Abstract
The range of the resting sinus heart rate is 50–90 beats per minute (bpm); most average healthy individuals have resting rates in the 60–70 bpm range. Bradycardia (slow heart beat) is arbitrarily defined as any heart rate <60 bpm, and tachycardia (fast heart beat) as any rate >100 bpm. Disturbances of cardiac impulse formation and/or transmission comprise the principal mechanisms causing abnormalities of heart rhythm. In basic terms, these are classified as being either brady- or tachy-arrhythmias. The primary goals for treatment of arrhythmias are: (1) to alleviate symptoms and improve quality of life and; (2) to prolong patient survival. Pharmacologic treatment has been the mainstay for management of most cardiac arrhythmias, although implantable devices and ablation have become increasingly important. In recent years, nonpharmacologic therapy has begun to play an increasingly important role in curing many arrhythmias (catheter ablation) and preventing their life-threatening consequences (implantable cardioverter defibrillator therapy for both primary and secondary prevention of sudden cardiac death).
References
Anonymous. The Sicilian Gambit. A new approach to the classification of antiarrhythmic drugs based on their actions on arrhythmogenic mechanisms. Task Force of the Working Group on Arrhythmias of the European Society of Cardiology. Circulation 1991;84:1831–51.
Anonymous. Preliminary report: Effect of encainide and flecainide on mortality in a randomized trial of arrhythmia suppression after myocardial infarction. The Cardiac Arrhythmia Suppression Trial (CAST) Investigators. N Engl J Med 1989;321:406–12.
Anonymous. Effect of the antiarrhythmic agent moricizine on survival after myocardial infarction. The Cardiac Arrhythmia Suppression Trial II Investigators. N Engl J Med 1992;327:227–33.
Josephson ME, ed. Clinical cardiac electrophysiology. Techniques and interpretations, 2nd ed. Malvern, PA: Lea & Febiger, 1993.
Benditt DG, Lu F. Atriofascicular pathways: Fuzzy nomenclature or merely wishful thinking? J Cardiovasc Electrophysiol 2006;17:261–65.
Fuster V, Ryden LE, Cannom DS, et al. ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation—executive summary: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines. J Am Coll Cardiol 2006;48:854–906.
Estes NA III, Halperin JL, Calkins H, et al. ACC/AHA/Physician Consortium 2008 Clinical performance measures for adults with nonvalvular atrial fibrillation or atrial flutter: A report of the American College of Cardiology/American Heart Association Task Force on Performance Measures and the Physician Consortium for Performance Improvement. Developed in Collaboration with the Heart Rhythm Society. J Am Coll Cardiol 2008;51:865–84.
Laupacis A, Albers G, Dalen J, Dunn MI, Jacobson AK, Singer DE. Antithrombotic therapy in atrial fibrillation. Chest 1998;114:579–89S.
Zipes DP, Camm AJ, Borggrefe M, et al. ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: A report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines. J Am Coll Cardiol 2006;48:e247–346.
Stevenson WG, Friedman PL, Kocovic D, Sager PT, Saxon LA, Pavri B. Radiofrequency catheter ablation of ventricular tachycardia after myocardial infarction. Circulation 1998;98:308–14.
Nabar A, Rodriguez LM, Timmermans C, Smeets JL, Wellens HJ. Isoproterenol to evaluate resumption of conduction after right atrial isthmus ablation in type I atrial flutter. Circulation 1999;99:3286–91.
Nabar A, Rodriguez LM, Timmermans C, van den Dool A, Smeets JL, Wellens HJ. Effect of right atrial isthmus ablation on the occurrence of atrial fibrillation: Observations in four patient groups having type I atrial flutter with or without associated atrial fibrillation. Circulation 1999;99:1441–45.
Calkins H, Brugada J, Packer DL, et al. HRS/EHRA/ECAS expert Consensus Statement on catheter and surgical ablation of atrial fibrillation: recommendations for personnel, policy, procedures and follow-up. A report of the Heart Rhythm Society (HRS) Task Force on catheter and surgical ablation of atrial fibrillation. Heart Rhythm 2007;4:816–61.
