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Huang's Catheter Ablation of Cardiac Arrhythmias
- 5th Edition - July 22, 2024
- Editors: Shoei K. Stephen Huang, Jason S. Bradfield, Kalyanam Shivkumar
- Language: English
- Hardback ISBN:9 7 8 - 0 - 3 2 3 - 9 3 1 1 0 - 6
Written and edited by world-renowned experts in the field, including Dr. Shoei K. Stephen Huang, a pioneer of radiofrequency catheter ablation procedures, Huang's Catheter Ab… Read more
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Request a sales quoteWritten and edited by world-renowned experts in the field, including Dr. Shoei K. Stephen Huang, a pioneer of radiofrequency catheter ablation procedures, Huang's Catheter Ablation of Cardiac Arrhythmias, 5th Edition, provides authoritative, comprehensive information on these increasingly used electrophysiology procedures. This outstanding resource is packed with cutting-edge content in every area of this fast-changing field, including anatomy, diagnostic criteria, differential diagnosis, mapping, and ablation. Ideal for practitioners who need a definitive, user-friendly ablation text for the electrophysiology lab or office setting, it offers quick access to practical content, using detailed tables and high-quality images to help you apply what you learn in your practice.
- Reflects all the latest technology, including the new pulse field ablation (PFA) procedure, new balloon technologies (RF, laser, and PFA) for pulmonary vein isolation, and high-resolution 3D mapping systems.
- Offers expert guidance on atrial tachycardia and flutter, atrial fibrillation, atrioventricular nodal reentrant tachycardia, tachycardias related to accessory atrioventricular connections, ventricular tachycardia, transseptal catheterization techniques, ablation for pediatric patients, and patient safety and complications.
- Contains new chapters covering Biophysics and Clinical Applications of Laser Ablation, Biophysics and Clinical Applications of Pulse Field Ablation, Multiple Strategic Approach to Ablate Atrial Fibrillation, Ablation of Challenging/Difficult Accessory Pathways, Ablation of Ventricular Tachycardia in Arrhythmogenic Ventricular Cardiomyopathy, and more.
- Contains 450 figures, including ECGs, intracardiac recordings, 3D mapping, ultrasound, fluoroscope, and ablation images.
- Includes numerous tables and boxes that provide quick access to key points, arrhythmia mechanisms, diagnostic criteria, target sites for ablation, use of special equipment, complications, and troubleshooting problems and their solutions.
- Provides access to 20 video clips, including transseptal access to the left atrium, intracardiac ultrasound, and techniques of pericardial access.
- An eBook version is included with purchase. The eBook allows you to access all of the text, figures, videos, and references, with the ability to search, customize your content, make notes and highlights, and have content read aloud.
Electrophysiologists, cardiologists who treat patients with cardiac arrhythmias, EP fellows
- Cover image
- Title page
- Copyright
- Dedication
- Contributors
- Preface (Shoei K. Stephen Huang)
- Preface (Jason S. Bradfield and Kalyanam Shivkumar)
- Acknowledgments
- Contents
- Video Contents
- PART 1 Fundamental Concepts of Transcatheter Energy Delivery
- 1 Biophysics and Pathophysiology of Radiofrequency Lesion Formation
- Key Points
- Biophysics of Radiofrequency Energy Tissue Heating
- Tissue Pathology and Pathophysiologic Response to Radiofrequency Ablation
- Cellular Mechanisms of Thermal Injury
- Determinants Of Effective Lesion Formation
- Improving Radiofrequency Ablation Effectiveness
- Biophysics of Pulsed-Field Ablation Compared to Radiofrequency Ablation
- Conclusion
- References
- 2 Biophysics and Clinical Applications of Cryoablation
- Key Points
- Introduction
- History of Cryothermal Energy Use in Cardiovascular Medicine
- Biophysics and Mechanisms of Cryothermal Energy Tissue Injury
- Cryoablation Technical Aspects
- Clinical Advantages of Cryothermal Energy for Catheter Ablation
- Clinical Applications
- New Perspectives
