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Handbook of Cardiac Anatomy, Physiology, and Devices pp 493–520Cite as

Catheter Ablation of Cardiac Arrhythmias

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Abstract

In humans, the typical 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 a term used to refer to any heart rate <60 bpm, and tachycardia (fast heart beat) indicates rates >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 thus improve an individual’s quality of life; and (2) to prolong patient survival. Pharmacologic treatment has been the mainstay for management of most cardiac arrhythmias, although in recent years, implantable devices and ablations have become increasingly important. Therefore, nonpharmacologic therapies have begun to play an increasingly important role in curing many arrhythmias (catheter ablation), and preventing their life-threatening consequences [implantable cardioverter defibrillator (ICD) therapy for both primary and secondary prevention of sudden cardiac death (SCD)].

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Abbreviations

AFib:

Atrial fibrillation

AT:

Atrial tachycardia

AV:

Atrioventricular

AVNRT:

Atrioventricular nodal reentry tachycardia

AVRT:

Atrioventricular reentry tachycardia

Bpm:

Beats per minute

CFAE:

Complex fractionated atrial electrogram

DC:

Direct current

ECG:

Electrocardiography

EPS:

Electrophysiologic study

ICD:

Implantable cardioverter defibrillator

IST:

Inappropriate sinus tachycardia

LV:

Left ventricular

PAC:

Premature atrial complex

PSVT:

Paroxysmal supraventricular tachycardia

PVC:

Premature ventricular complex

RF:

Radiofrequency

RV:

Right ventricular

SCD:

Sudden cardiac death

SND:

Sinus node dysfunction

SVT:

Supraventricular tachycardia

TdP:

Torsades de Pointes

VT:

Ventricular tachycardia

WPW:

Wolff–Parkinson–White syndrome

References

  1. Task Force of the Working Group on Arrhythmias of the European Society of Cardiology (1991) The Sicilian Gambit. A new approach to the classification of antiarrhythmic drugs based on their actions on arrhythmogenic mechanisms. Circulation 84:1831–1851

    Article  Google Scholar 

  2. The Cardiac Arrhythmia Suppression Trial (CAST) Investigators (1989) Preliminary report: effect of encainide and flecainide on mortality in a randomized trial of arrhythmia suppression after myocardial infarction. N Engl J Med 321:406–412

    Article  Google Scholar 

  3. The Cardiac Arrhythmia Suppression Trial II Investigators (1992) Effect of the antiarrhythmic agent moricizine on survival after myocardial infarction. N Engl J Med 327:227–233

    Article  Google Scholar 

  4. Josephson ME (ed) (1993) Clinical cardiac electrophysiology. Techniques and interpretations, 2nd edn. Lea & Febiger, Malvern, PA

    Google Scholar 

  5. Benditt DG, Lu F (2006) Atriofascicular pathways: fuzzy nomenclature or merely wishful thinking? J Cardiovasc Electrophysiol 17:261–265

    Article  PubMed  Google Scholar 

  6. January CT, Wann LS, Alpert JS et al (2014) 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: executive summary. J Am Coll Cardiol 64:2246–2280

    Article  Google Scholar 

  7. Estes NA 3rd, Halperin JL, Calkins H et al (2008) 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. J Am Coll Cardiol 51:865–884

    Article  PubMed  Google Scholar 

  8. Zipes DP, Camm AJ, Borggrefe M et al (2006) 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 48:e247–e346

    Article  PubMed  Google Scholar 

  9. Stevenson WG, Friedman PL, Kocovic D, Sager PT, Saxon LA, Pavri B (1998) Radiofrequency catheter ablation of ventricular tachycardia after myocardial infarction. Circulation 98:308–314

    Article  CAS  PubMed  Google Scholar 

  10. Nabar A, Rodriguez LM, Timmermans C, Smeets JL, Wellens HJ (1999) Isoproterenol to evaluate resumption of conduction after right atrial isthmus ablation in type I atrial flutter. Circulation 99:3286–3291

    Article  CAS  PubMed  Google Scholar 

  11. Oral H, Sticherling C, Tada H et al (2001) Role of transisthmus intervals in predicting bidirectional block after ablation of typical atrial flutter. J Cardiovasc Electrophysiol 12:169–217

    Article  CAS  PubMed  Google Scholar 

  12. Calkins H, Kuck KH, Cappato R et al (2012) 2012 HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design: a report of the Heart Rhythm Society (HRS) Task Force on Catheter and Surgical Ablation of Atrial Fibrillation. Heart Rhythm 9:632–696

    Article  PubMed  Google Scholar 

  13. Stavrakis S, Garabelli P, Reynolds DW (2012) Cardiac resynchronization therapy after atrioventricular junction ablation for symptomatic atrial fibrillation: a meta-analysis. Europace 14:1490–1497

