Chapters authored
Epicardial Radiofrequency Ablation: Who, When, and How?
In the past decades, it has been known that reentry circuits for ventricular tachycardia or focal triggers of premature ventricular complexes are not limited to the subendocardial myocardium. Rather, intramural or subepicardial substrates may also give rise to ventricular tachycardia, particularly in those with non-ischemic cardiomyopathy. Besides, some of the idiopathic ventricular tachycardia might be originated from epicardial foci. Percutaneous epicardial mapping and ablation have been successfully introduced to treat this sub-epicardiac ventricular tachycardia. Herein, this chapter reviews the indications for epicardial ablation and the identification of epicardial ventricular tachycardia by disease entity, electrocardiography and imaging modalities. This chapter also described the optimal technique for epicardial access and the potential complication.
Part of the book: Cardiac Rhythm Management
Perspective Chapter: Management and Practice for Atrial Fibrillation
Atrial fibrillation (AF) is a prevalent arrhythmia projected to affect millions of people worldwide, increasing the risk of stroke, myocardial infarction, and cardiac death. Effective management strategies for AF focus on a comprehensive approach that addresses the disease as a whole rather than isolating individual aspects. The three main pillars of AF management are stroke prevention, symptom management, and risk factor modification. Stroke prevention remains paramount, utilizing anticoagulation therapy and left atrial appendage occlusion (LAAO) for patients intolerant to novel oral anticoagulants (NOACs). Symptom management prioritizes rhythm control, particularly through catheter ablation, which is effective in maintaining sinus rhythm and improving patient outcomes. Risk factor modification involves managing obesity, hypertension, diabetes, alcohol consumption, and smoking cessation, as well as promoting physical activity to reduce AF incidence and recurrence. This holistic approach, integrating advanced diagnostic tools and personalized treatment plans, aims to mitigate the multifaceted impact of AF and enhance long-term prognosis.
Part of the book: Atrial Fibrillation - Current Management and Practice [Working title]