- References
- 3 Biophysics and Clinical Applications of Laser Ablation
- Key Points
- Biophysics of Laser Ablation
- Clinical Applications of Laser Ablation
- Surgical Ablation
- Transvenous Ablation
- Clinical Outcomes
- References
- 4 Biophysics and Clinical Applications of Pulsed-Field Ablation
- Key Points
- Biophysics of Lesion Formation
- Biological Effects of Cardiac Pulsed-Field Ablation
- Effects and Safety of Pfa on Specific Tissue
- Atrial Pulsed-Field Ablation
- Ventricular Pulsed-Field Ablation
- “Reversible” Electroporation
- Summary
- References
- 5 Contemporary Irrigated Radiofrequency Catheter Ablation
- Key Points
- Introduction
- Biophysics of Irrigated Radiofrequency Ablation
- Design of Irrigated- and Cool-Tip Radiofrequency Catheters
- Titrating Power and Duration During Irrigated Radio frequency Ablation
- Irrigated Radiofrequency Ablation of Atrial Fibrillation
- Irrigated Radiofrequency Ablation for Atrial Flutter
- Irrigated Ablation for Ventricular Tachycardia
- Irrigated Ablation from the Coronary Sinus for Accessory Pathways and Ventricular Arrhythmias
- Conclusion
- References
- PART 2 Cardiac Mapping and Imaging
- 6 Cardiac Anatomy for Catheter Mapping and Ablation of Arrhythmias
- Key Points
- Introduction
- Progressive Real Dissection of the Heart Viewed from the Right Anterior Oblique Direction
- Progressive Virtual Dissection of the Heart Viewed from the Left Anterior Oblique Direction
- Conclusion
- Acknowledgment
- References
- 7 Fundamentals of Intracardiac Mapping
- Key Points
- Underlying Basis for the Extracellular Electrogram
- Electrogram Recording: Amplification, Filtering, and Digitization of Signals
- Unipolar and Bipolar Signals
- Characteristics of Intracardiac Signals: Normal Heart
- Endocardial Mapping Techniques
- References
- 8 Fundamentals of Catheter Three-Dimensional Mapping Systems
- Key Points
- Introduction
- Technology Used in 3D Mapping Systems
- Functions (Capabilities) of 3D Mapping Systems
- Step-By-Step Guide for Mapping
- Additional Functions
- Use in Various Arrhythmias
- References
- 9 High-Resolution Three-Dimensional Mapping Systems
- Key Points
- Introduction
- Point-By-Point Versus Multielectrode Mapping
- Types of Multielectrode Catheters
- Limitations of High-Resolution Mapping
- Future Perspectives of High-Resolution Mapping
- Conclusion
- References
- 10 Intracardiac Echocardiography, Computed Cardiac Tomography, and Magnetic Resonance Imaging for Guiding Mapping and Ablation
- Key Points
- Introduction
- Intracardiac Echocardiography
- Cardiac Magnetic Resonance
- Multidetector Computed Tomography
- Summary
- References
- PART 3 Catheter Ablation of Atrial Tachycardias and Flutters
- 11 Ablation of Focal Atrial Tachycardias
- Key Points
- Introduction
- Anatomy
- Pathophysiology
- Arrhythmia Diagnosis and Differential Diagnosis
- Mapping
- Troubleshooting the Difficult Case
- Discussion
- Conclusion
- References
- 12 Ablation of Cavotricuspid Isthmus–Dependent Atrial Flutters
- Key Points
- Atrial Flutter Terminology
- Anatomy and Pathophysiology
- Diagnosis
- Ablation
- Outcomes and Complications
- Troubleshooting the Difficult Case
- References
- 13 Ablation of Non–Isthmus-Dependent Flutters and Atrial Macroreentry
- Key Points
- Introduction
- Anatomy
- Pathophysiology
- Diagnosis
- Ablation
- Specific Forms of Atypical Flutter (See Table 13.1)
- References
- 14 Ablation of Atrial Flutter/Tachycardia in Congenital Heart Disease
- Key Points
- Introduction
- General Principles of Catheter Ablation for Congenital Heart Disease
- Intra-Atrial Reentrant Tachycardia Circuit Characteristics in Congenital Heart Disease
- Approach to Catheter Ablation
- Potential Complications and Collateral Damage
- Catheter Ablation for Specific Forms of Congenital Heart Disease
- Outcomes of Catheter Ablation in Congenital Heart Disease
- Conclusion
- References
- PART 4 Catheter Ablation of Atrial Fibrillation
- 15 Pulmonary Vein Isolation Using Radiofrequency Energy Ablation Technologies
- Key Points
- Preprocedural Considerations
- Procedural Considerations
- Complications of Pulmonary Vein Isolation
