J Wave Syndromes

This book delineates the state of the art of the diagnosis and treatment of J wave syndromes, as well as where future research needs to be directed. It covers basic science, translational and clinical aspects of these syndromes. The authors are leading experts in their respective fields, who have contributed prominently to the literature concerning these topics. J wave syndromes are one of the hottest topics in cardiology today. Cardiac arrhythmias associated with Brugada syndrome (BrS) or an early repolarization (ER) pattern in the inferior or infero-lateral ECG leads are thought to be mechanistically linked to accentuation of transient outward current (Ito)-mediated J waves. Although BrS and ER syndrome (ERS) differ with respect to magnitude and lead location of abnormal J waves, they are thought to represent a continuous spectrum of phenotypic expression termed J wave syndromes. ERS is divided into three subtypes with the most severe, Type 3, displaying an ER pattern globally in the inferior, lateral and right precordial leads. BrS has been linked to mutations in 19 different genes, whereas ERS has been associated with mutations in 7 different genes. There is a great deal of confusion as to how to properly diagnose and treat the J wave syndromes as well as confusion about the underlying mechanisms. The demonstration of successful epicardial ablation of BrS has provided new therapeutic options for the management of this syndrome for which treatment alternatives are currently very limited, particularly in the case of electrical storms caused by otherwise uncontrollable recurrent VT/VF. An early repolarization pattern is observed in 2-5% of the US population. While it is clear that the vast majority of individuals exhibiting an ER pattern are not at risk for sudden cardiac death, the challenge moving forward is to identify those individuals who truly are at risk and to design safe and effective treatments.

This book delineates the state of the art of the diagnosis and treatment of J wave syndromes, as well as where future research needs to be directed. It covers basic science, translational and clinical aspects of these syndromes. The authors are leading experts in their respective fields, who have contributed prominently to the literature concerning these topics. J wave syndromes are one of the hottest topics in cardiology today. Cardiac arrhythmias associated with Brugada syndrome (BrS) or an early repolarization (ER) pattern in the inferior or infero-lateral ECG leads are thought to be mechanistically linked to accentuation of transient outward current (Ito)-mediated J waves. Although BrS and ER syndrome (ERS) differ with respect to magnitude and lead location of abnormal J waves, they are thought to represent a continuous spectrum of phenotypic expression termed J wave syndromes. ERS is divided into three subtypes with the most severe, Type 3, displaying an ER pattern globally in the inferior, lateral and right precordial leads. BrS has been linked to mutations in 19 different genes, whereas ERS has been associated with mutations in 7 different genes. There is a great deal of confusion as to how to properly diagnose and treat the J wave syndromes as well as confusion about the underlying mechanisms. The demonstration of successful epicardial ablation of BrS has provided new therapeutic options for the management of this syndrome for which treatment alternatives are currently very limited, particularly in the case of electrical storms caused by otherwise uncontrollable recurrent VT/VF. An early repolarization pattern is observed in 2-5% of the US population. While it is clear that the vast majority of individuals exhibiting an ER pattern are not at risk for sudden cardiac death, the challenge moving forward is to identify those individuals who truly are at risk and to design safe and effective treatments.

Until recently, the cellular basis for sudden death, the BrugadaSyndrome, has largely remained an unknown to modernarrhythmologists and cardiologists, particularly in the absence ofany structural heart disease. Detailed observations of age-groups,especially the young, families and populations where sudden deathfrequently occurs, and improved understanding of its contributoryfactors and mechanisms are, however, showing the way forward. This addition to the Clinical Approaches to Tachyarrhythmias(CATA) Series, written by the investigators who discovered andprobed the Brugada Syndrome, discusses the history, etiology,pathology and clinical manifestations of sudden death. Fromdiagnosis, prognosis, to therapeutic approaches using the latest incathater ablation techniques, electrophysiological surgery, andgenetic appraisal, the work is a testimony to the author'sinvestigation. Using clinical cases in Thailand and Laos, theyfurther unravel the syndrome's molecular mechanisms, studyingrelated syndromes, such as the long-QT syndrome, infant death, andarryhthmogenic right ventricular cardiomyopathy. By being informed of the electrophysiological abnormalities thatcontribute to familial and genetic diseases, physicians,cardiologists and all those who care for patients with cardiacarrhythmias will be better able to identify and treat patients inwhom the Brugada Syndrome may strike next.

