Zipes and Jalife’s Cardiac Electrophysiology: From Cell to Bedside

8th Edition - December 16, 2021
Imprint: Elsevier
Editors: Jose Jalife, William Gregory Stevenson
Language: English
Hardback ISBN:
9 7 8 - 0 - 3 2 3 - 7 5 7 4 5 - 4
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 7 5 7 4 6 - 1

Fully updated from cover to cover, Zipes and Jalife’s Cardiac Electrophysiology: From Cell to Bedside, 8th Edition, provides the comprehensive, multidisciplinary c… Read more

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Fully updated from cover to cover, Zipes and Jalife’s Cardiac Electrophysiology: From Cell to Bedside, 8th Edition, provides the comprehensive, multidisciplinary coverage you need—from new knowledge in basic science to the latest clinical advances in the field. Drs. José Jalife and William Gregory Stevenson lead a team of global experts who provide cutting-edge content and step-by-step instructions for all aspects of cardiac electrophysiology.

Instructions for online access
Cover image
Title page
Table of Contents
Copyright
Dedication
Dedication
Contributors
Preface
Part I. Structural and Molecular Bases of Ion Channel Function
1. Voltage-Gated Sodium Channels and Electrical Excitability of the Heart
Introduction
Subunit Structure of Sodium Channels
Sodium Channel Genes
Three-Dimensional Structure of Sodium Channels
Sodium Channel Structure and Function
Expression of Multiple Sodium Channel Subtypes in the Heart
2. Voltage-Gated Calcium Channels
Introduction
Molecular Composition of Voltage-Gated Ca2+ Channels
L-Type Ca2+ Channels
T-Type Ca2+ Channels
Transient Receptor Potential Channels
3. Voltage-Regulated Potassium Channels
Introduction
Myocardial Kv Channels: Transient Outward Kv Channels
Myocardial Kv Channels: Delayed Rectifier Kv Channels
Non–Voltage-Regulated K+ Channels also Contribute to Repolarization
Pore-Forming Subunits of Myocardial Kv Channels
Accessory/Auxiliary Subunits of Myocardial Kv Channels
Molecular Determinants of Native Myocardial Transient Outward Kv Channels
Molecular Determinants of Native Myocardial Delayed Rectifier Kv Channels
Molecular Determinants of Non–Voltage-Regulated K+ Channels
Summary, Conclusions, and Questions
4. Molecular Regulation of Cardiac Inward Rectifier Potassium Channels
Introduction
Inward Rectifier Potassium Current
Acetylcholine-Activated Inward Rectifier Potassium Current
ATP-Sensitive Inward Rectifier Potassium Current
5. Mammalian Calcium Pumps in Health and Disease
Introduction
Sarco/Endoplasmic Reticulum Ca2+ ATPase
Secretory Pathway Ca2+ ATPase
Plasma Membrane Ca2+ ATPase
Ca2+ Pumps in the Disease Process
Final Comments
6. Structural and Molecular Bases of Sarcoplasmic Reticulum Ion Channel Function
Structural Arrangement of the Sarcoplasmic Reticulum
Excitation-Contraction Coupling and its Molecular Underpinnings
Molecular Structure of the Cardiac Ryanodine Receptor
Accessory Proteins of the RyR2 Channel
Ca2+ Regulation of RyR2 Channels
Modulation of RyR2 Channel Function
RyR2 Channels in Disease
7. Organellar Ion Channels and Transporters
Introduction: Structural and Molecular Bases of Mitochondrial Ion Channel Function
Ion Channels/Transporters at Mitochondrial Inner Membrane
Ion Channels/Transporters at the Mitochondrial Outer Membrane
Mitochondrial Ion Channels/Transporters in Cardiac Function and Dysfunction
Closing Remarks
8. Gap Junctional Connexin43: Novel Insights from the New Millennium and Their Clinical Implications
Introduction
Heart Connexins: An Overview
The Perinexus: A Novel Connexin43 Gap Junction Domain
Connexin43 And Cardiac Conduction
Connexin43 Posttranscriptional Regulation
Connexin43 Hemichannels
Connexin43 Targeting Pharmacologic Agents
Cardiac Connexin43 in Nonstandard Locations
Connexin43-Mediated Interactions Between Myocytes And Nonmyocytes
Concluding Comments
Acknowledgments
Part II. Biophysics of Cardiac Ion Channel Function
9. Computational Modeling and Simulation for Human Cardiac Electrophysiology: From Induced Pluripotent Stem Cell–Derived Cardiomyocytes to Adult Cardiomyocytes
Induced Pluripotent Stem Cell–Derived Cardiomyocytes for Study of Human Cardiac Electrophysiology
Modeling and Simulation of Cardiac Electrophysiology
Modeling and Simulation of Drugs and Disease
First Steps Toward Interrogating Induced Pluripotent Stem Cell–Derived Cardiomyocytes Through Modeling and Simulation
10. Regulation of Cardiac Calcium Channels
Overview
Calcium Channel Expression in the Myocardium
The Cardiac L-Type Calcium Channel is a Multiprotein Complex
11. Molecular Genetics of ATP-Sensitive Potassium Channels in Cardiovascular Diseases
Introduction
Molecular Biology of KATP Channels
Monogenic Pathologies Arising From KATP Genetic Variants
KATP Channels In Nonsyndromic Cardiovascular Pathology
Vascular KATP Channels and Blood Pressure Control
Summary
Sources of Funding
12. Role of Enhancers in Transcriptional Regulation of Cardiac Electrical Activity
Function of the Cardiac Conduction System
Genetic Variation and the Role of T-Box Factors in Gene Regulation and Electrical Activity
Transcriptional Regulation by Cis-Regulatory Elements
Three-Dimensional Chromatin Architecture Regulates Transcription
Enhancers Involved in the Regulation of Cardiac Ion Channels
13. Functional Characterization of Ion Channel Gene Variants in Sudden Unexplained Natural Death
Sudden Unexplained Death
Genetic Testing In Sudden Unexplained Death
Channelopathies And Sudden Unexplained Death
Functional Testing Of Sudden Unexplained Death Variants
Do Channelopathy Gene Variants Lead To Sudden Unexplained Death Or Sudden Infant Death Syndrome?
Reclassification And Interpretation Of Variants
Possible Interpretations of Data
Future Directions
Funding Sources
14. Stretch-Activated Potassium Channels in the Human Heart: Pathophysiologic and Clinical Significance
Introduction: Mechanics Matters
Mechanosensitive Ion Channels
SACK in Cardiac Physiology and Pathophysiology
Summary and Outlook
15. Connexins and Pannexins in Cardiovascular Disease
Background
Connexins and Pannexins
Short-Term Consequences of Ischemia
Underlying Causes of Acute Myocardial Infarction
Tissue Damage Associated With Resolution of Ischemia
Conclusion
16. Excitation–Contraction Coupling
Excitation-Contraction Coupling and Relationship to Action Potentials
Sources and Sinks of Ca2+ in Myocytes: Sarcolemma, Sarcoplasmic Reticulum, and Mitochondria
Balance of Fluxes, E-C Coupling Gain, and Fractional Ca2+ Release
Structure of the Couplon and Submembrane Spaces
E-C Coupling: Ca2+-Induced Ca2+ Release, Ca2+ Sparks, and Ca2+ Waves
Cardiac Alternans
Ca2+ Fluxes can Influence the Cardiac Action Potential
Myocyte Ca2+ Handling in Rhythmicity and Arrhythmogenesis
Part III. Intermolecular Interactions and Cardiomyocyte Electrical Function
17. Ion Channel Trafficking in the Heart
Overview of Ion Channel Trafficking in the Heart
Cx43 Trafficking in the Heart
CaV1.2 Channel Trafficking in the Heart
Conclusions
18. Microdomain Interactions of Macromolecular Complexes and Regulation of the Sodium Channel NaV1.5
NaV1.5 and Interacting Proteins
Localization of NaV1.5 in Cardiac Cells: Evidence for Distinct Pools
Proteins Interacting With NaV1.5 Without Demonstrated Roles in Arrhythmias
Proteins Interacting With NaV1.5 That are Linked to Cardiac Arrhythmias
Conclusions and Perspectives
19. Connecting Cardiac Excitation to the Atomic Interactions of Ion Channels
Introduction
Insights From High-Resolution Structures of Voltage-Gated Cardiac Ion Channels
Measuring the Conformational Dynamics of Voltage-Gated Channels
Computational Modeling of the Molecular Interactions of Ion Channels
Computational Modeling of Ion Channels in Cells and Tissues
Using Computational Models to Connect the Molecular Details to Whole Heart Function
Conclusions
20. Macromolecular Complexes and Cardiac Potassium Channels
Introduction
Four General Classes of Accessory Subunits
Membrane-Associated Guanylate Kinase Proteins
Membrane Lipids And Potassium Channel Complexes
Macromolecular Complex Involved In The Delivery Of Potassium Channels
Conclusion
Financial Supports
21. Reciprocity of Cardiac Sodium and Potassium Channels in the Control of Excitability and Arrhythmias
Introduction
Sodium Channels And Cardiac Excitation
Inward Rectifier Potassium Current
Reciprocal Regulation Of Nav1.5 And Kir2.1
Nav1.5 And Kir2.1/2.2 Channels Form Multiprotein Complexes At The Cardiomyocyte Membrane
Kir2.1 Interacts With Both Sap97 And α-Syntrophin
Sap97 And Syntrophin Are Involved In Nav1.5-Kir2.1 Interactions
Transgenic Mouse Models Demonstrate That Nav1.5-Kir2.1 Interactions Are Posttranslational
Nav1.5-Kir2.1 Interactions Involve Membrane Trafficking
Disease-Associated Nav1.5 And Kir2.1 Mutations And Reciprocal Modulation
Reciprocal Nav1.5-Kir2.1 Interactions Control Reentry Frequency
Conclusion
22. The Intercalated Disc: A Molecular Network That Integrates Electrical Coupling, Intercellular Adhesion, and Cell Excitability
Introduction And Historical Perspective
Structural Features Of The Intercalated Disc
Ion Channel Complexes That Reside At The Intercalated Disc
Connexome, Visual Proteomics, And The Existence Of Mini-Nodes Of Ranvier At The Intercalated Disc
Noncanonical Functions Of Intercalated Disc Molecules
Physical And Functional Relation Between The Intercalated Disc And The Dyads
Mitochondrial Organization At The Intercalated Disc
Intercalated Disc Proteins In Inherited Diseases
Conclusions
23. Function and Dysfunction of Ion Channel Membrane Trafficking and Posttranslational Modification
Introduction
Defects In Ion Channel Trafficking And Cardiac Arrhythmia
Channel Dysfunction Induced By Altered Posttranslational Modifications
Summary
24. Feedback Mechanisms for Cardiac-Specific microRNAs and cAMP Signaling in Electrical Remodeling
Overview Of Cardiac microRNAs
Functional Roles Of microRNAs In Cardiac Camp Signaling And Electrical Remodeling
Feedback Mechanisms For Cardiac microRNAs And camp Signaling In Cardiac Electrical Remodeling
Therapeutic Potentials Of microRNA Delivery In Cardiac Electrical Remodeling
Summary And Future Perspectives
Part IV. Cell Biology of Cardiac Impulse Initiation and Propagation
25. Coupled Oscillators and Sinoatrial Pacemaker Activity
Introduction
Biophysical Engine of the Coupled-Clock System
Biochemical Engine of the Coupled-Clock System
Biochemical and Biophysical Engines Cross Talk in the Basal State and Autonomic Modulation
Coupled-Clock System in Human Sinoatrial Node Cells
Action Potential Firing Rate and Rate Rhythm Inform on Fidelity of Clock Coupling Determined by Clock Protein Phosphorylation Status
Spectrum of Clock Coupling Defines Action Potential Firing Rate and Rhythm: From Dormancy to Highly Rhythmic Firing
Heterogeneity of Sinoatrial Node Cells
Additional Level of Complexity of Coupled-Clock System Operation Within the Intact Sinoatrial Node Tissue: A New Emerging Paradigm of Sinoatrial Node Operation
Cell Coupling Within Sinoatrial Node Tissue
Summary, Future Studies, and Harnessing the Coupled-Clock Operation FOR Clinical Applications
26. Mapping of Cardiac Action Potentials in Zebrafish to Assess Genetic Variants
Introduction
Zebrafish
Optogenetics And Optical Mapping
Current Applications And Future Outlook
27. Cell-To-Cell Communication and Impulse Propagation
Cardiac Cell-To-Cell Communication By Gap Junctions
Cx43, Cx40, And Cx45 In The Myocardium
How Safe Is Propagation In Tissue With Reduced Cell-To-Cell Coupling?
