Brigham and Women's Hospital, Cardiovascular Research--William Stevenson, MD
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Cardiovascular Medicine

Pathophysiology and Therapy of Cardiac Arrhythmias

William G. Stevenson, MD and his colleagues have research interests in the pathophysiology and therapy of cardiac arrhythmias and sudden death. Studies of ventricular tachycardia focus on developing methods to characterize, locate, and ablate the arrhythmia source during catheter mapping in humans. Using computer simulations of reentry to explain findings in patients, methods have been developed  to identify reentry cicuit sites based on the responses to electrical stimulation. There is substantial heterogeneity in reentry circuit size and configuration. Preferential locations of reentry circuits have been identified in regions of chronic infarction. A multicenter trial of a novel RF ablation method that achieves larger and deeper lesions for ablation of reentry circuits in regions of infarction is in progress.

A variety of electrophysiologic, autonomic, and structural abnormalities may contribute to the high incidence of sudden death in patients with heart failure. In collaboration with Dr. Lynne W. Stevenson, risk factors for sudden death and approaches to arrhythmia management in heart failure patients are under investigation.


References:

Soejima K, Stevenson WG, Sapp JL, Selwyn AP, Couper G, Epstein LM. Endocardial and epicardial radiofrequency ablation of ventricular tachycardia associated with dilated cardiomyopathy. J Am Coll Cardiol 2004; 43: 1834-42.

Soejima K, Couper G, Cooper JM, Sapp JL, Epstein LM, Stevenson WG. Subxiphoid surgical approach for epicardial catheter-based mapping and ablation in patients with prior cardiac surgery or difficult pericardial access. Circulation. 2004; 110: 1197-201.

Stevenson WG, Stevenson LW. Atrial fibrillation and heart failure--five more years. N Engl J Med. 2004; 351: 2437-40.

Sacher F, Sobieszczyk P, Tedrow U, Eisenhauer AC, Field ME, Selwyn A, Raymond JM, Koplan B, Epstein LM, Stevenson WG. Transcoronary ethanol ventricular tachycardia ablation in the modern electrophysiology era. Heart Rhythm. 2008 Jan; 5(1): 62-68.

Zeppenfeld K, Schalij MJ, Bartelings MM, Tedrow UB, Koplan BA, Soejima K, Stevenson WG; Catheter ablation of ventricular tachycardia after repair of congenital heart disease: electroanatomic identification of the critical right ventricular isthmus. Circulation. 2007 Nov 13; 116(20): 2241-52.

Eckart RE, Hruczkowski TW, Tedrow UB, Koplan BA, Epstein LM, Stevenson WG. Sustained ventricular tachycardia associated with corrective valve surgery. Circulation. 2007 Oct 30; 116(18): 2005-11.

Stevenson WG, Soejima K. Catheter ablation for ventricular tachycardia. Circulation. 2007 May 29; 115(21): 2750-60.

Stevenson WG, Tedrow U. Management of atrial fibrillation in patients with heart failure. Heart Rhythm. 2007 Mar; 4(3 Suppl): S28-30.

Sapp JL, Cooper JM, Zei P, Stevenson WG. Large radiofrequency ablation lesions can be created with a retractable infusion-needle catheter. J Cardiovasc Electrophysiol. 2006 Jun; 17(6): 657-61.

Stevenson WG, Epstein LM. Endpoints for ablation of atrial fibrillation. Heart Rhythm. 2006; 3(2):146-147.