The Practice of Catheter Cryoablation for Cardiac Arrhythmias -  - E-Book

The Practice of Catheter Cryoablation for Cardiac Arrhythmias E-Book

4,9
114,99 €

oder
-100%
Sammeln Sie Punkte in unserem Gutscheinprogramm und kaufen Sie E-Books und Hörbücher mit bis zu 100% Rabatt.
Mehr erfahren.
Beschreibung

Offering patients a higher safety profile and less discomfort than radio-frequency ablation, catheter cryoablation is a safe, effective and efficient alternative for clinicians treating atrial fibrillation and other arrhythmias. In The Practice of Catheter Cryoablation for Cardiac Arrhythmias, cardiac electrophysiologists, cardiologists and cardiology fellows will be able to gain an in-depth update in this rapidly advancing field. Those who wish to offer their patients this treatment option will learn how to master various procedural techniques related to catheter cryoablation. Edited by the pioneer of cryoablation therapy in Asia, with chapters written by expert cardiac electrophysiologists from centers in Asia, Europe and the US who have extensive experience using cryoablation to treat patients, this new book: * Provides comprehensive, clinically-focused guidance on all applications of catheter cryoablation for the treatment of arrhythmias * Focuses on catheter-based techniques that can be performed in the EP laboratory * Reflects global best practices form centers with extensive experience in cryoablation techniques * Covers the use of catheter cryoablation in both adult and pediatric arrhythmias To further enhance reader's understanding of the emergent techniques covered in the text, the book's companion website features video clips of live cryoablation procedures, plus case-based self-assessment questions for selected chapters.

Sie lesen das E-Book in den Legimi-Apps auf:

Android
iOS
von Legimi
zertifizierten E-Readern

Seitenzahl: 313

Veröffentlichungsjahr: 2013

Bewertungen
4,9 (16 Bewertungen)
14
2
0
0
0
Mehr Informationen
Mehr Informationen
Legimi prüft nicht, ob Rezensionen von Nutzern stammen, die den betreffenden Titel tatsächlich gekauft oder gelesen/gehört haben. Wir entfernen aber gefälschte Rezensionen.



Table of Contents

Dedication

Title page

Copyright page

List of Contributors

Preface

Acknowledgments

About the Companion Website

CHAPTER 1: Biophysical Principles and Properties of Cryoablation

Background

Thermodynamics of the cryoablation system

Mechanisms of injury

Lesion characteristics

Factors affecting cryoablation efficacy

Conclusion

CHAPTER 2: Catheter Cryoablation for Pediatric Arrhythmias

Introduction

Cryoablation in immature myocardium – animal studies

Transcatheter cryoablation technique for the treatment of tachyarrhythmias in pediatrics

Outcomes of cryoablation in pediatrics

Cryoablation for other substrates

Cryoablation in congenital heart disease

Practice trends in pediatric cryoablation

CHAPTER 3: Atrioventricular Nodal Reentrant Tachycardia: What Have We Learned from Radiofrequency Catheter Ablation?

Introduction

Basis of catheter ablation for AVNRT

Techniques of radiofrequency catheter ablation

Safety and efficacy of RFCA

Lessons learned from RFCA

Conclusion

Acknowledgements

CHAPTER 4: Catheter Cryoablation for Atrioventricular Nodal Reentrant Tachycardia

Atrioventricular block after radiofrequency catheter ablation for atrioventricular nodal reentrant tachycardia

Is cryoablation free of the complication of permanent inadvertent AVB in the treatment of AVNRT?

