In the rapidly evolving field of treating cardiac arrhythmias, the importance of direct management of patients with implantable cardiac devices is growing. The devices have become increasingly complex, and understanding their algorithms and growing programming options is essential for physicians who implant and manage them. Written by experts and world authorities in the field, Pacemakers and Implantable Cardioverter Defibrillators: An Expert's Manual provides electrophysiologists, fellows in training, nurses, and cardiovascular technicians involved in day-to-day management of device patients with detailed information about the many device algorithms and interactions. *Heavily illustrated with over 300 figures and tables *Uniquely meets the day-to-day needs of all direct management professionals *Focuses in detail on algorithms *Describes device interactions, addressing every major manufacturer *Provides in-depth insight into pacing, including biventricular pacing *Discusses arrhythmia detection and device classification, testing, and therapy

Cardiology to Impress is the ultimate guidebook for medical students preparing for the clinical experience. It is written in collaboration with top teaching consultants and newly qualified doctors who are familiar with the pitfalls of clinical attachments, and understand the fears and apprehensions when students are thrown into difficult exams and the hospital setting. This pocket-size handbook specifically outlines what medical students are to expect, and what is expected of them in clinics, theatres and in exam settings. It teaches how to be competent in front of senior doctors and provides useful tips on how to answer questions on ward rounds. This book does not mindlessly regurgitate facts, rather it tailors the facts to the clinical setting, thus bridging the gap between textbook knowledge and clinical practice in a way that enables the student to understand, and appreciate the clinical relevance of medical knowledge.

Adopting a multidisciplinary approach with input from physicists, researchers and medical professionals, this is the first book to introduce many different technical approaches for the visualization of microcirculation, including laser Doppler and laser speckle, optical coherence tomography and photo-acoustic tomography. It covers everything from basic research to medical applications, providing the technical details while also outlining the respective strengths and weaknesses of each imaging technique.
Edited by an international team of top experts, this is the ultimate handbook for every clinician and researcher relying on microcirculation imaging.

This book provides comprehensive reviews on our most recent understanding of the molecular and cellular mechanisms underlying atherosclerosis and calcific aortic valve disease (CAVD) as visualized in animal models and patients using optical molecular imaging, PET-CT, ultrasound and MRI. In addition to presenting up-to-date information on the multimodality imaging of specific pro-inflammatory or pro-calcification pathways in atherosclerosis and CAVD, the book addresses the intriguing issue of whether cardiovascular calcification is an inflammatory disease, as has been recently supported by several preclinical and clinical imaging studies. In order to familiarize researchers and clinicians from other specialties with the basic mechanisms involved, chapters on the fundamental pathobiology of atherosclerosis and CAVD are also included. The imaging chapters, written by some of the foremost investigators in the field, are so organized as to reveal the nature of the involved mechanisms as disease progresses.

The Poincare plot (named after Henri Poincare) is a popular two-dimensional visualization tool for dynamic systems due to its intuitive display of the dynamic properties of a system from a time series. This book presents the basis of Poincare plot and focus especially on traditional and new methods for analysing the geometry, temporal and spatial dynamics disclosed by the Poincare plot to evaluate heart rate variability (HRV). Mathematical descriptors of Poincare plot have been developed to quantify the autonomic nervous system activity (sympathetic and parasympathetic modulation of heart rate). Poincare plot analysis has also been used in various clinical diagnostic settings like diabetes, chronic heart failure, chronic renal failure and sleep apnea syndrome. The primary aims of quantification of the Poincare plots are to discriminate healthy physiological systems from pathological conditions and to classify the stage of a disease. The HRV analysis by Poincare plot has opened up ample opportunities for important clinical and research applications. Therefore, the present book can be used either for self-study, as a supplement to courses in linear and nonlinear systems, or as a modern monograph by researchers in this field of HRV analysis.