Propagation In Tissue With Heterogeneous Connexin Expression Is Robust
Cell-To-Cell Coupling, Tissue Architecture, And Ion Currents Form An Interacting System
Ephaptic Impulse Transmission: Revival Of An Old Concept To Explain Cardiac Cell-To-Cell Impulse Transfer
Coupling Between Cardiomyocytes And Nonmyocytes And Its Effect On Propagation
Remodeling Proteins Of The Intercalated Disc: Interactions Between Mechanical Junctions And Gap Junctions
Summary
28. Mechanisms of Normal and Dysfunctional Sinoatrial Nodal Excitability and Propagation
Structural and Molecular Characteristics of The Sinoatrial Pacemaker Complex
Robustness: An Intrinsic Property of Sinoatrial Node Conduction
Conduction Abnormalities And Arrhythmias In The Mammalian And Human Sinoatrial Node
Conclusion and Future Directions
29. Cell Biology of the Specialized Cardiac Conduction System
Histological Analysis Of The Developing Mammalian Cardiac Conduction System
Cellular Origins Of The Cardiac Conduction System
Models Of Cardiac Conduction System Development
Molecular Markers Of The Cardiac Conduction System
Transcription Factor Networks
Conclusion
Part V. Models of Cardiac Excitation
30. Computational Prediction of Drug-Induced Arrhythmias
Limitations of Current Methods for Predicting Drug-Induced Torsades De Pointes
Proposed Use of Mathematical Models For Drug-Induced Arrhythmia Prediction
Recent Studies Have Demonstrated the Value Of Computational Modeling
New Directions in Computational Prediction Of Drug-Induced Arrhythmia
Conclusions and Outlook
31. Global Optimization Approaches to Generate Dynamically Robust Electrophysiologic Models
Introduction
Genetic Algorithm Optimization
Use Of Complex Objectives In Optimization
Discussion And Outlook
32. Calcium Signaling in Cardiomyocyte Models With Realistic Geometries
Electrophysiological Structure of The Ventricular Myocyte
Structure-Function Relationships At The Nanometer Scale (Calcium Release Unit And Couplon)
Structure-Function Relationships At The Micron Scale (T-Tubule And T-System)
33. Theory of Rotors and Arrhythmias
Basic Properties of Electrical Patterns In The Heart
Advanced Concepts In The Theory of Rotors And Arrhythmias
Outlook And Challenges
34. Distinct ECG Phenotypes Identified in Hypertrophic Cardiomyopathy Using Machine Learning Associated With Arrhythmic Risk Markers
Introduction
Methods
Results
Discussion
Conclusions
35. Computational Approaches for Accurate Rotor Localization in the Atria
Introduction
Action Potential Rotor
Phase Representation Of The Action Potential Time Course
Phase Frequency Domain Analysis Of Rotor Activity
Singular Value Decomposition For Enhanced Rotor Detection
Rotor Localization By Its Singularity Point In The Phase Map
Rotor Detection In Electrical Mapping In Patients
Dispersion Of Electrical Activity In A Rotor Region
Transient Frequency And Amplitude Modulations For Detection Of Rotor Footprints
Detection Of Driving Rotors By Body Surface Mapping
Conclusion
36. Modeling the Aging Heart
Introduction
Overview Of Methodology For Simulating Arrhythmogenesis And Representing Fibrotic Remodeling In The Myocardium
Modeling Fibrotic Remodeling In The Atria And Its Contribution To Atrial Fibrillation
Comparison Of The Predictions Of Atrial Fibrosis Models With Clinical Recordings
Personalized Targeted Ablation Of Persistent Atrial Fibrillation Guided By Computational Modeling
Conclusions
37. Electromechanic Imaging of the Heart
Introduction
Conclusions
Part VI. Neural Control of Cardiac Electrical Activity
38. Innervation of the Sinoatrial Node
General Neuroanatomy of The Heart
Nerve Supply Of The Sinoatrial Node Area
Morphology And Immunohistochemistry Of The Sinoatrial Node Innervation In Humans And Other Mammals
Intrinsic Ganglia And Neuronal Somata Related To The Sinoatrial Node
Conclusions
39. Autonomic and Oxidant Regulation of Cardiac Sodium Currents: Mechanisms and Consequences
Introduction
Na Channels: Structural Aspects of Oxidant and Autonomic Regulation
Myocardial Metabolism and Oxidant Stress
Modulation of Cardiac NaV1 Channels in Health and Disease
Cardiac Metabolism, Oxidant Stress, and NaV Channels
Autonomic Regulation of NaV1 Channels
Conclusions
40. Neural Activity and Atrial Tachyarrhythmias
Cardiac Autonomic Nervous System
Neural Activities In Atrial Electrophysiology And Arrhythmogenesis
Nerve Activity Recording In Ambulatory Canine Models
Nerve Activities Recording From The Skin
Neuromodulation For Atrial Arrhythmias
Conclusions
41. Sympathetic Modulation of Cardiac Electrophysiology
Introduction
Sympathetic Remodeling
Functional Sympathetic Nerve Remodeling
Antiarrhythmic Therapies to Modulate Sympathetic Signaling
Conclusions and Future Direction
42. Role of the Autonomic Nervous System in Atrial Fibrillation
Cardiac Autonomic Nervous System
Autonomic Mechanisms Of Atrial Fibrillation Initiation And Maintenance
Ablating The Cardiac Autonomic Nervous System To Treat Atrial Fibrillation
Modulation Of Cardiac Autonomic Nervous System To Treat Atrial Fibrillation without Destroying Autonomic Neural Elements
Perspectives
Part VII. Arrhythmia Mechanisms
43. Rotational and Focal Sources of Atrial Fibrillation: Scientific Rationale and Comparative Clinical Mapping
Introduction
Mechanisms For The Initiation Of Human Atrial Fibrillation
Mechanisms That Sustain Human Atrial Fibrillation
Comparative Atrial Fibrillation Mapping In Patients
Mapping Atrial Fibrillation In Patients To Guide Therapy
Results Of Clinical Mapping Of Atrial Fibrillation In Patients
Evidence That Rotational And Focal Sites Drive Human Atrial Fibrillation
Clinical Results Of Driver Ablation
Conclusions
44. Noninvasive Frequency-Phase Mapping of Atrial Fibrillation
Introduction
Body Surface Potential Mapping And Electrocardiographic Imaging Methodology
Technical Limitations OF Electrocardiographic Imaging For Atrial Fibrillation Evaluation
Electrocardiographic Imaging Identification Of Arrhythmia Mechanisms During Atrial Fibrillation
Simplifying Electrocardiographic Imaging Acquisition
Clinical Validation Of The Inverse Problem Solution For Noninvasive Estimation Of Dominant Frequency And Phase Mapping During Atrial Fibrillation: The Personalize-Af Study
Atrial Fibrillation Stratification Based On Arrhythmia Perpetuation Mechanisms: The Stratify-Af Study
What’s Next?
