Cardiac Mapping

1 - Cardiac Mapping [Seite 3]
2 - Contents [Seite 7]
3 - List of Contributors [Seite 11]
4 - Preface to the Fourth Edition [Seite 17]
5 - Preface to the First Edition [Seite 18]
6 - Foreword [Seite 19]
7 - European Perspective [Seite 21]
8 - Acknowledgements [Seite 22]
9 - PART I Methodological and Technical Considerations [Seite 23]
9.1 - CHAPTER 1 Evolution of Cardiac Mapping: From Direct Analog to Digital Multi-dimensional Recording [Seite 25]
9.1.1 - Introduction [Seite 25]
9.1.2 - Indirect recordings of the electrical activity from the heart [Seite 26]
9.1.3 - Direct recordings of the electrical activity from the heart [Seite 27]
9.1.4 - Multi-channel mapping systems [Seite 27]
9.1.5 - Multi-terminal electrodes [Seite 28]
9.1.5.1 - Catheter-based multi-electrodes [Seite 28]
9.1.6 - Unipolar versus bipolar recordings [Seite 29]
9.1.7 - The Laplacian recording mode [Seite 29]
9.1.8 - Information extracted from extracellular electrograms [Seite 30]
9.1.8.1 - Signal morphology: mono- and biphasic, double potentials, fractionation [Seite 30]
9.1.8.2 - Activation maps [Seite 31]
9.1.8.3 - Potential mapping [Seite 31]
9.1.8.4 - Activation recovery interval [Seite 31]
9.1.9 - Three-dimensional patterns [Seite 31]
9.1.10 - Integrative approaches [Seite 32]
9.1.11 - Alternative mapping techniques [Seite 32]
9.1.12 - References [Seite 32]
9.2 - CHAPTER 2 Image Acquisition and Processing in New Technologies [Seite 34]
9.2.1 - Introduction [Seite 34]
9.2.2 - History of 3D mapping systems and image integration [Seite 34]
9.2.3 - Potential benefits of 3D mapping [Seite 35]
9.2.4 - Principles of 3D mapping systems [Seite 35]
9.2.4.1 - Impedance mapping systems [Seite 35]
9.2.4.2 - Comparison of magnetic and impedance-based systems [Seite 36]
9.2.4.3 - Non-contact mapping [Seite 36]
9.2.5 - Hybrid systems [Seite 36]
9.2.6 - Intracardiac echocardiography [Seite 37]
9.2.7 - Fluoroscopic integration [Seite 37]
9.2.8 - Magnetic resonance imaging integration [Seite 38]
9.2.9 - Dynamic maps [Seite 39]
9.2.10 - Optical coherence tomography [Seite 39]
9.2.11 - Future directions [Seite 39]
9.2.12 - References [Seite 39]
9.3 - CHAPTER 3 Microelectrode Arrays in Cardiac Mapping [Seite 40]
9.3.1 - Microelectrode arrays [Seite 40]
9.3.1.1 - Passive metal arrays [Seite 40]
9.3.1.2 - Complementary metal oxide semiconductor electrode-based mapping [Seite 42]
9.3.2 - Mapping techniques [Seite 43]
9.3.2.1 - In vivo [Seite 43]
9.3.2.2 - In vitro [Seite 44]
9.3.3 - Embryonic stem cell-derived cardiomyocytes [Seite 46]
9.3.4 - Induced pluripotent stem cell-derived cardiomyocytes [Seite 47]
9.3.5 - Patient specific induced pluripotent stem cell-derived cardiomyocytes [Seite 48]
9.3.6 - Acknowledgements [Seite 48]
9.3.7 - References [Seite 48]
9.4 - CHAPTER 4 Cardiac Morphology Relevant to Mapping [Seite 50]
9.4.1 - Introduction [Seite 50]
9.4.2 - General overview: location and spatial relationships of chambers [Seite 50]
9.4.3 - The chambers of the heart [Seite 51]
9.4.3.1 - The right atrium [Seite 51]
9.4.3.2 - The atrial septum and interatrial connections [Seite 53]
9.4.3.3 - The left atrium [Seite 53]
9.4.3.4 - The right ventricle [Seite 54]
9.4.3.5 - The left ventricle [Seite 55]
9.4.4 - References [Seite 56]
9.5 - CHAPTER 5 Comparison of Mapping Technologies for Cardiac Electrophysiology [Seite 58]
9.5.1 - Introduction [Seite 58]
9.5.2 - The EnSite NavX system [Seite 58]
9.5.3 - The CARTO system [Seite 60]
9.5.4 - Image integration with CARTO and NavX [Seite 60]
9.5.5 - Mapping of complex fractionated electrograms for AF [Seite 62]
9.5.6 - Other mapping systems [Seite 62]
9.5.7 - Non-contact mapping [Seite 64]
9.5.8 - Comparison of CARTO and NavX [Seite 66]
9.5.9 - References [Seite 66]
9.6 - CHAPTER 6 Interpretation of Electrograms and Complex Maps of Different Mapping Technologies [Seite 68]
9.6.1 - Introduction [Seite 68]
9.6.1.1 - Complex local electrogram [Seite 69]
9.6.1.2 - Far-field potential [Seite 70]
9.6.1.3 - Passively activated chamber [Seite 70]
9.6.1.4 - Identification of the scar [Seite 72]
9.6.1.5 - Mechanical premature ventricular contractions [Seite 72]
9.6.1.6 - Small potential at the earliest activation site [Seite 73]
9.6.2 - References [Seite 74]
9.7 - CHAPTER 7 Cardiac Mapping: Approach and Troubleshooting for the Electrophysiologist [Seite 75]
9.7.1 - Introduction [Seite 75]
9.7.2 - General principles [Seite 76]
9.7.2.1 - Determining type of arrhythmia and correct chamber [Seite 76]
9.7.2.2 - Mapping windows [Seite 76]
9.7.2.3 - Correct contact [Seite 76]
9.7.2.4 - Interpreting the colors [Seite 77]
9.7.2.5 - Choice of reference signal [Seite 77]
9.7.3 - Taking points: activation mapping [Seite 78]
9.7.3.1 - Normal tissue [Seite 78]
9.7.4 - Taking points: substrate mapping [Seite 80]
9.7.5 - Mapping systems [Seite 81]
9.7.6 - Troubleshooting [Seite 81]
9.7.6.1 - Missing activation: scar and hidden anatomy [Seite 81]
9.7.6.2 - Mapping density [Seite 83]
9.7.6.3 - Early versus late: distance, loops and alleys [Seite 83]
9.7.6.4 - Reentry or focal? [Seite 86]
9.7.6.5 - Masquerading scar [Seite 88]
9.7.7 - References [Seite 89]
10 - PART II Mapping in Experimental Models of Cardiac Arrhythmias [Seite 91]
10.1 - CHAPTER 8 Optical Mapping: Its Impact on Understanding Arrhythmia Mechanisms [Seite 93]
10.1.1 - Rescuing the diseased heart [Seite 93]
10.1.1.1 - Arrhythmias in a dish [Seite 93]
10.1.1.2 - Cell therapy can prevent post-infarct arrhythmias [Seite 95]
10.1.2 - Mapping the human heart [Seite 96]
10.1.3 - References [Seite 100]
10.2 - CHAPTER 9 Optical Mapping of the Sinoatrial Node and Atrioventricular Node [Seite 101]
10.2.1 - Optical mapping methodology [Seite 101]
10.2.1.1 - Sample preparation [Seite 101]
10.2.1.2 - Optical mapping setup [Seite 102]
10.2.1.3 - Optical mapping of the SA node [Seite 102]
10.2.1.4 - Background [Seite 102]
10.2.1.5 - SAN anatomy [Seite 102]
10.2.1.6 - SAN electrophysiology [Seite 102]
10.2.1.7 - Interpretation of optical action potentials from the SAN [Seite 103]
10.2.1.8 - Optical mapping of the canine SAN [Seite 103]
10.2.1.9 - Optical mapping of the human SAN [Seite 105]
10.2.2 - Optical mapping of the AVN [Seite 106]
10.2.2.1 - Background [Seite 106]
10.2.2.2 - AVN anatomy [Seite 106]
10.2.2.3 - AVN immunohistochemistry [Seite 106]
10.2.2.4 - AVN electrophysiology [Seite 106]
10.2.2.5 - Interpretation of optical action potentials from the AVN [Seite 107]
10.2.2.6 - Optical mapping of the rabbit AVN [Seite 107]
10.2.2.7 - Optical mapping of the human AVN [Seite 108]
10.2.3 - References [Seite 110]
10.3 - CHAPTER 10 Panoramic Optical Imaging of Cardiac Arrhythmias [Seite 112]
10.3.1 - Introduction [Seite 112]
10.3.2 - Panoramic imaging techniques [Seite 112]
10.3.2.1 - Panoramic imaging system [Seite 113]
10.3.2.2 - Geometric heart surface reconstruction [Seite 113]
10.3.2.3 - Texture mapping of fluorescence [Seite 114]
10.3.3 - Panoramic data analysis techniques [Seite 114]
10.3.3.1 - Conduction velocity [Seite 116]
10.3.4 - Physiological insights from panoramic optical mapping [Seite 116]
10.3.4.1 - Mechanisms of ventricular tachycardia/ventricular fibrillation [Seite 116]
10.3.4.2 - Mechanisms of defibrillation [Seite 116]
10.3.5 - Informing and validating computational models [Seite 117]
10.3.6 - Complementary mapping techniques [Seite 117]
10.3.7 - References [Seite 119]
10.4 - CHAPTER 11 Optical Imaging of Arrhythmias in Cardiomyocyte Monolayer Culture [Seite 120]
10.4.1 - Introduction [Seite 120]
10.4.2 - Imaging electrical activity in the monolayer [Seite 121]
10.4.2.1 - Macroscopic optical mapping [Seite 121]
10.4.2.2 - Microscopic optical mapping [Seite 122]
10.4.3 - Cardiac arrhythmias in the monolayer [Seite 123]
10.4.4 - Cardiac myocyte-myofibroblast electronic coupling and arrhythmogenesis [Seite 123]
10.4.5 - The role of heterogeneity and intercellular coupling in wave propagation in the monolayer [Seite 125]
10.4.6 - Studies of ischemia/reperfusion related arrhythmias in the monolayer [Seite 126]