This atlas is a comprehensive compendium of congeni and two-dimensional echocardiographic examples. The tal cardiac morphology as depicted by tomographic two examples and experience span all ages and may be used dimensional echocardiography. Anatomic specimens by both pediatric and adult cardiologists. The intended cut in planes of section corresponding to the echocar emphasis is on tomographic morphology and not on diographic views help in the understanding of the echo specialty applications such as fetal, contrast, or Dop cardiographic sections. Composite photographs relate pler echocardiography. different planes of section or cardiac events. Still-frame The tomographic approach to congenital anomalies is photography cannot always adequately relate real-time the imaging modality of the 80s and is applicable to echocardiography, computerized tomography, and imaging events. However, the emphasis of this text is to demonstrate the tomographic morphology and no at magnetic resonance imaging. It is the building block tempt is made to discuss in detail functional or physio from which the expected three-dimensional imaging logic events. techniques of the 1990s will be developed. The wide spread clinical application of these imaging modalities Those performing two-dimensional echocardiography should have a working knowledge of cardiac anatomy has rekindled interest in cardiac anatomy and pathol and common congenital aberrations. This is an in-depth ogy, particularly in the evaluation of patients with con tomographic atlas not only of the common congenital genital heart disease."

Heart failure affects over 5 million patients in the United States alone, and is a chronic and debilitating disease. While a number of pharmacologic therapies have shown varying degrees of effectiveness, many recent advances in the treatment of heart failure has focused on device based therapies. In Device Therapy in Heart Failure, William H. Maisel and a panel of authorities on the use and implementation of device based therapies provide a comprehensive overview of the current and developing technologies that are used to treat heart failure. Individual chapters provide an in-depth analysis of devices such as CRT's and ICD's, while broader topics such as the pathophysiology of heart failure and its current medical therapies are also discussed. Additional topics include Pacing and Defibrillation for Atrial Arrhythmias, Atrial Fibrillation Ablation, and Percutaneous Treatment of Coronary Artery Disease.

Peter Hunter Computational physiology for the cardiovascular system is entering a new and exciting phase of clinical application. Biophysically based models of the human heart and circulation, based on patient-specific anatomy but also informed by po- lation atlases and incorporating a great deal of mechanistic understanding at the cell, tissue, and organ levels, offer the prospect of evidence-based diagnosis and treatment of cardiovascular disease. The clinical value of patient-specific modeling is well illustrated in application areas where model-based interpretation of clinical images allows a more precise analysis of disease processes than can otherwise be achieved. For example, Chap. 6 in this volume, by Speelman et al. , deals with the very difficult problem of trying to predict whether and when an abdominal aortic aneurysm might burst. This requires automated segmentation of the vascular geometry from magnetic re- nance images and finite element analysis of wall stress using large deformation elasticity theory applied to the geometric model created from the segmentation. The time-varying normal and shear stress acting on the arterial wall is estimated from the arterial pressure and flow distributions. Thrombus formation is identified as a potentially important contributor to changed material properties of the arterial wall. Understanding how the wall adapts and remodels its material properties in the face of changes in both the stress loading and blood constituents associated with infl- matory processes (IL6, CRP, MMPs, etc.

There are growing questions regarding the safety, quality, risk management, and costs of PCC teams, their training and preparedness, and their implications on the welfare of patients and families. This innovative book, authored by an international authorship, will highlight the best practices in improving survival while paving a roadmap for the expected changes in the next 10 years as healthcare undergoes major transformation and reform. An invited group of experts in the field will participate in this project to provide the timeliest and informative approaches to how to deal with this global health challenge. The book will be indispensable to all who treat pediatric cardiac disease and will provide important information about managing the risk of patients with pediatric and congenital cardiac disease in the three domains of: the analysis of outcomes, the improvement of quality, and the safety of patients.

The book is divided in 4 parts. In the first one, the importance of the analysis of the cardiac dynamics using the ambulatory monitoring technique is presented. The second part contains the description of foundations of impedance cardiography (ICG), the models used to describe the ICG technique and the description of available systems for ambulatory monitoring of cardiac hemodynamics. The third part is devoted to the validation of the ambulatory ICG method, the verification of the quality of long term ICG recordings and the discussion of the limitations of this technique. In the last part, some clinical and research applications of the ICG ambulatory monitoring are presented. The simultaneous recordings of electrocardiogram (ECG) and ICG in the transient cardiac arrhythmia events illustrate the potential applications of that method for quantitative analysis of hemodynamics when the implementation of the stationary methods would be either difficult or not possible to do. The book is followed by references, alphabetical index and appendices containing the technical data of the available systems for portable monitoring of cardiac hemodynamics.

