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[Medical] Catheter Ablation A Current Approach on Cardiac Arrhythmias

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Post time 2019-2-7 12:10:29 | Show all posts |Read mode

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The atrio-ventricular conduction system is so wisely and efficiently created that the signals
from the atria can travel slowly through the AV node and then be delivered at a high conduction
velocity via both bundle branches to the ventricles, which eventually enable an effective pumping
action of the whole heart. Professor Sunao Tawara discovered the AV conduction system,
which was reported in a monograph in German in 1906 [2]. Tawara undertook his laborious
work on the pathology and anatomy of the heart with Professor Ludwig Aschoff in Philipps
University Marburg, Germany. His work covered the discovery of the AV node, connecting
proximally to the His bundle with both bundles branches then connecting to the His bundle,
and the accurate tracing of the Purkinje fibers from the bundle branches. Moreover, the interdigitating
connections between the Purkinje fibers and ventricular myocardium were precisely
drawn as well as the node and atrial myocardium. Thus, what he established and named was
the “stimulus conduction system” of the heart, where he succeeded in identifying a complete
discreet pathway starting from the atrial myocardium and ending in the ventricular myocardium.
Of note, he predicted the conduction velocity of each component within the system as
well as the precise description of the location of all thesystem. Thus, Tawara’s discovery of the AV conduction system is regarded as having advanced
cardiology, particularly cardiac electrophysiology and electrocardiology [3].
The ingenious work of Tawara on the anatomy of the AV conduction system and his extraordinary
insight into the electrophysiological characteristics of each component of the system
has allowed us to understand the critical factors for a successful catheter ablation. That is, it
has provided us with an accurate knowledge of the cardiac anatomy, including the AV conduction
system, as well as a full understanding of the normal electrophysiological properties of the
whole heart.
From that perspective, the 39 chapters have been designed to progress from cardiac anatomy
and a fundamental understanding of the techniques for diagnosing the tachycardia mechanism
to practical and advanced techniques for catheter ablation of tachycardias. We have
assembled a mostly Japanese team of experts to describe the up-to-date information, which is
supplemented by extensive illustrations and images. These experts include some who have
advocated new concepts of tachycardia circuits, new pacing diagnostic maneuvers, and new
ablation methods, and others who have experienced a great number of cases with common
tachycardias or rare cases such as inherited arrhythmogenic diseases. I hope that the information
contained in each chapter will provide electrophysiologists with invaluable knowledge skills
for this field and can help their understanding of catheter ablation.
I have been truly fortunate to have enlisted the superb support of my colleagues, Drs.
Yagishita A. and Shirai Y., who have helped revise the entire text with great commitment and
patience. It is thanks to the Springer Editorial Team’s tireless efforts that it has been possible
to publish this book within such a short period of time. For this, I would like to express my
deepest appreciation. It is my great honor to have edited this book and to have invited the
world-leading Japanese electrophysiologists as the authors for each chapter. Finally, it is my
sincerest hope that this book will be a valuable part of every electrophysiology laboratory. components of the AV conduction

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