Search

The sixth edition of Ellestad's classic text on cardiac stress testing has been extensively updated and re-written to communicate contemporary understanding of the classical principles of stress testing to clinicians and researchers, students and seasoned practitioners alike. The current techniques for performing stress tests presented herein reflect major technologic advances in imaging, physiologic monitoring and the assessment of cardiovascular risk, addressing fundamental paradigm shifts in interventional, surgical and medical treatment of heart disease. Moreover, the text addresses the dramatic changes that are occurring in patient demographics and the environmental, socioeconomic, gender and genomic factors that crucially impact heart disease and warrant attention when performing cardiac stress testing. Chapters on the physiology of exercise testing including practical details regarding protocols for conducting the stress test, proper supervision, important parameters to be monitored, and the diagnostic and prognostic information to be gleaned from the electrocardiogram set the stage for expanded chapters on the use of cardiac imaging in conjunction with stress testing. Physiologic and metabolic considerations during stress testing are covered in detail. Application of stress testing to special populations, such as women, children, athletes, and individuals in both high and low risk groups are covered in new chapters. Finally, the authors address the use of stress testing in limited resource environments and discuss global changes in the incidence of atherosclerosis, and suggest how stress testing may evolve.

This book on investigative electrocardiography is addressed to investigators who are using electrocardiology as a research tool in epidemiological or clinical research or in investigations on possible adverse responses of new pharmacological agents. The primary emphasis of the book is on prognostic implications of ECG abnormalities in the conditions covered, including the prevalence and incidence of ECG abnormalities in contrasting populations. We excluded from our book cardiac disorders with a relatively low population pre- lence that otherwise may be of great clinical interest. We also decided to exclude acute myocardial infarction because we had only limited resources available on this topic from our population studies and from those clinical trials in which we have personally p- ticipated in the classi? cation of trial endpoints within the framework of an ECG research center. Clinical trials are a relatively new area of electrocardiology. However, electrocard- graphy has become a most valuable research tool in clinical trials and in investigations on morbidity and mortality risk associated with various clinical and subclinical con- tions. It has also become a crucial research tool in investigating adverse cardiac events associated with administration of new drugs. Evaluation of QT prolongation plays a central role in these investigations. As a possible marker of malignant arrhythmias, it is used by regulating agencies in their decision process for approval of new pharmacolo- cal agents.