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The Third Decade of Cardiac Pacing: Advances in Technology and Clinical Appucations
A PHYSICAL AND PHYSIOLOGICAL BASIS FOR THE INTERPRETATION OF CARDIAC AUSCUlXATION: EVALUATIONS BASED PRIMARILY ON THE SECOND SOUND AND EJECTION MURMURS. By PAUL D. STEIN. Mt. Kisco. NY: Futura Publishing. 1981.288 pp, $37.50
THE THIRD DECADE OF CARDIAC PACING: ADVANCES IN TECHNOLOGYAND CLINICAL APPLICATIONS. By S. SERCE BAROLD and JACQUES MUCICA. Mt. Kisco. NY: Futura Publishing Co.• 1982. 495 pp, $43.00 The primary thrust in clinicalcardiologyover the lastfewdecadeshas been directed towards hemodynamic control. achievedeither pharmacologicallyor through surgical interventions. In recent yean there has been an exciting resurgence c1interest in applied electrophysiology. Abetter undentanding of the baic principles of cardiac electricity. imaginative investigational techniques in catheterization laboratories. and the advent ofmodem technologyin designing pulse generaton of extraordinary potential have added an exciting dimension to the thenpy of life-threatening anbythmias. Pacemaken are no longer simple stimulation devices designed to increase ventricular rates in patients with bradyalThythmlas. This is a very timely book which will make physicians awareof the complexitiesinvolvedin modem pacemakingtechnology. Cardiologists can ill aftOrd to neglect this relatively under-emphastsed Beld, where versatile advances can potentially save lives and relieve symptoms. Complex lie-threatening anbythmias often demand application of specialized knowledge for adequate control. Like most other InterYeDtions. they are alsoprone to serious complicationsifapplied cavalierly. The potential application of sophisticated pacemaken is no exception to this rule. Applied wisely.it will deliver medical relief: but inappropriate use may render severe damage. 1bis book is written to educate physicians not only about available units. but also to familiarizethem with the industry as a whole. The biomedical engineering involvedin this realm has been vastlyenhanced by microprocessor technology. Simultaneously clinicians have been more exacting in their demands to devise anti-tachycardia pacemaken. implantable deBbrillaton and implantable Holten. I would strongly recommend thisbook to interested readers whoconsider it important to have a basic understanding of the state of the art in plCemaldng today. I Bnd it difBcult to dwell on any outstanding negative criticisms. If anything, perhaps one may comment that the Beld is quite vast in its total scope. and the emphasis here is on what Is new and intriguing. Thus. perhaps the more mundane problems related to eDIting commercially available pacemalcen have not received enough attention. Nuclear powered units are also being designed and may have been ofinterest to the readen. However,the book very etTectively accomplishes its goal. which is to practically and philosophicallyappraise the third decade c:lcardiacpacing. D. S. DtuCupt4. M.D. Cldctlgo. lL
CARDIOVASCULAR THERAPt By DoNALD G. VIDT. Philadelphia: F: A. Davis. 1981, 9111 pp, t35.00
CGrdIootucultJr'I'laenJpv is the latestin the seriesofCGrdIootucultJr ClmkI. nowentering its 12thyear C'A publication. The current issue is the product of27 contributon. all from the Cleveland Clinic, under the edftonhip of Dr. Donald G. Vidt. There are 19 cbapten dealing with dlvene fOrms C'A cardiovucular therapy. reSecting to someextent the interesb andendeavon of the Cleveland group. There are 7 cbapten dewted to various aspects ~ coronary artery disease. 4 to the thenpy of hypertension. and 1 each to medical management of congenital heart disease. therapy of cardiac aJ'o rhythmiu. pacemaker therapy. vasodilatorthenpy cicongestive heart failure. mechanical usistance of the failingheart. and treatment eX periphenl arterial disease. In addition. there is discussion of blood conservation in cardiac surgery and a review of the current status and clinical use of plasma catecholamine determinations. 1be book shares the virtues and ftaws associated with most multfauthored works of this type. At its best. the reader is rewarded by discussions and recommendations derived &om decades of experience at one c:lthe world'sleading centers in the diagnosisand therapy eX hypertension and atherosclerotic cardiovascular disease. Few other institutions can report and analyze the results eX 21,092 coronary artery bypass operations over a 13-yearperiod. as do Sheldon and Loop here. As it might be expected. not all of the book's therapeutic recommendations would receive uniwnal acceptance; some areas (such as angioplasty in the treatment of renovascularhypertension) are not discussed adequately; nonetheless. on the whole the work is a valuable statement about the state of the art eX cardiovucular therapy. as cummtly practiced at a highly respected center.