Other advantages of using cryoablation to treat AVNRT

Recurrence rates: The Achilles' Heel of cryoablation in treating AVNRT

Procedural techniques of cryoablation for AVNRT

Strategies to decrease the recurrence rate after cryoablation for AVNRT

Conclusions

CHAPTER 5: Cryoballoon Pulmonary Vein Isolation for Atrial Fibrillation

Introduction

Function of the Arctic Front cryoballoon

Ablation of the pulmonary vein antrum – technique

Significance of measuring the proximal balloon temperature

Factors determining lesion size and homogeneity

Confirming adequate balloon occlusion

Impact of pulmonary vein anatomy

Impact of balloon characteristics

Imaging

Special isolation techniques

Confirming isolation

Monitoring pulmonary vein signals

Risk of phrenic nerve palsy

Other adverse events

Anticoagulation

Results of cryoballoon ablation

Outlook and future development

Acknowledgments

CHAPTER 6: Prevention of Phrenic Nerve Palsy during Cryoballoon Ablation for Atrial Fibrillation

Introduction

Anatomy

Mechanisms of phrenic nerve injury

Pacing the phrenic nerve

Monitoring of the phrenic nerve function

Recommendations

See it, hear it, feel it, and measure it

What to do when phrenic nerve injury occurs

Summary

CHAPTER 7: Linear Isthmus Ablation for Atrial Flutter: Catheter Cryoablation versus Radiofrequency Catheter Ablation

Introduction

Atrial flutter terminology

Pathophysiologic mechanisms of AFL

Electrocardiogram diagnosis of AFL

Mapping of AFL

Radiofrequency catheter ablation of AFL

Procedure endpoints for ablation of AFL

Outcomes of radiofrequency catheter ablation of typical AFL

Cryocatheter ablation of typical AFL

Summary

CHAPTER 8: Catheter Cryoablation for the Treatment of Accessory Pathways

Performance of RFCA of APs

Uncommon complications of RFCA for APs

Potential advantages of using cryoablation instead of RFCA in the treatment of APs

Procedural techniques of cryoablation for accessory pathways

Performance of catheter cryoablation of APs

Conclusions

CHAPTER 9: Catheter Cryoablation for the Treatment of Ventricular Arrhythmias

Introduction

History of cryoablation

Cryoablation technology

Conclusions

CHAPTER 10: Catheter Cryoablation for the Treatment of Miscellaneous Arrhythmias

Electrophysiological characteristics and anatomical locations of focal atrial tachycardia

Efficacy and safety of radiofrequency catheter ablation of FAT

Catheter cryoablation treatment for “high-risk” FAT

Radiofrequency and cryothermal ablation for inappropriate sinus tachycardia

Radiofrequency and cryothermal ablation for atrioventricular nodal ablation in atrial fibrillation

Conclusions

Index

To my wife, Lillian, and my little daughter, Nam Nam, for bringing me a new page of life.

– NY

This edition first published 2014 © 2014 by John Wiley & Sons, Ltd.

Registered office: John Wiley & Sons, Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK

Editorial offices: The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK

9600 Garsington Road, Oxford, OX4 2DQ, UK

111 River Street, Hoboken, NJ 07030-5774, USA

For details of our global editorial offices, for customer services and for information about how to apply for permission to reuse the copyright material in this book please see our website at www.wiley.com/wiley-blackwell

The right of the author to be identified as the author of this work has been asserted in accordance with the UK Copyright, Designs and Patents Act 1988.

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher.

Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book. It is sold on the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional should be sought.

The contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting a specific method, diagnosis, or treatment by health science practitioners for any particular patient. The publisher and the author make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of fitness for a particular purpose. In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. Readers should consult with a specialist where appropriate. The fact that an organization or Website is referred to in this work as a citation and/or a potential source of further information does not mean that the author or the publisher endorses the information the organization or Website may provide or recommendations it may make. Further, readers should be aware that Internet Websites listed in this work may have changed or disappeared between when this work was written and when it is read. No warranty may be created or extended by any promotional statements for this work. Neither the publisher nor the author shall be liable for any damages arising herefrom.

Library of Congress Cataloging-in-Publication Data

The practice of catheter cryoablation for cardiac arrhythmias / edited by Ngai-Yin Chan.

p. ; cm.

Includes bibliographical references and index.

