Essential Concepts of Electrophysiology and Pacing through Case Studies

311 Pages·2014·18.01 MB·English

by  Kenneth A. Ellenbogen

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EDITED BY
KENNETH A. ELLENBOGEN MD

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EDITED BY
Kenneth A. Ellenbogen, MD
CONTRIBUTORS
Roderick Tung, MD
Prabal K. Guha, MD
Jeanine Leffler, RN
Kevin D. Oakeson, MS
Minneapolis, Minnesota
© 2014 Kenneth A. Ellenbogen, Roderick Tung, Prabal K. Guha, Jeanine Leffler, Kevin D. Oakeson
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This book is intended for educational purposes and to further general scientific and medical knowledge, research, and understanding of the conditions and associated
treatments discussed herein. This book is not intended to serve as and should not be relied upon as recommending or promoting any specific diagnosis or method of
treatment for a particular condition or a particular patient. It is the reader’s responsibility to determine the proper steps for diagnosis and the proper course of treatment
for any condition or patient, including suitable and appropriate tests, medications or medical devices to be used for or in conjunction with any diagnosis or treatment.
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Library of Congress Control Number: 2013954649
ISBN: 978-1-935395-85-0
eISBN: 978-1-935395-99-7
Printed in the United States of America
iv
Dedication
To Mark E. Josephson, MD, our friend and mentor whose life and work has been a constant source of inspiration and
encouragement and who continues to challenge us to advance the science of arrhythmias.
In memory of Mark A. Wood, MD, my friend and colleague whose life will always be remembered.
—Kenneth A. Ellenbogen, MD
v
vi Essential Concepts of Electrophysiology and Pacing through Case Studies
Contents
About the Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix Part 2: Electrophysiology Concepts . . . . . . . . . . . . . . . 45
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi Case 2.A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .47
Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xiii Case 2.B . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .52
Case 2.C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .57
Part 1: ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 Case 2.D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .62
Case 2.E . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .65
Case 1.A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3
Case 2.F . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .71
Case 1.B . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
Case 2.G . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .75
Case 1.C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
Case 2.H . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .79
Case 1.D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17
Case 2.I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .83
Case 1.E . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21
Case 2.J . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .87
Case 1.F . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25
Case 2.K . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .92
Case 1.G . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30
Case 2.L . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .96
Case 1.H . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36
Case 2.M . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .100
Case 1.I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42
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viii Essential Concepts of Electrophysiology and Pacing through Case Studies
Part 3: Intracardiac Tracings . . . . . . . . . . . . . . . . . . . . . .105 Case 3.V . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .201
Case 3.W . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .205
Case 3.A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .106
Case 3.X . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .209
Case 3.B . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .111
Case 3.Y . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .213
Case 3.C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .117
Case 3.D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .121
Part 4: Device Tracings . . . . . . . . . . . . . . . . . . . . . . . . . . . .217
Case 3.E . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .126
Case 3.F . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .131 Case 4.A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .218
Case 3.G . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .135 Case 4.B . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .226
Case 3.H . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .140 Case 4.C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .232
Case 3.I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .145 Case 4.D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .236
Case 3.J . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .150 Case 4.E . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .244
Case 3.K . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .155 Case 4.F . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .250
Case 3.L . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .160 Case 4.G . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .254
Case 3.M . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .164 Case 4.H . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .258
Case 3.N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .167 Case 4.I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .264
Case 3.O . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .171 Case 4.J . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .268
Case 3.P. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .175 Case 4.K . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .272
Case 3.Q . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .179 Case 4.L . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .278
Case 3.R . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .183 Case 4.M . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .284
Case 3.S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .187
Appendix A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .291
Case 3.T . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .192
Appendix B . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .293
Case 3.U . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .195