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Clinical Cases in Cardiac
Electrophysiology:
Ventricular Arrhythmias
Vol. 3
Lucian Muresan
Editor
123
Clinical Cases in Cardiac Electrophysiology:
Ventricular Arrhythmias
Lucian Muresan
https://t.me/medicina_free
Editor
Clinical Cases in Cardiac
Electrophysiology:
Ventricular Arrhythmias
Vol. 3
Editor
https://t.me/medicina_free
Lucian Muresan
Dept. of Cardiology
Centre Hospitalier de Mulhouse
Mulhouse, France
ISBN 978-3-031-35578-3 ISBN 978-3-031-35579-0 (eBook)
https://doi.org/10.1007/978-3-031-35579-0
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature
Switzerland AG 2023
This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher,
whether the whole or part of the material is concerned, specically the rights of translation,
reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microlms or in any
other physical way, and transmission or information storage and retrieval, electronic adaptation,
computer software, or by similar or dissimilar methodology now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this
publication does not imply, even in the absence of a specic statement, that such names are
exempt from the relevant protective laws and regulations and therefore free for general use.
The publisher, the authors, and the editors are safe to assume that the advice and information in
this book are believed to be true and accurate at the date of publication. Neither the publisher nor
the authors or the editors give a warranty, expressed or implied, with respect to the material
contained herein or for any errors or omissions that may have been made. The publisher remains
neutral with regard to jurisdictional claims in published maps and institutional afliations.
This Springer imprint is published by the registered company Springer Nature Switzerland AG
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
Paper in this product is recyclable.
Foreword
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Endosseous dental implants have revolutionized the practice of dentistry in
the last 40years. No other development, technology, or material has had such
an effect on the dental profession in our lifetime. Such a sea change in a
health profession requires extensive scrutiny and massive scientic investigation. The concept that a foreign body could integrate with the tissues of the
oral cavity and establish a functional equilibrium was unthinkable just a few
decades ago. This is particularly true given the dynamic complexities in the
oral cavity such as the microbial challenges, the immune responses, multiple
tissue interaction and turnover, the ow of salvia and all of its components,
and the functional needs of food and liquid intake, chewing, speaking, and
swallowing. Given this situation, it is remarkable that endosseous dental
implants today are a routine dental procedure with very high success rates
both in the placement and maintenance of the implant itself, as well as of the
prosthesis fabrication and usage. This remarkable success story has occurred
through extensive scientic investigation that has accompanied the use of
dental implants at rst mainly in edentulous patients but then evolved with
developments into partially edentulous patients. This fascinating story has
now enhanced and inuenced millions of lives daily and has evolved because
of serious and comprehensive scientic investigations. This outstanding book
has managed to bring together incredible information that exhaustively and
very comprehensively explains how the science of dental implantology has
supported the translational application of this remarkable treatment for our
patients. It covers scientic research over the entire spectrum of dental
implantology from various in vitro and animal models for investigation to
translational studies for clinical success.
The editor nicely sets the tone for the book by suggesting that dental
implant researchers are “knowledge explorers” and that their mission as surgical researchers is the “generation of knowledge, transmitting it, and adding
clinical value.” The book then begins with insights into various animal model
systems and the advantages and disadvantages of the many species of animals
that researchers have used to evaluate tissue interactions with the implanted
foreign body. The structural, functional, and compositional components of
various animal species offer a wide array of tissue reaction for the evaluation
of the implant. For example, some animal models offer osseous tissue comprised of mainly cortical bone and little cancellous bone while other models
offer a more balanced composition of cortical and cancellous bone tissue for
evaluation. The authors of these chapters have complied in this one resource
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an incredibly comprehensive documentation when one is deciding what animal model might be applicable for further scientic investigation.
These chapters exhaustively describe preclinical study designs in a number of animal models including rodents, rabbits, swine, canine, ovine, and
caprine animals. These are well-written chapters that describe advantages and
limitations of each model, the particular locations that have been typically
utilized for implant studies, systemic conditions possible in the species, how
outcomes can be evaluated, and furthermore describe some major studies that
have utilized the model in the literature. I believe these chapters are one of the
only places that one can turn to in order to have all the information you might
need to learn about all the possible animal models to use for implant research
and have the information needed to evaluate how the models can best be
utilized.
