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Doody's Review ServiceReviewer: Martin C. Burke, DO (Loyola University Medical Center)
Description: This is an extensive overview of the current scientific and clinical database used to predict a person's probability of suffering a cardiac arrest. The flow of the book is excellent with a well-directed organization.
Purpose: The objective is to concisely evaluate the current state-of-the-art in the management of risk in sudden death. The editor has solicited an international panel of experts to describe by cardiac substrate the scientifically proven and theoretically supported basis of current clinical practice. These are worthy objectives and I believe that they are met.
Audience: The book is written for practitioners with a special interest in clinical cardiac electrophysiology. However, the layout and the content allows for selected chapters to be read out of order with no loss of information or understanding. Thus, this book may be used as a reference at any level of medical education — medical student to attending physician. This is a compilation of work and research by an international panel of experts in their respective fields of cardiovascular medicine, electrocardiology and electrophysiology.
Features: The authors have endeavored to concisely put forth in detail the past, current, and future state-of-the-art assessment and management in cardiac arrhythmic death. The editor has correctly organized this work by cardiac disease substrate due to the different responses of the various cardiac malconditions to stratification testing and sudden death itself. The book takes into account not only the clinical signs but also the basic science and in certain circumstances the molecular basis of etiology. The power of this book lies in its complete coverage of the subject matter using a succinct delivery. This enables readers to quickly get the information they need. The editor made a conscious decision to have some overlap in bibliographies in order to allow the reader to skip from chapter to chapter depending on their interest while still allowing for distinct references per cardiac substrate. He also includes a chapter on the development of future clinical trials in risk stratification. The detail of this chapter reviews a powered statistical setup of a proposed prospective trial specifically in risk stratification with a mortality endpoint. Its position early in the book is helpful as readers find themselves immersed in data and large prospective trials comparing treatments. The book covers all aspects of stratification testing and what the results mean in the many cardiac substrates ranging from ischemic cardiomyopathy, dilated cardiomyopathy, hypertrophic cardiomyopathy to the long QT syndrome, Brugada syndrome, primary arrhythmic disease and valvular heart disease. There are chapters that deal separately with many of these substrates and others that tie them together, such as the well written chapter on "Risk Assessment: The 12-lead Electrocardiogram." The book reverses from substrate to specific arrhythmia and looks at the substrate from reverse. I enjoy the two different perspectives on the same topic that this editorial setup offers.
Assessment: Readers with an advanced knowledge in some of the areas covered may find the read cursory and therefore find fault. The depth of coverage is purposeful and therefore acceptable. I want this book in my office library in order to quickly reference the many areas of risk that I am seeing daily as a consultant in clinical electrophysiology. It is easy to read and very informative. The editor has assembled world-class authorities on each topic and approaches the topic of risk stratification from a substrate and an arrhythmic end. The subject matter is up to date and very useful. It is an excellent addition to Josephson's Clinical Cardiac Electrophysiology: Techniques and Interpretation (Lippincott Williams & Wilkins, 2002) and Zipes' Cardiac Electrophysiology: From Cell to Bedside (W.B. Saunders, 2000). I recommend it as a well-balanced and informative book in the field.