10.4.7 - Concordant/discordant alternans and arrythmogenesis in the monolayer [Seite 127]
10.4.8 - References [Seite 128]
10.5 - CHAPTER 12 Mapping of Rotors in Atrial Fibrillation: From Animal Models to Humans [Seite 130]
10.5.1 - Introduction [Seite 130]
10.5.2 - Reentrant activity during acute AF in the isolated sheep heart [Seite 131]
10.5.3 - Formation of reentrant activity [Seite 132]
10.5.4 - Increased intra-atrial pressure and rotor dynamics [Seite 134]
10.5.5 - Activation frequency and rotor drivers in humans [Seite 135]
10.5.6 - Acknowledgements [Seite 139]
10.5.7 - References [Seite 139]
10.6 - CHAPTER 13 Multiple Mechanisms Causing Ventricular Tachycardia [Seite 141]
10.6.1 - Classification of arrhythmogenic mechanisms [Seite 141]
10.6.2 - Automaticity [Seite 141]
10.6.2.1 - Normal automaticity [Seite 141]
10.6.2.2 - Clinical electrophysiology [Seite 142]
10.6.2.3 - Abnormal automaticity [Seite 143]
10.6.3 - Triggered activity [Seite 144]
10.6.3.1 - DADs and triggered activity [Seite 144]
10.6.3.2 - Arrhythmogenic substrate in structural heart disease [Seite 148]
10.6.4 - Gap junction remodeling [Seite 149]
10.6.4.1 - Reentrant ventricular tachycardia in structural heart disease [Seite 149]
10.6.4.2 - Arrhythmogenic right ventricular cardiomyopathies [Seite 150]
10.6.4.3 - Hypertrophic cardiomyopathy [Seite 150]
10.6.4.4 - Heart failure [Seite 150]
10.6.5 - References [Seite 151]
10.7 - CHAPTER 14 Modeling of Atrial Fibrillation [Seite 153]
10.7.1 - Introduction [Seite 153]
10.7.2 - Modeling of AF [Seite 154]
10.7.2.1 - Integrative approach: from the single cell to the whole atrium [Seite 154]
10.7.2.2 - Initiation, perpetuation and termination of AF [Seite 154]
10.7.2.3 - Modeling different types of AF [Seite 155]
10.7.3 - Computer modeling as a tool to develop new therapeutical strategies for AF [Seite 156]
10.7.3.1 - Antiarrhythmic drugs [Seite 158]
10.7.3.2 - Catheter or surgical ablation [Seite 158]
10.7.3.3 - Pacing of AF [Seite 159]
10.7.4 - Link to clinical data and patient-specific modeling [Seite 159]
10.7.5 - Acknowledgements [Seite 161]
10.7.6 - References [Seite 161]
10.8 - CHAPTER 15 Modeling of Ventricular Arrhythmias [Seite 162]
10.8.1 - Introduction [Seite 162]
10.8.2 - General approach to ventricular arrhythmia modeling [Seite 162]
10.8.3 - Models of ventricular arrhythmias [Seite 164]
10.8.3.1 - Models of ventricular arrhythmia mechanisms in the normal heart [Seite 164]
10.8.3.2 - Models of arrhythmias in the diseased heart [Seite 165]
10.8.3.3 - Simulation of drug-induced ventricular arrhythmias [Seite 166]
10.8.3.4 - Ventricular models of arrhythmia incorporating non-myocytes [Seite 166]
10.8.3.5 - Ventricular models of arrhythmia incorporating the Purkinje system [Seite 169]
10.8.4 - Challenges and future directions of ventricular arrhythmias modeling [Seite 169]
10.8.5 - Acknowledgements [Seite 170]
10.8.6 - References [Seite 170]
10.9 - CHAPTER 16 Personalized Electrophysiological Modeling of the Human Atrium [Seite 172]
10.9.1 - Introduction [Seite 172]
10.9.2 - Basics of anatomy and electrophysiology relevant to atrial modeling [Seite 173]
10.9.2.1 - Anatomical features [Seite 173]
10.9.2.2 - Electrophysiology [Seite 173]
10.9.3 - Data acquisition [Seite 174]
10.9.3.1 - Imaging of the atria [Seite 174]
10.9.3.2 - Catheter measurement of atrial electrical signals [Seite 174]
10.9.3.3 - ECG and BSPM [Seite 174]
10.9.4 - Personalized anatomical atrial models [Seite 174]
10.9.4.1 - Image segmentation [Seite 174]
10.9.4.2 - Existing geometrical models [Seite 175]
10.9.4.3 - Structural information [Seite 175]
10.9.4.4 - Validation of anatomical models [Seite 175]
10.9.5 - Personalized electrophysiological atrial models [Seite 176]
10.9.5.1 - Existing electrophysiological models [Seite 176]
10.9.5.2 - Integration of measurement data [Seite 176]
10.9.5.3 - Validation of atrial electrophysiology [Seite 177]
10.9.6 - Personalization of excitation conduction and ECG in atrial models [Seite 177]
10.9.6.1 - Existing models of atrial excitation [Seite 177]
10.9.6.2 - Patient-specific excitation conduction [Seite 177]
10.9.6.3 - Patient-specific ECG [Seite 178]
10.9.6.4 - Validation of atrial conduction [Seite 178]
10.9.7 - Perspectives [Seite 178]
10.9.8 - References [Seite 179]
10.10 - CHAPTER 17 Mapping of the Atrial Neural Network: Autonomic Mechanisms Underlying Complex Fractionated Atrial Electrograms and the Substrate for Atrial Fibrillation [Seite 181]
10.10.1 - Background [Seite 181]
10.10.2 - Definitions of CFAEs [Seite 182]
10.10.3 - Non-contact mapping systems [Seite 182]
10.10.4 - Other lines of evidence linking autonomic mechanisms underlying CFAEs [Seite 184]
10.10.5 - The cardio-cardiac reflex and CFAEs [Seite 187]
10.10.6 - Clinical implications [Seite 191]
10.10.7 - Acknowledgements [Seite 192]
10.10.8 - References [Seite 192]
10.11 - CHAPTER 18 Mapping of Atrial Repolarization Changes and Tachyarrhythmia Sites of Origin During Activation of Mediastinal Nerve Inputs to the Intrinsic Cardiac Nervous System [Seite 194]
10.11.1 - The clinical issue [Seite 194]
10.11.2 - Limitations of functional electrophysiological mapping based on the extrastimulus technique [Seite 195]
10.11.3 - Functional electrophysiological mapping of repolarization changes [Seite 195]
10.11.4 - Neurally induced atrial tachyarrhythmias: spatially concordant repolarization changes [Seite 195]
10.11.5 - Functional versus anatomical mapping of ganglionated plexus and juxtacardiac nerves [Seite 197]
10.11.6 - Interplay with myocardial tissue and cellular properties [Seite 199]
10.11.7 - Acknowledgements [Seite 199]
10.11.8 - References [Seite 199]
10.12 - CHAPTER 19 How to Map Autonomic Activity [Seite 201]
10.12.1 - Introduction [Seite 201]
10.12.2 - Anatomy of cardiac autonomic nervous system [Seite 202]
10.12.3 - Mapping techniques [Seite 203]
10.12.4 - Data analysis [Seite 203]
10.12.5 - Extrinsic cardiac nervous activity - sympathetic and parasympathetic nerve activities [Seite 203]
10.12.6 - Intrinsic cardiac nervous activity [Seite 204]
10.12.7 - Modulation of cardiac autonomic nervous activity [Seite 206]
10.12.8 - Acknowledgements [Seite 208]
10.12.9 - References [Seite 208]
11 - PART III Mapping of Supraventricular Tachyarrhythmias [Seite 211]
11.1 - CHAPTER 20 Mapping of Human Atrial Flutter and Its Variants [Seite 213]
11.1.1 - Introduction [Seite 213]
11.1.2 - AFL terminology [Seite 213]
11.1.3 - Pathophysiological mechanisms of typical (and reverse typical) AFL [Seite 214]
11.1.4 - Electrocardiogram diagnosis of typical (and reverse typical) AFL [Seite 215]
11.1.5 - Standard catheter mapping of typical (and reverse typical) AFL [Seite 215]
11.1.6 - Radio-frequency catheter ablation of typical AFL [Seite 217]
11.1.7 - Procedure endpoints for RFCA of typical AFL [Seite 220]
11.1.8 - Outcomes and complications of catheter ablation of typical AFL [Seite 223]
11.1.9 - Alternative energy sources for ablation of typical AFL [Seite 224]
11.1.10 - Computerized 3D mapping in diagnosis and ablation of AFL [Seite 224]
11.1.11 - Simplified approach to ablation of typical (and reverse typical) AFL [Seite 227]
11.1.12 - Mapping and diagnosis of atypical right AFL [Seite 228]
11.1.13 - References [Seite 232]
11.2 - CHAPTER 21 New Insights into Reentry Circuits from Mapping and Ablation of Atrioventricular Nodal Reentrant Tachycardia [Seite 235]
11.2.1 - Introduction [Seite 235]
11.2.2 - Conducting tissue of the atrioventricular junction [Seite 235]
11.2.3 - Functional inputs to the AV node [Seite 235]
11.2.4 - The slow pathway [Seite 236]
11.2.5 - The fast pathway [Seite 237]
11.2.6 - The AVNRT reentry circuit [Seite 238]
11.2.7 - Catheter ablation of AVNRT [Seite 238]
11.2.8 - Endpoints for slow pathway ablation [Seite 238]
11.2.9 - Typical AVNRT variants [Seite 240]
11.2.10 - Non-inducible AVNRT [Seite 241]
11.2.11 - Risk of AV block [Seite 241]
11.2.12 - Ablation of AVNRT in the presence of preexisting AV nodal conduction abnormalities [Seite 241]