Auscultation of the cardiovascular system is an art. The need tor it by the physicianhas not decreased with the passage eX time. In fact. at no time in the history of medicine has there been more pertinent infOrmation by the use cl one's stethoscope than is availableand possible today.Auscultationofthe heart frequently supplies a clue to the correct diagnosis. or makes the diagnosis of a speciftc cardiaclesion. The stethoscope, therefOre.continues to be one eX the most useful tools available to the practicing physician. Of course. today. auscultation is on a very Brm basis due to a number of faeton which include better and accurate correlation of acoustic events with physiology, pathology. advances in cardiovascular surgery. cardiovascular radiology. cardiaccatheterization and echocardiography. 'Ibis exceUentbook represents an additionally valuable contribution to our knowledge and better undentanding of the etiology eX heart sounds and mormon. Dr. Stein utilizes hisknowledge of physicsand mathematics (poorly undentood by many of us). in addition to basic cardiovucular physiology. to logicallyexplain his concepts of the mechanism of these clinically important heart sounds and mormon. Dr. Stein and his colleagues are to be congratulated on their work. Let's hope theycontinue along these lines of investigation as outlined in this book. ToaU physiciansand students who use a stethoscope (and most should). this book is highly recommended tor careful study and reference.
W Proctor HGroer/, M.D. Wahington. DC MANSON'S TROPICAL DISEASES. 18th ed. By ~ E. C. MANSON-BAHR and F: I. C. APrED. New York: Macmillan. 1982.843 pp, $75.00 Sir Patrick Mansonwrote 6 editions of this bookbetween 1898and 1921. and the next 10 editions were prepared by Sir Philip Manson-Bahr. The 17th edition wasprepared in 1972by ~ E. C. Manson-BahrandIf: I. C. Apted, who revised it fOr the present 18thedition. It is written in the same style and many c:lthe illustrations are retained from previous editions. However.this edition. with contributions by distinguished specialists. includes new or rewritten sections on hemoglobinOpathies. ophthalmologyin the tropics. drugs. animal venoms and medical entomology. The latter is one mthe detailed appendices on the natural histories of tropical parasites and vectors, and contains many new illustrations. After a short introductory part there are 9 sections dealing with diseases causedby the fOUowing: Protozoa, helminths. viroses. bacteria,spirochaetes. riclcettsfae and bartonel1ae. venereal disease. fungi and the environment. These are i>llowedby sections on nutritional diseases. venoms and poisons. ophthalmologyin the tropics. and drugs. There are a number ofappendices on medical protozoology. medical helminthology. medical entomology and clinical pathology. As it had always been. MGnIOfti 'IropicGl Diletue, provides physicians. wherever they practice. with a comprehensive manual mtropical medicine. It emphasizes the accurate diagnosisand treatment of diseases that atrect both indigenous populations and expatriate residents and traveUen of warm climates. The diseases conventionally referred to as tropical include many which are by no means confined to the tropics. The importance eX keeping in mind the possibilityofexoticdiseases in patients who have travelled to endemic areas should be stressed. Such diseases provide difBcult and urgent problems in diagnosisand treatment. It would be tragic. therefOre.to ignore such diseases in the preparation of curricula tOr the training of physicians in temperate climates. Moreover, there are diseases within the category eXtropical diseases whichare regarded ascosmopolitan.1bis book has paid more attention to tuberculosis. measles and poliomyelitiswhich. though so greatly reduced in developed countries. are still common in the tropics. It is a pity that the section on trematodes is marred with Incorrect spellings of scientific names. eg. Chlonorclau Table 12.3 and Fig. 12.10 page 231. SchUfolomtlthium page 228. H~m, PhGneropolUl, Echtnonoma ilfoccanum, and Achillurbaniidae page 693. instead of C lonorcbu, S~. H~. P~. Echlnoltom4 floc4num and Achillurbainiidae. respectiwly. In Table12.4 pages 234.235. thelung Sukes of South America should not include ftanagonimu.t 1cellicotti; moreover, the second intermediate hosts of P 1ceUIcoffi in North America are crayfishes not crabs. The discussion c:lhuman fascioliasis on page 228 should have been updated. The use of praziquantel in the treatment of clonorchiasis and opisthorchiasis should have been mentioned. For no reason. a group of Sukes belonging to three families. Lecithodendriidae. Heteropbyidae and Echinostomatidae. are listed under the AchiUurbainiidae befOre the discussion of the superfamily Echinostomatoidea. In general, the photographs and line drawings are good; however. some photographs have sWferedfrom reproduction. eg. Fig. 12.3page 215and Fig. 12.11page 232. There is a very useful index at the end ~ the book.