- Difficult Cases
- Postprocedural Considerations
- Radiofrequency-Balloon Ablation for Pvi
- Conclusion
- References
- 16 Pulmonary Vein Isolation Using the Cryoballoon Catheter
- Key Points
- Introduction
- Randomized Controlled Trial Data
- Preprocedural Considerations
- Cryoballoon Ablation Procedure
- Cryoballoon Dosing
- Postprocedure Care
- Conclusion
- References
- 17 Pulmonary Vein Isolation Using Pulsed-Field Ablation or Laser Balloon
- Key Points
- Pulsed-Field Ablation for Pulmonary Vein Isolation
- Pulmonary Vein Isolation with Laser Balloon
- Summary
- References
- 18 Catheter Ablation of Atrial Fibrillation Initiated by Non–Pulmonary Vein Triggers
- Key Points
- Introduction
- Electrophysiologic Characteristics and Incidence of Npv Triggers
- Pathophysiology of Af Triggers from Npv Areas
- Provocation Test for Npv Triggers
- Mapping and Localization of the Npv Triggers
- Npv Triggers From Different Locations
- Efficacy and Outcome of Catheter Ablation
- Conclusion
- References
- 19 Substrate-Based Ablation of Atrial Fibrillation
- Key Points
- Introduction
- Anatomic Approaches to Substrate Modification
- Electrogram-Guided Atrial Ablation
- Right Atrial Substrate Ablation
- Additional Techniques and Future Considerations
- Conclusion
- References
- 20 Ablation of Persistent and Long-Standing Persistent Atrial Fibrillation
- Key Points
- Introduction
- Assessment of the Patient with Persistent and Long-Standing Persistent AF
- Ablation Strategies in Patients with Persistent AF
- Conclusion
- References
- 21 Epicardial and Endocardial Hybrid Ablation for Atrial Fibrillation
- Key Points
- Introduction
- Catheter Approach
- Surgical Approaches
- Hybrid Approach
- Conclusion
- References
- 22 Ablation Strategies for Persistent and Long-Standing Persistent Atrial Fibrillation
- Key Points
- Introduction
- Anatomy
- Pathophysiology
- How to Map Patients with Nonparoxysmal AF
- Ablation
- Ancillary Techniques in Patients with PeAF
- Ablation of Other Structures
- Future Perspectives
- Conclusion
- References
- PART 5 Catheter Ablation of Atrioventricular Nodal Reentry Tachycardia and the Atrioventricular Junction
- 23 Ablation of Atrioventricular Nodal Reentry Tachycardia and Focal Junctional Tachycardia
- Key Points
- Introduction
- Anatomy of the Atrioventricular Node and Its Inputs
- Pathophysiology
- Diagnosis
- Differential Diagnosis
- Atrioventricular Nodal Reentry and Atypical Presentations
- AV Nodal Reentry and Other Arrhythmias
- Junctional Tachycardia
- Ablation
- Radiofrequency Ablation
- Cryoablation
- End Points of Ablation
- Preventing Atrioventricular Block During Catheter Ablation
- Outcomes of Slow Pathway Ablation
- Ablation of Junctional Tachycardia
- Troubleshooting the Difficult Case
- Acknowledgments
- References
- 24 Ablation of Challenging/Difficult Atrioventricular Nodal Reentry Tachycardia
- Key Points
- Introduction
- Anatomical Challenges
- Diagnostic Challenges
- Baseline Electrophysiologic Challenges
- When Your Ablation does not Seem To Be Working
- Conclusion
- References
- 25 Ablation/Modification of Atrioventricular Junction for Heart Rate Control of Permanent Atrial Fibrillation
- Key Points
- Introduction
- Complete Atrioventricular Junction Ablation
- Atrioventricular Junction Ablation in Patients Undergoing Cardiac Resynchronization Therapy Device Implantation
- Atrioventricular Junction Ablation Plus Pacing Versus Primary Catheter Ablation in Drug-Refractory Atrial Fibrillation
- Outcomes and Complications of AV Junction Ablation
- Troubleshooting the Difficult Cases
- Atrioventricular Junction Modification
- References
- PART 6 Catheter Ablation of Accessory Atrioventricular Connections
- 26 Ablation of Free Wall Accessory Pathways
- Key Points
- Anatomy
- Pathophysiology
- Mapping
- Clinical Results
- Troubleshooting the Difficult Case
- Acknowledgments
- References
- 27 Ablation of Posteroseptal Accessory Pathways
- Key Points
- Anatomy
- Pathophysiology
- Arrhythmia Diagnosis and Differential Diagnosis
- Mapping
- Target Sites
- Ablation
- Outcomes
- Complications