The next series of chapters comprehensively explain how animal preclinical research is translated into clinical investigations in implant dentistry. This
information again exhaustively covers a broad range of topics in an extremely
comprehensive fashion and denes and describes the components of different
kinds of studies that are usually performed in implant dentistry. Levels of
evidence are explained and standard guidelines for the reporting of results
and quality control practices are also included. A plea is also made for standardization for data collection and evaluation methods including data from
private practice to reect what goes on in the so-called real world.
These chapters are followed with extensive discussions on other crucial
aspects of implant dentistry research including biomechanics and testing in
vitro and then in vivo for various materials including nite element analyses;
a really excellent, comprehensive, and up-to-date review of the biological
events that take place at the interface of the implant and bone including ve
phases of osseointegration, and material inuences and surface characteristics of the implant and their signicance on implant integration. Also included
are comprehensive chapters on radiographic imaging, the mechanics of the
implant-abutment connection, and prosthetic rehabilitation and the factors
relevant for the prosthesis to be successful in the long term.
Implant dentistry often involves the use of various bone graft materials.
Each of these materials has advantages and disadvantages so a thorough
understanding of bone grafts is essential and is included in the book. Several
chapters discuss bone substitute materials including non-resorbable and
resorbable grafts as well as the biology of low substitution bone materials,
calcium-phosphate, and polymer-based bone substitutes. An emphasis is also
placed on the various techniques for imaging these materials and evaluating
their effectiveness as a bone promoting material, the host tissue reaction to
the material, and the degradation of the bone substitute. The use of membranes and soft tissue grafting goes hand in hand with bone grafting, and
these materials are additionally covered.
Three additional chapters are included in the book that round out current
research in implant dentistry. These include how biomarkers have been examined to monitor tissue health around the implant including the use of saliva
and peri-implant crevicular uid composition. A second chapter provides a
Foreword
Foreword
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vii
comprehensive examination of the state-of-the-art use of computer-assisted
concepts and digital technologies and how these have been incorporated and
inuenced diagnosis, planning, and evaluation of implant therapy for patients.
Exciting new digital technologies like photogrammetry are explained; CAD/
CAM use and static and dynamic guidance for implant placement are also
explored and discussed. Lastly, a chapter is included on hypothesis testing,
sample size determination, probability distributions, data collection, and how
statistical analyses are typically performed with the incorporation of a statistician who has the mathematical and statistical knowledge to use appropriate
techniques to get the most out of your experimental and clinical dental
implant studies.
As you can see, this book is a unique resource in implant dentistry that is
comprehensive in the eld and extensive in its breath and depth in all areas of
dental implant research. The contents of this book conrm that the placement
of foreign bodies into the jaw bones has revolutionized dentistry as a profession. The scientic investigation of all aspects of this procedure is outlined
here, and it has demonstrated the evolution of this therapy to its highly successful outcome that it enjoys today. Achieving the goal of replacing and
supporting teeth with endosseous implants has required enormous scientic
discovery, and this book provides an outstanding resource for appreciating
and understanding the tremendous scientic advancements and evolution that
have taken place in implant dentistry.
Department of Periodontics DavidL.Cochran
University of Texas
Health Science Center, San Antonio
San Antonio, TX, USA
Preface
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The eld of interventional treatment of cardiac arrhythmias is continuously
expanding. New diagnostic and therapeutic techniques are developed every
year, improving our understanding and capabilities of offering better treatment options to our patients. In this regard, reading and learning remains a
crucial step in keeping up with this rapidly evolving eld.