Together, the volumes in this series present all of the data needed at various length scales for a multidisciplinary approach to modeling and simulation of flows in the cardiovascular and ventilatory systems, especially multiscale modeling and coupled simulations. The cardiovascular and respiratory systems are tightly coupled, as their primary function is to supply oxygen to and remove carbon dioxide from the body's cells. Because physiological conduits have deformable and reactive walls, macroscopic flow behavior and prediction must be coupled to nano- and microscopic events in a corrector scheme of regulated mechanism. Therefore, investigation of flows of blood and air in anatomical conduits requires an understanding of the biology, chemistry, and physics of these systems together with the mathematical tools to describe their functioning in quantitative terms. The present volume focuses on macroscopic aspects of the cardiovascular and respiratory systems in pathological conditions, i.e., diseases of the cardiac pump, blood vessels, and airways, as well as their treatments. Only diseases that have a mechanical origin or are associated with mechanical disorders are covered. Local flow disturbances can trigger pathophysiological processes or, conversely, result from diseases of conduit walls or their environment. The ability to model these phenomena is essential to the development and manufacturing of medical devices, which incorporate a stage of numerical tests in addition to experimental procedures.

The past 50 years have witnessed a breathtaking evolution in the approaches to the patient with an acute ST elevation myocardial infarction. In the 1960s, the now commonplace cardiac intensive care unit was but a nascent idea. Without much to offer the patient but weeks of absolute bedrest, substantial morbidity and high rates of mortality were the norm. Just 30 years ago, seminal discoveries by DeWood and colleagues suggested that the culprit was plaque rupture with thrombosis, not progressive luminal compromise. Subsequent fibrinolyt- based strategies resulted in a halving of the mortality of acute myocardial infarction. With the introduction of balloon angioplasty in the late 1970s, a few interventional cardiologists braved the question: why not perform emergency angioplasty as a primary reperfusion strategy? Indeed, reports of successful reperfusion via balloon angioplasty appeared (mostly in local newspapers) as early as 1980. Despite being thought of as heretical by mainstream cardiology, these pioneers nonetheless persevered, proving the benefit of ''state-of-the-art'' balloon angioplasty compared with ''state-of-t- art'' thrombolytic therapy in a series of landmark trials published in the New England Journal of Medicine in March of 1993. Publication of the first edition of Primary Angioplasty in Acute Myocardial Infarction in 2002 to some extent anticipated the widespread acceptance of primary percutaneous coronary intervention as the standard of care. Since then, in all respects, the evolution of emergency percutaneous revascularization has only accelerated. The universal replacement of balloon angioplasty with stent implantation was clearly one key.

This book presents a collection of expert reviews on different subcellular compartments of the cardiomyocyte, addressing fundamental questions such as how these compartments are assembled during development, how they are changed in and by disease and which signaling pathways have been implicated in these processes so far. As such, it offers the first overview of the cell biology of heart disease of its kind, addressing the needs of cell biology students specializing in vascular and cardiac biology, as well as those of cardiologists and researchers in the field of cell biology.

