Clinical Cardiac Electrophysiology Techniques and by Mark E. Josephson MD

By Mark E. Josephson MD

Fully revised and up-to-date for its Fourth version, Dr. Josephson's vintage textual content offers a radical figuring out of the mechanisms of cardiac arrhythmias and the healing interventions used to regard arrhythmias. The booklet info the electrophysiologic technique required to outline the mechanism and location of foundation of arrhythmias in order that secure and potent remedy could be selected. shut consciousness is given to the mechanisms, medical implications, and barriers of present healing interventions, together with medications, implantable units, and catheter and surgical ablation.

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

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1974;22:302A. 12. Josephson ME, Scharf DL, Kastor JA, et al. Atrial endocardial activation in man. Electrode catheter technique of endocardial mapping. Am J Cardiol. 1977;39:972–981. 13. Ross J Jr. Considerations regarding the technique for transseptal left heart catheterization. Circulation. 1966;34:391–399. 14. Shirey EK, Sones FM Jr. Retrograde transaortic and mitral valve catheterization. Physiologic and morphologic evaluation of aortic and mitral valve lesions. Am J Cardiol. 1966;18:745–753.

Not enough data, however, are available to define normal responses under these circumstances. Even in the presence of autonomic blockade the varying site of origin of the “sinus” impulse in different patients would limit the definition of normal values. FIGURE 2-5 Method of measurement in the His bundle electrogram. The vertical black lines mark the onset of the P wave and earliest ventricular activation in the surface ECG or intracardiac records. The open arrows show the site of measurement of the onset of the low atrial and His bundle electrograms.

9 Thus, when a multipolar (≥3) electrode catheter is used, it is often helpful to simultaneously record from the proximal and distal pair of electrodes to ensure that the His bundle deflection present in the distal pair of electrodes is the most proximal His bundle deflection. 5 cm distance. Use of more closely spaced electrodes (1 to 2 mm) does not add a more accurate recording of the proximal His potential, since a His potential can be recorded up to 8 mm from the tip. However, use of a decapolar catheter with 1- to 2-mm interelectrode distance can record proximal, mid, and distal recordings of the His bundle as well as the RBB potential.

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