Since the first pacemaker implantation in October 1958 by Senning and Elmqvist in Sweden, cardiac pacing for bradycardia has become a well-established therapy. The impressive growth of clinical experience and the rapid development of pacemaker devices have greatly contributed to this situation. The electrical therapy appears to be so easy that insertion of the lead and its connection to the pacemaker generator requires little effort, skill or insight. However, after implantation a patient's condition seldom remains stable, which requires a flexible pacing program to cover all new cardiac events, and broad insight from clinician and technical colleagues. The Pacemaker Clinic of the 90's teaches anatomical and electrophysiological aspects of pacing, supports the prevention of complications, and points to new developments in the field. Apart from classical indications for cardiac pacing, the book discusses the validity of the latest indications, supporting the cardiologist and the associated professional in selecting the appropriate pacing mode and pacemaker follow-up in individual patients. The Pacemaker Clinic of the 90's will be a helpful companion for years to come.

Foreword. Preface. Section 1: Concepts and Clinics of Atrial Fibrillation. 1. From Experiment to Therapeutic Innovation in Atrial Fibrillation and Flutter. 2. Atrial Functional Anatomy. 3. The Pathology of Drug Resistant Lone Atrial Fibrillation in Eleven Surgically Treated Patients. 4. Termination of Atrial Fibrillation by Classic Antiarrhythmic Drugs, a Paradox? 5. Characteristics of Patients with Chronic Atrial Fibrillation and the Prediction of Successful DC Electrical Cardioversion. Section 2: Recent Advances in the Treatment of Paroxysmal Atrial Fibrillation and Flutter. 6. Pharmacological Cardioversion of Paroxysmal Atrial Fibrillation or Atrial Flutter to Sinus Rhythm. 7. Drugs after Cardioversion to Prevent Relapses of Chronic Atrial Fibrillation or Flutter. 8. Episodic Treatment of Paroxysmal Atrial Fibrillation. 9. An AICD for Atrial Fibrillation? 10. The 'Corridor' Operation as an Alternative in the Treatment of Atrial Fibrillation. Section 3: Why Aggressive Therapy in Atrial Fibrillation? 11. Tachycardiomyopathy in Patients with Supraventricular Tachycardia. 12. Sinus Rhythm, the Autonomic Nervous System, and Quality of Life. 13. Atrial Tachyarrhythmias following Coronary Bypass Surgery: Sympathetic Mechanisms. 14. Management of Paroxysmal Atrial Fibrillation and Atrial Flutter shortly after Coronary Artery Bypass Graft Surgery. 15. Risk and Prevention of Embolism in Atrial Fibrillation. 16. Value of Left Atrial Appendage Flow Velocitiesin Patients with Nonrheumatic Atrial Fibrillation and Systemic Embolism. 17. Management of Atrial Fibrillation: From Palliation to Intervention.Index.

Since the first pacemaker implantation in October 1958 by Senning and Elmqvist in Sweden, cardiac pacing for bradycardia has become a well-established therapy. The impressive growth of clinical experience and the rapid development of pacemaker devices have greatly contributed to this situation. The electrical therapy appears to be so easy that insertion of the lead and its connection to the pacemaker generator requires little effort, skill or insight. However, after implantation a patient's condition seldom remains stable, which requires a flexible pacing program to cover all new cardiac events, and broad insight from clinician and technical colleagues. The Pacemaker Clinic of the 90's teaches anatomical and electrophysiological aspects of pacing, supports the prevention of complications, and points to new developments in the field. Apart from classical indications for cardiac pacing, the book discusses the validity of the latest indications, supporting the cardiologist and the associated professional in selecting the appropriate pacing mode and pacemaker follow-up in individual patients. The Pacemaker Clinic of the 90's will be a helpful companion for years to come.

The attack of atrial fibrillation experienced by President Bush of the United States attracted more attention from the general public to atrial fibrillation than ever before. Also, there is a growing body of knowledge of the pathophysiologic mechanism, the pathology and epidemiology, and especially of the thrombo-embolic complications of this arrhythmia, which is responsible for a renewed interest of the clinician in this very common human arrhythmia. These new perspectives on atrial fibrillation were presented during a conference on Atrial Fibrillation, a Treatable Disease?', organized on May 7, 1992, in Amsterdam, the Netherlands. Atrial fibrillation is not the prerogative of the cardiologist only. Many practitioners from other areas in health care, in particular general physicians, internists and neurologists, are faced with this arrhythmia and its untoward consequences. This book bridges the gap between theory, experiment and the clinic. Emphasis is therefore on the selection of the optimal approach, including pharmacotherapy, catheter ablation, pacemaker and surgical therapy, based on the current scientific insights in the mechanism and prevention of atrial fibrillation.