1. The controlled clinical trial - a model for the intricate relationships between clinical medicine and drug research.- 1.1. Introduction.- 1.2. The evolution of the controlled clinical trial (CCT).- 1.3 The implementation of the controlled clinical trial in drug research.- 1.4. Criticism of the classical view of the controlled clinical trial.- 1.5. Conclusions.- 2. The architecture of drug discovery.- 2.1. Introduction.- 1. The discovery process.- 2.2. Current views of drug discovery.- 2.2.1. Basic concepts in drug discovery.- 2.2.2. Basic epistemologies in drug discovery.- 2.3. Scientific discovery from the viewpoint of cognitive science.- 2.4. The drug discovery process revisited.- 2. The representation of knowledge about drugs and diseases.- 2.5. An epistemological analysis of the concept of drug and disease profiles.- 2.5.1. Introduction.- 2.5.2. The concept of drug profile.- 2.5.2.1..The classification of drugs.- 2.5.2.2. Incursion of drug profiles into disease profiles.- 2.5.2.3. The nature of drug characteristics.- 2.5.3. The concept of disease profile.- 2.5.3.1. Disease profiles as pigeon holes of medical knowledge.- 2.5.3.2. The fundamental basis of taxonomy in medicine.- 2.5.3.3. Convergent and divergent forces in clinical taxonomy.- 2.5.3.4. The translation of everyday medical language into the structure of profiles.- 2.5.4. Conclusions.- 3. A set-theoretical model of drug discovery.- 2.6. A definition of the concept of profile in terms of set theory.- 2.6.1. Introduction.- 2.6.2. The first aspect of a profile: membership.- 2.6.3. The second aspect of the concept of profile: values of the disease characteristics.- 2.6.4. The third aspect of the concept of profile: ranking order of characteristics.- 2.6.5. Conclusions.- 2.7. The drug discovery process - a set-theoretical model.- 2.7.1. Introduction.- 2.7.2. A naive definition.- 2.7.3. First adjustment of the naive defenition: structural and functional characteristics of drugs.- 2.7.4. Second adjustment of the naive defenition: disease characteristics.- 2.7.5. The improvement of toxic effects of drugs: positive and negative aspects and their judgment.- 2.7.6. Conclusions.- 3.Experimental and therapeutic profiling in drug innovation: the early history of the beta blockers.- 3.1. Introduction.- 3.2. Historical overview of the development of the beta blockers.- 3.3. From Dale to Ahlquist: a new methodology in pharmacology.- 3.4. Change in the concepts of agonist and antagonist.- 3.5. Experimental and therapeutic profiling in drug innovation.- 3.5.1. Cardiac arrhythmias.- 3.5.2. Angina pectoris.- 3.6. Conclusions.- 4. Industrial research and beta blockade.- 4.1. Introduction.- 4.2. Beta blocker research at Imperial Chemical Industries (ICI).- 4.2.1. The early phase.- 4.2.2. The birth of pronethalol.- 4.2.3. The demise of pronethalol.- 4.2.4. The development of propranolol.- 4.2.4.1. A "clean" drug.- 4.2.4.2. The rapid expansion of a successful drug.- 4.2.4.3. Endangered drug.- 4.2.5. The development of practolol.- 4.2.5.1. Practolol: a tool in industrial research.- 4.2.5.2. Selectivity in industrial and academic research.- 4.2.5.3. The therapeutic interest.- 4.3. The beta blocker project of Eli Lilly & Co..- 4.4. The beta blocker project of Mead Johnson.- 4.5. The beta blocker project of AB Hassle.- 4.5.1. The early phase.- 4.5.2. Intrinsic sympathomimetic activity of alprenolol.- 4.5.3. The profiling of alprenolol.- 4.5.4. Selective beta blockade.- 4.6. The beta blocker project at CIBA.- 4.7. Conclusions.- 5. Verapamil: dying drug or sleeping beauty?.- 5.1 Introduction.- 5.2 The early history of verapamil.- 5.3 Verapamil: a coronary vasodilator?.- 5.4 Verapamil: a beta blocker?.- 5.5. Verapamil: a calcium antagonist! - The elucidation of verapamil's mechanism of action by Fleckenstein.- 5.6. Citation analysis of the concept of calcium antagonism elaborated by Fleckenstein.- 5.7. The application of the theory of drug and disease profiles.- 5.7.1. Changing views on the

Interstitial lung disease (ILD) is a broad category of lung diseases that includes more than 150 disorders characterized by scarring or fibrosis of the lungs. In Pulmonary Arterial Hypertension and Interstitial Lung Disease: A Clinical Guide, renowned experts provide a state-of-the-art overview of the problems seen by physicians in the clinical management of ILDs. Divided into two sections, the first part provides and update on general issues and introduces both interstitial lung disease and associated pulmonary hypertension. A detailed analysis of the pathology of the various interstitial lung diseases is also provided. The second part addresses specific categories of disease. Bronchiolitis, hypersensitivity pneumonitis, and other conditions are covered, and the use of inspiratory and expiratory high resolution CT scan is discussed as well. This important new text is an invaluable resource for the practicing physician who must be aware of the broad and troubling manifestations of interstitial lung disease.