11.2.13 - Catheter ablation of atypical AVNRT [Seite 241]
11.2.14 - References [Seite 244]
11.3 - CHAPTER 22 Atrioventricular Nodal Reentrant Tachycardia: Current Understanding and Controversies [Seite 246]
11.3.1 - Introduction [Seite 246]
11.3.2 - AV node with its neighboring atrium [Seite 246]
11.3.3 - EP characteristics of the AVNRT circuit [Seite 247]
11.3.4 - Different forms of AVNRT [Seite 247]
11.3.4.1 - Typical AVNRT [Seite 247]
11.3.4.2 - Atypical AVNRT [Seite 250]
11.3.5 - Differential diagnosis [Seite 250]
11.3.6 - Blocks and "pseudo-blocks" during AVNRT [Seite 255]
11.3.6.1 - AV discordance with A V [Seite 255]
11.3.6.2 - AV discordance with V A [Seite 256]
11.3.7 - Extent of the AVNRT circuit [Seite 260]
11.3.7.1 - Upper turnaround point [Seite 260]
11.3.7.2 - Lower turnaround point [Seite 263]
11.3.8 - Transcatheter ablation [Seite 265]
11.3.8.1 - Approaches to slow pathway ablation [Seite 265]
11.3.8.2 - Practical tips for achieving successful results with RFA [Seite 266]
11.3.8.3 - Cryomapping and cryoablation [Seite 268]
11.3.8.4 - Potential complications [Seite 268]
11.3.8.5 - Cryomapping of the fast pathway [Seite 268]
11.3.8.6 - Clinical and EP outcomes after ablation [Seite 269]
11.3.9 - Acknowledgements [Seite 269]
11.3.10 - References [Seite 269]
11.4 - CHAPTER 23 Mapping of Typical Preexcitation Syndromes [Seite 271]
11.4.1 - Introduction [Seite 271]
11.4.2 - Epidemiology and prognosis [Seite 271]
11.4.3 - AP characteristics [Seite 271]
11.4.4 - ECG localization of AP [Seite 272]
11.4.5 - Electrophysiology study [Seite 272]
11.4.5.1 - Baseline measurements [Seite 272]
11.4.5.2 - Para-Hisian and pure Hisian pacing [Seite 273]
11.4.5.3 - Differential (base vs. apex) pacing [Seite 273]
11.4.6 - Diagnostic maneuvers during tachycardia [Seite 274]
11.4.6.1 - ORT tachycardia characteristics [Seite 274]
11.4.6.2 - Preexcitation index [Seite 274]
11.4.6.3 - His-synchronous ventricular extrastimuli (HSVE) [Seite 275]
11.4.6.4 - Ventricular overdrive pacing and entrainment [Seite 275]
11.4.6.5 - Pacing at the tachycardia cycle length [Seite 276]
11.4.7 - Mapping strategies [Seite 276]
11.4.7.1 - Mapping the earliest ventricular signal [Seite 277]
11.4.7.2 - Mapping the earliest atrial signal [Seite 277]
11.4.7.3 - Short local VA/AV time [Seite 278]
11.4.7.4 - AP potentials [Seite 278]
11.4.8 - Slanted pathways [Seite 278]
11.4.9 - Approach [Seite 279]
11.4.9.1 - Retrograde aortic approach [Seite 279]
11.4.9.2 - Transeptal approach [Seite 280]
11.4.9.3 - Coronary sinus ablation [Seite 280]
11.4.10 - Special anatomic considerations [Seite 281]
11.4.10.1 - Posteroseptal accessory pathways [Seite 281]
11.4.10.2 - Free wall accessory pathways [Seite 282]
11.4.11 - References [Seite 282]
11.5 - CHAPTER 24 Cardiac Mapping in Variants of the Ventricular Preexcitation Syndrome [Seite 284]
11.5.1 - Introduction: the Mahaim fiber in the new millennium (Figure 24.1) [Seite 284]
11.5.1.1 - Atriofascicular pathways and decrementally conducting long AV pathways [Seite 286]
11.5.2 - Short decrementally conducting accessory AV pathways (short AV Mahaim fibers) [Seite 296]
11.5.2.1 - Definitions [Seite 296]
11.5.2.2 - Pre-ablation ECG findings [Seite 298]
11.5.2.3 - Electrophysiological findings [Seite 299]
11.5.2.4 - Common features in patients with short AV Mahaim fibers [Seite 301]
11.5.2.5 - Discordant features in patients with short AV Mahaim fibers [Seite 302]
11.5.2.6 - AV node-like features [Seite 302]
11.5.2.7 - Short AV Mahaim fibers without AV node-like behavior [Seite 303]
11.5.2.8 - Previous studies [Seite 303]
11.5.2.9 - Do all short AV Mahaim fibers need to undergo catheter ablation therapy? [Seite 303]
11.5.2.10 - Mapping and ablating short AV Mahaim fibers [Seite 304]
11.5.3 - Fasciculoventricular fibers [Seite 304]
11.5.3.1 - Introduction [Seite 304]
11.5.3.2 - Electrocardiographic recognition of a fasciculoventricular pathway and its differentiation from midseptal and anteroseptal accessory pathways [Seite 305]
11.5.3.3 - Electrocardiographic similarities with anteroseptal accessory pathways [Seite 305]
11.5.3.4 - Electrocardiographic similarities with midseptal accessory pathways [Seite 306]
11.5.3.5 - Electrocardiographic dissimilarities between fasciculoventricular pathways, midseptal and anteroseptal accessory pathways (Table 24.4) [Seite 306]
11.5.3.6 - Electrophysiological findings of fasciculoventricular pathways [Seite 307]
11.5.3.7 - Relationship between fasciculoventricular pathway and PRKAG2 mutation [Seite 307]
11.5.4 - Nodoventricular and nodofascicular pathways [Seite 314]
11.5.4.1 - Electrophysiology [Seite 314]
11.5.4.2 - Proof of the participation of the nodofascicular/ nodoventricular fiber in the tachycardia circuit [Seite 315]
11.5.4.3 - Definition of the Mahaim fiber insertion sites [Seite 315]
11.5.4.4 - Retrograde VH conduction [Seite 316]
11.5.4.5 - Differential diagnosis [Seite 316]
11.5.4.6 - Radio-frequency catheter ablation [Seite 317]
11.5.5 - References [Seite 318]
11.6 - CHAPTER 25 Three-Dimensional Post-Pacing Interval Mapping of Left Atrial Tachycardia [Seite 321]
11.6.1 - Introduction [Seite 321]
11.6.2 - Role of imaging [Seite 321]
11.6.3 - Mapping modalities [Seite 322]
11.6.3.1 - Role of 3D mapping systems [Seite 322]
11.6.3.2 - Activation mapping [Seite 322]
11.6.3.3 - Voltage mapping [Seite 322]
11.6.3.4 - PPI mapping [Seite 322]
11.6.3.5 - Catheter ablation strategies [Seite 324]
11.6.3.6 - Success rates [Seite 325]
11.6.4 - Procedural complications [Seite 325]
11.6.5 - Limitations [Seite 326]
11.6.6 - References [Seite 327]
11.7 - CHAPTER 26 Recent Observations in Mapping of Complex Fractionated Atrial Electrograms in Atrial Fibrillation [Seite 328]
11.7.1 - Introduction [Seite 328]
11.7.2 - Definition of CFAEs [Seite 329]
11.7.3 - Electrophysiological mechanisms underlying CFAEs [Seite 329]
11.7.4 - Regional distribution of CFAEs [Seite 329]
11.7.5 - CFAE mapping [Seite 331]
11.7.5.1 - Procedural details [Seite 332]
11.7.6 - Evidence that CFAE areas represent AF substrates [Seite 335]
11.7.7 - Other studies and controversy [Seite 335]
11.7.7.1 - Studies in paroxysmal AF patients: is CFAE targeting ablation alone appropriate for treating these patients? [Seite 335]
11.7.7.2 - Studies in persistent AF: role of targeting CFAEs alone or as an adjuvant to PVI or linear ablation [Seite 336]
11.7.8 - References [Seite 337]
11.8 - CHAPTER 27 Monophasic Action Potential Recordings in Atrial Fibrillation and Role of Repolarization Alternans [Seite 339]
11.8.1 - Epidemiology of atrial fibrillation [Seite 339]
11.8.2 - Mechanisms of AF [Seite 339]
11.8.3 - MAP recording [Seite 339]
11.8.4 - Action potential duration and restitution [Seite 341]
11.8.5 - Substrate for arrhythmia [Seite 341]
11.8.6 - Atrial electrophysiological properties and atrial fibrillation [Seite 342]
11.8.7 - References [Seite 347]
11.9 - CHAPTER 28 Mapping of the Atrial Electrogram in Sinus Rhythm and Different Atrial Fibrillation Substrates [Seite 350]
11.9.1 - Introduction [Seite 350]
11.9.2 - Mapping procedure and technical consideration [Seite 350]
11.9.2.1 - Electroanatomic mapping [Seite 351]
11.9.2.2 - Bipolar intracardiac electrogram analysis [Seite 351]
11.9.2.3 - Non-contact mapping for sinus rhythm [Seite 351]
11.9.3 - Clinical implication of electrogram voltage [Seite 353]
11.9.3.1 - Indicator of degree of atrial substrate remodeling [Seite 353]
11.9.3.2 - Indicator of sinus node dysfunction [Seite 354]
11.9.3.3 - Implication for intracardiac mapping: identification of the disease substrate or scar [Seite 354]
11.9.3.4 - Implication for intracardiac mapping: identification of the conduction block and conduction isthmuses [Seite 355]
11.9.4 - Spectral analysis during sinus rhythm: AF nest identification [Seite 357]
11.9.4.1 - Clinical implications [Seite 357]
11.9.4.2 - Mechanism of the AF nest [Seite 358]
11.9.5 - References [Seite 360]