Andtn' HUVDa, M.D.
B08fon,MA
Conflnued on page A-45
EmileA Mtde1c, Ph.D. New DrleG'"
THE THIRD DECADE OF CARDIAC PACING: ADVANCES IN TECHNOLOGYAND CLINICAL APPLICATIONS. By S. SERCE BAROLD and JACQUES MUCICA. Mt. Kisco. NY: Futura Publishing Co.• 1982. 495 pp, $43.00 The primary thrust in clinicalcardiologyover the lastfewdecadeshas been directed towards hemodynamic control. achievedeither pharmacologicallyor through surgical interventions. In recent yean there has been an exciting resurgence c1interest in applied electrophysiology. Abetter undentanding of the baic principles of cardiac electricity. imaginative investigational techniques in catheterization laboratories. and the advent ofmodem technologyin designing pulse generaton of extraordinary potential have added an exciting dimension to the thenpy of life-threatening anbythmias. Pacemaken are no longer simple stimulation devices designed to increase ventricular rates in patients with bradyalThythmlas. This is a very timely book which will make physicians awareof the complexitiesinvolvedin modem pacemakingtechnology. Cardiologists can ill aftOrd to neglect this relatively under-emphastsed Beld, where versatile advances can potentially save lives and relieve symptoms. Complex lie-threatening anbythmias often demand application of specialized knowledge for adequate control. Like most other InterYeDtions. they are alsoprone to serious complicationsifapplied cavalierly. The potential application of sophisticated pacemaken is no exception to this rule. Applied wisely.it will deliver medical relief: but inappropriate use may render severe damage. 1bis book is written to educate physicians not only about available units. but also to familiarizethem with the industry as a whole. The biomedical engineering involvedin this realm has been vastlyenhanced by microprocessor technology. Simultaneously clinicians have been more exacting in their demands to devise anti-tachycardia pacemaken. implantable deBbrillaton and implantable Holten. I would strongly recommend thisbook to interested readers whoconsider it important to have a basic understanding of the state of the art in plCemaldng today. I Bnd it difBcult to dwell on any outstanding negative criticisms. If anything, perhaps one may comment that the Beld is quite vast in its total scope. and the emphasis here is on what Is new and intriguing. Thus. perhaps the more mundane problems related to eDIting commercially available pacemalcen have not received enough attention. Nuclear powered units are also being designed and may have been ofinterest to the readen. However,the book very etTectively accomplishes its goal. which is to practically and philosophicallyappraise the third decade c:lcardiacpacing. D. S. DtuCupt4. M.D. Cldctlgo. lL
CARDIOVASCULAR THERAPt By DoNALD G. VIDT. Philadelphia: F: A. Davis. 1981, 9111 pp, t35.00
CGrdIootucultJr'I'laenJpv is the latestin the seriesofCGrdIootucultJr ClmkI. nowentering its 12thyear C'A publication. The current issue is the product of27 contributon. all from the Cleveland Clinic, under the edftonhip of Dr. Donald G. Vidt. There are 19 cbapten dealing with dlvene fOrms C'A cardiovucular therapy. reSecting to someextent the interesb andendeavon of the Cleveland group. There are 7 cbapten dewted to various aspects ~ coronary artery disease. 4 to the thenpy of hypertension. and 1 each to medical management of congenital heart disease. therapy of cardiac aJ'o rhythmiu. pacemaker therapy. vasodilatorthenpy cicongestive heart failure. mechanical usistance of the failingheart. and treatment eX periphenl arterial disease. In addition. there is discussion of blood conservation in cardiac surgery and a review of the current status and clinical use of plasma catecholamine determinations. 1be book shares the virtues and ftaws associated with most multfauthored works of this type. At its best. the reader is rewarded by discussions and recommendations derived &om decades of experience at one c:lthe world'sleading centers in the diagnosisand therapy eX hypertension and atherosclerotic cardiovascular disease. Few other institutions can report and analyze the results eX 21,092 coronary artery bypass operations over a 13-yearperiod. as do Sheldon and Loop here. As it might be expected. not all of the book's therapeutic recommendations would receive uniwnal acceptance; some areas (such as angioplasty in the treatment of renovascularhypertension) are not discussed adequately; nonetheless. on the whole the work is a valuable statement about the state of the art eX cardiovucular therapy. as cummtly practiced at a highly respected center.
