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Ambulatory Monitoring of the Cardiac Patient
Mayo Clin Proc, October 1988, Vol 63
tance of upper airway function in the cause of sudden infant death syndrome and sleep apnea, the book appropriately includes a chapter devoted exclusively to upper airway function in the new born. Surprisingly, however, none of the chapters addresses upper airway function during sleep, and the important functional considerations in the cause of sleep apnea are largely neglected. The book includes a chapter that explores the relationship of respiration to the production of sound. Apparently, the purpose of this chapter is to bridge considerations of the respiratory func tion of the upper airway and the study of phonation. The chapter is unavoidably incomplete be cause of the large amount of literature available on phonation. By presenting in one volume a definitive view of upper airway function, this book will be an invaluable resource for respiratory physiologists. In addition, it provides important background material for those in the clinical fields of otolaryngology and pulmonology. This book will no doubt be the major reference source in this area for some time to come and should prompt further investigation in the still underdeveloped area of respiratory function. Thomas V. McCaffrey, M.D. Department of Otorhinolaryngology Ambulatory Monitoring of the Cardiac Pa tient (Cardiovascular Clinics, Vol 18, No. 3), edited by Daniel David, Eric L. Michelson, and Leonard S. Dreifus, 218 pp, with illus, $50, Philadelphia, F. A. Davis Company, 1988 This 18th volume of the Cardiovascular Clinics series covers the use of ambulatory monitoring techniques in the diagnosis and treatment of com mon cardiovascular conditions, including myocardial ischemia, arrhythmias, hypertension, heart failure, and valvular disease. Contributing ex perts in the field discuss the application of both traditional and new approaches to many serious cardiovascular problems in the outpatient set ting. Cost-efficacy is addressed both from the standpoint of approximately a 50% savings over inpatient assessment and from the perspective of the specific patient population in which each technique would be most cost-effective. For ex ample, the usefulness of evaluating residual
BOOK REVIEWS
1063
ischemia in patients with myocardial infarction and arrhythmias with use of ambulatory electrocardiographic monitoring is addressed in detail. I found the in-depth discussion of technical con siderations in the accuracy of conventional am bulatory electrocardiographic monitors and the limitations and advantages of various ambula tory electrocardiographic monitoring systems for the detection of ST segment shift particularly interesting. The text also reviews transtelephonic electrocardiographic systems for monitoring myocardial ischemia, infarction, ventricular ar rhythmias, and cardiac pacemakers. Other topics of discussion include the use of the signalaveraged electrocardiogram in the detection of ventricular late potentials and the interpreta tion of their prognostic significance, the use of ambulatory blood pressure measurements and implications for the management of hyperten sion, echocardiographic assessment of ambula tory monitoring of valvular heart disease and radionuclide ventriculography, and ambulatory monitoring of patients with valvular heart disease. This book will be useful to physicians involved in the ambulatory care of patients with common cardiovascular problems. The authors thoroughly review the latest ambulatory techniques and their applications to well-defined patient groups. Each chapter is well referenced, the illustrations are of high quality, and a complete index is included. William T. Bardsley, M.D. Division of Cardiovascular Diseases and Internal Medicine Acute Coronary Intervention, edited by Eric J. Topol, 302 pp, with illus, $49.50, New York, Alan R. Liss, 1988 This text is a compilation of the current knowl edge on myocardial reperfusion therapy for evolv ing acute myocardial infarction. It is logically divided into four sections encompassing 17 chap ters and 302 pages. The first section of the text consists of an excellent review of all the currently available thrombolytic agents, including pharmacologic considerations, mechanisms of action, and a thorough review of the literature. The relative efficacy, advantages, complication rates, and benefits in terms of morbidity, mortality, and
tance of upper airway function in the cause of sudden infant death syndrome and sleep apnea, the book appropriately includes a chapter devoted exclusively to upper airway function in the new born. Surprisingly, however, none of the chapters addresses upper airway function during sleep, and the important functional considerations in the cause of sleep apnea are largely neglected. The book includes a chapter that explores the relationship of respiration to the production of sound. Apparently, the purpose of this chapter is to bridge considerations of the respiratory func tion of the upper airway and the study of phonation. The chapter is unavoidably incomplete be cause of the large amount of literature available on phonation. By presenting in one volume a definitive view of upper airway function, this book will be an invaluable resource for respiratory physiologists. In addition, it provides important background material for those in the clinical fields of otolaryngology and pulmonology. This book will no doubt be the major reference source in this area for some time to come and should prompt further investigation in the still underdeveloped area of respiratory function. Thomas V. McCaffrey, M.D. Department of Otorhinolaryngology Ambulatory Monitoring of the Cardiac Pa tient (Cardiovascular Clinics, Vol 18, No. 3), edited by Daniel David, Eric L. Michelson, and Leonard S. Dreifus, 218 pp, with illus, $50, Philadelphia, F. A. Davis Company, 1988 This 18th volume of the Cardiovascular Clinics series covers the use of ambulatory monitoring techniques in the diagnosis and treatment of com mon cardiovascular conditions, including myocardial ischemia, arrhythmias, hypertension, heart failure, and valvular disease. Contributing ex perts in the field discuss the application of both traditional and new approaches to many serious cardiovascular problems in the outpatient set ting. Cost-efficacy is addressed both from the standpoint of approximately a 50% savings over inpatient assessment and from the perspective of the specific patient population in which each technique would be most cost-effective. For ex ample, the usefulness of evaluating residual
BOOK REVIEWS
1063
ischemia in patients with myocardial infarction and arrhythmias with use of ambulatory electrocardiographic monitoring is addressed in detail. I found the in-depth discussion of technical con siderations in the accuracy of conventional am bulatory electrocardiographic monitors and the limitations and advantages of various ambula tory electrocardiographic monitoring systems for the detection of ST segment shift particularly interesting. The text also reviews transtelephonic electrocardiographic systems for monitoring myocardial ischemia, infarction, ventricular ar rhythmias, and cardiac pacemakers. Other topics of discussion include the use of the signalaveraged electrocardiogram in the detection of ventricular late potentials and the interpreta tion of their prognostic significance, the use of ambulatory blood pressure measurements and implications for the management of hyperten sion, echocardiographic assessment of ambula tory monitoring of valvular heart disease and radionuclide ventriculography, and ambulatory monitoring of patients with valvular heart disease. This book will be useful to physicians involved in the ambulatory care of patients with common cardiovascular problems. The authors thoroughly review the latest ambulatory techniques and their applications to well-defined patient groups. Each chapter is well referenced, the illustrations are of high quality, and a complete index is included. William T. Bardsley, M.D. Division of Cardiovascular Diseases and Internal Medicine Acute Coronary Intervention, edited by Eric J. Topol, 302 pp, with illus, $49.50, New York, Alan R. Liss, 1988 This text is a compilation of the current knowl edge on myocardial reperfusion therapy for evolv ing acute myocardial infarction. It is logically divided into four sections encompassing 17 chap ters and 302 pages. The first section of the text consists of an excellent review of all the currently available thrombolytic agents, including pharmacologic considerations, mechanisms of action, and a thorough review of the literature. The relative efficacy, advantages, complication rates, and benefits in terms of morbidity, mortality, and