11.10 - CHAPTER 29 Management of Atrial Tachycardias Arising in the Context of Atrial Fibrillation Ablation [Seite 363]
11.10.1 - Introduction [Seite 363]
11.10.2 - Burden of AT after AF ablation [Seite 363]
11.10.3 - Classification [Seite 364]
11.10.4 - Mechanisms of AT [Seite 364]
11.10.5 - Drug therapy [Seite 364]
11.10.5.1 - ATs occurring during AF ablation [Seite 364]
11.10.6 - Locations of AT circuits [Seite 364]
11.10.7 - Diagnosis [Seite 365]
11.10.7.1 - Clinical diagnosis [Seite 365]
11.10.7.2 - Electrophysiological diagnosis [Seite 366]
11.10.7.3 - Three-dimensional mapping tools [Seite 368]
11.10.8 - Catheter ablation [Seite 369]
11.10.9 - Procedural outcome and prognosis [Seite 370]
11.10.10 - Prevention of AT [Seite 371]
11.10.11 - References [Seite 371]
11.11 - CHAPTER 30 Stepwise Approach to Management of Atrial Arrhythmias after Catheter Ablation of Atrial Fibrillation [Seite 373]
11.11.1 - Incidence and importance of the problem [Seite 373]
11.11.2 - Mechanisms of the recurrent ATs after AF ablation [Seite 373]
11.11.3 - Classification of the ATs after AF ablation [Seite 374]
11.11.4 - ECG recognition of ATs secondary to prior AF ablation [Seite 374]
11.11.5 - Preferential localization of ATs after left atrial substrate modification [Seite 374]
11.11.5.1 - Stepwise approach in left AT diagnosis and ablation [Seite 375]
11.11.6 - Pulmonary vein re-isolation [Seite 375]
11.11.7 - Entrainment maneuvers and 3D-entrainment mapping [Seite 375]
11.11.8 - Activation mapping [Seite 376]
11.11.9 - Procedural endpoint [Seite 376]
11.11.10 - Outcome of the re-ablation procedures [Seite 377]
11.11.11 - References [Seite 378]
11.12 - CHAPTER 31 Mapping of Persistent Atrial Fibrillation: How Many Sites, How Many Lines? [Seite 380]
11.12.1 - Introduction [Seite 380]
11.12.2 - Ablation strategies [Seite 380]
11.12.2.1 - Pulmonary vein antrum isolation (PVAI) (Figure 31.1) [Seite 380]
11.12.2.2 - Complex fragmented atrial electrograms (Figure 31.2) [Seite 381]
11.12.2.3 - Linear ablation [Seite 382]
11.12.2.4 - Non-PV foci [Seite 383]
11.12.2.5 - Other/new strategies [Seite 383]
11.12.3 - Endpoints for ablation in persistent AF [Seite 383]
11.12.4 - Outcomes [Seite 384]
11.12.5 - References [Seite 385]
11.13 - CHAPTER 32 Mapping of Focal Right Atrial and Coronary Sinus Tachycardias [Seite 389]
11.13.1 - Introduction [Seite 389]
11.13.2 - Pathophysiology [Seite 389]
11.13.3 - Electrocardiographic characteristics [Seite 390]
11.13.4 - Electrophysiological characteristics [Seite 392]
11.13.5 - Electroanatomical mapping [Seite 394]
11.13.6 - AT arising from CS musculature [Seite 396]
11.13.7 - Ablation [Seite 397]
11.13.8 - References [Seite 399]
11.14 - CHAPTER 33 Is There a Role For Mapping of Dominant Frequency in Human Atrial Fibrillation? [Seite 402]
11.14.1 - Introduction [Seite 402]
11.14.2 - Clinical studies on CFAE mapping [Seite 402]
11.14.3 - Mechanisms of CFAEs [Seite 406]
11.14.4 - Frequency mapping [Seite 407]
11.14.5 - Future directions [Seite 410]
11.14.6 - References [Seite 410]
11.15 - CHAPTER 34 Do Mapping Strategies Influence the Outcome in AF Ablation? [Seite 413]
11.15.1 - Introduction [Seite 413]
11.15.2 - Techniques and outcomes [Seite 413]
11.15.2.1 - Role of PVs: from early experiences to PV antral approach [Seite 413]
11.15.2.2 - Role of atrial substrate modification [Seite 415]
11.15.2.3 - Outcome in complex and multistep approaches [Seite 418]
11.15.2.4 - Results from worldwide surveys [Seite 419]
11.15.3 - References [Seite 419]
11.16 - CHAPTER 35 Mapping of Atrial Fibrillation: Comparing Complex Fractionated Atrial Electrograms, Voltage Maps, Dominant Frequency Maps and Ganglionic Plexi [Seite 422]
11.16.1 - Introduction [Seite 422]
11.16.2 - Complex fractionated atrial electrograms [Seite 422]
11.16.3 - Voltage maps [Seite 424]
11.16.4 - Dominant frequency maps [Seite 426]
11.16.5 - Ganglionic plexi [Seite 427]
11.16.6 - References [Seite 430]
11.17 - CHAPTER 36 Mapping Strategies in Failed and Redo Ablation of Atrial Arrhythmias [Seite 432]
11.17.1 - Introduction [Seite 432]
11.17.2 - Pre-procedure planning [Seite 432]
11.17.3 - Technical considerations [Seite 433]
11.17.4 - Mapping strategy after previous PVI [Seite 433]
11.17.5 - Mapping strategy after previous stepwise ablation for persistent AF [Seite 434]
11.17.6 - References [Seite 438]
11.18 - CHAPTER 37 The Use of Multi-electrode Catheters for Electroanatomical Mapping of Atrial Fibrillation [Seite 440]
11.18.1 - Introduction [Seite 440]
11.18.2 - Types of multi-electrode catheters [Seite 440]
11.18.2.1 - The circular mapping catheter [Seite 440]
11.18.2.2 - The multi-spine catheter [Seite 441]
11.18.2.3 - The spiral mapping catheter [Seite 441]
11.18.3 - Anatomy acquisition [Seite 441]
11.18.4 - Electrical data acquisition [Seite 442]
11.18.4.1 - Activation mapping of focal and reentrant tachycardias [Seite 442]
11.18.4.2 - Rapid detection of gaps along ablation lines [Seite 442]
11.18.4.3 - Mapping of complex fractionated electrograms [Seite 442]
11.18.4.4 - Activation mapping of AF [Seite 443]
11.18.5 - Limitations of micro-electrode catheters [Seite 443]
11.18.6 - References [Seite 443]
12 - PART IV Mapping of Ventricular Tachyarrhythmias [Seite 445]
12.1 - CHAPTER 38 Mapping of VT in Structurally Normal Hearts [Seite 447]
12.1.1 - Idiopathic ventricular tachycardia [Seite 447]
12.1.2 - Ventricular outflow tachycardias [Seite 447]
12.1.3 - Anatomy and relationship between LVOT and RVOT [Seite 448]
12.1.4 - RVOT tachycardia: ECG characteristics [Seite 448]
12.1.5 - LVOT tachycardia: anatomic origins and ECG characteristics [Seite 450]
12.1.6 - Mapping and ablation of outflow tract VT [Seite 452]
12.1.7 - Verapamil sensitive VT [Seite 453]
12.1.8 - Electrocardiography [Seite 453]
12.1.9 - Anatomical basis, substrate and mechanism [Seite 455]
12.1.10 - Characteristics and electrophysiological study [Seite 455]
12.1.11 - Medication [Seite 455]
12.1.12 - Ablation [Seite 456]
12.1.13 - Triggered epicardial left VT [Seite 457]
12.1.14 - Papillary muscle ventricular tachycardia [Seite 457]
12.1.15 - Mitral annular VT [Seite 457]
12.1.16 - References [Seite 459]
12.2 - CHAPTER 39 Advances in Mapping and Catheter Ablation of Ventricular Arrhythmias in Ischemic and Scar-related Substrates [Seite 461]
12.2.1 - Introduction [Seite 461]
12.2.2 - Activation mapping [Seite 462]
12.2.3 - Entrainment techniques [Seite 462]
12.2.4 - Pacemapping [Seite 462]
12.2.5 - Substrate mapping [Seite 463]
12.2.5.1 - Scar distribution [Seite 463]
12.2.5.2 - Use of voltage mapping [Seite 464]
12.2.5.3 - Other information [Seite 464]
12.2.5.4 - Inexcitable areas [Seite 464]
12.2.6 - Pre-procedure studies including imaging [Seite 466]
12.2.7 - Recognition of non-traditional sites for VT mapping and ablation [Seite 467]
12.2.8 - Hemodynamic support [Seite 468]
12.2.9 - Current approaches [Seite 469]
12.2.10 - Endpoints and outcomes [Seite 469]
12.2.11 - Remaining problems [Seite 470]
12.2.12 - References [Seite 471]
12.3 - CHAPTER 40 Mapping of Ventricular Tachycardias in Rare Cardiomyopathies [Seite 472]
12.3.1 - Introduction [Seite 472]
12.3.2 - Sarcoidosis: general pathology and diagnosis [Seite 473]
12.3.3 - Amyloidosis - general pathology and diagnosis [Seite 473]
12.3.4 - Ventricular tachyarrhythmias in cardiac sarcoidosis [Seite 475]
12.3.5 - Steroid therapy in cardiac sarcoidosis [Seite 475]
12.3.6 - Ventricular tachyarrhythmias in cardiac amyloidosis [Seite 476]
12.3.7 - Data on mapping and catheter ablation [Seite 476]
12.3.8 - References [Seite 478]
12.4 - CHAPTER 41 Advances in Mapping of Ventricular Fibrillation and Defibrillation: Role of the Purkinje System [Seite 481]
12.4.1 - Anatomy of the Purkinje network [Seite 481]
12.4.2 - Recording Purkinje activation in humans [Seite 482]
12.4.3 - Mechanisms of Purkinje fiber activation during VT [Seite 482]
12.4.4 - Purkinje fiber involvement in VF [Seite 482]
12.4.5 - Purkinje involvement in post-shock arrhythmias [Seite 485]
12.4.6 - Acknowledgements [Seite 487]
