Clinical Cardiac Electrophysiology, Techniques and by Mark E. Josephson MD

By Mark E. Josephson MD

Fully revised and up-to-date for its Fourth variation, Dr. Josephson's vintage textual content presents a radical knowing of the mechanisms of cardiac arrhythmias and the healing interventions used to regard arrhythmias. The e-book information the electrophysiologic technique required to outline the mechanism and placement of beginning of arrhythmias in order that secure and potent treatment may be selected. shut cognizance is given to the mechanisms, medical implications, and obstacles of present healing interventions, together with medicinal drugs, implantable units, and catheter and surgical ablation.

More than 1,100 illustrations make clear the options and methods provided within the textual content. This variation has a brand new full-color design.

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Extra resources for Clinical Cardiac Electrophysiology, Techniques and Interpretation

Example text

2-43. Block within the His-Purkinje system during ventricular stimulation. A–D. Progressively premature ventricular extrastimuli (S 2) are delivered during a paced cycle length (CL) of 700 msec. A retrograde His bundle potential is noted during the paced beats (S 1–H1). B and C. Progressive retrograde His-Purkinje conduction delay appears as S 1–S 2 shortens. D, At an S1–S 2 of 300 msec, block within the His-Purkinje system occurs. FIG. 2-44. Use of retrograde His to demonstrate site of delay during retrograde stimulation .

2-35. Ventricular pacing protocol used to analyze His-Purkinje system (HPS) and ventricular muscle (VM) refractory periods during an extrasystole-postextrasystole sequence. The constant basic cycle length (S 1 S1 or V1 V1) of method I was identical to that used with methods II and III. Note also that the extrasystolic beat coupling interval (S 1S2 or V1V2) was the same in both methods II and III. So that method I could serve as a control for method III, the postextrasystolic pause (S 2S1' or V 2V1') in method III was programmed to equal S1S1.

Following a ventricular extrastimulus (S 2) activation is reversed, going from His to RB. See text for discussion. FIG. 2-48. Retrograde conduction in the presence of ipsilateral bundle branch block. This figure is organized the same as Fig. 2-47. Schemas are shown below. On the left activation during sinus rhythm with right bundle branch block (RBBB) is present. The open arrow demonstrates the site of RBBB. During ventricular pacing (right panel) retrograde conduction proceeds over the left bundle branch to activate the His bundle with subsequent engagement and block in the RB ( open arrow).

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