    Article  PubMed  Google Scholar 

  14. Haissaguerre M, Jais P, Shah DC et al (1998) Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med 339:659–666

    Article  CAS  PubMed  Google Scholar 

  15. Chen SA, Tai CT, Tsai CF, Hsieh MH, Ding YA, Chang MS (2000) Radiofrequency catheter ablation of atrial fibrillation initiated by pulmonary vein ectopic beats. J Cardiovasc Electrophysiol 11:218–227

    Article  CAS  PubMed  Google Scholar 

  16. Haissaguerre M, Shah DC, Jais P et al (2000) Electrophysiological breakthroughs from the left atrium to the pulmonary veins. Circulation 102:2463–2465

    Article  CAS  PubMed  Google Scholar 

  17. Pappone C, Rosanio S, Oreto G et al (2000) Circumferential radiofrequency ablation of pulmonary vein ostia: a new anatomic approach for curing atrial fibrillation. Circulation 102:2619–2628

    Article  CAS  PubMed  Google Scholar 

  18. Oral H, Scharf C, Chugh A et al (2003) Catheter ablation for paroxysmal atrial fibrillation: segmental pulmonary vein ostial ablation versus left atrial ablation. Circulation 108:2355–2360

    Article  PubMed  Google Scholar 

  19. Pappone C, Manguso F, Vicedomini G et al (2004) Prevention of iatrogenic atrial tachycardia after ablation of atrial fibrillation: a prospective randomized study comparing circumferential pulmonary vein ablation with a modified approach. Circulation 110:3036–3042

    Article  PubMed  Google Scholar 

  20. Nademanee K, McKenzie J, Kosar E et al (2004) A new approach for catheter ablation of atrial fibrillation: mapping of the electrophysiologic substrate. J Am Coll Cardiol 43:2044–2053

    Article  PubMed  Google Scholar 

  21. Nademanee K, Schwab M, Porath J, Abbo A (2006) How to perform electrogram-guided atrial fibrillation ablation. Heart Rhythm 3:981–984

    Article  PubMed  Google Scholar 

  22. Pappone C, Santinelli V, Manguso F et al (2004) Pulmonary vein denervation enhances long-term benefit after circumferential ablation for paroxysmal atrial fibrillation. Circulation 109:327–334

    Article  PubMed  Google Scholar 

  23. Packer DL, Kowal RC, Wheelan KR et al (2013) Cryoballoon ablation of pulmonary veins for paroxysmal atrial fibrillation: first results of the North American Arctic Front (STOP AF) pivotal trial. J Am Coll Cardiol 61:1713–1723

    Article  PubMed  Google Scholar 

  24. Morady F (1999) Radio-frequency ablation as treatment for cardiac arrhythmias. N Engl J Med 340:534–544

    Article  CAS  PubMed  Google Scholar 

  25. Zipes DP (1997) Specific arrhythmias: diagnosis and treatment. In: Braunwald E (ed) Heart disease: a text book of cardiovascular medicine, 5th edn. W.B. Saunders Company, Philadelphia, pp 640–704

    Google Scholar 

  26. Triedman J, Perry J, Van Hare G (2005) Risk stratification for prophylactic ablation in asymptomatic Wolff–Parkinson–White syndrome. N Engl J Med 352:92–93

    Article  CAS  PubMed  Google Scholar 

  27. Stevenson WG, Friedman PL (2000) Catheter ablation of ventricular tachycardia. In: Zipes DP, Jalife J (eds) Cardiac electrophysiology from cell to bedside, 3rd edn. W.B. Saunders Company, Philadelphia, pp 1049–1056

    Google Scholar 

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Authors and Affiliations

  1. Department of Medicine, Cardiovascular Division and Electrophysiology, University of Minnesota, 420 Delaware Street SE, MMC 508, Minneapolis, MN, 55455, USA

    Henri Roukoz MD, FACC, FHRS, Fei Lü MD, PhD & Scott Sakaguchi MD

Authors
  1. Henri Roukoz MD, FACC, FHRS
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  2. Fei Lü MD, PhD
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  3. Scott Sakaguchi MD
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Corresponding author

Correspondence to Henri Roukoz MD, FACC, FHRS .

Editor information

Editors and Affiliations

  1. B172 Mayo, MMC 195, University of Minnesota Department of Surgery, Minneapolis, Minnesota, USA

    Paul A. Iaizzo

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© 2015 Springer International Publishing Switzerland

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Roukoz, H., Lü, F., Sakaguchi, S. (2015). Catheter Ablation of Cardiac Arrhythmias. In: Iaizzo, P. (eds) Handbook of Cardiac Anatomy, Physiology, and Devices. Springer, Cham. https://doi.org/10.1007/978-3-319-19464-6_28

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