Essential Cardiac Electrophysiology: With Self-Assessment (Blackwell's Essentials) PDF
Preview Essential Cardiac Electrophysiology: With Self-Assessment (Blackwell's Essentials)
Essential Cardiac Electrophysiology With Self Assessment Zainul Abedin, ( ) MD, FRCP C AssociateProfessorofClinicalMedicine TexasTechUniversityHealthSciencesCenter ElPaso,TX AdjunctAssociateProfessorofElectricalEngineeringandComputerScience UniversityofTexasatElPaso Robert Conner, RN Essential Cardiac Electrophysiology With Self Assessment InlovingmemoryofmybrotherHusainali and TomywifeKarunawhosepatienceandunderstandingmadethisprojectpossible and TomychildrenMoeen,SakenaandZameer ZainulAbedin Toallthestudentsofcardiacelectrophysiology RobertConner Essential Cardiac Electrophysiology With Self Assessment Zainul Abedin, ( ) MD, FRCP C AssociateProfessorofClinicalMedicine TexasTechUniversityHealthSciencesCenter ElPaso,TX AdjunctAssociateProfessorofElectricalEngineeringandComputerScience UniversityofTexasatElPaso Robert Conner, RN ©2007ZainulAbedin&RobertConner PublishedbyBlackwellPublishing BlackwellFuturaisanimprintofBlackwellPublishing BlackwellPublishing,Inc.,350MainStreet,Malden,Massachusetts02148-5020,USA BlackwellPublishingLtd,9600GarsingtonRoad,OxfordOX42DQ,UK BlackwellPublishingAsiaPtyLtd,550SwanstonStreet,Carlton,Victoria3053,Australia Allrightsreserved.Nopartofthispublicationmaybereproducedinanyformorbyany formorbyanyelectronicormechanicalmeans,includinginformationstorageandretrieval systems,withoutpermissioninwritingfromthepublisher,exceptbyareviewerwhomay quotebriefpassagesinareview. Firstpublished2007 1 2007 LibraryofCongressCataloging-in-PublicationData Abedin,Zainul,MD. Essentialcardiacelectrophysiology:selfassessment/by ZainulAbedinandRobertConner. p.;cm. Includesbibliographicalreferencesandindex. ISBN-13:978-1-4051-5108-5(pbk.:alk.paper) ISBN-10:1-4051-5108-0(pbk.:alk.paper) 1.Heart–Electricproperties–Handbooks,manuals,etc. 2.Arrhythmia–Pathophysiology–Handbooks,manuals,etc. 3.Electrophysiology–Handbooks,manuals,etc. 4.Heartconductionsystem–Handbooks, manuals,etc. I.Conner,RobertP. II.Title. [DNLM:1.Arrhythmia–physiopathology–Handbooks. 2.Arrhythmia–therapy–Handbooks. 3.ElectrophysiologicTechniques,Cardiac–Handbooks. WG39A138e2007] QP112.5.E46A242007 612.1’71–dc22 2006015740 ISBN-13:978-1-4051-51085 ISBN-10:1-4051-51080 AcataloguerecordforthistitleisavailablefromtheBritishLibrary AcquisitionsEditor:GinaAlmond DevelopmentEditor:LaurenBrindley EditorialAssistant:VictoriaPittman ProductionController:DebbieWyer Setin9/12ptMeridienbyNewgenImagingSystems(P)Ltd.,Chennai,India PrintedandboundbyReplikaPressPvtLtd,Haryana,India ForfurtherinformationonBlackwellPublishing,visitourwebsite: www.blackwellfutura.com [email protected] Thepublisher’spolicyistousepermanentpaperfrommillsthatoperateasustainable forestrypolicy,andwhichhasbeenmanufacturedfrompulpprocessedusingacid-free andelementarychlorine-freepractices.Furthermore,thepublisherensuresthatthetext paperandcoverboardusedhavemetacceptableenvironmentalaccreditationstandards. BlackwellPublishingmakesnorepresentation,expressorimplied,thatthedrugdosagesin thisbookarecorrect.Readersmustthereforealwayscheckthatanyproductmentionedin thispublicationisusedinaccordancewiththeprescribinginformationpreparedbythe manufacturers.Theauthorandthepublishersdonotacceptresponsibilityorlegalliability foranyerrorsinthetextorforthemisuseormisapplicationofmaterialinthisbook. Contents Foreword,vii Preface,ix Acknowledgements,xi ListofAbbreviations,xiii 1 Ions,channels,andcurrents,1 