Arrhythmias Book

Editor's Preface     ix
Preface     xi
Basics     1
Basic Cardiac Anatomy and Physiology     1
The Cardiac Action Potential     3
What Defines Normal Sinus Rhythm?     4
The 12-Lead ECG     4
Heart Rate     4
What is the Atrial Rhythm?     5
Relationship Between the P Waves and the QRS Complexes     6
Bradyarrhythmias and Conduction Blocks     6
First-Degree AV Block (AV Delay)     7
Second-Degree AV Block     7
Third-Degree AV Block (Complete Heart Block)     10
Supraventricular Tachycardia (SVT)     13
Diagnosis     13
Drug Theraphy for SVT     14
Sinus Tachycardia     14
Atrial Tachycadria     19
Atrioventricular Reentry Tachycardia (AVRT)     20
AV Nodal Reentry Tachycardia (AVNRT)     20
Pathway-Mediated Tachycardias     25
Atrial Fibrillation     27
Approach to the Patient in Atrial Fibrillation     31
Cardioversion     32
Post-Op Atrial Fibrillation     33
Atrial Flutter     34
Atrial Flutter Treatment     35
Long-Term Theraphy for Atrial Fibrillation and Atrial Flutter     37
References     38
Wide-Complex Tachycardia (WCT)     41
ECG Diagnosis     42
Characteristics of VT with a Right Bundle Morphology     42
Characteristics of VT with a Left Bundle Morphology     43
Ventricular Tachycardia     46
Ischemic Ventricular Tachycardia     46
Nonischemic Ventricular Tachycardia     47
SVT with Aberrant Conduction     53
WPW with Antidromic Conduction (Rare)     54
Acute Treatment of VT/VF     56
Hemodynamically Stable VTach     57
Asystole or Pulseless Electrical Activity (PEA)     57
Drug Therapy for Ventricular Tachyarrhythmias     58
Long-Term Therapy for Patients with VT/VF     60
Implantable Defibrillators (ICDs)     60
References     61
Special Considerations     63
Premature Atrial Contractions (PACs)     63
Premature Ventricular Contractions (PVCs)     63
Conduction Disturbances with Acute Myocardial Infarct/Ischemia     63
Pacemakers and Implantable Cardiac Defibrillators (ICDs)     64
Proarrhythmia     64
Torsade de Pointes      65
Bradyarrhythmias     67
Temporary Transthoracic Pacing     69
Temporary Transvenous Pacing     70
Syncope     70
Summary     70
References     71
Antiarrhythmic Drugs     73
Antiarrhythmic Drugs     73
Antiarrhythmic Drugs: Sodium Channel Blockers     73
Antiarrhythmic Drugs     74
Antiarrhythmic Drugs     80
Antiarrhythmic Drugs     83
Antiarrhythmic Drugs: Beta-Blockers     87
General Considerations     87
Side Effects     88
Dosing     88
Clinical Results     89
Antiarrhythmic Drugs: Potassium Channel Blockers     89
D,l-Sotalol     89
Amiodarone     91
Dofetilide     92
Ibutilide     95
Bretylium     96
Antiarrhythmic Drug: Calcium Channel Blockers     97
Diltiazem     97
Verapamil     98
Miscellaneous Antiarrhythmic Agents     99
Adenosine     99
Digoxin     100
Special Situations     101
Pregnancy     101
Drugs Requiring Dose Reduction in Cirrhosis     101
Dialysis     102
Procainamide-Induced Lupus     102
Antiarrhythmic Effects on Pacing Tresholds and Defibrillation Threshold     102
Antiarrhythmic Agents with Active Metabolites with Antiarrhythmic Properties     103
ECG Noise     103
References     103
Drug Trials and Device Therapy in Patients with Ventricular Arrhythmias     107
Ventricular Ectopic Activity and Sudden Cardiac Death: Post-MI     107
BHAT (Beta-Blocker Heart Attack Trial)     107
CAST I and II (Cardiac Arrhythmia Suppression Trial)     108
BASIS (Basel Antiarrhythmic Study of Infarct Survival)     108
CAMIAT (Canadian Amiodarone Myocardial Infarction Arrhythmia Trial)     109
EMIAT (European Amiodarone Myocardial Infarction Arrhythmia Trial)     109
SWORD (Survival with Oral D-Sotalol)     110
Congestive Heart Failure     110
CHF-STAT (Survival Trial of Antiarrhythmic Therapy in Congestive Heart Failure)     110
GESICA (Grupo de Estudio de la Sobrevida en la Insuficiecia Cardiaca en Argentina)     111
Nonsuitained Ventricular Tachycardia: Primary Prevention of SCD     111
MADIT (Multicenter Automatic Defibrillator Implantation Trial)      112
MUSTT (Multicenter Unsustained Tachycardia Trial)     112
MADIT II (Multicenter Automatic Defibrillator Implantation Trial II)     112
SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial)     113
Sustained Ventricular Arrhythmia: Secondary Prevention of SCD     114
AVID (Antiarrhythmics Versus Implantable Defibrillators)     114
ESVEM (Electrophysiologic Study Versus Electrocardiographic Monitoring)     114
2005 Changes to the AHA's BLS and ACLS Guidelines     115
Index     117