Health Sciences Center
Harvard Medical School Oklahoma City, Oklahoma
Director, Pacemaker and ICD Service Permanent Pacemaker and Implantable Cardioverter-Defibrillator
Beth Israel Deaconess Medical Center Implantation
Boston, Massachusetts
Guidelines for Managing Pacemaker and Implantable Michael P. Riley, MD, PhD
Defibrillator Advisories Assistant Professor of Medicine
Hospital of the University of Pennsylvania
Saman Nazarian, MD Philadelphia, Pennsylvania
Assistant Professor of Medicine Troubleshooting of Implantable Cardioverter-Defibrillators
Johns Hopkins University School of Medicine
Director, Ventricular Arrhythmia Ablation Service Anthony Rorvick, BS
Johns Hopkins Hospital Medtronic, Inc.
Baltimore, Maryland Minneapolis, Minnesota
Electromagnetic Interference and CIEDs Power Systems for Implantable Pacemakers, Cardioverters, and
Defibrillators
x Contributors
Elizabeth Vickers Saarel, MD Warren M. Smith, MBChB
Associate Professor Honorary Clinical Associate Professor in Medicine
University of Utah University of Auckland
Director, Electrophysiology Cardiologist
Primary Children’s Medical Center Auckland City Hospital
Salt Lake City, Utah Auckland, New Zealand
Imaging of Implantable Devices Subcutaneous Implantable Cardioverter-Defibrillators
Leslie A. Saxon, MD Bruce S. Stambler, MD
Clinical Scholar and Chief Professor of Medicine
Division of Cardiovascular Medicine Case Western Reserve University
Keck School of Medicine Cleveland, Ohio
University of Southern California Pacing for Atrioventricular Conduction System Disease
Los Angeles, California
Clinical Trials of Cardiac Resynchronization Therapy: Pacemakers and Marc Strik, MD
Defibrillators PhD Student
Department of Physiology
Craig L. Schmidt, PhD Maastricht University
Senior Director, Energy Systems Research Maastricht, the Netherlands
Medtronic Energy and Component Center Basic Physiology and Hemodynamics of Cardiac Pacing
Medtronic, Inc.
Minneapolis, Minnesota Michael O. Sweeney, MD
Power Systems for Implantable Pacemakers, Cardioverters, and Associate Professor of Medicine
Defibrillators Harvard Medical School
Cardiac Pacing and Defibrillation
Gerald A. Serwer, MD Cardiac Arrhythmia Service
Professor of Pediatrics Brigham and Women’s Hospital
University of Michigan Boston, Massachusetts
Attending Pediatric Cardiologist Troubleshooting of Biventricular Devices
University of Michigan Congenital Heart Center
Ann Arbor, Michigan Charles D. Swerdlow, MD, FACC, FAHA, FHRS
Pediatric Pacing and Defibrillator Use Clinical Professor of Medicine
Department of Cardiology
Robert S. Sheldon, BSc, MD, PhD Cedars Sinai Heart Institute
Professor of Cardiac Sciences David Geffen School of Medicine
University of Calgary University of California Los Angeles
Senior Vice President of Research Los Angeles, California
Alberta Health Services Sensing and Detection
Calgary, Alberta, Canada
Pacing in Neurally Mediated Syncope Syndromes Sandeep Talwar, MD, PhD, FRCP
Senior Electrophysiology Fellow
Richard B. Shepard Division of Cardiology
Emeritus Professor, Cardiovascular Surgery University of Utah
University of Alabama at Birmingham Salt Lake City, Utah
Birmingham, Alabama Clinical Trials of Cardiac Resynchronization Therapy: Pacemakers and
Cardiac Electrical Stimulation Defibrillators
Ira Shetty, MD Patrick J. Tchou, MD
Clinical Assistant Professor Associate Section Head, Cardiac Electrophysiology and Pacing
Loyola University Medical Center Department of Cardiovascular Medicine
Maywood, Illinois Heart and Vascular Institute
Pediatric Pacing and Defibrillator Use Cleveland Clinic
Cleveland, Ohio
Chung-Wah Siu, MD Defibrillation Testing, Implant Testing, And Relation to Empiric ICD
Clinical Assistant Professor Programming
Department of Medicine
University of Hong Kong Hung-Fat Tse, MD
Hong Kong, China William MW Mong Professorship in Cardiology
Implantable Sensors for Rate Adaptation and Hemodynamic Academic Chief, Cardiology Division
Monitoring Department of Medicine
Queen Mary Hospital
Paul M. Skarstad, PhD The University of Hong Kong
Senior Director of Research (Retired) Hong Kong, China
Medtronic Energy and Component Center Implantable Sensors for Rate Adaptation and Hemodynamic
Medtronic, Inc. Monitoring
Minneapolis, Minnesota
Power Systems for Implantable Pacemakers, Cardioverters, and
Defibrillators
Contributors xi
Mintu P. Turakhia, MD, MAS Oussama Wazni, MD
Instructor of Medicine Assistant Professor of Medicine
Stanford University School of Medicine Cleveland Clinic Lerner College of Medicine of Case Western Reserve
Director of Cardiac Electrophysiology University
Veterans Affairs Palo Alto Health Care System Director, Research Development
Stanford, California Director, Out Patient Department, Cardiac Electrophysiology
Timing Cycles of Implantable Devices Cleveland Clinic
Cleveland, Ohio
Darrel F. Untereker, PhD Prevention and Management of Procedural Complications; Techniques
Vice President of Corporate Research and Technology and Devices for Lead Extraction
Strategic and Scientific Operations
Medtronic, Inc. Bruce L. Wilkoff, MD
Minneapolis, Minnesota Professor of Medicine
Power Systems for Implantable Pacemakers, Cardioverters, and Cleveland Clinic Lerner College of Medicine of Case Western Reserve