- Troubleshooting the Difficult Case
- References
- 28 Catheter Ablation of Superoparaseptal (“Anteroseptal”) and Midseptal Accessory Pathways
- Key Points
- Anatomy and Nomenclature
- Diagnosis and Differential Diagnosis
- Mapping and Ablation Techniques
- Troubleshooting the Difficult Case
- Summary
- References
- 29 Ablation of Atriofascicular Accessory Pathways and Variants
- Key Points
- Atriofascicular Accessory Pathways
- Anatomy
- Pathophysiology
- Diagnosis
- Differential Diagnosis
- Atrioventricular Nodal Reentry Tachycardia Coexisting with Atriofascicular Accessory Pathways
- Mapping
- Mapping of Accessory Pathway Along the Tricuspid Annulus
- Catheter-Induced Mechanical Conduction Block
- Identification of the Atrial Insertion
- Identification of the Ventricular Insertion
- Ablation
- Troubleshooting the Difficult Case
- Atriofascicular Pathway Variants
- Atrioventricular Pathways with Decremental Conduction
- Left-Sided Decremental Accessory Pathways
- Nodoventricular and Nodofascicular Accessory Pathways
- Mapping and Ablation
- Fasciculoventricular Accessory Pathways
- References
- 30 Ablation of Challenging/Difficult Accessory Pathways
- Key Points
- Introduction
- Common Challenges in Accessory Pathway Mapping/Ablation
- 1. Misdiagnosis of the Tachycardia
- 2. Localization Error
- Oblique Accessory Pathways
- 3. Unusual Ap Location
- Challenging Case Presentation
- Conclusion
- References
- PART 7 Catheter Ablation of Ventricular Tachycardias
- 31 Ablation of Ventricular Outflow Tract Tachycardias
- Key Points
- Mechanism
- Anatomical Substrate
- Anatomy of the Outflow Tracts
- Diagnosis
- Ablation
- Clinical Outcomes and Complications
- Troubleshooting the Difficult Case
- Basal Inferoseptum: Site of Origin for Idiopathic VAs
- Conclusion
- References
- 32 Ablation of Idiopathic Left and Right Ventricular and Fascicular Tachycardias
- Key Points
- Mitral Annular Ventricular Tachycardia
- Tricuspid Annular Ventricular Tachycardia
- Papillary Muscle Ventricular Tachycardia
- Ventricular Tachycardia Arising from the Crux of the Heart
- Reentrant Left Fascicular Ventricular Tachycardia
- Nonreentrant Fascicular Ventricular Tachycartdia
- Conclusion
- References
- 33 Ablation of Ventricular Tachycardia in Coronary Artery Disease
- Key Points
- Introduction
- Anatomy
- Pathophysiology
- Arrhythmia Diagnosis and Differential Diagnosis
- Periprocedural Considerations
- Mapping Strategies
- Ablation Lesion Delivery
- Outcomes
- Complications
- Troubleshooting the Difficult Case
- Conclusions
- References
- 34 Ablation of Ventricular Tachycardia in Nonischemic Cardiomyopathy
- Key Points
- Disease Spectrum
- Etiology and Characterization of the Arrhythmogenic Substrate
- Disease-Specific Arrhythmogenic Substrate
- Preablation Workup and Procedural Planning
- Selection of Target Sites for Ablation
- Ablation Technique and Endpoints
- Disease-Specific Considerations For Ablation
- Troubleshooting the Difficult Case
- References
- 35 Ablation of Unstable Ventricular Tachycardia and Idiopathic Ventricular Fibrillation
- Key Points
- Introduction
- Ablation Strategies Based on Substrate Mapping
- Integrating the Mapping and Ablation Strategies for Ablation of Unstable Ventricular Tachycardia
- Ablation of Idiopathic Ventricular Fibrillation
- Conclusion and Future Directions
- References
- 36 Substrate-Based Ablation for Ventricular Tachycardia
- Key Points
- Introduction
- Anatomy and Pathophysiology
- Mapping Ventricular Tachycardia Substrate
- Cardiac Imaging to Guide Substrate-Based Ablation
- Substrate-Based Ablation for Elimination of Ventricular Tachycardia
- Complications
- Troubleshooting the Difficult Case
- Conclusion
- References
- 37 Epicardial Approach to Catheter Ablationof Ventricular Tachycardia
- Key Points
- Pericardial Anatomy
- Clinical Indications for Epicardial Mapping
- Subxiphoid Percutaneous Technique
- Surgical Access
- Mapping and Ablation Tools
- Coronary Arteries
- Phrenic Nerve
- Epicardial Fat
- Intrapericardial Steroid and Repeat Access
- Reported Complications
- Efficacy
- Conclusion
- References