In recent years there have been major advances in the fields of cardiovascular nuclear medicine and cardiac magnetic resonance imaging. In nuclear cardiology more adequate tomographic systems have been designed for routine cardiac use, as well as new or improved quatitative analytic software packages both for planar and tomographic studies implemented on modern state-of-the-art workstations. In addition, artificial intelligence techniques are being applied to these images in attempts to interpret the nuclear studies in a more objective and reproductive manner. Various new radiotracers have been developed, such as antimyosin, labelled isonitriles, metabolic compounds, etcetera. Furthermore, alternative stress testing with dipyridamole and dobutamine has received much attention in clinical cardiac practice. Magnetic resonance imaging is a relative newcomer in cardiology and has already shown its merits, not only for anatomical information but increasingly for the functional aspects of cardiac performance.

In the last 35 years, declining deaths from heart disease have translated into 13 million lives saved and extended. Medical treatments and lifestyle changes have dealt successfully with the serious heart problems of Vice President Richard Cheney, talk show host David Letterman, Disney-ABC CEO Michael Eisner, and countless other less famous people. In the past, those with serious heart disease would have died young, but today can live long and active lives. Few families have not benefited from improvements in the way we treat and prevent heart problems, yet we often hear that poor lifestyles and the limitations of modern medicine threaten our health and well-being. Although room for improvement always remains, this book provides evidence to the contrary: we have made and continue to make tremendous progress in dealing with heart disease. In reviewing the progress being made in this crucially important area of health, Pampel and Pauley offer an optimistic view of the potential for continued improvement and for longer, healthier lives. Despite the prevalence of heart disease, deaths from this cause have declined greatly in past decades. From its peak in 1968, the heart disease mortality rate has fallen by 52% for men and 48% for women. That translates into over 13 million lives saved and extended. The lives saved are not limited to the very old. To the contrary, heart disease mortality has fallen faster among the young and middle aged.

This book synthesizes the major research advances in molecular, biochemical and translational aspects of aging and heart failure over the last four decades and addresses future directions in management and drug discovery. It presents clinical issues and molecular mechanisms related to heart failure, including the changing demographics in the aging population with heart failure; hypertension and prevention of diastolic heart failure in the aging population; polypharmacy and adverse drug reactions in the aging population with heart failure; changes in the heart that accompany advancing age from humans to molecules; aging-associated alterations in myocardial inflammation and fibrosis and aging-related changes in mitochondrial function and implications for heart failure therapy. The book succinctly summarizes the large volume of data on these key topics and highlights novel pathways that need to be explored. Featuring contributions from leading clinician-scientists, Aging and Heart Failure: Mechanisms and Management is an authoritative resource on the major clinical issues in heart failure therapy in the elderly for cardiologists, gerontologists and internists.

This book analyzes the internal and external causes of acquired and familiar venous thrombosis and proposes the origins and onset of venous thrombus diseases and their triggering factors. It discusses venous and arterial thrombus in two parts, each starting from the genomics and the findings of immunocytological research conducted in a variety of clinical groups and on different experimental models and revealing the mechanisms behind the development of thrombotic diseases and the pathogenesis processes. Further, the book describes the clinical manifestation and the nature of the diseases. The book offers valuable insights important in the prevention and treatment of thrombotic disease.

This comprehensive reference textbook examines in detail physiological and pathophysiological aspects of the cardiovascular system and cardiovascular disease in the sporting population. In the first part of the book, the non-invasive and invasive diagnostic techniques employed in cardiology are systematically reviewed, with explanation of their indications and clinical utility. The second, more extensive part is devoted to clinical cardiology and covers the great majority of cardiological problems encountered among athletes and other sportsmen and -women. Syncope, cardiac arrhythmias, and sudden cardiac death are extensively addressed, and guidance is provided on sports practice for individuals with different forms of heart disease. Cardiologic rehabilitation is discussed, and attention is also paid to the legal implications of diagnosed or unsuspected cardiovascular diseases for sportspeople. Sports Cardiology will be an invaluable resource for trainee and experienced health care professionals, including in particular cardiologists and sports medicine physicians. It will provide the knowledge required in order to make critical decisions regarding eligibility, thereby preventing tragic events and especially sudden death -- the most devastating occurrence in sport.

