Book Review

Cardiac Electrophysiology: From cell to bedside

N Engl J Med 1995; 333:395August 10, 1995

Article

Cardiac Electrophysiology: From cell to bedside
Second edition. Edited by Douglas P. Zipes and José Jalife. 1612 pp., illustrated. Philadelphia, W.B. Saunders, 1995. $235. ISBN: 0-7216-4941-6

Cardiac Electrophysiology: From Cell to Bedside is a remarkable book that lives up to the promise of its title. It is an encyclopedic review of all areas of adult and pediatric cardiac electrophysiology. It has been five years since the first edition, and the information explosion in this area has made this complete revision very welcome.

A total of 271 experts in their fields have written 138 chapters. The organization of the book reflects its subtitle: from cell to bedside. The first 27 chapters deal with the cellular basis of rhythmogenesis, including the biochemistry and biophysics of ion-channel activity. The next 11 chapters construct three-dimensional models; they include an intriguing and surprisingly accessible section on the insights provided by nonlinear dynamics and chaos theory. The following 45 chapters form a coherent section dealing with nervous control, the physiology of normal rhythms, and the pathophysiology of arrhythmias. Of the remaining chapters, 21 discuss electrocardiographic diagnosis, surface mapping, and electrophysiologic testing; 5 cover specific syndromes; and 29 are dedicated to the treatment of arrhythmias, ranging from pharmacologic and electrical to surgical therapy.

In the chapters on diagnostic procedures, I was particularly impressd by the balanced reporting on such topics as the value of tilt-table testing for syncope or the clinical value of electrophysiologic studies for guiding the treatment of ventricular arrhythmias. The review of therapeutic methods is well written, and the chapters on antiarrhythmic agents are particularly useful to the clinician. The sections on ablation procedures and surgical interventions not only are informative to the specialist electrophysiologist but also provide necessary information to those of us who have to advise our patients. The illustrations are consistently clear and easy to follow, virtues that are somewhat unexpected in an electrophysiology textbook. The legends are extensive and well constructed and carefully lead the reader through the maze of intracardiac electrograms.

As you would expect in a multiauthored textbook organized “from cell to bedside,” the same rhythm is discussed in many places. If you wish to read about torsade de pointes or atrial fibrillation, you will find them discussed in several chapters and ventricular tachycardia in half a dozen. It is a tribute to the editors' work that these discussions, although they tackle the same subject from different angles (theoretical, experimental, or clinical) remain remarkably consistent.

The book can be used by the trainee as an all-inclusive, in-depth course in electrophysiology. However, it will also be useful to the clinician who needs an accessible reference work. Although its price takes it out of the reach of most cardiology trainees, it is a necessary addition to the library of every cardiology training program and every electrophysiologist, as well as all physicians with a special interest in arrhythmias.

John A. Paraskos, M.D.
University of Massachusetts Medical School, Worcester, MA 01605