Conclusion
45. Mechanistic Approaches for Persistent Atrial Fibrillation Ablation
Introduction
Dominant Frequency Mapping
Focal Impulse And Rotor Modulation Mapping
Electrocardiographic Imaging And Phase Mapping
CartoFinder
Spatiotemporal Electrogram Dispersion
High-Density Mapping Of Repetitive-Regular Activities
Stochastic Trajectory Analysis Of Ranked Signals
Focal Source And Trigger Mapping
Noncontact Charge Density Mapping
Real-Time Electrogram Analysis For Drivers Of Atrial Fibrillation Mapping
Instantaneous Amplitude And Frequency Modulation Mapping
Concluding Remarks And Future Steps
46. Mechanisms of Human Ventricular Tachycardia and Human Ventricular Fibrillation
Introduction
Established Myocardial Infarction
Nonischemic Dilated Cardiomyopathy
Arrhythmogenic Right Ventricular Cardiomyopathy
Hypertrophic Cardiomyopathy
Inherited Primary Arrhythmia Syndromes
Noninherited Ventricular Tachycardia In Patients With Structurally Normal Hearts
Mechanisms Of Human Ventricular Fibrillation
Ventricular Fibrillation Triggers
Transitional Mechanisms To Ventricular Fibrillation
Maintenance Of Early Human Ventricular Fibrillation
Maintenance Of Long-Duration Human Ventricular Fibrillation
Summary
47. Genetics of Atrial Fibrillation
Heritability of Atrial Fibrillation
Future Directions
Conclusions
Part VIII. Molecular Genetics and Pharmacogenomics
48. Mechanisms in Genetic Sodium Channel Diseases
Cardiac Sodium Channel
Consequences of Sodium Channel Dysfunction
Delayed Repolarization
Impaired Impulse Propagation
Altered Intracellular Ion Homeostasis
Syndromes with Complex Mechanisms
49. Genetic, Ionic, and Cellular Mechanisms Underlying the J Wave Syndromes
Introduction
Genetics
Cellular Mechanisms Underlying Brugada Syndrome and Early Repolarization Syndrome
Approaches to Therapy of Brugada Syndrome and Early Repolarization Syndrome
50. Inheritable Potassium Channel Diseases
Introduction
Long Qt Syndrome
Long Qt Syndrome Because Of Iks Loss Of Function
Long Qt Syndrome Because Of Ikr Loss Of Function
Other Long Qt Syndrome Subtypes
Short Qt Syndrome
Other Inheritable Potassium Channel Diseases
51. Inheritable Phenotypes Associated With Altered Intracellular Calcium Regulation
Overview of Calcium Homeostasis in the Heart
Inherited Structural Cardiomyopathy
Conclusions and Perspectives
Part IX. Pharmacologic, Genetic, and Cell Therapy of Ion Channel Dysfunction
52. Dominant Frequency as a Tool for Personalized Monitoring of Atrial Fibrillation Progression and Upstream Therapy
Introduction
Electrical Remodeling and the Dynamics of AF Progression
Possible Mechanisms of AF-Induced Remodeling
Transcriptomic and Proteomic Analysis Of AF Progression
Remodeling and Upstream Therapies in AF
Monitoring of AF Progression in Patients
Summary
Future Directions
53. Pharmacogenomics of Cardiac Arrhythmias
Introduction
Principles Of Pharmacogenomics
Pharmacokinetic Mechanisms Contributing To Variable Drug Actions
Pharmacodynamic Mechanisms Contributing To Variable Drug Actions
The Future: Using Pharmacogenetic Information In Patient Management
54. Deep Phenotyping: Adding New Tools to Understand Disease
DefiNing Phenotype
Deep Phenotyping
Emerging Tools for Phenotyping
Care Delivery In The Context Of Continuous Deep Phenotyping
Atrial Fibrillation as a Case Study
Conclusions
55. Gene Therapy for Atrial Fibrillation
Introduction
Myocardial Transduction
Targets For Gene Therapy In Atrial Fibrillation
Conclusions and Future Directions
Part X. Cell Biology and Electrophysiology of Human Induced Pluripotent Stem Cell–Derived Cardiomyocytes
56. Cardiac Remodeling and Regeneration
Cardiac Remodeling
Cardiac Regeneration
57. High-Throughput Optical Mapping of Two-Dimensional hiPSC-CM Platforms for Drug Discovery and Cardiotoxicity Testing
Current Guidelines for Cardiotoxicity and Proarrhythmia Screening
Current ICH S7B Guidelines for Preclinical Drug Testing: hERG Current Assay
Limitations of the In Vitro Heterologous Cell-Based hERG Current Assay
Human Cardiomyocytes for Preclinical Cardiotoxicity Testing: Primary Cells
Human Pluripotent Stem Cell–Derived Cardiomyocytes for Cardiotoxicity Testing
Technological Hurdles for Implementation of CiPA Using hiPSC-CMs: Maturing the Cellular Structural and Functional Phenotypes
58. Functional Cardiac Fibroblasts Derived From Human Pluripotent Stem Cells via Second Heart Field Progenitors
Introduction
Developmental Origins of Cardiac Fibroblasts
Human Pluripotent Stem Cell–Derived Cardiac Fibroblasts
Crosstalk between Human Pluripotent Stem Cell–Derived Cardiac Fibroblasts and Human Pluripotent Stem Cell–Derived Cardiomyocytes
Cardiac Fibroblasts and Arrhythmias
Future Applications Using Human Pluripotent Stem Cell–Derived Cardiac Fibroblasts
59. Challenges of Human iPSC-CM Technology: Increasingly Complex Approaches Improve Cell Maturation and Relevance to Modeling Human Cardiac Disease
Introduction
Derivation of hiPSC-CMs
Matrix Sandwich Protocol
Purification Approaches
hiPSC-CM Differentiation Into Atrial and Ventricular Lineages
What Constitutes an Adult Cardiomyocyte?
