During the past decade there have been enormous advances in the management of
patients with cardiac arrhythmias. Catheter ablation has become a first-line therapy for
a growing number of supraventricular tachyarrhythmias and idiopathic ventricular
tachycardia. Frequently performed on an outpatient basis, radiofrequency catheter
ablation actually cures the majority of patients with these disorders, restoring a normal
quality of life.
Implantable cardioverter defibrillators (ICDs) have progressed from a therapy of last
resort at the time of FDA approval in 1985, to the preferred therapy in the majority of
patients with life-threatening ventricular arrhythmias. ICD implantation, once a morbid
cardiothoracic surgical procedure, is now similar to pacemaker implantation. Advances
in pacemaker technology have restored normal physiology to many patients; current
trials focus on the utility of multisite atrial pacing to prevent atrial fibrillation and
biventricular pacing (cardiac resynchronization) in patients with advanced congestive
heart failure. For patients with syncope, new diagnostic approaches such as the implantable
loop recorder, as well as new therapies, offer improved outcomes.
New nonpharmacologic therapies have been developed for virtually every type of
cardiac arrhythmia. Previously the mainstay of therapy for arrhythmia patients, pharmacologic
therapies have assumed an adjunctive rather than primary role in many patients.
This paradigm shift, from pharmacologic to nonpharmacologic therapies, the proliferation
of the types of devices and procedures available, as well as the growing number of
patients who may benefit, require that cardiac electrophysiologists keep their colleagues
in general cardiology, cardiac surgery, and primary care updated. The purpose of this
fine text is to help inform these physicians and surgeons about recent advances in the
diagnosis and management of patients with cardiac arrhythmias, and to describe how
electrophysiologists can best assist in the care of their patients. Written by leaders in the
field of cardiac electrophysiology, and well edited by Leonard I. Ganz, Management of
Cardiac Arrhythmias provides lucid descriptions of diagnostic and therapeutic strategies
in patients with heart rhythm disturbances. Tables, figures, and treatment algorithms
are used extensively to make this book a practical clinical guide as well as an
excellent reference source. This book will prove to be of enormous value both to specialists
and generalists responsible for the care of patients with cardiac arrhythmias.