Topics in Arrhythmias and Ischemic Heart Disease: (Emerging Concepts in Cardiology Series)

198 Pages·2009·4.93 MB·English

by  Bruce B. Lerman

Topics in Arrhythmias and
Ischemic Heart Disease
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Emerging Concepts in Cardiology
Topics in Arrhythmias and
Ischemic Heart Disease
Bruce B. Lerman, MD
H. Altschul Master Professor of Medicine
Chief, Division of Cardiology
Department of Medicine
Weill Medical College of Cornell University
New York Presbyterian Hospital
New York, New York
Craig T. Basson, MD, PhD
Gladys and Roland Harriman Professor of Medicine
Director, Cardiovascular Research
Division of Cardiology
Department of Medicine
Weill Medical College of Cornell University
New York Presbyterian Hospital
New York, New York
New York
Acquisitions Editor: Richard Winters
Cover Design: Joe Tenerelli
Compositor: NewGen North America
Printer: King Printing
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without the prior written permission of the publisher.
Library of Congress Cataloging-in-Publication Data
Topics in Arrhythmias and Ischemic Heart Disease / [edited by] Bruce B. Lerman,
Craig T. Basson.
p.; cm.
Includes bibliographical references and index.
ISBN 978–1–933864–58–7
1. Coronary heart disease. 2. Arrhythmia. I. Lerman, Bruce B. II. Basson, Craig T.
[DNLM: 1. Myocardial Ischemia. 2. Arrhythmias, Cardiac. WG 300 I77335 2010]
RC685.C6I5895 2010
616.1'23—dc22 2009034461
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Made in the United States of America
09 10 11 12 13 5 4 3 2 1
To my wife, Karen,
my children, Josh, Jessica, Rachel and Jennifer,
and my parents, Lillian and Philip Lerman.
—Bruce B. Lerman
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Contents
Preface ix
Contributors xi
1 Risk Stratification of Sudden Cardiac Death 1 6 Catheter Ablation of Atrial Fibrillation 97
Apoor Patel and Sei Iwai Andy Lin and Steven M. Markowitz
2 Management of Acute Coronary Syndromes 21 7 Percutaneous Treatment of Valvular
Heart Disease 123
Luke K. Kim and Dmitriy N. Feldman
S. Chiu Wong, Eric Au, and Suzanne Zentko
3 Percutaneous Coronary Intervention in the
8 Advances in Pulmonary Hypertension 141
Modern Era 45
Irina Sobol and Evelyn M. Horn
Hasan A. Ahmad and Robert M. Minutello
9 Asymptomatic Carotid Artery Stenosis: Detection,
4 Predictors of Outcome in Chronic
Risk Stratification, and Management 165
Ischemic Heart Disease 63
Issam D. Moussa
Robert J. Kim
5 Cardiac Resynchronization Therapy 83
Christopher F. Liu and Kenneth M. Stein Index 179
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Preface
Cardiology continues to be a dynamic field, one fueled and the introduction of novel therapeutic approaches.
in part by innovation in mechanical and cell-based Pulmonary hypertension is an area that was rela-
therapies. This makes the field fascinating to observe but
tively dormant until recent advances promoted new
challenges one to remain au courant. Therefore, the task
approaches to patients with this disorder. The chapter
before the editors is to strike a balance in a single source
on this topic synthesizes the striking developments in
that is authoritative, current, and readily absorbed. This
this area. Likewise, cardiac resynchronization therapy
is the goal of the current volume. We have organized
has provided dramatic symptomatic relief for appropri-
this text to reflect the most current thinking in the field.
ately screened patients. Familiarity with understanding
To accomplish this mission, we have solicited the efforts
of recognized authorities in ischemic heart disease and who benefits from such therapy and the determinants of
cardiac arrhythmias from the Weill Medical College of such an outcome are essential for the clinician.
Cornell University, Division of Cardiology. Interventional cardiology no longer refers to just
Although this volume, Topics in Arrhythmias and percutaneous coronary procedures. Peripheral vascular
Ischemic Heart Disease, emphasizes state-of-the-art procedures are now a well-established part of the arma-
modalities in the treatment of coronary artery disease mentarium. Perhaps the most exciting innovation in the
and arrhythmias, we are mindful that any coherent and interventional domain is percutaneous valvular repair
integrated approach to the treatment of such patients for treatment of aortic stenosis and mitral regurgita-
must incorporate the impressive advances made in risk tion. This area has the potential to be transformative.
stratification. To that end, we have included a chapter Finally, in the field of electrophysiology, percutaneous
that deciphers the myriad and sometimes contradictory ablation to isolate the pulmonary veins in patients with
data regarding biomarkers and their prognostic signifi- atrial fibrillation achieves success in the majority of
cance in ischemic heart disease. Prognostication for sud- patients. Whether this procedure will replace antiar-
den cardiac death has become more sophisticated with rhythmic therapy as a first-line approach remains to be
the completion of several large randomized studies. seen, but for time being this approach at the very least
The chapter dealing with this subject guides the reader can offer dramatic symptomatic relief for debilitated
through the nuances of the data, allowing one to incor- patients.
porate the information into sound clinical decisions. We wish to express appreciation to Demos Medical
Impressive advancements in the treatment of acute Publishing for their professionalism and expertise. It is
coronary syndromes and congestive heart failure have our hope that this book serves as a useful guide and
been introduced in recent years. This has relied on a supplement for clinicians treating patients with isch-
better understanding of the underlying pathogenesis emic heart disease and cardiac arrhythmias.
Bruce B. Lerman, MD
Craig T. Basson, MD, PhD