Risk of Arrhythmia and Sudden Death

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Suden cardiac death is one of the major challenges of modern cardiac cardiology. This book explains the modern risk stratification procedures which are aimed at idenfitifcation of patients who are at increased risk of malignant arrhythmias and sudden cardiac death. In addition to the description of the individual procedures and stratification tests, the book proposes strategies of using these tests in different clinically defined groups of patients.
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Overview

Suden cardiac death is one of the major challenges of modern cardiac cardiology. This book explains the modern risk stratification procedures which are aimed at idenfitifcation of patients who are at increased risk of malignant arrhythmias and sudden cardiac death. In addition to the description of the individual procedures and stratification tests, the book proposes strategies of using these tests in different clinically defined groups of patients.
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Editorial Reviews

Doody's Review Service
Reviewer: 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.
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Product Details

  • ISBN-13: 9780727915818
  • Publisher: Wiley
  • Publication date: 12/28/2000
  • Edition number: 1
  • Pages: 432
  • Product dimensions: 8.80 (w) x 11.20 (h) x 1.20 (d)

Table of Contents

Preface.

Abbreviations.

Part I: Problem and Methodology.

1. Clinical Goals of Risk Stratification.

2. Definition of Arrhythmic Risk.

3. Statistical Methods for Risk-Stratification Studies.

4. Step-wise Risk-Stratification Strategies.

5. Risk-stratification Studies for Prospective Trial Design.

Part II: Techniques of Risk-Assessment.

6. Basic Clinical Assessment.

7. Left Ventricular Ejection Fraction and Wall Motion Score.

8. Risk Assessment: The 12 Lead Electrocardiogram.

9. Electrophysiological Study for Risk Stratification of Cardiac Patients.

10. QT Dispersion.

11. Electrocardiographic Assessment of Myocardial Ischaemia.

12. Exercise Electrocardiography for the Assessment of Arrhythmias.

13. Analysis of Monophasic Action Potentials.

14. Ventricular Signal Averaged Electrocardiography.

15. Signal Averaged P Wave.

16. Non-invasive Investigation of Wedensky Modulation.

17. Ambulatory Electrocardiography: Use in Arrhythmia Risk Assessment.

18. Even Loop Recorders and Implantable Monitors.

19. Basic Autonomic Tests.

20. Heart Rate Assessments and Monitoring.

21. Heart Rate Variability.

22. Baroflex Sensitivity.

23. Heart-Rate Turbulence.

24. T-wave Dynamicity.

25. Repolarisation Alternans.

26. Social and Psychosocial Influences on Sudden Cardiac Death, Ventricular Arrhythmia and Cardiac Autonomic Function.

Part III: Clinical Studies of Risk Assessment.

27. Risk Stratification after Myocardial Infarction.

28. Ventricular Arrhythmias in Chronic Heart Failure.

29. Ventricular Arrhythmias in Hypertrophic Cariomyopathy.

30. Ventricular Arrhythmias in Apparently Healthy Athletes.

31. Paroxysmal Atrial Fibrillation.

32. Persistent Atrial Fibrillation.

33. Permanent Atrial Fibrillation.

34. Arrhythmias Associated with the Long QT Syndrome.

35. Arrhythmia Associated with Other Cardiac Diseases.

36. Arrhythmias Associated with Non-Cardiac Disease.

Part IV: Antiarrhythmic Trials.

37. Anti-arrhythmic Device Trials.

38. Recent Antiarrhythmatic Drug Trials.

Index.

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