Some Approaches Used to Promote hiPSC-CMs Maturation
Summary and Conclusions
Part XI. Diagnostic Evaluation
60. Assessment of the Patient With a Cardiac Arrhythmia
Introduction
Acute Tachycardia
Assessment of the Patient with Suspected Arrhythmia
Physical Examination
Laboratory Evaluation
Cardiovascular Testing
Summary
61. Differential Diagnosis of Narrow and Wide Complex Tachycardias
Introduction
Narrow Qrs Tachycardias
Wide QRS Tachycardias
Other Sources of Electrocardiographic Material
Remaining Problems
Summary
62. Electrocardiographic Monitoring: Short- and Long-Term Recording
Introduction
Short-Term Recording
Intermediate Duration Monitoring
Prolonged Monitoring: Insertable Cardiac Monitors
Future Directions
Conclusion
63. Personal Cardiac Monitoring
Introduction
History: Cardiac Monitoring Technology
Digital Biomarkers
Remote Arrhythmia Monitoring In Patients With Cardiac Rhythm Management Devices
Remote Intracardiac Pressure Monitoring
ecohort Studies
Wearable Studies in Atrial Fibrillation Detection
Personal Cardiac Monitoring and Chronic Disease Management
Privacy Protections and Cybersecurity
Conclusion
64. Computed Tomography for Electrophysiology
Technical Background of Cardiac Computed Tomography Imaging
Image Integration
Current Applications of Cardiac Computed Tomography in Cardiac Electrophysiology
Assessment of Procedural Complications
Future Applications And Evolving Technology
65. Magnetic Resonance Imaging for Electrophysiology
Introduction
Cardiac Magnetic Resonance Imaging Intertissue Contrasts
Advantages and Deficiencies of Magnetic Resonance Imaging versus Computed Tomography in the Electrophysiology Setting
Imaging The Arrhythmia Substrate: Implications For Diagnosis And Prognosis
Intraprocedural Guidance with Magnetic Resonance Imaging
Specific Magnetic Resonace Imaging-Guided Electrophysiologic Procedures
Summary
66. Intracardiac Echocardiography for Electrophysiology
Intracardiac Echocardiographic Platforms
Basic Intracardiac Echocardiographic Imaging Planes
Detecting And Preventing Complications
Summary
67. Autonomic Nervous System Assessment for Syncope and Arrhythmia Risk
Introduction
Basic Autonomic Nervous System Anatomy/Physiology as It Affects Cardiovascular Homeostasis
Assessing Autonomic Nervous System Status
Syncope and Arrhythmia Risk in Reflex Autonomic Disturbances
Syncope and Arrhythmia Risk in Primary Autonomic Diseases
Syncope and Arrhythmia Risk in Common Secondary Autonomic Diseases
Conclusions
68. Noninvasive Electrocardiographic Imaging of Arrhythmogenic Substrates and Ventricular Arrhythmias
Electrocardiographic Imaging and its Validation
Electrophysiologic Substrate of Post–Myocardial Infarction Scar
Electrophysiologic Substrate of Hereditary Disorders
Examples of Ventricular Tachycardia
Appendix: Methodology Considerations and Validation of Electrocardiographic Imaging in the Rudy Laboratory
69. Genetic Testing
Basic Genetics
Genetic Testing in Cardiovascular Disease
Genes and Cardiovascular Disease
Clinical Applications of Genetic Testing
Family Management
Ethical, Legal, and Societal Implications
Conclusions and the Future
Part XII. Supraventricular Arrhythmias: Diagnosis and Therapy
70. Supraventricular Tachycardias: Diagnostic Maneuvers in the Electrophysiology Laboratory
Introduction
Initial Evaluation and Preprocedural Planning
Vascular Access and Catheter Placement
Baseline Observations
Electrophysiologic Maneuvers Done in Sinus Rhythm
Tachycardia Induction and Characteristics
Electrophysiologic Pacing Maneuvers During Tachycardia
Typical Atrioventriucular Nodal Reentrant Tachycardia Versus Junctional Ectopic Tachycardia
Conclusion
71. Atrial Tachycardia
Introduction
Definition
Differential Diagnosis of Focal Atrial Tachycardia
Conclusions
72. Atrioventricular Nodal Reentrant Tachycardia
Anatomic Correlates to the Atrionodal Connections
Variants of Atrioventricular Nodal Reentrant Tachycardia
Differential Diagnosis of Atrioventricular Nodal Reentrant Tachycardia
Future Directions
73. Junctional Tachycardia
Electrocardiographic Features and Diagnosis
Differentiation During Electrophysiologic Study
Mechanisms
Clinical Features
Management
Conclusions
74. Preexcitation, Atrioventricular Reentry, Variants
Classification of Accessory Pathways
Electrocardiogram Features of Accessory Pathways
Arrhythmias Associated with Accessory Pathways
Clinical Features of Atrioventricular Reentrant Tachycardia
Electrocardiographic Features of Atrioventricular Reentrant Tachycardia
Electrophysiology Studies in Patients with Accessory Pathways and Ventricular Preexcitation
Electrophysiologic Features of Orthodromic Atrioventricular Reentrant Tachycardia
Induction of Atrioventricular Reentrant Tachycardia
Ventriculoatrial Intervals During Atrioventricular Reentrant Tachycardia
Retrograde Accessory Pathway Conduction Characteristics
Bundle Branch Block During Atrioventricular Reentrant Tachycardia
75. Atrial Fibrillation: Mechanisms, Clinical Features, and Management
Epidemiology and Societal Impact
Classification
Pathophysiology
Treatment
Conclusions and Future Directions
76. Ablation for Atrial Fibrillation
Background
Underlying Mechanisms Of Atrial Fibrillation
Ablation Strategy
Preprocedural Assessment
Conclusion
77. Left Atrial Appendage Management: Anatomy, Physiology, and Role in Atrial Fibrillation–Related Stroke
Left Atrial Appendage Anatomy And Imaging
Left Atrial Appendage Physiology
Role of Left Atrial Appendage Thrombus And Association with Atrial Fibrillation–Related Stroke
Association of Left Atrial Appendage with Initiation and Persistence of Atrial Fibrillation
Conclusions
78. Typical and Atypical Atrial Flutter: Mapping and Ablation
Mechanisms of Atrial Flutter
Cavotricuspid Isthmus–Dependent Flutter
Noncavotricuspid Isthmus–Dependent Flutter (Atypical Flutter)
High-Density Mapping
Conclusions
Part XIII. Ventricular Arrhythmias
79. Sudden Cardiac Death in Adults