Defibrillators University
Director, Cardiac Pacing and Tachyarrhythmia Devices
Niraj Varma, MA, DM, FRCP Medical Information Officer
Consultant Cardiac Electrophysiologist Heart and Vascular Institute
Heart and Vascular Institute Cleveland, Ohio
Cleveland Clinic Prevention and Management of Procedural Complications; Techniques
Cleveland, Ohio and Devices for Lead Extraction
Follow-up Monitoring of Cardiac Implantable Electronic Devices
Seth J. Worley, MD
Gregory P. Walcott, MD Section Chief for Research
Associate Professor of Medicine Lancaster General Health
University of Alabama at Birmingham President and Medical Director
Birmingham, Alabama Lancaster Heart and Stroke Foundation
Principles of Defibrillation: From Cellular Physiology to Fields and Lancaster, Pennsylvania
Waveforms Left Ventricular Lead Implantation; Interventional Techniques for
Device Implantation
Paul J. Wang, MD
Professor of Medicine Paul C. Zei, MD, PhD
Stanford University School of Medicine Clinical Associate Professor of Medicine
Director, Cardiac Arrhythmia Service and Cardiac Electrophysiology Stanford University School of Medicine
Stanford University Medical Center Director, Cardiovascular Medicine Outpatient Clinics
Stanford, California Chief, Clinic Advisory Council
Timing Cycles of Implantable Devices Stanford University Medical Center
Stanford, California
Timing Cycles of Implantable Devices
PREFACE
I
t all started with cardiac pacemakers in 1958, but now we have car- demonstrate interest. He will always be greatly missed and remind us
diovascular implantable electronic devices (CIED). Investigations of of our debt to all our colleagues, physicians, engineers, nurses, and
the electrical stimulation of the heart began long ago, but the truly technicians. We also owe a great debt of gratitude to Serge Barold and
impressive technological developments of this technology over the past particularly to his singularly important text, Modern Cardiac Pacing,
more than 60 years has been the result of intense collaborative efforts published in 1985 by the Futura Publishing Company. Each of us
of physicians, engineers, allied professionals, and heart rhythm device learned more about cardiac pacing from this textbook than from any
manufacturers. When we began to collect the information to mentor mentor. It is hard to give credit to some and not others, but clearly
heart rhythm device professionals for the initial 1995 edition of Clini- there are so many others and also the giants that came before them. It
cal Cardiac Pacing we did not have a chapter on implantable defibril- is our hope that this edition will continue to mentor the next genera-
lators. We added implantable defibrillators in the second edition tion of heart rhythm professionals.
(2000), and in the third edition (2007) we added resynchronization We gratefully acknowledge the invaluable assistance and encourage-
therapy. Now we have a fourth edition. Although there is not a new ment of Natasha Andjelkovic and Janice Gaillard of the Health Sciences
form of therapy, there are still important changes in the technologies Division of Elsevier for all their help in keeping the fourth edition on
and our insights into how they are applied. There has been a huge track. We owe a great debt of gratitude to our colleagues and fellows
increment in the evidence base of how and in whom these devices from the Medical College of Virginia and the McGuire Veterans Affairs
should be used, and a great maturation of the techniques of implanta- Medical Center, the University of Alabama, The University of Hong
tion and extraction of devices, and management of patients with spe- Kong and Queen Mary Hospital, and the Cleveland Clinic for their
cific conditions. Many new technologies are discussed, including patience and support in shouldering the extra workload that allowed
leadless pacing, and the subcutaneous ICD. us to finish our chapters and editing on time.
Our philosophy in putting together the fourth edition remains the Most important, we cannot thank enough our many contributors
same as that of our first three editions. We have planned this book to and their colleagues, who labored extensively, often taking time from
emphasize the science of cardiac pacing, implantable defibrillation, family and other projects, to finish their chapters. This large group of
and cardiac resynchronization therapy, and to underline the impor- individuals deserves all the credit and thanks for making the fourth
tance of the fact that it is an interdisciplinary field. Physicians are part edition possible.
of a large web of health professionals who need increasing amounts of Our wonderful secretaries, Vera Wilkerson (Virginia Common-
information about implantable devices. We have a web site with this wealth University/Medical College of Virginia), Monica Crosby (Cleve-
edition that includes figures and movies not included in the paper land Clinic), Jenny To (The University of Hong Kong), and Dorothy
version of our text, as well as much additional material. All of the Welch (University of Alabama) were invaluable for their contributions
figures from the text are included and available for download from this to help complete this project.
