Clinical Cardiac Electrophysiology Josephson Pdf File
Mark E Josephson (photo by Jan de Jonge)Mark E Josephson, a pioneer of clinical cardiac electrophysiology (EP), passed away at the age of 73 on 11 January 2017 after a courageous battle with cancer. With his passing, the EP community lost a great physician whose achievements will be remembered for years to come. Andrew L Wit (Emeritus Professor of Pharmacology, Columbia University College of Physicians and Surgeons, New York, USA), a close professional colleague and friend of Josephson for over 40 years, writes this tribute for Cardiac Rhythm News.Mark E Josephson’s death is an extraordinary loss to his family, friends, colleagues and to medicine and cardiology.
Clinical Cardiac Electrophysiology Josephson Pdf File Online
Josephson is also a giant in the field of education. His textbook, Clinical Cardiac Electrophysiology: Techniques and Interpretations, now in its fourth edition, is a comprehensive text that still serves as the Bible for the cardiac electrophysiology specialty today. As part of his commitment to education and training, Dr. Josephson worked. Josephson - Clinical Cardiac Electrophysiology Techniques An - Free ebook download as PDF File (.pdf), Text File (.txt) or read book online for free. Clinical cardiac electrophysiology has evolved rapidly over the past several decades, allowing wide-ranging therapeutics to improve the lives of millions of patients. 1 The progression from physiology-based investigations to large, randomized trials of new drugs and devices has allowed clinicians to treat patients with greater confidence and an.
His life was inextricably intertwined with the development of clinical cardiac EP. Josephson was one of the pioneers of this relatively new medical discipline which was born in the 1960s. A recently published book details his legacy and aptly identifies the “Josephson School” of electrophysiologists trained by him, who will carry out his legacy. 1When Josephson began his electrophysiology training in the laboratory of Anthony N Damato at the US Public Health Service Hospital in Staten Island, USA, in 1971, clinical EP was in its infancy. Brilliant minds over five decades following the invention of the electrocardiogram (ECG) in 1903, using deductive reasoning, had established classifications of arrhythmias according to sites of origin, and hypothesised mechanisms. 2 However, clinical EP was not born until the 1960s when invention of the electrode catheter enabled the heart to be electrically stimulated directly and electrical activity to be recorded from localised regions without thoracotomy, in Amsterdam and in Paris independently. In Amsterdam, Dirk Durrer, Hein J Wellens and Reinier Schuilenburg showed that programmed premature stimuli using a specially designed stimulator, applied to the atria or ventricles initiated tachycardia in patients with accessory atrioventricular (AV) pathways.
3 This was the origin of programmed electrical stimulation (PES) to induce and terminate tachycardias that were interpreted to be caused by reentrant excitation. Subsequently Wellens and his colleagues used PES and intracardiac recordings to demonstrate that other supraventricular tachycardias as well as ventricular tachycardias could be induced and terminated by stimulation and were also likely caused by reentry. 3,4 Andrew L WitThe Damato group then began using PES of the atria to define conduction and refractory properties of the components of the AV junction in normal and diseased hearts. The Damato lab was one of the earliest laboratories in the USA that had a major involvement in the development and growth of clinical EP owing to the pioneering development of the catheter technique for recording electrical activity from the His bundle by Benjamin J Scherlag in that laboratory. 5 Josephson’s initial research with this group described the clinical EP of antiarrhythmic drugs, properties of the AV conduction system, and mechanisms of supraventricular tachycardia. 1,6 Perhaps more importantly, this is where he began to formulate his ideas about mechanisms and treatment of ventricular tachycardia (VT).After leaving this laboratory, Josephson went to the University of Pennsylvania in 1973 to join a fledgling cardiac EP group and within a few years, was head of that group while still a cardiology fellow. It was at Penn in the mid to late 1970s that he began to publish his series of ground-breaking studies that has had a lasting influence on clinical EP to the present day.
Josephson and colleagues used systematic multi-site programmed stimulation to initiate and terminate sustained VT resulting from myocardial infarction 7 and developed the technique of endocardial catheter mapping of VT. 8 This approach led to recognition of the subendocardial origin of the majority of these arrhythmias adjacent to aneurysms. 8 What followed was the innovative surgical technique of subendocardial resection where a subendocardial layer of tissue was stripped off from around an aneurysm (along with resection of the aneurysm). 9 Continuing these investigations, the Josephson group described the properties of the electrophysiological substrate for VT. Mapping during sinus rhythm, they showed abnormal electrograms that provided markers for locating the reentrant circuits. 10 Subsequent investigations defined the properties of the circuits including their size and shape, the cause of slow conduction, the nature of the excitable gap and localisation of the pathways using the 12 lead ECG.