This is the third volume of a three-volume project aimed at providing
unique case reports (20 cases per volume) of a large number of supraventricular and ventricular arrhythmias encountered in clinical practice. This volume
is focused on the treatment of ventricular arrhythmias, both in structurally
normal hearts and in patients with structural heart disease (ischemic heart
disease, arrhythmogenic cardiomyopathy, dilated cardiomyopathy). All presented cases were performed using the CARTO electro-anatomical mapping
system, which allows the reader to better understand the arrhythmia features
due to the high number of images provided. A large number of high-quality
gures, which represent the core of the authors’ work, enrich the contents: all
cases are built around suggestive gures acquired during the patients’ hospitalization, which clearly illustrate important concepts used in catheter ablation of cardiac arrhythmias. The gures are not only related to the catheter
ablation procedure, but also to the patient history, thus helping the reader to
place the invasive treatment of the arrhythmias into clinical context: electrocardiograms, Holter ECGs, signal-averaged ECGs, chest X-Rays, transthoracic and transesophageal echocardiography images, MRI, CT scans, and
coronary angiography images are provided when considered relevant, in
order to better present the patient’s condition. Short videoclips with activation maps of the atria or the ventricles during the studied arrhythmia complete
the information provided. Teaching-oriented, all chapters include questions
and answers and key messages at the end of each case. For this reason, it will
be an invaluable tool for cardiologists, clinical cardiac electrophysiologists,
and interventional cardiac electrophysiologists in training, but also for all
those interested in learning more about the subject.
We would like to address our very warm and special thanks to our dear
colleagues: Dr. Jorge Aventin, Dr. Gokhan Bodur, Dr. Narcisa Bors, Dr.
Alexandrina Calatan, Dr. Jean-Pierre Chemouny, Dr. Claudine Cordier, Dr.
Paul Klero de Rosbo, Dr. Daniel Franck, Dr. Stéphane Greciano, Dr. Francis
Homatter, Dr. Jean-René Kieny, Dr. Patricia Magnus, Dr. Alvaro Pereira
Zenklusen, Dr. John Philippe, Dr. Pedro Rodriguez, Dr. Olivier Roth, Dr.
Elena Rugina, Dr. Antoine Wuillermin, Dr. Jean-Julien Stolz, Dr. Jean-Marie
ix
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Reinbold, to our wonderful nurses: Catherine Paulus, Gaëlle Meyer, Sabine
Bruckert, Elodie Gaullard, Natacha Meyer, and to our hard-working radiology technicians: Anne Maresca, François Moreira, Michaël Wittiche, Anne
Pelloux Gervais, Julie Welter, Marion Giannipatrani, Françoise Furstenberger,
and Valérie Luttenauer, whose dedication and implication in the patients’ care
made a signicant difference. Without their effort, this project would never
have been possible. Thank you!
Mulhouse, France LucianMuresan
June 2022
Preface
Contents
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1 Case 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Ronan Le Bouar, Frédéric Halbwachs, Jacques Levy,
Jean-Yves Wiedemann, Crina Muresan, and Laurent Dietrich
2 Case 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Frédéric Halbwachs, Matthieu George, Lucien Diene,
Marine Kinnel, Jacques Levy, and Laurent Jacquemin
3 Case 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Ronan Le Bouar, Frédéric Halbwachs, Emmanuelle Gain,
Charline Daval, Didier Bresson, Mihaela Calcaianu,
Aubrietia Lawson, and Marine Kinnel
4 Case 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Frédéric Halbwachs, Ronan Le Bouar, Thomas Robein,
Jean-Yves Wiedemann, Laurent Dietrich, Tarek El Nazer,
and Jacques Levy
5 Case 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
Justine Havard, Frédéric Halbwachs, Ronan Le Bouar,
Crina Muresan, Tarek El Nazer, Marine Kinnel,
and Nicolas Bourrelly
6 Case 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
Ronan Le Bouar, Frédéric Halbwachs, Jean- Yves Wiedemann,
Jacques Levy, David Kenizou, and Romaric Bouillard
7 Case 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Ronan Le Bouar, Frédéric Halbwachs, Jean- Yves Wiedemann,
Jacques Levy, Maxim Tissier, David Kenizou,
and Laurent Dietrich
8 Case 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
Frédéric Halbwachs, Ronan Le Bouar, Charline Daval,
Serban Schiau, Jacques Levy, Crina Muresan, Lucien Diene,
Arthur Kholer, and Didier Bresson
xi
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