An Atlas of Radioscopic Catheter Placement for the Electrophysiologist

The heart is a four-dimensional structure, comprising three spatial dimensions of shape and one temporal dimension of motion. Many technological advances in the field of imaging, such as intracardiac echocardiography, computed tomography, magnetic resonance imaging and 3-D electroanatomical image integration mapping systems, have enhanced our ability to visualize, map, and navigate in the heart. Nevertheless, fluoroscopy remains the cornerstone of all interventional electrophysiology procedures and, with the limitations of current technologies, will continue to be extensively used for many years to come. A skilled fluoroscopist with the use of multiple projections can deduce the anatomy and catheter location with remarkable spatial detail. However, since fluoroscopy provides a real-time unmodified view to the operator, there is no easy way to organize the multiple measurements taken from a moving catheter into a more clinically useful model of cardiac electrical activity. As a result, significant clinical experience with fluoroscopy is necessary to accurately position catheters at an exact intracardiac site. Atlas of Radioscopic Catheter Placement for the Electrophysiologist is unique because it is the first book that provides a teaching tool for fellows in training, allied health professionals and accomplished electrophysiologists on relevant X-ray views commonly encountered in different electrophysiology procedures, and how these views correlate with cardiac anatomy. It was specifically designed to address this challenging aspects of all electrophysiology procedures systematically and is written in a perspicuous manner to demystify the subject, thus making it easier to better understand cardiac anatomy and successfully perform electrophysiology procedures. Front Matter....Pages i-xvi X-Ray Anatomy of the Heart....Pages 3-7 Computed Tomography of Anatomy of the Heart....Pages 9-24 The Electrophysiologic Study....Pages 27-53 Ablation of Supraventricular Tachycardias from the Right Atrium....Pages 55-72 Approach to the Left Heart Chambers....Pages 73-111 Accessory Pathways Ablation....Pages 113-127 Atrial Fibrillation Ablation....Pages 129-190 Ventricular Tachycardia Ablation....Pages 191-218 Pacemaker and Implantable Cardioverter-Defibrillator Implantation....Pages 221-234 Biventricular Pacemaker and Implantable Cardioverter Defibrillator....Pages 235-264 Pacemaker and Implantable Cardioverter Defibrillator Lead Extraction....Pages 265-286 Endomyocardial Biopsy....Pages 289-301 Back Matter....Pages 303-313 Interventional cardiac electrophysiology has undergone a rapid development in technique and application in recent years. New 3-dimensional techniques have been proposed for catheter navigation in the heart but, an up-to-date X-ray guide is still indispensable for the correct positioning of catheters in the different cardiac chambers. An Atlas of Radioscopic Catheter Placement presents fundamental knowledge about radiographic anatomy of the heart and some advices to correctly move and rotate the catheters, in a concise and clear manner. An Atlas of Radioscopic Catheter Placement is unique, and has been conceived as a handy reference guide for students, interventional cardiologists, nurses and electrophysiology technicians. It includes plenty of schemes and X-ray images, and every EP correct catheter positioning is explained step by step through detailed descriptions of the necessary manoeuvres, including some "trucks" brought about by the experience.