Sudden Cardiac Death as A Public Health Burden
Structural Substrates and Clinical Expressions
Pathologic Substrates
Strategies for Prediction and Prevention
Prediction of Risk in Coronary Heart Disease
Risk in Nonischemic Dilated Cardiomyopathy
Cardiac Arrest Mechanisms: Tachyarrhythmic, Pulseless Electrical Activity, and Asystole
Inherited Basis of Risk in Adults
Epidemiologic Paradigms for Prediction
Interventional Epidemiology of Risk
80. Premature Ventricular Complexes
Epidemiology
Diagnosis and Assessment
Clinical Management
Conclusions and Future Directions
81. Outflow Tract Ventricular Tachyarrhythmias: Mechanisms, Clinical Features, and Management
Anatomy
Epidemiology
Mechanism
Diagnosis
Prognosis
Management
82. Premature Ventricular Contraction Ablation With Anatomic Guidance: Papillary Muscles, Moderator Band, and Valve Annulus Sites
Introduction
Left Ventricle Papillary Muscles
Moderator Band and Right Ventricle Papillary Muscles
Mitral Annulus
Tricuspid Annulus
83. Fascicular Ventricular Arrhythmias
Verapamil-Sensitive Fascicular Ventricular Tachycardia
Focal Ventricular Tachycardia Originating From the Purkinje System
Ventricular Premature Contractions and Ventricular Fibrillation Triggered From The Fascicular System
Bundle Branch Reentry and Interfascicular Reentry
Conclusions
84. Bundle Branch Reentry Tachycardia
Surface Electrogram and Classification
Pathophysiology
Underlying Structural Heart Disease
Initiation of Tachycardia
Diagnosis
Mapping
Differential Diagnosis
Catheter Ablation
Right Bundle Branch Ablation
Left Bundle Branch Ablation
Ablation of Interfascicular Tachycardia
Clinical Outcomes
Complications
Conclusions
85. Ischemic Heart Disease
Electroanatomic Substrate
Ventricular Tachycardia Mechanisms
Clinical Presentation and Acute Management
Chronic Management and Areas Of Uncertainty
86. Ablation of Postmyocardial Infarction Ventricular Tachycardia
Historical Perspective
Preprocedural Planning
Mapping and Ablation Techniques
Epicardial Mapping and Ablation
Postprocedural Testing
Procedural Risks and Outcomes
Management in Patients With Recurrence
Future Directions
87. Ventricular Tachycardia in Patients With Dilated Cardiomyopathy
Definition, Epidemiology, and Etiology of Dilated Cardiomyopathy
Sudden Cardiac Death Risk Stratification in Dilated Cardiomyopathy
Ventricular Arrhythmias in Dilated Cardiomyopathy
Therapy of Ventricular Arrhythmias in Dilated Cardiomyopathy
Conclusion
88. Lamin A/C, Noncompaction, and Other Genetic Cardiomyopathies With Ventricular Arrhythmias
Introduction
Familial Dilated Cardiomyopathy
Hypertrophic Cardiomyopathy
Arrhythmogenic Cardiomyopathy
Noncompaction Cardiomyopathy
Brugada Syndrome
Conclusion
89. Ventricular Tachyarrhythmias in Hypertrophic Cardiomyopathy: Sudden Death, Risk Stratification, and Prevention With Implantable Defibrillators
Clinical Presentation and Sudden Cardiac Death
Myocardial Substrate and Mechanism of Sudden Cardiac Death in Hypertrophic Cardiomyopathy: Ventricular Tachyarrhythmias
Initiatives for Sudden Death Prevention
Selecting High-Risk Patients for Implantable Cardioverter-Defibrillators
Other Disease Variables and Considerations in Risk Assessment
Ambiguous or “Gray Zone” Levels Of Risk
Prospective Identification of High-Risk Patients and Decision Making
Risk Assessment in Children
Implantable Cardioverter-Defibrillator–Related Complications
90. Ventricular Tachycardias in Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy
Clinical Presentation and Natural History
Etiology
Pathogenesis
Relationship Between Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy and Exercise
Management
Summary
91. Catecholaminergic Polymorphic Ventricular Tachycardia
Genetic Basis
Clinical Presentation
Diagnosis
Clinical Management
92. Arrhythmias and Conduction Disturbances in Noncompaction Cardiomyopathy
—
Pathology
Incidence
Clinical Features and Diagnosis
Subtypes
Imaging
Electrocardiography
Arrhythmias
Clinical Genetics
Molecular Genetics of Left Ventricular Noncompaction
Therapy and Outcome
Antithrombotic Therapy
Arrhythmias
Genetic Counseling
93. Ventricular Arrhythmias in Takotsubo Cardiomyopathy
Clinical Characteristics of Takotsubo Cardiomyopathy
Electrocardiographic Changes
Ventricular Arrhythmias
Pathogenesis of Ventricular Arrhythmias
Management
Conclusions
94. Mitral Valve Prolapse, Ventricular Arrhythmias, and Sudden Death
Introduction
Historical Perspective
Ventricular Arrhythmias and Mitral Valve Prolapse
Pathophysiology of Ventricular Arrhythmias in Mitral Valve Prolapse: Old Theories
Pathophysiology of Ventricular Arrhythmias in Mitral Valve Prolapse: New Theories of Diseased Purkinje Fibers and Left Ventricular Fibrosis
A Possible Unifying Theory: Padua Hypothesis
Sources of Funding
95. Brugada Syndrome
Electrocardiographic Features
Pathophysiologic Mechanisms
Overlapping and Discordant Intrafamily Syndromes
Risk Stratification
External Factors and Brugada Syndrome
Brugada Syndrome and Pregnancy
Brugada Syndrome in Children
Brugada Syndrome in Older Individuals
The Future
96. Long and Short QT Syndromes
Long QT Syndrome
Clinical Presentation
Clinical Diagnosis
Molecular Diagnosis in Long QT Syndrome
Sudden Infant Death Syndrome and Neonatal Electrocardiogram Screening
Therapy
Short QT Syndrome
Clinical Presentation
Clinical Diagnosis
97. Andersen-Tawil Syndrome
Introduction
Andersen-Tawil Syndrome
Phenotypic Overlap Between Andersen-Tawil Syndrome and Catecholaminergic Polymorphic Ventricular Tachycardia
Cellular Basis of Andersen-Tawil Syndrome
Treatment Options For Andersen-Tawil Syndrome
98. Timothy Syndrome
Introduction
Pathophysiology
Clinical Presentation
Therapy
99. J Wave Syndromes
Acquired J Wave Syndromes: Hypothermia and Ischemic Ventricular Fibrillation
Congenital J Wave Syndromes: Brugada Syndrome and Idiopathic Ventricular Fibrillation with Early Repolarization