1.1 Potassiumchannelsandcurrents,6 1.2 Sodiumchannelsandcurrents,12 1.3 Calciumchannelsandcurrents,16 2 Electrophysiologiceffectsofcardiacautonomicactivity,21 2.1 Adrenergicreceptors,23 2.2 Cholinergicreceptors,25 2.3 Purinergicreceptors,26 3 Mechanismsofarrhythmias,30 4 SinusnodedysfunctionandAVblocks,43 5 Supraventriculartachycardia,57 5.1 Atrialflutter,72 5.2 Atrialtachycardias,77 5.3 Atrialfibrillation,83 5.4 Automaticjunctionaltachycardia,93 5.5 AVnodereentrytachycardias,94 5.6 AVreentranttachycardia,103 6 Differentialdiagnosisofwidecomplextachycardia,127 v vi Contents 7 Ventriculartachycardiaandventricularfibrillation,132 7.1 Ventriculartachycardiainthepresenceofcoronaryarterydisease,145 7.2 Arrhythmogenicrightventriculardysplasia/cardiomyopathy ARVD/C,153 7.3 Ventriculararrhythmiasinhypertrophicanddilated ardiomyopathy,159 7.4 LongQTsyndromeandTorsadedePointes,167 7.5 Brugadasyndrome,177 7.6 Ventriculartachycardiainstructurallynormalheart,183 7.7 Bundlebranchreentryventriculartachycardia,190 7.8 Catecholaminergicpolymorphicventriculartachycardia,194 7.9 Miscellaneousformsofventriculararrhythmias,197 8 Suddencardiacdeathandriskstratification,202 9 Cardiacarrhythmiasinpatientswithneuro-musculardisorders,214 10 Syncope,218 11 Pharmacologictherapyofarrhythmias,229 11.1 Pharmacologicprinciplesasappliedtoantiarrhythmicdrugs,230 11.2 Antiarrhythmicdrugs,234 11.3 Betablockers,239 11.4 ClassIIIantiarrhythmicdrugs,240 11.5 Calciumchannelblockers,246 11.6 Adenosine,247 11.7 Digoxin,249 12 Electricaltherapyforcardiacarrhythmias,254 12.1 Cardioversiondefibrillation,256 12.2 Pacemakers,258 12.3 Implantabledefibrillators,266 Self-assessmentanswers,275 Index,279 Foreword Medical texts are written with the goal of disseminating knowledge. However, the approaches used to achieve this goal vary widely. There are comprehensive textbooks that cover a wide variety of topics in moderate detail, more focused textbooksthatprovideagreatdealofdetailonasingletopic, andsuccincttexts that review the basics, providing quick and practical access to information that mayassistinpatientcare. EssentialCardiacElectrophysiologybelongsinthislastcategory.Thefirstsectionsof thebookprovideareviewofbasicelectrophysiology,providingessentialfactsina fashionsuitableforthosestudyingfortheClinicalCardiacElectrophysiologyboard certificationexamination.Materialthatisrelevanttopatientcareisemphasized, withahealthydoseofbasicconcepts.Forexample,thebookprovidesaquickand simple way to look up a basic electrophysiology fact such as the gene mutation that causes catecholaminergic polymorphic ventricular tachycardia. The liberal useoftablesandillustrationseffectivelysupplementstheconcisetext. Thelater chapters review all major areas of arrhythmia management in a succinct fash- ion. The chapters on supraventricular and ventricular tachycardia stand out as being particularly useful as a reference for those seeking a quick review. Other strengthsincludetheself-assessmentquestionsatthebeginningofeachchapter andreferencestokeyreviewarticlespublishedin2001–2006.However,thebook wasnotintendedtobea“how-to”manual,andthereforeprovidesnoinstructions onproceduressuchascatheterablationordeviceimplantation. Dr Abedin has succeeded admirably in producing a concise review of both basic and clinical electrophysiology that complements but does not replace lar- gerelectrophysiologytextbooks.Thisbookshouldserveasanexcellentresource forstudentsofcardiacelectrophysiologyatalllevels. FredMorady,MD vii
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