Lu F, Iaizzo PA, Benditt DG, Mehra R, Warman EN, McHenry BT. Isolated atrial segment pacing: An alternative to His bundle pacing after atrioventricular junctional ablation. J Am Coll Cardiol 2007;49:1443–49.
Haissaguerre M, Jais P, Shah DC, et al. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med 1998;339:659–66.
Chen SA, Tai CT, Tsai CF, Hsieh MH, Ding YA, Chang MS. Radiofrequency catheter ablation of atrial fibrillation initiated by pulmonary vein ectopic beats. J Cardiovasc Electrophysiol 2000;11:218–27.
Haissaguerre M, Shah DC, Jais P, et al. Electrophysiological breakthroughs from the left atrium to the pulmonary veins. Circulation 2000;102:2463–65.
Pappone C, Rosanio S, Oreto G, et al. Circumferential radiofrequency ablation of pulmonary vein ostia: A new anatomic approach for curing atrial fibrillation. Circulation 2000;102:2619–28.
Oral H, Scharf C, Chugh A, et al. Catheter ablation for paroxysmal atrial fibrillation: Segmental pulmonary vein ostial ablation versus left atrial ablation. Circulation 2003;108:2355–60.
Pappone C, Manguso F, Vicedomini G, et al. Prevention of iatrogenic atrial tachycardia after ablation of atrial fibrillation: A prospective randomized study comparing circumferential pulmonary vein ablation with a modified approach. Circulation 2004;110:3036–42.
Nademanee K, McKenzie J, Kosar E, et al. A new approach for catheter ablation of atrial fibrillation: Mapping of the electrophysiologic substrate. J Am Coll Cardiol 2004;43:2044–53.
Nademanee K, Schwab M, Porath J, Abbo A. How to perform electrogram-guided atrial fibrillation ablation. Heart Rhythm 2006;3:981–84.
Pappone C, Santinelli V, Manguso F, et al. Pulmonary vein denervation enhances long-term benefit after circumferential ablation for paroxysmal atrial fibrillation. Circulation 2004;109:327–34.
Fisher JD, Spinelli MA, Mookherjee D, Krumerman AK, Palma EC. Atrial fibrillation ablation: Reaching the mainstream. Pacing Clin Electrophysiol 2006;29:523–37.
Morady F. Radio-frequency ablation as treatment for cardiac arrhythmias. N Engl J Med 1999;340:534–44.
Zipes DP. Specific arrhythmias: Diagnosis and treatment. In: Braunwald E, ed. Heart disease: A text book of cardiovascular medicine, 5th ed. Philadelphia, PA: W.B. Saunders Company, 1997:640–704.
Triedman J, Perry J, Van Hare G. Risk stratification for prophylactic ablation in asymptomatic Wolff-Parkinson-White syndrome. N Engl J Med 2005;352:92–93.
Stevenson WG, Friedman PL. Catheter ablation of ventricular tachycardia. In: Zipes DP, Jalife J, eds. Cardiac electrophysiology from cell to bedside, 3rd ed. Philadelphia, PA: W.B. Saunders Company; 2000:1049–56.
Schilling RJ, Peters NS, Davies DW. Simultaneous endocardial mapping in the human left ventricle using a noncontact catheter: Comparison of contact and reconstructed electrograms during sinus rhythm. Circulation 1998;98:887–98.
Kalman JM, Olgin JE, Karch MR, Lesh MD. Use of intracardiac echocardiography in interventional electrophysiology. Pacing Clin Electrophysiol 1997;20:2248–62.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2009 Humana Press, a part of Springer Science+Business Media, LLC
About this chapter
Cite this chapter
Li, XH., Lü, F. (2009). Catheter Ablation of Cardiac Arrhythmias. In: Iaizzo, P. (eds) Handbook of Cardiac Anatomy, Physiology, and Devices. Humana Press. https://doi.org/10.1007/978-1-60327-372-5_26
Download citation
DOI: https://doi.org/10.1007/978-1-60327-372-5_26
Published:
Publisher Name: Humana Press
Print ISBN: 978-1-60327-371-8
Online ISBN: 978-1-60327-372-5
eBook Packages: MedicineMedicine (R0)