12.4.7 - References [Seite 487]
12.5 - CHAPTER 42 Phase Mapping of Cardiac Fibrillation: Applications in Studying Human Ventricular Fibrillation [Seite 489]
12.5.1 - Background [Seite 489]
12.5.2 - Electrical and optical mapping of human VF [Seite 489]
12.5.3 - Phase mapping [Seite 490]
12.5.3.1 - Temporal organization [Seite 490]
12.5.3.2 - Hilbert transform [Seite 490]
12.5.3.3 - Spatial organization [Seite 491]
12.5.4 - Applications in studying human VF [Seite 493]
12.5.4.1 - Types of reentrant circuits [Seite 493]
12.5.4.2 - Border zone affinity [Seite 493]
12.5.4.3 - Expanding phase mapping in a 3D model [Seite 493]
12.5.4.4 - Scroll waves [Seite 494]
12.5.4.5 - Effect of ischemia-reperfusion on spatial organization of VF [Seite 496]
12.5.4.6 - Phase mapping in clinical studies [Seite 496]
12.5.4.7 - Limitations [Seite 497]
12.5.5 - References [Seite 498]
12.6 - CHAPTER 43 Myocardial Substrate Mapping in Non-ischemic Cardiomyopathy Ventricular Tachycardia [Seite 499]
12.6.1 - Introduction [Seite 499]
12.6.2 - Initial assessment of VT in the electrophysiology laboratory [Seite 500]
12.6.3 - Substrate mapping [Seite 500]
12.6.3.1 - Endocardial voltage mapping [Seite 500]
12.6.3.2 - Pace mapping [Seite 500]
12.6.3.3 - Sinus or paced rhythm electrograms [Seite 501]
12.6.3.4 - Epicardial or intramural substrate [Seite 502]
12.6.3.5 - Endocardial voltage mapping to detect epicardial scars [Seite 502]
12.6.3.6 - Epicardial substrate mapping [Seite 502]
12.6.3.7 - Avoiding injury to coronary arteries and the phrenic nerve [Seite 503]
12.6.4 - Application of substrate-guided ablation for VT in NICM [Seite 503]
12.6.5 - References [Seite 504]
12.7 - CHAPTER 44 Epicardial Mapping: Technique, Indication and Results [Seite 506]
12.7.1 - Introduction [Seite 506]
12.7.2 - When to consider an epicardial approach [Seite 506]
12.7.3 - Method for pericardial access [Seite 508]
12.7.4 - Techniques for epicardial mapping and ablation [Seite 510]
12.7.5 - Complications and risks associated with epicardial ablation [Seite 511]
12.7.6 - Outcome of epicardial mapping and ablation in specific arrhythmogenic substrates [Seite 513]
12.7.6.1 - Idiopathic VT [Seite 513]
12.7.6.2 - Non-ischemic cardiomyopathy [Seite 514]
12.7.6.3 - Ischemic heart disease [Seite 517]
12.7.7 - References [Seite 518]
12.8 - CHAPTER 45 Combined Endocardial and Epicardial Mapping of Ventricular Tachycardia [Seite 522]
12.8.1 - Introduction [Seite 522]
12.8.2 - General procedural considerations [Seite 522]
12.8.3 - Substrate characterization [Seite 523]
12.8.3.1 - Normal electrogram characteristics [Seite 523]
12.8.3.2 - Ischemic cardiomyopathy (ICM) [Seite 524]
12.8.3.3 - LV cardiomyopathy [Seite 524]
12.8.3.4 - RV cardiomyopathy (ARVC/D) [Seite 525]
12.8.3.5 - Chagas disease [Seite 526]
12.8.4 - VT morphology [Seite 527]
12.8.5 - Mapping strategies [Seite 529]
12.8.5.1 - Entrainment mapping [Seite 529]
12.8.5.2 - Pace mapping [Seite 530]
12.8.5.3 - Substrate modification [Seite 530]
12.8.6 - Combined LV and RV cardiomyopathy [Seite 532]
12.8.7 - References [Seite 533]
12.9 - CHAPTER 46 Localization of the Arrhythmogenic Substrate in Non-ischemic Cardiomyopathy: Combined Endocardial and Epicardial Mapping and Ablation [Seite 536]
12.9.1 - Introduction [Seite 536]
12.9.2 - Pathologic features of the arrhythmogenic substrate [Seite 536]
12.9.3 - Location of arrhythmogenic substrate in NICM [Seite 537]
12.9.4 - Can an epicardial substrate be predicted? [Seite 540]
12.9.4.1 - 12-lead ECG [Seite 540]
12.9.4.2 - Imaging [Seite 542]
12.9.4.3 - Electroanatomical mapping [Seite 544]
12.9.4.4 - Endocardial/epicardial or both? [Seite 544]
12.9.5 - References [Seite 544]
12.10 - CHAPTER 47 Is Resetting and Entrainment Mapping Still Useful with New Technologies? [Seite 546]
12.10.1 - Introduction [Seite 546]
12.10.2 - Understanding the physiology of resetting and entrainment [Seite 546]
12.10.3 - Efficacy of entrainment mapping vs. activation mapping or substrate ablation [Seite 548]
12.10.4 - Importance of determining the tachycardia mechanism [Seite 548]
12.10.5 - Using entrainment to verify activation mapping information [Seite 555]
12.10.6 - Use of entrainment mapping to validate novel substrate mapping approaches [Seite 555]
12.10.7 - References [Seite 558]
12.11 - CHAPTER 48 Should We Map and Ablate the Triggers, Substrates, Ventricular Tachycardia Circuit or All? [Seite 559]
12.11.1 - Introduction [Seite 559]
12.11.2 - Ablating the triggers [Seite 559]
12.11.3 - Purkinje-related extrasystole [Seite 560]
12.11.4 - Ablating the substrate [Seite 560]
12.11.5 - Ablating the circuit [Seite 562]
12.11.6 - References [Seite 565]
12.12 - CHAPTER 49 Mapping of Ventricular Arrhythmias Originating from Aortic and Pulmonic Valves [Seite 566]
12.12.1 - Introduction [Seite 566]
12.12.2 - Anatomic correlate [Seite 566]
12.12.3 - Mechanism of arrhythmia [Seite 567]
12.12.4 - Clinical presentation and treatment options [Seite 567]
12.12.5 - 12-Lead surface ECG [Seite 567]
12.12.5.1 - RVOT VT [Seite 568]
12.12.5.2 - Differentiating aortic root from RVOT VT [Seite 568]
12.12.5.3 - LCC VT [Seite 568]
12.12.5.4 - RCC VT [Seite 568]
12.12.5.5 - Supravalvular versus epicardial OT VT [Seite 568]
12.12.6 - Pre-procedural considerations [Seite 569]
12.12.7 - Mapping strategies [Seite 569]
12.12.7.1 - Activation mapping [Seite 569]
12.12.7.2 - Pacemapping [Seite 569]
12.12.8 - Catheter ablation [Seite 569]
12.12.8.1 - Ablation of VT originating from the RVOT and pulmonary artery [Seite 570]
12.12.8.2 - Ablation of VT arising from the aortic sinuses of Valsalva [Seite 570]
12.12.9 - Complications [Seite 571]
12.12.10 - Procedural endpoint and success rates [Seite 571]
12.12.11 - References [Seite 571]
12.13 - CHAPTER 50 Do Mapping Strategies Influence Outcomes in Ventricular Tachycardia Ablation? [Seite 573]
12.13.1 - Introduction [Seite 573]
12.13.2 - Entrainment mapping [Seite 573]
12.13.3 - Pacemapping [Seite 574]
12.13.4 - Non-contact mapping [Seite 575]
12.13.4.1 - Dynamic substrate mapping [Seite 575]
12.13.4.2 - Mapping during ongoing arrhythmia [Seite 575]
12.13.5 - Substrate mapping [Seite 576]
12.13.5.1 - LP mapping [Seite 577]
12.13.6 - References [Seite 580]
13 - PART V Future Directions and Technologies in Cardiac Mapping and Imaging of Cardiac Arrhythmias [Seite 583]
13.1 - CHAPTER 51 Future in Intracardiac Three-dimensional Mapping-Fluroscopy Integrated Sensor-Based Catheter Navigation: The MediGuide Technology [Seite 585]
13.1.1 - Introduction [Seite 585]
13.1.2 - Description of the technology [Seite 585]
13.1.3 - Clinical experience [Seite 587]
13.1.4 - References [Seite 587]
13.2 - CHAPTER 52 Role of Remote Navigation in Mapping and Ablation of Complex Arrhythmias [Seite 588]
13.2.1 - Introduction [Seite 588]
13.2.2 - Electromechanical remote navigation [Seite 588]
13.2.2.1 - Sensei: baseline concept [Seite 589]
13.2.2.2 - Amigo: baseline concept [Seite 589]
13.2.2.3 - Clinical experience using electromechanical systems [Seite 589]
13.2.3 - Magnetic navigation [Seite 590]
13.2.3.1 - NIOBE: baseline concept of permanent magnetic navigation [Seite 590]
13.2.3.2 - Catheter Guidance Control and Imaging system: baseline concept [Seite 590]
13.2.3.3 - Clinical experience: tachycardia substrates [Seite 591]
13.2.3.4 - Remote-controlled ablation of AF [Seite 592]
13.2.4 - Further advantages of remote navigation [Seite 592]
13.2.5 - Comparison between electromechanical and magnetic remote navigation [Seite 594]
13.2.6 - References [Seite 594]
13.3 - CHAPTER 53 Diffusion Tensor Magnetic Resonance Imaging-Derived Myocardial Fiber Disarray in Hypertensive Left Ventricular Hypertrophy: Visualization, Quantification and the Effect on Mechanical Function [Seite 596]
13.3.1 - Abstract [Seite 596]
13.3.2 - Introduction [Seite 596]
13.3.2.1 - Myocardium microarchitecture [Seite 596]
13.3.2.2 - Diffusion tensor magnetic resonance imaging [Seite 596]
13.3.2.3 - Tracking of the microstructural components of myocardium [Seite 597]
