Mechanisms of Arrhythmias [antikvár]

Foreword When all is said and done, cardiac tachyarrhythmias account for considerable distress and untimely death. The arrhythmias may only be a consequence of a more serious underlying pathology but, irrespective of its pathophysiology, an arrhythmia may pose a serious risk or a difficult medical problem. Tachyarrhythmias must therefore be diagnosed and treated with great care and expertise. For too long the cardiologist and the arrhythmolo-gist/electrophysiologist have guarded their professional skills as secrets. In the past, the physician used the electrocardiogram and the electrophysiological study to establish accurate diagnoses, but the therapeutic consequences of these erudite diagnoses were negligible until the advent of electrophysiological surgery. Now the introduction of techniques of catheter ablation have catapulted cardiac electrophysiology into the medical headlines. The mechanism of a cardiac arrhythmia is fundamentally important if therapy can be directed specifically toward that mechanism. Without knowledge of the target, the therapy cannot be aimed in the right direction. Some of our more successful therapies are "blunderbuss" treatments, such as amiodarone and the implantable cardioverter defibrillator. Irrespective of the cause of the arrhythmia, one of the many actions of amiodarone may well solve or suppress the problem.