Early Repolarization in Healthy Individuals and J Waves in Idiopathic Ventricular Fibrillation
Arrhythmic Risk for Patients With Early Repolarization in Large Prospective Population Studies
Approach to the Patient With J Waves
100. Idiopathic and Short-Coupled Ventricular Fibrillation
Definition
Phenotype and Triggers of Short-Coupled Ventricular Fibrillation
Molecular Mechanisms
Diagnostic Evaluation
Interaction with Other Inherited Arrhythmias
Management and Follow-Up
Future Directions
101. Mapping and Ablation of Ventricular Fibrillation
Background
Mechanistic Insights from Ventricular Fibrillation Mapping
Principles of Clinical Ventricular Fibrillation Mapping and Ablation
Idiopathic Ventricular Fibrillation
J Wave Syndromes
Ischemic Ventricular Fibrillation
Summary
102. Drug-Induced Ventricular Arrhythmias
Introduction
Pharmacokinetic Mechanisms
Pharmacodynamic Mechanisms
Conclusions
Part XIV. Syncope and Bradyarrhythmias
103. Syncope
Definitions and Scope
Etiologies and Pathophysiology
Clinical Evaluation
Treatment of Vasovagal Syncope
Conclusion
104. Sinus Node Abnormalities
Introduction
Sinus Node
Sinus Node Disease
Sinus Node Remodeling
Familial Sinus Node Disease
Clinical Presentation and Evaluation
Treatment
105. Postural Orthostatic Tachycardia Syndrome
Autonomic Nervous System
Historical Perspective
Definitions
Classification
Evaluation and Management
Conclusions
106. Atrioventricular Block
Types and Levels
Clinical Manifestations
Pathophysiology
Prognosis
Management
Part XV. Arrhythmias in Special Populations
107. Sex Differences in Arrhythmias
Basic Electrophysiology
Presentation and Management of Specific Arrhythmias
Pharmacotherapy
Implantable Device Therapy
Pregnancy and the Postpartum Period
108. Sudden Cardiac Deaths in Athletes, Including Commotio Cordis
Introduction
Epidemiology of Sudden Cardiac Death in Athletes
Commotio Cordis
Screening
Supplements
Resuscitation
Sports Participation in Athletes With Heart Disease
Conclusion
109. Cardiac Sarcoidosis
Introduction
Epidemiology
Pathogenesis
Clinical Manifestations
Diagnosis
Prognosis
Therapy
Summary and Future Directions
110. Sleep-Disordered Breathing and Arrhythmias
Obstructive Sleep Apnea
Central Sleep Apnea
Mechanisms of Arrhythmias in Sleep Apnea
Epidemiology of Arrhythmias in Sleep Apnea
Sleep Apnea Therapy and Arrhythmias
Approach to the Patient
111. Ventricular Assist Devices and Cardiac Transplant Recipients
Brief Overview of Ventricular Assist Devices
Arrhythmias in Patients With Ventricular Assist Devices
Mechanisms of Arrhythmias in Patients With Ventricular Assist Devices
Management of Ventricular Arrhythmias in Patients With Ventricular Assist Devices
Brief Overview of Heart Transplantation Techniques
Potential Mechanisms of Arrhythmias in Heart Transplant Recipients
Arrhythmias in Heart Transplant Recipients
Summary
112. Arrhythmia in Neurologic Disease
Neurologic Disorders With Transient Arrhythmia Manifestations
Neuromuscular Diseases
Summary
113. Cancer Therapy–Related Arrhythmias
Introduction
Atrial Fibrillation and Other Supraventricular ArrHythmias
QT Prolongation and Ventricular Arrhythmias
Bradyarrhythmia and Autonomic Dysfunction
Cardiac Implantable Devices
Part XVI. Congenital Heart Disease and Pediatrics
114. Arrhythmias in the Pediatric Population
Unique Aspects of Pediatric Electrophysiology
Supraventricular Tachycardia in Pediatric Patients
Ventricular Arrhythmias in Pediatric Patients
Bradycardia in Pediatric Patients
Summary
115. Supraventricular Tachycardias in Congenital Heart Disease
Introduction
Atrial Remodeling in Adult Congenital Heart Disease
Arrhythmia Mechanisms in Adult Congenital Heart Disease
Management of Atrial Tachycardia in Adult Congenital Heart Disease
Invasive Electrophysiologic Assessment
Mapping and Ablative Strategies
Outcomes and Complications
Conclusions
116. Ventricular Arrhythmias in Congenital Heart Disease
Tetralogy of Fallot
Transposition of the Great Arteries
Other
Part XVII. Pharmacologic Therapy
117. Antiarrhythmic Drugs
Mechanism-Based Approach to Treatment of Arrhythmias
Principles of Antiarrhythmic Therapy
Metabolizing Enzymes, Transporters, and Potential Drug Interactions
Classification of Antiarrhythmic Drugs
Class I Antiarrhythmic Drugs
Class III Antiarrhythmic Drugs
Other AntiarrHythmic Drugs
118. Impact of Nontraditional Antiarrhythmic Drugs on Sudden Cardiac Death
Introduction
Assessing the Impact of Nontraditional Antiarrhythmic Drugs on Sudden Cardiac Death
β-Adrenergic Blockers
β-Blockers After Myocardial Infarction
β-Blockers in Congestive Heart Failure
Efficacy of β-Blockers in Secondary Prevention of Sudden Death
Efficacy of β-Blockers in Genetic Arrhythmia Syndromes
Renin-Angiotensin-Aldosterone System
Angiotensin Receptor Blockers
Aldosterone Receptor Antagonists
Combined Angiotensin-Neprilysin Inhibition
Modulators of Cholesterol and Inflammation
Other
Emerging Therapies
Conclusion
119. Anticoagulation for Thromboembolic Prophylaxis
Indications for Anticoagulation in Atrial Fibrillation
Initiation, Monitoring, and Discontinuation of Direct Oral Anticoagulant Drugs
Important Drug Interactions With Direct Oral Anticoagulant Drugs
Reversal of Direct Oral Anticoagulant Drugs
Antiplatelet Agents
Specific Patient Characteristics
Gastrointestinal Bleeding
Atrial Fibrillation and Coronary Artery Disease
Periprocedural Anticoagulation in Patients With Atrial Fibrillation
Atrial Fibrillation Ablation
Cardiac Implantable Electronic Device Implantation
Part XVIII. Devices for Arrhythmia Management
120. Implantable Pacemakers
History of Pacing
Pacemaker Nomenclature
Indications for Cardiac Pacing
Basic Pacemaker Function and Modes
Selecting the Appropriate Pacing Mode
Selecting the Appropriate Sensor for Rate-Adaptive Pacing
Troubleshooting Electrocardiographic Abnormalities
Automatic Pacemaker Function
Electromagnetic Interference
Magnetic Resonance Imaging
Leadless Pacemakers
