Martin Borggrefe

Andrea Natale

Bruce L. Wilkoff

Antonio Pacifico

Philip D. Henry

Gust H. Bardy

Francis E. Marchlinski

Implantable defibrillators as originally conceived by Michel Mirowski were limited to the detection and automatic termination of ventricular fibrillation. In the original "AID" device, the detection algoritlun sought to distinguish sinus rhytlun from ventricular fibrillation by identifying the "more sinusoidal waveform of ventricular fibrillation. " The therapeutic intervention was elicited only once deadly polymorphic rhythms had developed. It was rapidly learned, however, that ventricular fibrillation is usually preceded by ventricular tachycardia. Mirowski recognized the pivotal importance of developing algoritllms based on heart rate. Ventricular tachycardia detection allowed the successful development of interventions for the termination of ventricular tachyarrhythmias before they degenerated into ventricular fibrillation. Current device therapy no longer confines itself to tlle termination of chaotic rhythms but seeks to prevent them. Diagnostic algorithms moved upward along the chain of events leading to catastrophic rhytlulls. Rate smoothing algorithms were developed to prevent postextrasystolic pauses from triggering ventricular and atrial tachyarrhytlmlias. Beyond the renaissance of ectopy-centered strategies, long-term prevention received increasing attention. Multisite pacing therapies provided by "Arrhythmia Management Devices" were designed to reduce the "arrhytlunia burden" and optimize the synergy of cardiac contraction and relaxation. Clinical evidence now suggests that atrial fibrillation prevention by pacing is feasible and tllat biventricular pacing may be of benefit in selected patients with heart failure. However, these applications of device therapy that generally require ventricular defibrillation backup remain investigational and were not considered in this book.

Implantable Defibrillator Therapy: A Clinical Guide

Mohammad Shenasa

Mark E. Josephson

Gerhard Hindricks

Gunter Breithardt

Cardiac Mapping is the cardiac electrophysiologist’s GPS. It will guide you to new places in the heart and help you find the old places more easily...a valuable addition to your bookshelf Douglas P. Zipes, from the Foreword. Over the course of three previous editions, this book has become the acknowledged gold standard reference on the electro-anatomical mapping of the heart. This new edition features greatly expanded coverage—the number of chapters have doubled to 80 with 40 new chapters—on leading edge science, new clinical applications and future frontiers, authored by a who’s-who of global electrophysiology. This unique text offers truly comprehensive coverage of all areas of cardiac mapping, from core scientific principals to methodological and technical considerations to the latest data that you can put to work caring for patients. In addition, the all new 4th edition adds essential content on: Mapping in experimental models of arrhythmias Mapping supraventricular and ventricular tachyarrhythmias New catheter-based techniques Also featuring a companion website with video clips illustrating essential techniques described in the text The only state-of-the-art, stand-alone text on this dynamic subject, Cardiac Mapping is an essential resource for basic scientists, clinical electrophysiologists, cardiologists and all physicians who care for patients with cardiac arrhythmias.

Cardiac Mapping

Ihor B. Gussak

John B. Kostis

Ibrahim Akin

Giovanni Campanile

Arshad Jahangir

Willam J Kostis

Gan-Xin Yan

Iatrogenesis is the occurrence of untoward effects resulting from actions of health care providers, including medical errors, medical malpractice, practicing beyond one’s expertise, adverse effects of medication, unnecessary treatment, inappropriate screenings, and surgical errors. This is a huge public health issue: tens to hundreds of thousands of deaths are attributed to iatrogenic causes each year in the U.S., and vulnerable populations such as the elderly and minorities are particularly susceptible. Edited by two renowned cardiology experts, Iatrogenicity: Causes and Consequences of Iatrogenesis in Cardiovascular Medicine addresses both the iatrogenicity that arises with cardiovascular interventions, as well as non-cardiovascular interventions that result in adverse consequences on the cardiovascular system. The book aims to achieve three things: to summarize the available information on this topic in a single high-yield volume; to highlight the human and financial cost of iatrogenesis; and to describe and propose potential interventions to ameliorate the effects of iatrogenesis. This accessible book is a practical reference for any practicing physician who sees patients with cardiovascular issues. .

Causes and Consequences of Iatrogenesis in Cardiovascular Medicine

Iatrogenicity

Günter Breithardt

John A. Camm

The past 10 years have seen a remarkable change in the approach to cardiac arrhythmias, from a position of confidence and a feeling of well-being about pharmacological treatment to a situation in which there is now marked uncertainty and general apprehension about the role of antiarrhythmic drugs. Until relatively recently the prevailing concept in antiarrhythmic therapy was that arrhythmias could be controlled by drugs which slowed conduction or suppressed automaticity, goals well served by the sodium channel-blocking drugs and glycosides. Drug re search was based largely on the development of agents mimicking those already available, but with greater efficacy, fewer side effects or a more favourable phar macokinetic profile. The CAST trial stands out as a landmark in the evolution of arrhytmia manage ment; rarely has a single trial had such a profound impact not only on clinical prac tice, but also on the whole approach of those involved in the research, development and regulation of antiarrhythmic drugs. The results of the CAST trial, designed to redress the shortcomings of earlier trials which had failed to demonstrate the anticipated improvement in mortality post-myocardial infarction with the use of class I agents, are well known. The CAST and CAST II showed an increase in mor tality associated with the active agent (encainide, flecainide or morizicine) com pared to placebo treatment. They firmly established the potential danger in the use of class I drugs.

Mechanisms of Antiarrhythmic and Proarrhythmic Actions

Antiarrhythmic Drugs

Martin Borggrefe

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