Auscultation of the cardiovascular system is an art. The need tor it by the physicianhas not decreased with the passage eX time. In fact. at no time in the history of medicine has there been more pertinent infOrmation by the use cl one's stethoscope than is availableand possible today.Auscultationofthe heart frequently supplies a clue to the correct diagnosis. or makes the diagnosis of a speciftc cardiaclesion. The stethoscope, therefOre.continues to be one eX the most useful tools available to the practicing physician. Of course. today. auscultation is on a very Brm basis due to a number of faeton which include better and accurate correlation of acoustic events with physiology, pathology. advances in cardiovascular surgery. cardiovascular radiology. cardiaccatheterization and echocardiography. 'Ibis exceUentbook represents an additionally valuable contribution to our knowledge and better undentanding of the etiology eX heart sounds and mormon. Dr. Stein utilizes hisknowledge of physicsand mathematics (poorly undentood by many of us). in addition to basic cardiovucular physiology. to logicallyexplain his concepts of the mechanism of these clinically important heart sounds and mormon. Dr. Stein and his colleagues are to be congratulated on their work. Let's hope theycontinue along these lines of investigation as outlined in this book. ToaU physiciansand students who use a stethoscope (and most should). this book is highly recommended tor careful study and reference.
W Proctor HGroer/, M.D. Wahington. DC MANSON'S TROPICAL DISEASES. 18th ed. By ~ E. C. MANSON-BAHR and F: I. C. APrED. New York: Macmillan. 1982.843 pp, $75.00 Sir Patrick Mansonwrote 6 editions of this bookbetween 1898and 1921. and the next 10 editions were prepared by Sir Philip Manson-Bahr. The 17th edition wasprepared in 1972by ~ E. C. Manson-BahrandIf: I. C. Apted, who revised it fOr the present 18thedition. It is written in the same style and many c:lthe illustrations are retained from previous editions. However.this edition. with contributions by distinguished specialists. includes new or rewritten sections on hemoglobinOpathies. ophthalmologyin the tropics. drugs. animal venoms and medical entomology. The latter is one mthe detailed appendices on the natural histories of tropical parasites and vectors, and contains many new illustrations. After a short introductory part there are 9 sections dealing with diseases causedby the fOUowing: Protozoa, helminths. viroses. bacteria,spirochaetes. riclcettsfae and bartonel1ae. venereal disease. fungi and the environment. These are i>llowedby sections on nutritional diseases. venoms and poisons. ophthalmologyin the tropics. and drugs. There are a number ofappendices on medical protozoology. medical helminthology. medical entomology and clinical pathology. As it had always been. MGnIOfti 'IropicGl Diletue, provides physicians. wherever they practice. with a comprehensive manual mtropical medicine. It emphasizes the accurate diagnosisand treatment of diseases that atrect both indigenous populations and expatriate residents and traveUen of warm climates. The diseases conventionally referred to as tropical include many which are by no means confined to the tropics. The importance eX keeping in mind the possibilityofexoticdiseases in patients who have travelled to endemic areas should be stressed. Such diseases provide difBcult and urgent problems in diagnosisand treatment. It would be tragic. therefOre.to ignore such diseases in the preparation of curricula tOr the training of physicians in temperate climates. Moreover, there are diseases within the category eXtropical diseases whichare regarded ascosmopolitan.1bis book has paid more attention to tuberculosis. measles and poliomyelitiswhich. though so greatly reduced in developed countries. are still common in the tropics. It is a pity that the section on trematodes is marred with Incorrect spellings of scientific names. eg. Chlonorclau Table 12.3 and Fig. 12.10 page 231. SchUfolomtlthium page 228. H~m, PhGneropolUl, Echtnonoma ilfoccanum, and Achillurbaniidae page 693. instead of C lonorcbu, S~. H~. P~. Echlnoltom4 floc4num and Achillurbainiidae. respectiwly. In Table12.4 pages 234.235. thelung Sukes of South America should not include ftanagonimu.t 1cellicotti; moreover, the second intermediate hosts of P 1ceUIcoffi in North America are crayfishes not crabs. The discussion c:lhuman fascioliasis on page 228 should have been updated. The use of praziquantel in the treatment of clonorchiasis and opisthorchiasis should have been mentioned. For no reason. a group of Sukes belonging to three families. Lecithodendriidae. Heteropbyidae and Echinostomatidae. are listed under the AchiUurbainiidae befOre the discussion of the superfamily Echinostomatoidea. In general, the photographs and line drawings are good; however. some photographs have sWferedfrom reproduction. eg. Fig. 12.3page 215and Fig. 12.11page 232. There is a very useful index at the end ~ the book.
Andtn' HUVDa, M.D.
B08fon,MA
Conflnued on page A-45
EmileA Mtde1c, Ph.D. New DrleG'"