His Bundle and Left Bundle Pacing
End-of-Life Considerations
Summary
121. Implantable Cardioverter-Defibrillators: Technical Aspects
System Elements
Tachyarrhythmia Detection
Tachyarrhythmia Therapy
System Malfunction
122. Transvenous Implantable Cardioverter-Defibrillator: Clinical Aspects
Risk Stratification and Indications for Implantable Cardioverter-Defibrillator Therapy
Implantable Cardioverter-Defibrillator System Selection
Implant Testing
Programming Sensing, Detection, and Therapies for Shock Reduction
Clinical Follow-up and Remote Monitoring
Troubleshooting
Shocks: Diagnosis and Management
Other Common Clinical Issues
123. Subcutaneous Implantable Cardioverter-Defibrillators
Early Research Program
Characteristics of the Subcutaneous Implantable Cardioverter-Defibrillator System
Initial Observational Studies and the IDE Submission Trial
System Implantation
Subsequent Clinical Trial Experience
Effective Defibrillation
Sensing and Discrimination
Need for Antitachycardia Pacing and Bradycardia Support
Local and Systemic Infection Risks
Future Developments
Conclusions
124. Wearable Defibrillators
Introduction
Wearable Defibrillator
Efficacy of the Wearable Defibrillator
Inappropriate Shocks
Studies of Wearable Cardioverter-Defibrillator Use
Systematic Review and Meta-Analysis
Indications for Wearable Cardioverter-Defibrillator Use
Evidence for Specific Indications for Wearable Cardioverter-Defibrillator Use
Considerations for Wearable Cardioverter-Defibrillator Use
Summary
125. Cardiac Resynchronization
Historical Perspectives
Landmark Trials of Biventricular Pacing for Cardiac Resynchronization Therapy
Biventricular Pacing in Patients With Non–Left Bundle Branch Block Patterns
Biventricular Pacing in Narrow QRS
Biventricular Pacing for High-Burden Pacing Requirements
Nonresponse to Cardiac Resynchronization Therapy and Optimization Strategies
New Methods to Deliver Cardiac Resynchronization Therapy
Future Directions
126. Management of Implanted Device Infections
Introduction
Pathogenesis and Microbiology
Epidemiology
Clinical Presentation
Diagnosis
Treatment
Outcomes
Prevention
Conclusion
Part XIX. Catheter and Surgical Mapping and Ablation
127. Electrogram Recording and Signal Processing
Introduction
Basic Circuitry Overview
Unipolar Versus Bipolar Recordings
Impact of Electrode Geometry and Orientation on Electrogram Recordings
Final Electrogram Processing and Extraction of Clinically Meaningful Information
Repolarization Mapping
Future Outlook: High-Throughput Electrogram Processing
128. Electroanatomic Mapping for Arrhythmias
Why Do We Use Mapping Systems?
Principles of Electroanatomic Mapping: Point Acquisition
Mapping Technologies
Principles of Electroanatomic Mapping: Optimizing Creation of a Valid Map
Additional Considerations in Modern mapping Techniques
Conclusion
129. Mapping Scar-Related Arrhythmias
Electrograms and Activation Sequence Mapping
Entrainment Mapping
Entrances
Pacing Rate
Stimulus Strength
Combining Activation Sequence and Entrainment Mapping
130. Radiofrequency Ablation
History of Electrosurgery and Use of Radiofrequency Alternating Current in Medicine
Use of Radiofrequency Energy in the Heart
Basic Biophysics of Radiofrequency Catheter Ablation
Radiofrequency Lesion Creation
Prescription of Radiofrequency Ablation Energy Dose
Monitoring the Tissue Effects of Radiofrequency Heating
Conclusions
131. Cryoablation and Other Radiofrequency Alternatives
Cryoablation
Pulsed Field Ablation
Laser Ablation
Ultrasound Ablation
Microwave Ablation
Chemical Ablation
Warm Saline-Enhanced Radiofrequency Ablation
132. Transvascular Ethanol Ablation
Introduction
Intraarterial Route for Ethanol Delivery to Treat Arrhythmias
Retrograde Coronary Venous Ethanol Ablation for Ventricular Tachycardia: Procedural Approach
Conclusion
133. Cardiac Radioablation
Background: Why Develop a New Technique for Cardiac Ablation?
Gap-Free, Full-Thickness Ablation: Stereotactic Ablative Radiotherapy
How Does Stereotactic Ablative Radiotherapy Work on Cardiac Tissue?
Clinical experience
Cardiac Stereotactic Ablative Radiotherapy Workflow: Role of the Heart Rhythm Specialist
Future Steps
134. Epicardial Approach in Electrophysiology
Anatomy
Indications
Higher-Risk Situations
Practical Aspects
Results
Complications
Conclusion
135. Surgery for Atrial Fibrillation and Other Supraventricular Tachycardias
Atrial Fibrillation
Development of Surgery for Atrial Fibrillation
Surgical Ablation Technology
Indications for Surgical Ablation of Atrial Fibrillation
Cox-Maze Procedure
Left Atrial Lesion Sets
Pulmonary Vein Isolation
Ganglionated Plexus Ablation
Hybrid Procedures
Follow-Up After Surgical Ablation of Atrial Fibrillation
Future Directions in Atrial Fibrillation Surgery
Inappropriate Sinus Tachycardia
Other Supraventricular Tachycardia Operations and Conclusions
136. Surgery for Ventricular Arrhythmias
Historical Perspective
Indications
Different Approaches for Accessing the Ventricle
Tools and Techniques for Mapping
Energy Sources for Surgical Ablation
End Points of Surgical Ablation
Postprocedure Arrhythmia Management
Complications
Long-Term Expectations
Future Developments
Conclusions
137. Neuromodulation for the Treatment of Arrhythmias
Anatomy of the Cardiac Nervous System
Sympathetic Neural Remodeling and Proarrhythmic Effects of Sympathetic Stimulation
Sympathetic Modulation for Treatment of Arrhythmias
Role of Parasympathetic Nervous System in Atrial and Ventricular Arrhythmias
Part XX. Drug Discovery for Cardiac Arrhythmias
138. Drug Discovery for Myocardial Diseases and Cardiac Arrhythmias Using Zebrafish
Challenges in Cardiovascular Drug Discovery
Myocardial Disease and Arrhythmia Mechanisms
Phenotype-Based Screens
Using Zebrafish for Cardiovascular Drug Discovery
Examples of Recent Successful Screens
Future Directions
Conclusion
Index

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