This extraordinary output of new and exciting information on the electrophysiology of VT in the late 1970s and 1980s were eventually translated into innovative therapeutic methodologies, which are now widely used tools of clinical EP. These methodologies include PES to induce and terminate VT, catheter mapping during sinus rhythm and VT to locate the sites of reentrant circuits, entrainment techniques to locate the critical isthmus of the circuits and catheter radiofrequency ablation at critical sites to prevent VT, replicating the effects of the original subendocardial resection technique.Josephson continued his studies on VT after he moved to Beth Israel Hospital, Boston, USA, in 1992, where he eventually became chief of cardiology. All in all, he eventually co-authored over 50 publications on this subject. In addition, he contributed to our current understanding of AV nodal reentrant tachycardia, atrial flutter and fibrillation and ventricular fibrillation and defibrillation.
He helped design and participated in many major clinical trials that have altered and improved clinical care of patients with arrhythmias (references to all his studies can be found in reference 1).Throughout his career, Josephson was devoted to teaching and training the next generation of cardiac electrophysiologists. His nurturing of his fellows who became life-long friends, produced the second generation of clinical electrophysiologists that have made many important contributions of their own to the growth of clinical EP. They now have their own students (third generation) entering the world of electrophysiology.
These generations insure that the Josephson School of Clinical Cardiac Electrophysiology and Mark Josephson’s legacy will be perpetuated. 1 Mark E Josephson teaching about complex arrhythmias, a course he gave with Hein J Wellens, sponsored by Medtronic (photo by Rich Wawrzynski)Josephson has also reached thousands of electrophysiologists through courses at both the beginning and advanced levels in the United States and Europe. These courses have been mostly taught with Wellens (Cardiovascular Research Institute, Maastricht, The Netherlands) who as mentioned above, was one of the founding fathers of clinical EP. Many of the courses were mechanism-based. The philosophy of this approach is centred on the belief that an understanding of mechanisms is the foundation of future development of clinical cardiac EP. The treatment of patients should not be based only on published algorithms for the type of arrhythmia under consideration but should also involve an understanding of the basic electrophysiology.
Those students who master these basics will be the ones who will make innovative contributions and devise new therapies in the future. To this end he also wrote the “bible” of clinical electrophysiology, Josephson’s Clinical Cardiac Electrophysiology, which is now in its fifth edition. 11 It is one man’s approach to the practice of clinical EP based on his many years of experience.
It is extraordinarily comprehensive. Another textbook focused more on basic electrophysiological mechanisms just went to press.
12I had a close personal and professional relationship with Mark Josephson throughout our careers. I have worked with him in the laboratory and the class room and have spent many hours with him at the dinner table over the past 40 years. He has been an important part of my life. I will miss him greatly.References.
Wellens HJ, et al. The Josephson School. A legacy of important contributions to electrophysiology. Cardiotext 2016. Scherf D and Schott A. Extrasystoles and Allied Arrhythmias.
A William Heinemann Medical Book Publication 1973. Wellens HJJ. Electrical stimulation of the heart in the study and treatment of tachyarrhythmias.
Leiden: Stenfort Kroese 1971. Wellens HJ et al. Electrical stimulation of the heart in patients with ventricular tachycardia. Circulation 1972;46:216‒226. Scherlag BJ et al. Catheter technique for recording His bundle activity in man.
Circulation 1969;39:13‒18. Josephson ME et al.
Effects of lidocaine on refractory periods in man. Am Heart J 1972;84:778‒776.
Josephson ME et al. Recurrent sustained ventricular tachycardia. Circulation 1978;57:431‒440. Josephson ME et al. Recurrent sustained ventricular tachycardia.
Endocardial mapping. Circulation 1978;57:440‒7. Josephson ME et al.
Endocardial Excision: A new surgical technique for the treatment of recurrent ventricular tachycardia. Circulation 19‒1439. Cassidy DM et al.