Brugada Phenocopy: The Art of Recognizing the Brugada ECG Pattern details all aspects associated with alternative diagnosis to Brugada Syndrome (BrS). Coverage includes how to identify the proper ECG pattern, what to do to investigate for BrP, and how to avoid misinterpretations and the use of unnecessary and expensive treatments. Chapters are written by experienced professionals, many of whom are colleagues that initially described this condition. This easy to use volume is a must have reference for researchers of cardiology, cardiologists, electrocardiologists, internists, emergency care doctors and students, residents and fellows. Assists in the proper recognition of the Brugada ECG patterns and how to distinguish true BrS from other conditions with identical ECG Expands understanding on how to properly recognize the ECG of Brugada patterns Contains access to a companion website with video to enhance understanding of proper measurement of the beta angle (Chevallier) and the base of the triangle (Serra)

A significantly expanded third edition, this book provides a comprehensive and concise overview of cardiac arrhythmias and their ECG/telemetry manifestations, including the principles of cardiac electrophysiology, current concepts of pharmacology, clinical features, diagnoses, and state-of-the-art treatments. Additionally, the book emphasizes decision-making strategies in approaching each individual patient and the application of technical innovations in specific clinical situations. Organized into eight parts, beginning chapters introduce the concepts and principles of cardiac electrophysiology, unique rhythms, and ECG waves/signs. These chapters are designed to integrate emerging knowledge in basic science and clinical medicine. Subsequent chapters focus on the diagnosis of a variety of cardiac arrhythmias using non-invasive methodology. Throughout the book, chapters continue to analyze pharmacological and other approaches to therapy of specific arrhythmias, including supraventricular tachycardias, atrial fibrillation and flutter, ventricular arrhythmias, and bradyarrhythmias. Finally, the book closes with coverage on inherited cardiac arrhythmia syndromes including the long, short QT, and J-wave syndromes, catecholaminergic polymorphic ventricular tachycardia, and arrhythmogenic right ventricular cardiomyopathy. The third edition of Management of Cardiac Arrhythmias, is an essential resource for physicians, residents, fellows, and medical students in cardiology, cardiac surgery, vascular surgery, cardiac electrophysiology, and cardiac radiology.

This book provides a unique contemporary and succinct distillation of the current status of recently delineated electrical diseases of the heart, emphasizing their common and diverse clinical features. The latest developments in the field of experimental and clinical cardiac electrophysiology, genetics, pharmacology and interventional therapies of various clinical arrhythmogenic entities are featured and discussed in terms of recent advances in basic and clinical science. The book is divided into seven major parts. Each part consists of chapters (total of 64) dealing with related topics.

Offers a guide for a complete understanding of the disease and conditions most frequently revealed in ECGs recorded in the acute, critical, and emergency care settings Electrocardiogram in Clinical Medicine offers an authoritative guide to ECG interpretation that contains a focus and perspective from each of the three primary areas of medical care: acute care, critical care and emergency care. It can be used as a companion with the book ECGs for the Emergency Physician I & II (by Mattu and Brady) or as a stand-alone text. These three books can be described as a cumulative EGG reference for the medical provider who uses the electrocardiogram on a regular basis. Electrocardiogram in Clinical Medicine includes sections on all primary areas of ECG interpretation and application as well as sections that highlight use, devices and strategies. The medical content covers acute coronary syndromes and all related issues, other diseases of the myocardium, morphologic syndromes, toxicology and paediatrics; dysrhythmias will also be covered in detail. This important resource: • Goes beyond pattern recognition in ECGs to offer a real understanding of the clinical syndromes evidenced in ECGs and implications for treatment • Covers the indications, advantages and pitfalls of the use of ECGs for diagnosis in all acute care settings, from EMS to ED to Critical Care • Examines the ECG in toxic, metabolic and environmental presentations; critical information for acute care clinicians who need to be able to differentiate ODs, poisoning and other environmental causes from MI or other cardiac events • Facilitates clinical decision-making Written for practicing ER, general medicine, family practice, hospitalist and ICU physicians and medical students, Electrocardiogram in Clinical Medicine is an important book for the accurate interpretation of EGG results.