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...

In the 1940s I was struck by reports about many apparently healthy middle-aged men who dropped dead instantly from heart attacks. The causes of these sudden deaths were unknown. I was interested to discover physio-chemical characteristics of individuals with predictive value for the occurrence of these fatal heart attacks. The discovery ofpreventive variables would point ways to prevent this disease. In order to find relationships between mode of life and susceptibility to heart disease contrasting populations had to be studied. Variety - not a high degree of homogeneity in culture and habits...

Mechanisms of Heart Failure is based on papers selected from poster presentations made at the International Conference on Heart Failure, Winnipeg, May 20-23, 1994. Although the entire book is one continuous discussion of subcellular mechanisms of heart failure and its treatment, the presentation has been divided into three sections: the opening section on the subcellular basis of heart failure includes discussions of cytokines, signal transduction, metabolism, extracellular matrix, organ level changes and newer approaches to understanding the pathogenesis of heart failure. The second...

Ischemic Preconditioning: The Concept of Endogenous Cardioprotection consolidates, in one volume, both current knowledge and the most recent advances in ischemic preconditioning. The editors have invited investigators at the forefront of ongoing research to provide their scholarly and candid comments concerning each of these issues. This volume includes a comprehensive review of infarct size reduction with ischemic preconditioning, and the most recent data on the effects of preconditioning on ischemia and reperfusion-induced arrhythmias, myocardial metabolism, contractile function,...

Coronary heart disease remains the leading cause of death for men and women in the United States and other industrialized nations. Acute myocardial infarction accounts for a majority of these deaths, approaching 750,000 yearly.
Thrombolytic therapy has revolutionized the treatment of myocardial infarction, saving lives to a greater extent than any treatment developed to date. The identification of patients best suited for thrombolytic therapy has been a challenging task, as has the ideal adjuvant strategy. Further, the noninvasic diagnosis of treatment successes and failures, as well as...

Although there are many books on angina, few are devoted to the important problem of how to evaluate drug efficacy in angina pectoris. Drug Evaluation in Angina Pectoris has two fundamental aims: the first is to review the methodological aspects of drug evaluation in stable and unstable angina pectoris; the second is to provide a logical and methodological background for future studies aimed at assessing the ability of medical treatment to improve prognosis.
Part I updates the pathophysiology, clinical presentation and prognosis of angina pectoris. Part II aims to put in...

In an attempt to clarify the situation regarding the diagnosis, pathogenesis and therapeutics of cardiovascular dysfunction in diabetes, an International Symposium on Diabetic Heart was held in Tokyo, Japan during October, 1989. Thirty-two selected articles from the poster presentations, compiled in this book, have been grouped in four sections, namely (a) Evaluation of Cardiovascular Problems, (b) Interactions of Diabetes and Hypertension, (c) Pathophysiological Aspects of Cardiovascular Dysfunction in Diabetes, and (d) Pharmacological and Therapeutic Aspects of Diabetic Heart. It is hoped...

The cardiac system represents one of the most exciting challenges to human ingenuity. Critical to our survival, it consists of a tantalizing array of interacting phenomena, from ionic microscopic transport, membrane channels and receptors through cellular metabolism, energy production to fiber mechanics, microcirculation, electrical activation to the global, clinically observed, function, which is measured by pressure, volume, coronary flow, heart rate, shape changes and responds to imposed loads and pharmaceutical challenges. It is a complex interdisciplinary system requiring the joint...

Accurate diagnosis of arrhythmias is the goal of this volume. Before the clinician can accurately classify the multiple permutations of cardiac rhythm encountered in daily practice, several essential preconditions must be met. At the most basic level, the clinician must know the diagnostic criteria for each rhythm. Without a clear understanding of these criteria, an accurate differential diagnosis is impossible, and without accurate diagnosis, correct intervention is a mere matter of chance.
A second precondition of accurate rhythm diagnosis is an understanding of the mechanism of...