ISBN 978-1-118-45183-0 (cloth : alk. paper) – ISBN 978-1-118-45179-3 – ISBN 978-1-118-45180-9 (Mobi) – ISBN 978-1-118-45181-6 (Pdf) – ISBN 978-1-118-45182-3 (ePub) – ISBN 978-1-118-75776-5 – ISBN 978-1-118-75777-2

I. Chan, Ngai-Yin, editor of compilation.

[DNLM: 1. Arrhythmias, Cardiac–surgery. 2. Catheter Ablation–methods. 3. Cryosurgery–methods. WG 330]

RC685.A65

616.1'28–dc23

2013017939

A catalogue record for this book is available from the British Library.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

Cover image: courtesy of the editor

Cover design by Rob Sawkins for Opta Design Ltd.

List of Contributors

Amin Al-Ahmad, MD

Division of Cardiovascular Medicine

Stanford University School of Medicine

Palo Alto, CA

USA

 

David J. Burkhardt, MD

Texas Cardiac Arrhythmia Institute

St. David's Medical Center

Austin, TX

USA

 

Ngai-Yin Chan, MBBS, FRCP, FACC, FHRS

Department of Medicine and Geriatrics

Princess Margaret Hospital

Hong Kong

China

 

Kathryn K. Collins, MD

University of Colorado and

Children's Hospital Colorado

Aurora, CO

USA

 

Luigi Di Biase, MD, PhD, FHRS

Texas Cardiac Arrhythmia Institute

St. David's Medical Center;

Department of Biomedical Engineering

University of Texas

Austin, TX

USA;

Department of Cardiology

University of Foggia

Foggia

Italy;

Albert Einstein College of Medicine

Montefiore Hospital

New York, NY

USA

 

Gregory K. Feld, MD

Clinical Cardiac Electrophysiology Program

Division of Cardiology

University of California, San Diego

San Diego, CA;

Sulpizio Family Cardiovascular Center

La Jolla, CA

USA

 

Jo Jo Hai, MBBS

Cardiology Division

Department of Medicine

Queen Mary Hospital

The University of Hong Kong

Hong Kong

China

 

Henry H. Hsia, MD

Division of Cardiovascular Medicine

Stanford University School of Medicine

Palo Alto, CA

USA

 

Marcin Kowalski, MD, FHRS

Department of Clinical Cardiac Electrophysiology

Staten Island University Hospital

Staten Island, NY

USA

 

Michael R. Lauer, MD

Permanente Medical Group

Cardiac Electrophysiology Laboratory

Kaiser-Permanente Medical Center

San Jose, CA

USA

 

Andrea Natale, MD, FACC, FHRS

Texas Cardiac Arrhythmia Institute

St. David's Medical Center;

Department of Biomedical Engineering

University of Texas

Austin, TX;

Division of Cardiovascular Medicine

Stanford University School of Medicine

Palo Alto, CA;

Sutter Pacific Medical Center

San Francisco, CA

USA

 

Pasquale Santangeli, MD

Texas Cardiac Arrhythmia Institute

St. David's Medical Center

Austin, TX

USA;

Department of Cardiology

University of Foggia

Foggia

Italy;

Division of Cardiovascular Medicine

Stanford University School of Medicine

Palo Alto, CA

USA

 

Navinder Sawhney, MD

Cardiac Electrophysiology Program

Division of Cardiology

University of California, San Diego

San Diego, CA;

Sulpizio Family Cardiovascular Center

La Jolla, CA

USA

 

Ruey J. Sung, MD

Division of Cardiovascular Medicine (Emeritus)

Stanford University School of Medicine

Stanford, CA

USA

 

Hung-Fat Tse, MD, PhD

Cardiology Division

Department of Medicine

Queen Mary Hospital

The University of Hong Kong

Hong Kong

China

 

George F. Van Hare, MD

Division of Pediatric Cardiology

Washington University School of Medicine and

St. Louis Children's Hospital

St. Louis, MO

USA

 

Jürgen Vogt, MD

Department of Cardiology

Heart and Diabetes Center North Rhine-Westphalia

Ruhr University Bochum

Bad Oeynhausen

Germany

 