- 38 Ablation of Ventricular Tachycardia in Congenital Heart Disease
- Key Points
- Introduction
- Anatomy
- Pathophysiology
- Arrhythmia Diagnosis and Differential Diagnosis
- Mapping: Approach to Efficient Mapping
- Ablation
- Success
- Risk Stratification Prior to Pulmonary Valve Replacement
- Surgical Ablation
- Troubleshooting the Difficult Case
- Ebstein Anomaly
- Conclusion
- References
- 39 Ablation of Ventricular Tachyarrhythmias in Brugada Syndrome
- Key Points
- Arrhythmogenic Substrates
- Catheter Ablation of Brugada Substrates
- Mapping
- Ablation Protocol and Endpoint
- Efficacy and Safety of Catheter Ablation for BRS
- Combined Syndrome of Brs and Ers
- Conclusion
- References
- 40 Catheter Ablation of Ventricular Tachycardia in Arrhythmogenic Right Ventricular Cardiomyopathy
- Key Points
- Introduction
- Substrate Formation: Arrhythmogenesis and Disease Phenotype
- Sympathetic Modulation and Arrhythmogenesis in Early ARVC
- Substrate Distribution: Patterns of Scar and Implications on Electroanatomical Mapping
- The Role of Endocardial Mapping and Ablation in ARVC
- Pericardial Access
- Epicardial Electroanatomical Mapping and Ablation Strategies
- Complications
- Outcomes of Epicardial Ablations in ARVC
- Perspectives
- References
- 41 Hybrid Approaches for Catheter Ablation of Ventricular Tachycardia
- Key Points
- Introduction
- Patient Selection
- Procedure Planning
- Access Site
- Mapping and Ablation
- Safety and Outcome
- Summary
- References
- PART 8 Miscellaneous Topics
- 42 Complications Associated with Catheter Ablation of Cardiac Arrhythmias
- Key Points
- Introduction
- Vascular Access–Related Complications
- Sheath/Catheter Manipulation–Related Complications
- Energy Delivery–Related Complications
- Epicardial Catheter Ablation–Related Complications
- Acknowledgments
- References
- 43 Atrial Transseptal Catheterization
- Key Points
- Introduction
- Anatomic Considerations for Transseptal Catheterization
- Indications and Contraindications for Atrial Transseptal Catheterization
- Intraprocedural Patient Management: Sedation and Anticoagulation
- Techniques and Tools for Transseptal Catheterization
- Approach to the Difficult Transseptal Catheterization
- Procedural Complications and Tools to Lower Their Risks
- Conclusion
- Acknowledgments
- References
- 44 Ablation of Cardiac Arrhythmias in Pediatric Population
- Key Points
- Introduction
- Are children just little adults?
- Arrhythmias Unique to the Pediatric Patient
- Summary
- Acknowledgment
- References
- Index
- No. of pages: 848
- Language: English
- Edition: 5
- Published: July 22, 2024
- Imprint: Elsevier
- Hardback ISBN: 9780323931106
SH
Shoei K. Stephen Huang
Shoei K. Stephen Huang, MD, FACC, FAHA, FHRS, Professor Emeritus and Former Professor of Medicine with Tenure, Texas A&M University Health Science Center; Former Director, Cardiac Electrophysiology and Pacing, Baylor-Scott & White Health, Temple, Texas
Affiliations and expertise
Professor Emeritus and Former Professor of Medicine with Tenure, Texas A&M University Health Science Center; Former Director, Cardiac Electrophysiology and Pacing, Baylor-Scott & White Health, Temple, TexasJB
Jason S. Bradfield
Affiliations and expertise
Associate Professor of Medicine, Director, Specialized Program for Ventricular Tachycardia, UCLA Cardiac Arrhythmia Center, David Geffen School of Medicine at UCLA, Los Angeles, CaliforniaKS
Kalyanam Shivkumar
Kalyanam Shivkumar, MD, who contributed to the current edition, is a well known and distinguished professor and electrophysiologist. He has been Director of the Cardiac Arrhythmia Center and Cardiac Catheterization Lab as well as the electrophysiology fellowship program at UCLA Medical Center for many years. He is also currently editor-in-chief of JACC: Clinical Electrophysiology, a well respected Elsevier/JACC cardiology journal. Dr Shivkumar will replace John Miller, MD who will retire from this edition.
Affiliations and expertise
Professor of Cardiology, Director, UCLA Cardiac Arrhythmia Center & Electrophysiology ProgramsRead Huang's Catheter Ablation of Cardiac Arrhythmias on ScienceDirect