web site. This textbook is designed to be a functional tool and reference,
We have sought to meet the needs of many with this textbook. Clini- helping clinicians, scientists, and engineers make the decisions that
cians, scientists, nurses, technicians, and engineers will find the infor- improve patients’ lives every day. It is our desire that this book serve
mation in these pages practical, authoritative, and helpful in better as a valuable resource to all of these people for many years to come.
understanding this therapy. We are excited about the opportunity to
present this material in a comprehensive scientific manner, and in Kenneth A. Ellenbogen, MD
doing so we stand on the shoulders of giants in the field of heart
G. Neal Kay, MD
rhythm devices. Sy Furman wrote the initial edition’s foreword, and
for that affirmation we are extremely thankful. We are more in debt to Chu-Pak Lau, MD
his legacy of innovation, problem solving, always asking more ques-
Bruce L. Wilkoff, MD
tions, and, finally, his commitment to educating any and all who
xiii
VIDEO CONTENTS
Introduction 22. Intracardiac View of Catheters in the Coronary Sinus and
Bruce L. Wilkoff, MD Through the Tricuspid Valve
23. Fluoroscopic Venogram of the Main Coronary Sinus and
9 Basic Physiology and Hemodynamics of Mid-CS Valve
Cardiac Pacing 24. Fluoroscopic Advancement of a Decapolar EP Catheter into the
1. 3D electroanatomical mapping in a patient with left bundle Coronary Sinus
branch block QRS morphology 25. 3D image of the Cardiac Venous Anatomy
2. Animated 3D reconstruction of the left ventricular wall with 26. Occlusive Venography of Coronary Sinus LAO 30
myocardial strain 27. Occlusive Venography of Coronary Sinus Anteroposterior
Projection
21 Permanent Pacemaker and Implantable Cardioverter- 28. Occlusive Venography of Coronary Sinus RAO 30 Projection
Defibrillator Implantation 29. Sheath and Wire Subselected into Anterolateral Branch
3. Catheter Delivery of a Fixed Extended Screw in Lead to 30. Sheath and Wire Subselected into Posterior Vein Branch
Coronary Sinus Os 31. Subvalvular Pouch Mimicking Coronary Sinus Os
4. Catheter Delivery of a Fixed Extended Screw in Lead 32. True Coronary Sinus Venogram
5. Removal of a Fixed Extended Screw in Lead in the Atrium 33. Final Lead Position in Posterior-Lateral Branch
22 Left Ventricular Lead Implantation 24 Approach to Pulse Generator Change
6. Intracardiac View of Coronary Sinus Os and Thebesian Valve 34. Abdominal ICD Pulse Generator with Subcutaneous Patch
7. Intracardiac View of the Thebesian Valve and Its Fenestrations Electrode
8. Intracardiac View of the Right Atrium from the IVC Including 35. Abdominal ICD Pulse Generator with Previously Cut and
the Coronary Sinus Os and Thebesian Valve Capped Additional Electrode
9. Rotating Intracardiac View of the Right Atrium from the IVC 36. Patient from Previous Case After Extraction and Reimplantation
Including the Coronary Sinus Os and Thebesian Valve 37. Alternative Approach to an Occluded Subclavian Vein
10. Intracardiac View of a White and Floppy Thebesian Valve 38. Total Occlusion of the Left Subclavian Vein with Reconstitution
11. Intracardiac View of a Tattered Thebesian Valve via the Right Side
12. Intracardiac View of an Occlusive Balloon Inflation in the
Coronary Sinus Os 25 Prevention and Management of Procedural
13. Intracardiac View of Insertion and Occlusion of the Coronary Complications
Sinus with a Venography Catheter 39. Transesophageal Echo of Large Right Atrial Vegetation on an
14. Intracardiac View of a Double Coronary Sinus OS and ICD Lead
Thebesian Valve 40. Transesophageal Echo of Large Right Atrial Vegetation on a
15. Intracardiac View of Coronary Sinus Os and Thebesian Valve Pacemaker Lead
with Only Free Access from Inferior Direction 41. Subclavian Vein Venography and Lead Fractures
16. Intracardiac View of Coronary Sinus Os and Tricuspid and
Thebesian Valves with Attempted EP Catheter Access from Above 26 Techniques and Devices for Lead Extraction
17. Intracardiac View of Coronary Sinus Os and Tricuspid and 42. Needles-Eye-Snare Extraction of Fractured Ventriculo-Jugular
Thebesian Valves with Successful EP Catheter Access from Below Shunt
18. Intracardiac View of Coronary Sinus OS and Thebesian Valve 43. Fluoroscopy of Embolized Telectronics Accufix Wire
with Attempted EP Catheter Access from Above 44. Laser Lead Extraction of Single Coil ICD Lead
19. Intracardiac View of a Complicated Thebesian and Tricuspid
Valve Special Presentation
20. Intracardiac View of Coronary Sinus Os with Early Branching 45. ICD Implantation: Implantation and Management of
21. Intracardiac View of Coronary Sinus Os with Early Branching Complications (PowerPoint presentation)
xvii