Practice and Progress in Cardiac Pacing and Electrophysiology

Developments in the electrical treatment of arrhythmias have been so fast over the last few years that access to available, state-of-the-art knowledge has become a major challenge. The proceedings of scientific meetings are therefore most helpful in this

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PRACTICE AND PROGRESS IN CARDIAC PACING AND ELECTROPHYSIOLOGY edited by

M.ALIOTO Department of Cardiology, Hacettepe University, School of Medicine, Ankara, Turkey

KLUWER ACADEMIC PUBLISHERS DORDRECHT / BOSTON / LONDON

Library of Congress Cataloging-in-Publication Data Practice and progress in cardiac pacing and electrophysiology I edited by Ali M. Oto. p. cm. -- (Developments in cardiovascular medicine; v. 183) Includes index. ISBN-l 3: 978-94-010-6582-5 e-ISBN-l 3: 978-94-009-0219-0 001: 10.1007/978-94-009-0219-0 1. Cardiac pacing. 2. Arrhythmia--Treatment. 3. Implantable cardioverter-deflbri llators. 4. Heart--Electric properties. 1. Oto, Ali. II. Series. [ONLM: 1. Cardiac Pacing, Artificial. 2. Arrhythmia--therapy. 3. Pacemaker, Artificial. 4. Electrophysiology. WI DE997VME v.183 1996 / WG 168 P8954 1996] RC684.P3P755 1996 617.4' 120645--dc20 ONLM/OLC 96-116 for Library of Congress

ISBN·13:978-94-0l0-6S82-S Published by Kluwer Academic Publishers, P.O. Box 17,3300 AA Dordrecht, The Netherlands. Kluwer Academic Publishers incorporates the publishing programmes of D. Reidel, Martinus Nijhoff, Dr W. Junk and MTP Press. Sold and distributed in the U.S.A. and Canada by Kluwer Academic Publishers, 101 Philip Drive, Norwell, MA 02061, U.S.A. In all other countries, sold and distributed by Kluwer Academic Publishers Group, P.O. Box 322, 3300 AH Dordrecht, The Netherlands.

Printed on acid-free paper

All Rights Reserved © 1996 Kluwer Academic Publishers Softcover reprint of the hardcover 1st edition 1996 No part of the material protected by this copyright notice may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording or by any information storage and retrieval system, without written permission from the copyright owner.

To the memory of my father, Nuri Oto, M.D.

Contents

Foreword

xiii xv

Preface List of Contributors

xvii

PART ONE: ARRHYTHMIAS AND ANTIARRHYTHMIC TREATMENT STRATEGIES l. Endpoints and trials: a matter of life and death. Classification

of death in patients under antiarrhythmic treatment Hugo Ector

2. The role of transient ischaemia in the pathophysiology of ventricular arrhythmias in patients with coronary artery disease Sergio L. Chierchia, Alberto Margonato & Alessandra Mailhac

7

3. Sudden death and tachyarrhythmias in athletes Luc lordaens

13

4. The evaluation of antiarrhythmics Philippe Coumel

23

5. Atrial fibrillation: maintaining the sinus rhythm

29

Samuel Levy

6. Arrhythmogenic right ventricular dysplasia Paolo Rizzon, Maria Vittoria Pitzalis, Giovanni Luzzi, Francesco Massari & Filippo Mastropasqua vii

37

Vlll

Contents

PART TWO: NON-INVASIVE ELECTROCARDIOLOGY 7. Signal averaged electrocardiogram. Current applications and limitations Thomas S. Faber & Marek Malik

47

8. Can analysis of heart rate variability predict arrhythmias and antiarrhythmic effects? Ronald W.E Campbell

63

9. QT dispersion Ronald W.E Campbell

71

10. Use of baroreceptor reflex sensitivity in the prediction of risk after myocardial