Angiogenesis is a multi-stage process that drives the generation of new blood and lymphatic vessels from pre-existing ones. It is highly active during embryogenesis, largely inactive during adulthood but reactivated during wound healing and under a number of pathological conditions including cancer and ocular diseases. In addition to endothelial cells, which line the walls of the vessels, several other cell types (pericytes, macrophages, progenitor cells ) also contribute to angiogenesis. A number of signaling pathways are activated and very finely tune the delicate morphogenetic events that ultimately lead to the formation of stable blood proof neovessels.

This book reviews recent advances in our understanding of the molecular and cellular mechanisms of angiogenesis, with a focus on how to integrate these observations into the context of developmental, post-natal and pathological neovascularization.

The book was published under the auspices of the French Angiogenesis Society. Most contributors are prominent members of this Society or international researchers who have actively contributed to the Annual Meetings of the Society."

The present book reveals the importance of preventive medicine in cardiology and public health, addressing the lack of a broad discussion of this topic in the current literature. It examines the most important risk factors for different cardiovascular diseases, discussing them in detail from a clinical standpoint and presenting important information from a preventive medicine perspective. Further, specific chapters discuss the burden of cardiologic risk factors in special contexts, such as in women, child and adolescents, and in low-income populations. Lastly, a number of conditions that are often overlooked in terms of their cardiological impact are discussed, such as Chagas disease, rheumatic cardiomyopathy and post-traumatic stress disorder. Cardiovascular diseases are still the major cause of death in the world, even though they are considered preventable clinical conditions. The increased prevalence of some risk factors for cardiovascular diseases is an important concern for cardiologists around the world. On the other hand, primary prevention programs have proven their efficacy concerning some known and treatable risk factors, such as with hypercholesterolemia, hypertension, diabetes and smoking, but still need to be made more of a priority in public health. Prevention of Cardiovascular Diseases is a book intended for multi-disciplinary audience and aimed for all professionals who are willing to face the challenge of cardiovascular prevention

This book focuses on how ventricular assist devices (VADs) can help provide destination therapy for patients with terminal heart failure, one of the most serious diseases in the world today because of the tremendous number of patients, the high mortality rate, and the cost of care. One means of providing cardiological support for patients suffering from heart failure is with VADs, and more than 10,000 patients worldwide have now been implanted with these devices. Half of them already have lived more than one year, and 2,000 patients more than two years, after surgery. This improved survival means that we have reached a point where VADs can be used for destination therapy, not just for bridge-to-recovery or bridge-to-transplant. In view of the increasing number of patients with advanced-stage heart failure and the availability and longevity of transplanted hearts, VADs can solve many problems. In addition to providing information about the devices themselves, this book includes vital guidelines on long-term management and support of VAD-implanted patients' everyday lives.

The second edition of this work continues to address the intimate pathophysiologic relationship between hypertension and stroke. The editors and authors clearly and concisely synthesize our developing knowledge of this relationship and place epidemiologic and physiologic information into a practical clinical context. Comprehensive chapters present the evidence supporting strategies for stroke prevention and care, including blood pressure lowering therapies, anti-coagulation, and management of other cerebrovascular risk factors. In addition to prescriptive measures for first stroke prevention, the book illuminates current regimens for care immediately after acute stroke and for the prevention of recurrent stroke. This latest edition also features extensively updated chapters from the previous edition, as well as new chapters on the effects of hypertension and stroke on the cerebral vasculature, blood pressure management in subarachnoid hemorrhage, and blood pressure variability, antihypertensive therapy, and stroke risk. Written by experts in the field, Hypertension and Stroke: Pathophysiology and Management, Second Edition is of great utility for specialists in neurology and cardiovascular medicine and a valuable practical resource for all physicians caring for older adults and hypertensive patients.