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The EP Lab - EP Articles

Articles Regarding EP topics of interest...

During my time working in EP, I have found a wide variety of articles that have been extremely helpful as far as advancing my own understanding of EP. As time allows, I will post the titles and where these articles may be located. Some may have links to online versions, others may contain the publication information. As this page develops, it will be organized into different subject matter. If you have an article that you would like to share with our readers, use the Contact Us button on the left side of this page.

Wells Classification of Atrial Flutter - http://circ.ahajournals.org/cgi/content/full/94/3/407 - Excellent article on Atrial Flutter

Effect of Skin Electrode Location on Radiofrequency Ablation Lesions - Mudit K. Jain, B.E., Gery Tomassoni, M.D., Richard E. Riley, M.S., and Patrick D. Wolf, Ph.D.     Journal of Cardiovascular Electrophysiology Vol 9, No 12, December 1998
          If you have ever heard experienced EP staff discussing placement of the RF skin electrode, you are probably hearing them discuss, in part, some of the information contained in this article. This is a must read for all EP staff.

 Substrate Mapping to Detect Abnormal Atrial Endocardium With Slow Conduction in Patinets With Atypical Right Atrial Flutter - Jin Long Huang, Md, PHD, Ching-Tai Tai, MD, Yenn-Jiang Lin, MD, Yoga Yaniadi, MD, Yi-Jen Chen, MD, PHD, Shih-Lin Chang MD, Li-Wei Lo, MD, Wanwarang Wongcharonen, MD, Chih-Tai Ting, MD, PHD, Shih-Ann Chen, MD / Journal of the American College of Cardiology / Vol 48, No 3, 2006
          This article provides a comparison of contact bipolar mapping and non-contact unipolar mapping during evaluation of voltage levels in patient's with atypical right atrial flutter.  For those who are looking for information that helps to clarify differences between non-contact unipolar and contact bipolar mapping, this article contains some excellent information.

The Assumptions of Isochronal Mapping - RAYMOND E. IDEKER, WILLIAM M. SMITH. SUSAN M. BLANCHARD, SUSAN L. REISER, EDWARD V. SIMPSON. PATRICK D. WOLF, and NED D. DANIELEY / From the Departments of Medicine, Pathology, and Surgery, Duke University Medical Center,
Durham, North Carolina / Address for reprints; Raymond E. Ideker. M.D.. Ph.D.. Box 3140, Duke University Medical Center, Durham, NC 27710.
          This article is essential for those starting out in cardiac mapping. In order to understand the principals behind mapping you need to understand what Ideker presents in this article. Strongly recommended for anyone who works on mapping cases.

Voltage and Activation Mapping - How the Recording Technique Affects the Outcome of Catheter Ablation Procedures in Patients With Congenital Heart Disease - Natusaja M.S. de Groot, MD; Martin J. Schalij, MD; Katja Zeppenfeld, MD; Nico A. Blom, MD; Enno T. Van der Velde, PhD, Ernst E. Van der Wall, MD.
          This article attempts to prove that bipolar voltage mapping in patients with congential heart disease can define substrate while unipolar voltage mapping can not discern the same information. At best, this article demonstrates the ease with which a lack of knowledge can create serious errors in the outcomes of scientific process and thus suggest results that, while appearing to be clinically sound, are inaccurate and even deceptive. In the article, published in Circulation, (2003) the comparison of unipolar and bipolar voltage is done using peak to peak measurements. Peak to peak is valid only in bipolar recordings. It is an accepted fact in basic electrophysiology that unipolar measurements are performed using peak negative values. It is my own experience that unipolar voltage mapping provides a very accurate assessment of cardiac voltage. It would be interesting to see the technique in this article repeated using more competant methods.

 

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