**Meet the editor**

Dr. John Kassotis received his doctorate in chemical engineering from the Columbia University, School of Engineering and Applied Sciences, in 1985 and earned his MD degree from the Columbia College of Physicians and Surgeons in 1990. After completing his residency, cardiovascular fellowship, and electrophysiology fellowship at the Presbyterian Hospital, Dr. Kassotis began the

Arrhythmia Service at New York Methodist Hospital (clinical affiliate of the NY Presbyterian Hospital Network) where he served as the director. In 2005, Dr. Kassotis was appointed the director of the Clinical Cardiac Electrophysiology Section and Fellowship Programs at SUNY Downstate Medical Center. He has authored or coauthored over 70 peer-reviewed articles, book chapters, and patents. He is the recipient of multiple teaching awards and serves as associate editor of the journal Cardiology.

## Contents

#### **Preface XI**



## Preface

**Section 3 Role of Trans-Catheter Ablation in Patients with Systolic**

Chapter 6 **Transcatheter Ablation of Atrial Fibrillation in Patients with**

Chapter 7 **Role of the Electrophysiologist in the Treatment of Tachycardia-Induced Cardiomyopathy 123**

Gusetu, Dana Pop and Dumitru Zdrenghea

**Section 4 Metabolic Impact on Systolic Heart Failure 139**

Chapter 8 **Impact of Thyroid Disease on Heart Failure 141**

Stanciu and Dan Cristian Gheorghe

Antonio Di Monaco, Federico Quadrini, Nicola Vitulano and

Cismaru Gabriel, Lucian Muresan, Puiu Mihai, Radu Rosu, Gabriel

Adina Elena Stanciu, Adina Zamfir‐Chiru‐Anton, Marcel Marian

**Heart Failure 101**

**VI** Contents

Massimo Grimaldi

**Chronic Heart Failure 103**

The impetus to write a textbook exploring the role of the clinical cardiac electrophysiologist, in the management of systolic heart failure, arose from a genuine interest in more intimately managing my patients with congestive heart failure. It became apparent that there was a lack of a streamline exchange of information, between the heart failure specialists and the electrophysiology service.

This inspired me to become boarded not only in clinical cardiac electrophysiology but also in advanced heart failure and cardiac transplantation. This furthered my appreciation of how important it has become for these two disciplines to work hand in hand. This inspired me to create a textbook, which explored the role of the clinical cardiac electrophysiologists in the management of systolic heart failure.

Electrophysiology has experienced a remarkable evolution. From the early days of using an intravascular catheter to recording a His Bundle, better identifying patients in need of per‐ manent pacing to the use of a similarly designed intravascular catheter to ablate the focus of a plethora of arrhythmias. This enabled us to better identify, understand, and more defini‐ tively treat the wide variety of arrhythmia we encounter in clinical medicine. Over the past decade with refinements in imaging technologies, we have expanded our armamentarium to more complex rhythm disturbances, effectively treating atrial fibrillation and complex ven‐ tricular tachycardia. These advances have resulted not only in mortality benefits but also in improved quality of life.

Equally remarkable is the evolution of the cardiac devices. From the first-generation pace‐ maker and the first implantable cardioverter defibrillator (ICD), we now have devices that integrate both technologies. From a cumbersome extracorporeal device, to a simple pacing and ICD system, we have now integrated these two technologies and incorporating a strate‐ gically placed coronary sinus lead to resynchronize the right and left ventricles in patients with systolic heart failure and a left bundle branch block. This has had a major impact on the morbidity and mortality of an ever-expanding population.

Although a great deal remains to be learned, in particular what will be the role of the elec‐ trophysiologist in the management of the arrhythmic issues faced by patients following the insertion of a left ventricular assist device (LVAD). With a reduction in available donor hearts and an expanded role of the (LVAD) destination therapy will have an ever-expanding role in managing these patients. This will undoubtedly expand the critical role of the electro‐ physiologists in the management of these complex patients.

The impetus of this textbook is to reinforce the electrophysiologists and their colleagues in advanced heart failure the synergistic roles they introduce in the management of these very complex patients. It also serves as a stepping stone to what I truly believe will be a growing body of literature.

The textbook is organized in four sections:

Section 1 explores newer pharmacology and novel therapeutic techniques in the treatment of systolic heart failure. Section 2 focuses on the role of implantable devices in the manage‐ ment of systolic heart failure including the impact of cardiac resynchronization therapy (CRT), addressing who is most likely to respond and how we can optimize this response. Section 3 discusses the role of transcatheter ablative therapy in the management of atrial fibrillation and other arrhythmias in patients with heart failure. The final section looks at the impact of thyroid disease in congestive heart failure.

I want to extend a heartfelt thank you to the collection of international authors who contrib‐ uted to this textbook, without whom this textbook would not have been possible. It is my hope that the textbook will meet its stated objective and will serve as the fodder for physi‐ cians at all levels of training to appreciate the intimate role of the these two important disci‐ plines of cardiovascular medicine.

I would like to extend a thank you to Carolyn my partner in crime who had to endure end‐ less hours without me while I was preparing this book. I also want to thank my twin daugh‐ ters Alexis and Denae who are busy with Medical and Law schools, respectively, and had to endure my lateness to many social engagements. Without everyone's patience, this book would not have been possible.

> **Dr. John Kassotis** Director of Clinical Cardiac Electrophysiology Section and Fellowship Program SUNY Downstate Medical Center New York, USA