13.3.2.4 - Hypertension-induced left ventricular hypertrophy as an ominous sign of heart failure [Seite 598]
13.3.2.5 - The role of mechanical modeling in cardiology [Seite 599]
13.3.2.6 - Contribution of this chapter [Seite 599]
13.3.3 - Materials and methods [Seite 600]
13.3.3.1 - Research animal model [Seite 600]
13.3.3.2 - Heart preparation [Seite 600]
13.3.3.3 - Diffusion imaging [Seite 600]
13.3.3.4 - Tensor data set reconstruction [Seite 600]
13.3.4 - Visualization of the myocardial fiber disarray using DT-MRI fiber tractography [Seite 600]
13.3.5 - DT-MRI quantitative study of the myocardial fiber disarray [Seite 601]
13.3.5.1 - Regions of interest [Seite 601]
13.3.5.2 - Quantitative analysis of myocardial fiber disarray [Seite 602]
13.3.6 - Mechanical effects of myocardial fiber disarray: a model-based study [Seite 604]
13.3.7 - Discussion and future directions [Seite 605]
13.3.8 - Acknowledgements [Seite 607]
13.3.9 - References [Seite 607]
13.4 - CHAPTER 54 Imaging Fiber Orientation with Optical Coherence Tomography and Diffusion-Tensor Magnetic Resonance Imaging and its Role in Arrhythmogenesis [Seite 611]
13.4.1 - Fiber orientation in the mammalian ventricle [Seite 611]
13.4.1.1 - Normal ventricular fiber orientation [Seite 611]
13.4.1.2 - The impact of fiber orientation on normal electrophysiological function [Seite 611]
13.4.1.3 - Measuring ventricular fiber orientation [Seite 612]
13.4.2 - Imaging of fiber orientation with OCT [Seite 612]
13.4.2.1 - Principles of OCT [Seite 612]
13.4.2.2 - Imaging of fiber orientation in cardiac tissues with OCT [Seite 613]
13.4.2.3 - Future developments in cardiac OCT [Seite 614]
13.4.3 - Imaging of fiber orientation with DT-MRI [Seite 615]
13.4.3.1 - Principles of DT-MRI [Seite 615]
13.4.3.2 - Imaging of fiber orientation in cardiac tissues with DT-MRI [Seite 615]
13.4.3.3 - Informing computational models of electrophysiology [Seite 615]
13.4.3.4 - Future developments in cardiac DT-MRI [Seite 615]
13.4.4 - The role of fiber orientation in arrhythmogenesis [Seite 616]
13.4.4.1 - Anisotropic conduction failure and reentry [Seite 616]
13.4.4.2 - Modeling how changes in fiber orientation effect wavefront propagation [Seite 617]
13.4.4.3 - Transmural fiber rotation and arrhythmogenesis in hypertrophic cardiomyopathy [Seite 617]
13.4.4.4 - Using geometry to tailor antiarrhythmic therapies [Seite 618]
13.4.5 - References [Seite 618]
13.5 - CHAPTER 55 Novel Imaging Strategies for Cardiac Arrhythmias [Seite 620]
13.5.1 - Introduction [Seite 620]
13.5.2 - Imaging in AF [Seite 620]
13.5.2.1 - Left atrial volume and function [Seite 620]
13.5.2.2 - Left atrial function [Seite 621]
13.5.2.3 - Imaging of left atrial scar [Seite 622]
13.5.3 - Intraprocedural echo-guided cardiac imaging [Seite 622]
13.5.4 - Image integration [Seite 624]
13.5.4.1 - Fluoroscopy and CT/MRI [Seite 624]
13.5.4.2 - Image integration: mapping system [Seite 625]
13.5.5 - Results of imaging integration in terms of clinical outcomes [Seite 625]
13.5.6 - Remote navigation systems [Seite 625]
13.5.7 - Rotational angiography [Seite 627]
13.5.8 - Advances in imaging for VT [Seite 628]
13.5.9 - Molecular imaging [Seite 628]
13.5.10 - Scar imaging [Seite 630]
13.5.11 - Non-invasive imaging of cardiac electrophysiology [Seite 631]
13.5.12 - References [Seite 631]
13.6 - CHAPTER 56 Role of Magnetic Resonance Imaging in Mapping the Architecture of the Arrhythmia Substrate in Patients with Ischemic and Non-ischemic Cardiomyopathy [Seite 634]
13.6.1 - Introduction [Seite 634]
13.6.2 - Delayed enhancement (DE) [Seite 634]
13.6.3 - MRI technology [Seite 634]
13.6.4 - Quantification of DE [Seite 635]
13.6.5 - Limitations of DE-MRI [Seite 635]
13.6.6 - Electroanatomical mapping [Seite 636]
13.6.7 - MRI and electroanatomical mapping [Seite 636]
13.6.8 - MRI and arrhythmogenic right ventricular dysplasia [Seite 636]
13.6.9 - MRI and hypertrophic cardiomyopathy [Seite 636]
13.6.10 - MRI and other forms of non-ischemic cardiomyopathy [Seite 637]
13.6.11 - MRI and prior myocardial infarction [Seite 639]
13.6.12 - References [Seite 640]
13.7 - CHAPTER 57 New Image Integration Technologies for Optimization of Cardiac Resynchronization Therapy [Seite 642]
13.7.1 - Introduction [Seite 642]
13.7.2 - Imaging methodologies for assessment of LV dyssynchrony [Seite 643]
13.7.2.1 - Echocardiography [Seite 643]
13.7.2.2 - Magnetic resonance imaging and cardiac computed tomography [Seite 643]
13.7.2.3 - Nuclear imaging techniques [Seite 643]
13.7.2.4 - Novel imaging techniques [Seite 643]
13.7.3 - Imaging methodologies for assessment of scar [Seite 643]
13.7.4 - Imaging methodologies for assessment of coronary sinus anatomy [Seite 644]
13.7.5 - Image integration approaches [Seite 644]
13.7.6 - Future directions [Seite 644]
13.7.7 - Disclosures [Seite 647]
13.7.8 - References [Seite 647]
13.8 - CHAPTER 58 Role of Mapping and Imaging in Brugada Syndrome [Seite 649]
13.8.1 - Introduction [Seite 649]
13.8.2 - Mapping and imaging of the electrophysiological substrate [Seite 649]
13.8.2.1 - Heterogeneity of ventricular repolarization [Seite 650]
13.8.2.2 - RV conduction abnormality [Seite 651]
13.8.3 - Catheter mapping and ablation of the arrhythmogenic substrate [Seite 657]
13.8.3.1 - Mapping and ablation of focal RVOT triggers [Seite 657]
13.8.3.2 - Mapping and ablation of the RVOT substrate [Seite 660]
13.8.4 - Acknowledgement [Seite 662]
13.8.5 - References [Seite 662]
13.9 - CHAPTER 59 Role of Mapping and Ablation in Genetic Diseases: Long QT Syndrome and Catecholaminergic Polymorphic Ventricular Tachycardia [Seite 666]
13.9.1 - Introduction [Seite 666]
13.9.2 - Mapping and ablation of channelopathies: challenges and opportunities [Seite 666]
13.9.3 - Long QT syndrome (LQTS) [Seite 667]
13.9.4 - Catecholaminergic polymorphic ventricular tachycardia (CPVT) [Seite 669]
13.9.5 - References [Seite 674]
13.10 - CHAPTER 60 Role of Late Gadolinium-Enhanced Magnetic Resonance Imaging in Detection and Quantification of Atrial Fibrosis [Seite 678]
13.10.1 - Introduction [Seite 678]
13.10.2 - Classification of AF [Seite 678]
13.10.2.1 - Consensus scheme and individualized model [Seite 678]
13.10.2.2 - Classification scheme based upon atrial tissue remodeling: the Utah model [Seite 679]
13.10.3 - Image acquisition and processing [Seite 681]
13.10.4 - Correlation between late gadolinium enhancement and contact voltage mapping [Seite 681]
13.10.5 - Left atrial structural remodeling to guide ablation of AF [Seite 681]
13.10.6 - Patient counseling and selection for ablation of AF [Seite 681]
13.10.7 - Use of LGE-MRI to visualize ablation [Seite 682]
13.10.8 - Pulmonary vein isolation and assessment of recurrent AF [Seite 683]
13.10.9 - References [Seite 684]
13.11 - CHAPTER 61 Hypertrophic Cardiomyopathy: Risk Stratification and Management of Arrhythmia [Seite 686]
13.11.1 - Introduction [Seite 686]
13.11.2 - Causes of HCM [Seite 686]
13.11.3 - Pathophysiology [Seite 688]
13.11.3.1 - Mechanisms of ventricular arrhythmia in HCM [Seite 688]
13.11.3.2 - Mechanisms of syncope in HCM [Seite 689]
13.11.4 - Risk stratification for sudden death in HCM [Seite 690]
13.11.4.1 - History [Seite 691]
13.11.4.2 - Electrocardiogram [Seite 692]
13.11.4.3 - Echocardiogram [Seite 692]
13.11.4.4 - 24-hour ECG monitoring [Seite 692]
13.11.4.5 - Blood pressure response on exercise testing [Seite 693]
13.11.4.6 - Newer strategies for risk stratification [Seite 693]
13.11.4.7 - Role of cardiac mapping and imaging in risk stratification and management of arrhythmias [Seite 694]
13.11.5 - Prevention of sudden death [Seite 695]
13.11.6 - Future risk stratification strategies [Seite 696]
13.11.7 - Electrophysiological aspects of management of hypertrophic cardiomyopathy patients [Seite 696]
13.11.7.1 - Arrhythmias: SVT and AF [Seite 696]
13.11.7.2 - ICD implantation and defibrillation threshold testing [Seite 697]
13.11.8 - Sources of funding [Seite 697]
13.11.9 - References [Seite 697]