Endocardial catheter mapping in patients in sinus rhythm: Relationship to underlying heart disease and ventricular arrhythmias. Circulation 1986;73:645‒652. Josephson ME. Josephson’s clinical cardiac electrophysiology. Techniques and interpretations. Wolters Kluwer 2016.
Wit AL, Wellens HJ and Josephson ME. Electrophysiological foundations of cardiac arrhythmias. A bridge between basic mechanisms and clinical electrophysiology. Cardiotext (in Press)Tributes for Mark E JosephsonElectrophysiologists such as David Callans, Eric Prystowsky, Jonathan Kalman and Peter Kowey and David Steinhaus and Julie Stephenson, both from Medtronic, pay tribute to Mark E Josephson.David Callans, University of Pennsylvania, USADavid Callans, Mark E Josephson and Bruce HookThe world of electrophysiology has lost a genius founding father, and I lost a great friend.Mark Josephson died just before his 74th birthday. Oh, but how he lived!His extensive achievements and intellectual triumphs aside, what made Mark really amazing to the people who knew him was his expansive and often challenging personality. He was dedicated to make both himself as well as everyone he cared for as successful as they could possibly be, as a scientist, physician but especially as a human being. Although it took me a long time to understand, he was not interested in his disciples being as good as he was (thankfully, as this would have been impossible!), but was passionately concerned that they simply strive to be the best version of themselves.
Around Mark, there was no avoiding this destiny though—halfhearted efforts were always called out in an aggressive but supportive way.One of my favourite memories characterising this attribute occurred during his last year at Penn. I was hanging out in his office when one of the cardiology fellows who was senior to me, and graduating that year walked in to sheepishly confess that he was “abandoning” an academic career and had taken a position in private practice. While he feared disappointing what he thought were Mark’s aspirations for him, Mark had actually been instrumental in getting him that position. He said: “I want you to be the best doctor that you can possibly be, that is what I want for you.”My relationship with Mark started during my fellowship, way before I was even a little equipped to understand anything he was talking about. I would travel to his Gladwyne home for discussion about the nature of the ventricular tachycardia circuit (I so wish I had kept the diagrams he scribbled out on napkins during those talks) and the nature of life, both his and mine.
I had not a chance to fully develop my sense of gratitude for his taking me on as a student, enthusiastic but slow as I was, but Mark was offering so much more, even from the start. He was offering incredibly loyal friendship, an opportunity to share in his life, not just in his work. I was and continue to be overwhelmed by this.At his funeral, his daughter Rachel said that Mark made everyone around him feel like they were Mark’s best friend. He meant so much to so many.He shared a birthdate with another genius, Mozart, who authored a quote that I feel personifies Mark:“Neither a lofty degree of intelligence nor imagination nor both together go into the making of a genius.
Love, love, love is the soul of genius.”Despite a profound sense of loss, his love, his ideas and his passion live on in all his dedicated disciples.Eric Prystowsky, St Vincent Hospital, Indianapolis, USA Mark E Josephson and Eric PrystowskyIt is an honour and privilege for me to pay tribute to Mark Josephson, a friend for many years and one of the pioneers of our field of clinical electrophysiology (EP).
♥ Book Title: Clinical Electrophysiology♣ Name Author: Andrew J. Robinson (Ph.
D.)∞ Launching: 2008◊ Info ISBN Link: ⊗ Detail ISBN code: 843⊕ Number Pages: Total 555 sheet♮ News id: C2-9bcIjPBsC☯ Full Synopsis: 'Organized by therapeutic goals, the Third Edition of this comprehensive textbook on electrotherapies provides a fundamental understanding of contemporary, evidence-based intervention and assessment procedures. The text takes a problem-oriented approach and recommends interventions consistent with both theory and the clinical efficacy of the intervention for specific, clearly identified clinical disorders. This edition has a new chapter on electrical stimulation and biofeedback for genitourinary dysfunction, including incontinence management in both women and men.
All the intervention-based chapters have a new format that emphasizes evidence-based practice and practical application. Additional self-study questions are included in each chapter. NEW TO THIS EDITION: New chapter on Electrical Stimulation and Biofeedback for Genitourinary Dysfunction (Chapter 9) includes topics such as incontinence management in both women and men, and gives solid evidence to support or refute specific procedures. New organization Chapter on mechanisms of pain transmission and pain control with electrotherapy will be moved up to chapter 4 to make the first four chapters the theoretical basis for the clinical application chapters that follow.
