Clinical Cardiac Pacing and Defibrillation, 2nd Edition
K.A. Ellenbogen, G.N. Kay, B.L. Wilkoff, eds.
1007 pp, illustrated. Philadelphia, Pa: WB Saunders Company; 2000. $225.00. ISBN 0-7216-7683-9
The second edition of the textbook edited by Ellenbogen, Kay, and Wilkoff has changed its name from Clinical Cardiac Pacing to Clinical Cardiac Pacing and Defibrillation. Although it has grown from 838 to 1007 pages, the number of contributors has declined from 80 to 73 and the number of chapters from 42 to 36. The book has a total of 847 illustrations (average 24/chapter) and 4316 references (average 119/chapter). There has been a considerable renewal of authors—the second edition retains only 32 of the 80 original contributors.
As the new title indicates, the editors have attempted to produce a textbook of cardiac device therapy covering both pacemakers and defibrillators (ICDs). However, only 6 of the 36 chapters are specifically dedicated to defibrillator topics. Nine additional chapters pertaining to arrhythmia detection, power systems (batteries), circuitry, lead codes, implantation, lead extraction, radiography, electromagnetic interference, and pediatric device therapy include information on both pacemakers and defibrillators. The emphasis on pacemakers is reflected in the relative lengths of chapters addressing analogous topics. Chapters on device malfunction are 49 pages long for pacemakers and 19 pages long for ICDs. Chapters on patient follow-up are 25 pages long for pacemakers and 8 pages long for ICDs. There is a chapter on survival and quality of life for pacemaker recipients, but not for ICD recipients. Pathophysiological or nosological entities of importance in the field of cardiac pacing such as sinus node disease or syncope are appropriately covered in separate chapters. Conversely, entities addressing sudden arrhythmic death including “electric diseases” (eg, long-QT syndromes and Brugada syndrome) receive little attention. Common terms used in ICD therapy such as shock (defibrillatory), committed therapy, redetection, antitachycardia pacing (ATP for ventricular tachycardia termination), ramp pacing, burst pacing, and cardioversion are not indexed. In fact, we found little or no information in the book on ICD programming for ATP and cardioversion therapy. The management of patients receiving frequent shocks is not discussed. In particular, adjunctive antiarrhythmic drug therapy for ICD recipients receives little attention.
Readers will find useful nontechnical information on basic concepts of pacemaker engineering. An entire book section (109 pages) is devoted to rate sensors and rate sensing. A 98-page-long chapter on “Timing Cycles and Operational Characteristics of Pacemakers” deals with many important and difficult questions of cardiac pacing.
Few chapters are dedicated to device applications under current investigational focus such as pacing for the prevention of tachyarrhythmias, pacing for heart failure, and implantable atrial defibrillators.
We believe that the inclusion of ICD therapy in the book was a good one because many questions about pacemakers and ICDs are obviously closely related. However, the coverage of ICD therapy in this textbook is in need of expansion. Contrarily, some chapters might be considerably abbreviated or written more succinctly. For instance, details on thoracotomy implantation of ICDs might be largely omitted.
Electric devices for the heart is a rapidly expanding field and many clinical decisions about device therapy remain empirical. Some readers may have different opinions compared with those expressed in some chapters. We believe, however, that such disagreements are unavoidable.
Our overall impression is that this comprehensive textbook should be very useful to all physicians and students interested in pacemaker and ICD therapy: there is to our knowledge no similar textbook available. Clinical Cardiac Pacing and Defibrillation belongs on the bookshelf of every cardiac electrophysiologist.