13.12 - CHAPTER 62 Role of Magnetic Resonance Imaging in Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy [Seite 700]
13.12.1 - Introduction [Seite 700]
13.12.2 - MRI in ARVD/C [Seite 700]
13.12.3 - MRI protocol [Seite 701]
13.12.4 - MRI findings in ARVD/C [Seite 701]
13.12.4.1 - Morphologic abnormalities [Seite 701]
13.12.4.2 - MRI fibrosis in ARVD/C [Seite 703]
13.12.4.3 - LV involvement in ARVD/C [Seite 704]
13.12.5 - MR assessment of cardiac function in ARVD/C [Seite 704]
13.12.6 - Functional abnormalities in ARVD/C [Seite 704]
13.12.6.1 - Global RV dilation/dysfunction [Seite 704]
13.12.7 - Regional dysfunction [Seite 704]
13.12.8 - Genotype-phenotype correlation [Seite 705]
13.12.9 - References [Seite 706]
13.13 - CHAPTER 63 Role of Cardiac Computed Tomography Imaging to Guide Catheter Ablation of Arrhythmias in Complex Cardiac Morphologies [Seite 708]
13.13.1 - Introduction [Seite 708]
13.13.2 - CT demonstration of intra-atrial anatomical landmarks relevant to catheter-based ablation [Seite 709]
13.13.2.1 - Atrial anatomy [Seite 709]
13.13.2.2 - Assessment of the conduction system [Seite 709]
13.13.2.3 - Crista terminalis [Seite 709]
13.13.2.4 - Cavotricuspid isthmus [Seite 710]
13.13.2.5 - Characterization of the interatrial septum [Seite 711]
13.13.2.6 - CT analysis of the PVs [Seite 711]
13.13.2.7 - Left atrial isthmus and AF [Seite 714]
13.13.2.8 - CT demonstration of the anterior interatrial muscle bundle [Seite 714]
13.13.2.9 - Posterior interatrial muscle connections through the CS [Seite 714]
13.13.3 - Anatomic barriers in transvenous interventions [Seite 714]
13.13.3.1 - Extracardiac sources [Seite 714]
13.13.3.2 - Trans-septal interventions [Seite 714]
13.13.3.3 - Intra-atrial obstacles [Seite 716]
13.13.4 - CT demonstration of extracardiac anatomical landmarks relevant to catheter-based ablation [Seite 717]
13.13.4.1 - Esophagus [Seite 717]
13.13.4.2 - Descending aorta [Seite 719]
13.13.4.3 - Phrenic nerve injury [Seite 719]
13.13.4.4 - Sympathetic plexus [Seite 719]
13.13.5 - Assessment of coronary arteries with CT [Seite 720]
13.13.6 - CT demonstration of anatomical variants and incidentally found congenital anomalies [Seite 720]
13.13.6.1 - Accessory LAA [Seite 720]
13.13.6.2 - Cor triatriatum sinister [Seite 720]
13.13.6.3 - S-shaped SAN artery [Seite 720]
13.13.6.4 - Large Thebesian (atrial) veins [Seite 720]
13.13.6.5 - Anomalous venous returns [Seite 720]
13.13.7 - CT demonstration of pathologies [Seite 720]
13.13.7.1 - Assessment of LAA thrombus [Seite 720]
13.13.7.2 - Myocardial scar tissue localization, potential use of CT in ventricular tachycardia [Seite 721]
13.13.7.3 - Gross myocardial fat and ARVD [Seite 723]
13.13.7.4 - Epicardial lipomatosis and conduction system [Seite 723]
13.13.8 - References [Seite 723]
13.14 - CHAPTER 64 Multi-modality and Multi-dimensional Mapping: How Far Do We Need To Go? [Seite 727]
13.14.1 - Introduction [Seite 727]
13.14.2 - Challenges and limitations of electroanatomical mapping systems [Seite 727]
13.14.3 - Movement of the patient or the reference electrode [Seite 728]
13.14.4 - Multi-modality: image integration [Seite 729]
13.14.4.1 - Intracardiac echocardiography [Seite 729]
13.14.4.2 - Cardiac tomography [Seite 729]
13.14.4.3 - Magnetic resonance imaging [Seite 729]
13.14.5 - Epicardial ablation [Seite 731]
13.14.6 - Non-fluoroscopic sensor-guided navigation [Seite 731]
13.14.7 - Positron emission tomography [Seite 731]
13.14.8 - References [Seite 732]
13.15 - CHAPTER 65 Advances in Non-invasive Electrocardiographic Imaging: Examples of Atrial Arrhythmias [Seite 734]
13.15.1 - Introduction [Seite 734]
13.15.2 - ECGI methodology [Seite 734]
13.15.3 - Normal atrial activation and repolarization [Seite 735]
13.15.4 - Typical atrial flutter [Seite 736]
13.15.5 - Atypical atrial flutter associated with a scar [Seite 736]
13.15.6 - Focal atrial tachycardia [Seite 738]
13.15.7 - Atrial fibrillation (AF) [Seite 740]
13.15.8 - Example of real-time interactive ECGI application during PV isolation procedure [Seite 741]
13.15.9 - Sources of funding [Seite 742]
13.15.10 - Disclosure [Seite 742]
13.15.11 - References [Seite 743]
13.16 - CHAPTER 66 ST Segment Mapping in Ventricular Tachycardia [Seite 744]
13.16.1 - Introduction [Seite 744]
13.16.2 - ST segment alternans mapping [Seite 744]
13.16.3 - Electrocardiographic imaging [Seite 745]
13.16.4 - 3D cardiac electrical imaging [Seite 746]
13.16.5 - References [Seite 746]
13.17 - CHAPTER 67 Microvolt T-wave Alternans [Seite 748]
13.17.1 - Introduction [Seite 748]
13.17.2 - Mechanisms underlying T-wave alternans [Seite 748]
13.17.3 - Methods and technical aspects of TWA assessment [Seite 749]
13.17.4 - Interpretation of MTWA recordings [Seite 749]
13.17.5 - Clinical implications of TWA [Seite 750]
13.17.5.1 - MTWA and invasive electrophysiological testing [Seite 750]
13.17.5.2 - MTWA and risk stratification [Seite 750]
13.17.5.3 - MTWA and guidance of ICD implantation [Seite 750]
13.17.5.4 - Risk stratification in patients with preserved ejection fraction [Seite 751]
13.17.5.5 - Guiding medical therapy [Seite 751]
13.17.6 - References [Seite 751]
13.18 - CHAPTER 68 Electrophysiological Implications of Myocardial Cell and Gene Therapy Strategies [Seite 754]
13.18.1 - Introduction [Seite 754]
13.18.2 - Cell therapy for infarct repair: electrophysiological implications [Seite 754]
13.18.3 - Electrophysiological integration [Seite 755]
13.18.3.1 - In vitro integration [Seite 755]
13.18.3.2 - In vivo integration [Seite 756]
13.18.4 - Arrhythmogenic risk [Seite 757]
13.18.5 - Antiarrhythmic potential [Seite 758]
13.18.6 - Cell and gene therapies for cardiac arrhythmias [Seite 758]
13.18.7 - Cell and gene therapies for bradyarrhythmias - biological pacemakers [Seite 758]
13.18.7.1 - Gene therapy approaches to generate biological pacemakers [Seite 759]
13.18.7.2 - Cell therapy approaches [Seite 759]
13.18.8 - Cell and gene therapies for cardiac tachyarrhythmias [Seite 759]
13.18.8.1 - Cell and gene therapy strategies for AF [Seite 760]
13.18.8.2 - Cell and gene therapies for VT [Seite 761]
13.18.9 - References [Seite 762]
13.19 - CHAPTER 69 Towards Non-invasive Mapping and Imaging of Cardiac Arrhythmias [Seite 764]
13.19.1 - Introduction [Seite 764]
13.19.2 - Atrial fibrillation [Seite 765]
13.19.3 - Non-invasive cardiac imaging to assess structural substrate of AF [Seite 765]
13.19.4 - Non-invasive cardiac imaging to assess electrical remodeling of the LA [Seite 768]
13.19.5 - Sudden cardiac death: ventricular tachyarrhythmias and ventricular fibrillation [Seite 769]
13.19.5.1 - Myocardial scar [Seite 771]
13.19.5.2 - Myocardial ischemia and viability [Seite 772]
13.19.5.3 - Sympathetic innervation [Seite 773]
13.19.6 - References [Seite 775]
13.20 - CHAPTER 70 Mapping and Ablation of Ventricular Arrhythmias in Patients with Congenital Heart Disease [Seite 778]
13.20.1 - Introduction [Seite 778]
13.20.2 - VT risk in CHD [Seite 779]
13.20.3 - VT mapping in CHD [Seite 780]
13.20.3.1 - Tetralogy of Fallot (TOF) [Seite 780]
13.20.3.2 - Ebstein's anomaly [Seite 787]
13.20.3.3 - Other CHD [Seite 790]
13.20.4 - Disclosure [Seite 790]
13.20.5 - References [Seite 790]
13.21 - CHAPTER 71 Mapping and Imaging of Supraventricular Arrhythmias in Adult Complex Congenital Heart Disease [Seite 793]
13.21.1 - Introduction [Seite 793]
13.21.2 - Anatomy of the conduction system in CHD [Seite 793]
13.21.2.1 - Sinus node [Seite 793]
13.21.2.2 - Atrioventricular (AV) node and His-Purkinje system [Seite 794]
13.21.3 - Supraventricular arrhythmias in CHD [Seite 795]
13.21.3.1 - Intra-atrial reentrant tachycardia (IART) [Seite 795]
13.21.3.2 - Focal atrial tachycardias [Seite 796]
13.21.3.3 - Atrial fibrillation (AF) [Seite 796]
13.21.4 - Approach to imaging, mapping and ablation [Seite 796]
13.21.5 - Arrhythmias in common forms of CHD [Seite 798]
13.21.5.1 - Atrial septal defect (ASD) [Seite 798]
13.21.5.2 - Atrioventricular canal defect [Seite 799]
13.21.5.3 - Ebstein's anomaly [Seite 800]
