Cardiac Imaging in Electrophysiology by Francesco Fulvio Faletra M.D., Ann C. Garlitski M.D.,

By Francesco Fulvio Faletra M.D., Ann C. Garlitski M.D., François Regoli M.D. (auth.), Angelo Auricchio, Jagmeet Singh, Frank E. Rademakers (eds.)

Cardiac arrhythmias are a big reason for dying (7 million instances each year around the globe; 400,000 within the U.S. on my own) and incapacity. but, a noninvasive imaging modality to spot sufferers in danger, supply exact analysis and consultant remedy isn't really but on hand in medical perform. however, there are many purposes of electrophysiologic imaging in people from ECG/CT reconstructions, MRI to tissue Doppler investigations that offer supplimentary diagnostic information to the heart specialist. EP laboratories are experiencing a rise in quantity, for either diagnostic and interventional electrophysiology experiences, together with mapping, ablation, and pacemaker implants. The apparatus necessities for those techniques are stringent, contain positioning functions, and dose administration. This ebook is designed to check all the present imaging methodologies that help in analysis in the electrophysiology department.

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25–30 This atrial myocardium is found between the adventitia and the media of the venous wall and may possess electrical ectopic activity that acts as a trigger of atrial fibrillation. 31,32 Regardless the strategy used to achieve PV isolation, knowledge of the PV anatomy and of the exact location of the junction of the left atrium and PVs are important guides to the electrophysiologist, providing pre-procedural anatomic details noninvasively. 33 The most common pattern of the entry of pulmonary veins into the left atrium is two veins from the hilum of each lung.

It is characterized by fatty/fibro-fatty replacement and myocyte loss, ventricular aneurysms, ventricular arrhythmias, and right ventricular failure. 15 Its prevalence is estimated to be around 1:5,000 in the United States, and accounts for 5% of all sudden cardiac death in patients younger than 35 years old in the United States. 16 They include evaluation for structural and electrophysiological abnormalities, as well as elements from the patient history. Cardiac MRI is a very useful noninvasive tool for the evaluation of ARVD/C since it can define the presence of myocardial fat infiltration, observed in T1-weighted sequences,15 and it can also allow for evaluation of the structure of the RV and quantification of its function.

However, accurate catheter location within the cardiac chambers has required electrophysiologic confirmation of catheter positioning. This led to the development of conventional cardiac mapping techniques. The limitations of fluoroscopy and conventional mapping techniques led to the development of electro-anatomical mapping systems (EAM), in which information regarding catheter position in a 3D space is combined with electrophysiological information in real time to provide an accurate localization of the catheter tip while, at the same time, data regarding electrophysiological properties of the underlying myocardial substrate.

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