An Atlas of Radioscopic Catheter Placement for the Electrophysiologist

About this book

The heart is a four-dimensional structure, comprising three spatial dimensions of shape and one temporal dimension of motion. Many technological advances in the field of imaging, such as intracardiac echocardiography, computed tomography, magnetic resonance imaging and 3-D electroanatomical image integration mapping systems, have enhanced our ability to visualize, map, and navigate in the heart. Nevertheless, fluoroscopy remains the cornerstone of all interventional electrophysiology procedures and, with the limitations of current technologies, will continue to be extensively used for many years to come.

A skilled fluoroscopist with the use of multiple projections can deduce the anatomy and catheter location with remarkable spatial detail. However, since fluoroscopy provides a real-time unmodified view to the operator, there is no easy way to organize the multiple measurements taken from a moving catheter into a more clinically useful model of cardiac electrical activity. As a result, significant clinical experience with fluoroscopy is necessary to accurately position catheters at an exact intracardiac site.

Atlas of Radioscopic Catheter Placement for the Electrophysiologist is unique because it is the first book that provides a teaching tool for fellows in training, allied health professionals and accomplished electrophysiologists on relevant X-ray views commonly encountered in different electrophysiology procedures, and how these views correlate with cardiac anatomy. It was specifically designed to address this challenging aspects of all electrophysiology procedures systematically and is written in a perspicuous manner to demystify the subject, thus making it easier to better understand cardiac anatomy and successfully perform electrophysiology procedures.

Content Level » Professional/practitioner
Related subjects » Cardiology & Angiology - Critical Care & Emergency Medicine - Internal Medicine - Radiology - Surgery

Table of contents

Section I. Brief review of the radioscopic anatomy of the heart.-Section II. Electrophysiology.-Chapter 1: The electrophysiological study.-Diagnostic catheters.- Atrial catheter.-Hissian catheter.-Ventricular catheter: apex and outflow tract.- Coronary sinus catheter.-Chapter 2: Ablation of right atrial arrhythmias.-2.1 Ablation catheters.-AV nodal re-entrant tachycardia.-AV nodal modulation and ablation.-Typical atrial flutter.-Right accessory pathways.-Chapter 3: Ablation of left atrial arrhythmias.-Retroaortic maneuver.-Transseptal puncture.-Left accessory pathways.-Chapter 4: Atrial fibrillation ablation.-Pulmonary veins angiography.-Catheter positioning in the left atrium with single transseptal puncture.-Pulmonary veins isolation.-Linear lesion.-Chapter 5: Ventricular tachycardia ablation.- Bundle branch re-entry tachycardia.-Right ventricular outflow tract tachycardia.-Idiopathic left ventricle tachycardia.-Post-ischemic ventricular tachycardia.-Section III. Cardiac Pacing.-Chapter 1: PM/ICD-Defibrillator.-Pacing and defibrillation leads.-Atrial lead placement.-Ventricular lead placement.-Chapter 2: Biventricular PM/ICD-Defibrillator.-Coronary sinus anatomy.-Left ventricular lead placement.-Chapter 3: Lead extraction.-Lead extraction technique.-Section IV. Commented bibliography.

Reviews

"This is an in-depth pictorial review of fluoroscopic anatomy related to electrophysiological studies, including pacing and radiofrequency catheter ablative procedures. … It will be of interest to practicing cardiologists, elctrophysiologists, and cardiology and electrophysiology fellows in training. This atlas may also be of interest to personnel in cardiac catheterization and electrophysiology laboratories, such as nurses and technicians, who work closely with elctrophysiologists. … All chapters are well organized with numerous images and procedural descriptions." (Anil Verma, Doody’s Review Service, February, 2009)