13.21.5.4 - L-transposition of the great arteries (L-TGA) [Seite 800]
13.21.5.5 - Heterotaxy syndromes [Seite 800]
13.21.5.6 - Fontan palliation [Seite 801]
13.21.5.7 - Tetralogy of Fallot (TOF) [Seite 802]
13.21.5.8 - D-transposition of the great arteries (D-TGA) [Seite 805]
13.21.6 - References [Seite 807]
13.22 - CHAPTER 72 Remodeling and Reverse Remodeling: Mapping/Imaging Findings [Seite 810]
13.22.1 - Remodeling due to myocardial ischemia [Seite 810]
13.22.1.1 - Atrial remodeling due to myocardial ischemia [Seite 810]
13.22.1.2 - Ventricular remodeling due to myocardial ischemia [Seite 810]
13.22.2 - Remodeling and reverse remodeling in HF [Seite 811]
13.22.2.1 - Atrial remodeling due to HF [Seite 812]
13.22.2.2 - Ventricular remodeling due to HF [Seite 814]
13.22.3 - Remodeling by arrhythmic electrical activity [Seite 815]
13.22.3.1 - Ventricular remodeling due to arrhythmic electrical activity [Seite 816]
13.22.4 - References [Seite 817]
13.23 - CHAPTER 73 Epicardial Mapping of Longstanding Persistent Atrial Fibrillation [Seite 819]
13.23.1 - Introduction [Seite 819]
13.23.2 - Unipolar or bipolar electrograms? [Seite 820]
13.23.3 - Wave-mapping [Seite 820]
13.23.4 - Double potentials and fractionated electrograms [Seite 822]
13.23.5 - Paroxysmal AF [Seite 823]
13.23.6 - Persistent AF [Seite 824]
13.23.7 - Longitudinal dissociation and effective conduction velocity [Seite 824]
13.23.8 - Endo-epicardial breakthrough [Seite 825]
13.23.9 - Quantification of the electropathological substrate of AF [Seite 828]
13.23.10 - References [Seite 829]
13.24 - CHAPTER 74 Use of Intracardiac Echocardiography to Guide Ablation of Atrial and Ventricular Arrhythmias [Seite 831]
13.24.1 - Introduction [Seite 831]
13.24.2 - ICE basics [Seite 831]
13.24.2.1 - Radial [Seite 831]
13.24.2.2 - Advantages [Seite 832]
13.24.3 - Trans-septal catheterization [Seite 832]
13.24.4 - Supraventricular tachyarrhythmias [Seite 834]
13.24.4.1 - Atrial fibrillation (AF) [Seite 834]
13.24.4.2 - Atrial flutter [Seite 835]
13.24.4.3 - Inappropriate sinus tachycardia [Seite 836]
13.24.5 - Ventricular tachyarrhythmias [Seite 836]
13.24.5.1 - Idiopathic [Seite 836]
13.24.5.2 - Papillary muscles [Seite 837]
13.24.5.3 - Scar [Seite 837]
13.24.6 - Epicardial ablation [Seite 837]
13.24.7 - Complex congenital heart disease [Seite 838]
13.24.8 - References [Seite 838]
13.25 - CHAPTER 75 Role of Magnetic Resonance Imaging in Electrophysiology [Seite 841]
13.25.1 - Introduction [Seite 841]
13.25.2 - Main limitations of voltage mapping alone [Seite 841]
13.25.3 - Cardiac MRI for scar assessment [Seite 842]
13.25.4 - Real-time integration of MRI and voltage data [Seite 843]
13.25.5 - Electrogram characteristics of hyperenhancing regions [Seite 843]
13.25.6 - Identification of substrate in non-ischemic cardiomyopathies [Seite 845]
13.25.7 - Acute and chronic assessment of ablative lesion formation [Seite 846]
13.25.8 - Atrial scar assessment [Seite 848]
13.25.9 - MRI thermography during ablation [Seite 848]
13.25.10 - References [Seite 848]
13.26 - CHAPTER 76 Magnetic Resonance Phase Mapping for Myocardial Structural Abnormalities Relevant to Arrhythmias [Seite 850]
13.26.1 - Introduction [Seite 850]
13.26.2 - Why MR phase mapping? [Seite 850]
13.26.3 - Phase mapping technique [Seite 851]
13.26.4 - Early applications of phase mapping [Seite 852]
13.26.5 - Phase mapping and myocardial synchrony [Seite 852]
13.26.6 - Phase mapping and coronary artery disease [Seite 854]
13.26.7 - Phase mapping and LV hypertrophy [Seite 854]
13.26.8 - Phase mapping and RV disease [Seite 855]
13.26.9 - Phase mapping and arrhythmogenic heart disease [Seite 855]
13.26.10 - References [Seite 855]
13.27 - CHAPTER 77 Three-Dimensional Mapping to Guide Optimal Catheter Position in Cardiac Resynchronization Therapy [Seite 858]
13.27.1 - Introduction [Seite 858]
13.27.2 - Mapping the CS [Seite 859]
13.27.3 - Data on optimal LV pacing site location [Seite 861]
13.27.4 - Mapping LV scar: implications for CRT [Seite 862]
13.27.5 - Mapping the electrical substrate [Seite 862]
13.27.6 - Inverse electrocardiographic imaging: technical aspects [Seite 863]
13.27.7 - Mapping the mechanical substrate [Seite 864]
13.27.8 - References [Seite 867]
13.28 - CHAPTER 78 Array Tomography for Cardiovascular Imaging: Description of Technique and Potential Applications [Seite 869]
13.28.1 - Introduction [Seite 869]
13.28.2 - Array tomography procedures [Seite 869]
13.28.3 - Application of array tomography to the study of blood vessel microstructure [Seite 871]
13.28.4 - Imaging cardiac innervation with array tomography [Seite 874]
13.28.5 - Acknowledgements [Seite 877]
13.28.6 - References [Seite 877]
13.29 - CHAPTER 79 Optimizing Patient Safety and Image Quality with Cardiac Mapping and Imaging Tools During Catheter Ablation [Seite 879]
13.29.1 - Introduction [Seite 879]
13.29.2 - Definitions [Seite 879]
13.29.3 - Radiation effects [Seite 880]
13.29.4 - Long-term effects of radiation exposure [Seite 880]
13.29.5 - Factors contributing to patient risk [Seite 880]
13.29.6 - Reducing radiation exposure [Seite 882]
13.29.6.1 - Table height and collimation [Seite 882]
13.29.6.2 - Imaging angle [Seite 882]
13.29.6.3 - Pulsed fluoroscopy [Seite 883]
13.29.7 - Fluoroscopy and alternative imaging technologies in mapping and ablation procedures [Seite 884]
13.29.8 - Guidelines to manage radiation dose [Seite 885]
13.29.9 - Education and policies for medical professionals [Seite 886]
13.29.10 - References [Seite 887]
13.30 - CHAPTER 80 The Future of Cardiac Mapping: Dawn of a New Decade [Seite 889]
13.30.1 - Cardiac mapping [Seite 889]
13.30.1.1 - Technological advances and challenges [Seite 893]
13.30.2 - Special subjects [Seite 902]
13.30.2.1 - Heart failure [Seite 902]
13.30.2.2 - Cardiac resynchronization therapy (CRT) [Seite 903]
13.30.2.3 - Myocardial ischemia and ischemic cardiomyopathy [Seite 903]
13.30.2.4 - Myocardial infarction [Seite 903]
13.30.2.5 - Myocardial scar [Seite 904]
13.30.2.6 - Atrial fibrillation (AF) [Seite 904]
13.30.2.7 - Ventricular tachyarrhythmia [Seite 905]
13.30.2.8 - Hypertrophic cardiomyopathy (HCM) [Seite 907]
13.30.2.9 - Right ventricular cardiomyopathies (ARVD/C) [Seite 911]
13.30.2.10 - Cardiac amyloidosis [Seite 911]
13.30.2.11 - Cardiac sarcoidosis [Seite 912]
13.30.2.12 - Myocarditis [Seite 912]
13.30.2.13 - Role of cardiac mapping and imaging in evaluation of stem cell implants [Seite 912]
13.30.2.14 - Cardiac involvement in carcinoid disease [Seite 912]
13.30.3 - Molecular imaging [Seite 912]
13.30.3.1 - Molecular MRI [Seite 913]
13.30.4 - Imaging in screening and risk stratification [Seite 914]
13.30.4.1 - Screening in highly trained athletes [Seite 914]
13.30.4.2 - Brugada syndrome [Seite 914]
13.30.5 - Cardiac imaging and outcomes [Seite 914]
13.30.5.1 - Non-invasive cardiac imaging in patient management and outcome [Seite 914]
13.30.5.2 - American College of Cardiology Foundation/American Heart Association (ACCF/AHA) practice guidelines [Seite 915]
13.30.6 - Future directions and advanced visualization [Seite 915]
13.30.6.1 - MR technologies [Seite 916]
13.30.6.2 - Optical imaging [Seite 918]
13.30.6.3 - Electromechanical wave imaging EWI and elastography [Seite 920]
13.30.6.4 - Electromechanical wave imaging EWI and elastography [Seite 920]
13.30.6.5 - Patient-specific approaches to analysis and treatment of heart rhythm disturbances and contractile dysfunction [Seite 921]
13.30.7 - Future of the cardiac EP laboratory [Seite 921]
13.30.8 - Molecular ablation [Seite 923]
13.30.8.1 - Direct visualization [Seite 925]
13.30.8.2 - Non-invasive stereotactic RF surgery for creation of ablation lesion in the LA [Seite 925]
13.30.9 - Future directions in mapping and imaging [Seite 925]
13.30.9.1 - Key areas for future imaging research [Seite 927]
13.30.10 - Authors' note [Seite 929]
13.30.11 - Acknowledgements [Seite 930]
13.30.12 - References [Seite 930]
14 - Epilogue [Seite 941]
15 - Index [Seite 943]