Xue Yan

Department of Biomedical Engineering

Texas Cardiac Arrhythmia Institute

St. David's Medical Center;

University of Texas

Austin, TX

USA

 

Charlie Young, MD

Permanente Medical Group

Cardiac Electrophysiology Laboratory

Kaiser-Permanente Medical Center

San Jose, CA

USA

Preface

I was trained to use radiofrequency as the energy source in the ablation of various cardiac arrhythmias more than 20 years ago. This time-honored energy source has been shown to perform well in terms of both efficacy and safety profile. It was not until I encountered my first complication of inadvertent permanent atrioventricular block, in a young patient who underwent catheter ablation for atrioventricular nodal reentrant tachycardia, that I recognized we might need an even better source of energy.

Certainly, catheter cryoablation is not a substitute for radiofrequency ablation. However, in many of the arrhythmic substrates (notably the perinodal area, Koch's triangle, pulmonary vein, coronary sinus, cavotricuspid isthmus, etc.), cryothermy may be considered as the energy source of choice. Unfortunately, there has been a shortage of educational materials in this area. This work thus represents the first book dedicated to the science and practice of catheter cryoablation.

The Practice of Catheter Cryoablation for Cardiac Arrhythmias is purposefully written and organized to update the knowledge base in catheter cryoablation, with the emphasis on “how to perform.” We compare cryothermy with radiofrequency energy source in different arrhythmic substrates, and we have also supplemented the textual content with a companion website (www.chancryoablation.com) providing interactive cases and real case videos for selected chapters.

I am sure that this book can benefit all those who are interested in better understanding this relatively new technology and the science behind it. More importantly, this book will serve as an indispensable reference for those who would like to adopt catheter cryoablation in treating patients with different cardiac arrhythmias.

Ngai-Yin Chan, MBBS, FRCP, FACC, FHRS

Acknowledgments

This book is the product of the collective effort of many dedicated people. I would like to thank all the contributing authors, who are all prominent leaders in the field of catheter cryoablation and have found time out of their busy schedules to write the various chapters of the book. I also thank my great colleagues Stephen Choy and Johnny Yuen, who were excellent assistants during my cryoablation procedures. Stephen Cheung, an expert radiologist and a good friend of mine, has to be acknowledged for his contribution of the beautiful reconstructed cardiac CT image that is used on the book cover. Lastly, I have to thank Adam Wang and Perry Tang for their technical support in the preparation of the live cryoablation procedures videos for the companion website.

About the Companion Website

This book is accompanied by a companion website:

www.chancryoablation.com

The website includes:

Interactive Case Studies to accompany Chapters 2, 4, 5, 6, 7, 8 and 10Video clips to illustrate various cryoablation procedures

CHAPTER 1

Biophysical Principles and Properties of Cryoablation

Jo Jo Hai and Hung-Fat Tse

Queen Mary Hospital, The University of Hong Kong, Hong Kong, China

Background

More than 4000 years have passed since the first documented medical use of cooling therapy, when the ancient Egyptian Edwin Smith Papyrus described applying cold compresses made up of figs, honey, and grease to battlefield injuries.1 Not until 1947 did Hass and Taylor first describe the creation of myocardial lesions using cold energy generated by carbon dioxide as a refrigerant.2 In contrast to the destructive nature of heat energy, which produces diffuse areas of hemorrhage and necrosis with thrombus formation and aneurysmal dilation, cryoablation involves a unique biophysical process that gives it the distinctive safety and efficacy profile.3 Cryoablation induces cellular damage mainly via disruption of membranous organelles, such that destruction to the gross myocardial architectures is reduced. Furthermore, cryomapping is feasible as lesions created at a less cool temperature (>−30 °C) are reversible. These potential advantages nurtured the extensive clinical applications of cryoablation in the treatment of cardiac arrhythmias, such as atrioventricular nodal reentrant tachycardia, septal accessory pathways, atrial fibrillation, and ventricular tachycardia, where a high degree of precision is desirable.

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!