Chapter on electrophysiologic evaluation will become the last chapter (chapter 12) in order to enable students to meet core educational competencies. New chapter format for the intervention chapters (chapters 5-11) adds consistency and clarity to emphasize evidenced-based practice and practical application. Additional self-study questions are included in each chapter to enhance understanding of key concepts. New emphasis on evidence-based preferential practice patterns. 'Article Andrew J. Robinson (Ph.
D.) Statement.' ♥ Book Title: Clinical Electrophysiology♣ Name Author: Andrew J. Robinson∞ Launching: 1995-01◊ Info ISBN Link: ⊗ Detail ISBN code: 176⊕ Number Pages: Total 490 sheet♮ News id: RMgJTB3fawkC☯ Full Synopsis: 'A problem-oriented textbook and clinical reference for students and clinicians in physical therapy, which aims to simplfy and facilitate the use of electrotherapy in the classroom.
It uses the most current standards in electrotherapy terminology. Organized by therapeutic goals, this edition of this basic text and clinical reference includes chapters on clinical biofeedback therapy and electrical stimulation for urogenital dysfunction. The chapters dealing with neuromuscular problems have been expanded. Each chapter includes case studies, high quality graphics, and study questions. 'Article Andrew J. Robinson Statement.'
♥ Book Title: Practical Clinical Electrophysiology♣ Name Author: Peter J. Zimetbaum∞ Launching: 2009◊ Info ISBN Link: ⊗ Detail ISBN code: 036⊕ Number Pages: Total 304 sheet♮ News id: VZakJLatx3AC☯ Full Synopsis: 'This book provides a comprehensive and clinically based approach to the diagnosis and management of arrhythmia disorders for the cardiology fellow and practicing general cardiologist. The clinical approach encompasses evidence-based medicine as well as practical pearls for the diagnosis and management of arrhythmia disorders. Chapters provide a comprehensive discussion of arrhythmia disorders, from noninvasive diagnostic strategies through pharmacologic and invasive therapeutic strategies. The level of sophistication ranges from the most basic to more sophisticated topics, and provides an excellent complement to Josephson's more advanced text. 'Article Peter J. Zimetbaum Statement.'
♥ Book Title: Clinical Electrophysiology♣ Name Author: Peter W. Kaplan∞ Launching: 2011-07-05◊ Info ISBN Link: 944⊗ Detail ISBN code: ⊕ Number Pages: Total 200 sheet♮ News id: iA0VbwpYGvsC☯ Full Synopsis: 'Bridging the clinical electrophysiological investigation with the neurological consultation Acutely ill patients present with symptoms that don’t immediately yield a diagnosis. Electrophysiological testing can support diagnosis but only if the appropriate tests are ordered. They must be properly interpreted in conjunction with the actual symptoms.
Clinical Electrophysiology presents a wide range of symptoms with specific electrophysiological results. The handbook shows how the complete picture leads to better diagnostic, prognostic or therapeutic conclusions.
The book is organized by the presenting neurological problem in a clinical setting. For each case the authors provide a possible electrophysiological result.
This is interpreted and tied to the patient’s symptoms to yield a clinical solution. The handbook avoids theoretical discussion to provide a direct practical guide that: Begins with the patient’s symptoms Uses a range of electrophysiological modalities Shows different test results for similar symptoms Relates clinical observation to electrophysiological testing A final casebook section presents readers with rarer clinical challenges for self-testing. Providing practical, to-the-point guidance on electrophysiological investigations, Clinical Electrophysiology will guide all neurologists attending acutely ill patients. 'Article Peter W.
Kaplan Statement.' ♥ Book Title: Clinical Arrhythmology and Electrophysiology E-Book♣ Name Author: Ziad Issa∞ Launching: 2018-08-07◊ Info ISBN Link: 821⊗ Detail ISBN code: ⊕ Number Pages: Total 752 sheet♮ News id: -41nDwAAQBAJ☯ Full Synopsis: 'Part of the highly regarded Braunwald’s family of cardiology references, Clinical Arrhythmology and Electrophysiology, 3rd Edition, offers complete coverage of the latest diagnosis and management options for patients with arrhythmias. Expanded clinical content, clear illustrations, and dynamic videos keep you fully abreast of current technologies, new syndromes and diagnostic procedures, new information on molecular genetics, advances in ablation, and much more. 'Article Ziad Issa Statement.' ♥ Book Title: Clinical Electrophysiology♣ Name Author: Peter W.
