Topics in Arrhythmias and Ischemic Heart Disease This page intentionally left blank 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 Visit our website at www.demosmedpub.com © 2010 Demos Medical Publishing, LLC. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, 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 Medicine is an ever-changing science. Research and clinical experience are continually expand- ing our knowledge, in particular our understanding of proper treatment and drug therapy. The authors, editors, and publisher have made every effort to ensure that all information in this book is in accordance with the state of knowledge at the time of production of the book. Nevertheless, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, express or implied, with respect to the contents of the publication. Every reader should exam- ine carefully the package inserts accompanying each drug and should carefully check whether the dosage schedules mentioned therein or the contraindications stated by the manufacturer differ from the statements made in this book. Such examination is particularly important with drugs that are either rarely used or have been newly released on the market. Special discounts on bulk quantities of Demos Medical Publishing books are available to cor- porations, professional associations, pharmaceutical companies, health care organizations, and other qualifying groups. For details, please contact: Special Sales Department Demos Medical Publishing 11 W. 42nd Street, 15th Floor New York, NY 10036 Phone: 800–532–8663 or 212–683–0072 Fax: 212–941–7842 E-mail: [email protected] 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 This page intentionally left blank 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 This page intentionally left blank 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
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