Kaplan∞ Launching: 2011-07-05◊ Info ISBN Link: 944⊗ Detail ISBN code: ⊕ Number Pages: Total 200 sheet♮ News id: iA0VbwpYGvsC☯ Full Synopsis: 'Bridging the clinical electrophysiological investigation with the neurological consultation Acutely ill patients present with symptoms that don’t immediately yield a diagnosis. Electrophysiological testing can support diagnosis but only if the appropriate tests are ordered. They must be properly interpreted in conjunction with the actual symptoms. Clinical Electrophysiology presents a wide range of symptoms with specific electrophysiological results.
The handbook shows how the complete picture leads to better diagnostic, prognostic or therapeutic conclusions. The book is organized by the presenting neurological problem in a clinical setting. For each case the authors provide a possible electrophysiological result. This is interpreted and tied to the patient’s symptoms to yield a clinical solution. The handbook avoids theoretical discussion to provide a direct practical guide that: Begins with the patient’s symptoms Uses a range of electrophysiological modalities Shows different test results for similar symptoms Relates clinical observation to electrophysiological testing A final casebook section presents readers with rarer clinical challenges for self-testing.
Providing practical, to-the-point guidance on electrophysiological investigations, Clinical Electrophysiology will guide all neurologists attending acutely ill patients. 'Article Peter W.
Kaplan Statement.' ♥ Book Title: Clinical Cardiac Electrophysiology in the Young♣ Name Author: Macdonald Dick∞ Launching: 2006-05-04◊ Info ISBN Link: ⊗ Detail ISBN code: 642⊕ Number Pages: Total 332 sheet♮ News id: NgNtAAAAMAAJ☯ Full Synopsis: 'This volume focuses on the practical aspects of clinical electrophysiology of cardiac arrhythmias in the young as practiced in the Department of Pediatric Cardiology at the University of Michigan. Cardiac arrhythmias in children are often symptomatic as well as frightening to the child patient and parent. This volume is intended as a practical guide for the novice or seasoned physician presented with a child with a cardiac arrhythmia.
'Article Macdonald Dick Statement.' ♥ Book Title: Difficult Decisions in Clinical Electrophysiology - A Case Based Approach, An Issue of Cardiac Electrophysiology Clinics - E-Book♣ Name Author: Mark C. Haigney∞ Launching: 2012-10-01◊ Info ISBN Link: 630⊗ Detail ISBN code: ⊕ Number Pages: Total 184 sheet♮ News id: EyZz2KoTPiwC☯ Full Synopsis: 'This issue consists of 17 case studies, each involving a difficult decision that has to be made in the catheterization laboratory. Reading about the cases and seeing the ECGs will help cardiac electrophysiologists sharpen their clinical skills. The cases are also useful reading for those studying for board certification.
'Article Mark C. Haigney Statement.' ♥ Book Title: Clinical Electrophysiology of the Somatosensory Cortex♣ Name Author: Christoph Baumgartner∞ Launching: 2012-12-06◊ Info ISBN Link: 536⊗ Detail ISBN code: ⊕ Number Pages: Total 198 sheet♮ News id: k2GvBQAAQBAJ☯ Full Synopsis: 'The clinical electrophysiology of the human somatosensory cortex was investigated with a combined approach using cortical stimulations and somatosensory evoked responses on electrocorticography, scalp-EEG, and magnetoencephalography, a new neurophysiological technique. The spatiotemporal structure of the evoked response was studied with novel biophysical modeling techniques which allowed identification of the three-dimensional intracerebral location, time activity, and interaction of the neuronal sources in human somatosensory cortex. Thus, new aspects on the functional anatomy of the human somatosensory cortex could be elicited. Furthermore, the somatotopy of the hand somatosensory cortex was investigated. Clinically, the results of comparison of the different techniques can improve the non-invasive localization criteria for primary motor and somatosensory cortex which is important in patients undergoing neurosurgical procedures adjacent to central fissure.
'Article Christoph Baumgartner Statement.'