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We were particularly pleased to compile this volume entitled'Clinical Aspects of Cardiac Arrhythmias'. Recent years have seen the publication of many textbooks on cardiac arrhythmias, some of which concentrate on one particular aspect such as drug management, electrocardiographic appearances, electrophysiological evaluation etc; and others of which are the collated reports of symposia, often dealing with detailed con­ siderations of highly specialised problems. Most of the larger more comprehensive texts have devoted a substantial proportion to basic considerations and experimental observations, far removed from the clinical arena. When asked to contribute to the series'Current Status of Clinical Cardiology'we felt that the clinical aspects of cardiac arrhyth­ mias should be emphasized, and that the text should be as comprehensive as possible within the limitations of a single volume in this series. This comprehensive but clinical approach has necessitated the inclusion of certain subjects such as the mechanisms of tachycardia, metabolic aspects of cardiac arrhythmias and reperfusion arrhythmias, which are not directly or exclusively clinical. However, the rapid advances in these areas in recent years are likely to have increasingly important clinical con seq uences. Although the epidemiology of clinical arrhythmias is difficult to dis­ cover, it is widely appreciated that arrhythmias are commonplace.

The molecular basis for atrial fibrillation continues to be largely unknown, and therapy remains unchanged, aimed at controlling the heart rate and preventing systemic emboli with anticoagulation. Familial atrial fibrillation is more common than previously suspected. While atrial fibrillation is commonly associated with acquired heart disease, a significant proportion of individuals have early onset without other forms of heart disease, referred to as'lone'atrial fibrillators. It is also well recognized that atrial fibrillation occurs on a reversible or functional basis, without associated structural heart disease, such as with hyperthyroidism or of atrial fibrillation following surgery. It remains to be determined what percentage in these individuals is familial or due to a genetic predisposition. Mapping the locus for familial atrial fibrillation is the first step towards the identification of the gene. Isolation of the gene and subsequent identification of the responsible molecular genetic defect should provide a point of entry into the mechanism responsible for the familial form and the common acquired forms of the disease and eventually provide more effective therapy. We know that the ionic currents responsible for the action potential of the atrium is due to multiple channel proteins as is electrical conduction throughout the atria. Analogous to the ongoing genetic studies in patients with familial long QT syndrome, it is highly likely that defects in each of these channel proteins will be manifested in familial atrial fibrillation.

This single-source reference/text is an authoritative, up-to-date, and multidisciplinary presentation of basic, applied, and clinical approaches to the diagnosis, treatment, and management of cardiac arrhythmia and the prevention of sudden cardiac death-providing essential concepts for new approaches to pharmacologic and electrical therapies.Over 50 leading physicians, scientists, and engineers integrate their research knowledge into a solid foundation of fundamentals in innovative new ways to promote an understanding of cardiac arrhythmias on a multilevel basis that spans the full range of topics from genes to therapy prevention.From the regular rhythm of the heart to the irregular, chaotic states that characterize fibrillation and tachyarrhythmias, Foundations of Cardiac Arrhythmiasexplores the ionic and molecular basis of electrogenesis and its control within different types of cardiac cells clarifies the molecular and biochemical regulation of cell-to-cell conduction that will help facilitate development of the next generation of antiarrhythmic drugs considers genetic determinants that influence the onset of sudden death in rare and acquired heart disease explores recent insights into macroscopic, three-dimensional interactions implicated in the genesis of malignant ventricular tachycardias surveys population studies that reveal new information about the relevance of higher frequency polymorphisms and variations in molecules involved in cardiac control discusses the role of cardiac ablation and the use of pacemakers and defibrillators, including new concepts in device design discusses promising new advances with noninvasive markers of arrhythmia risk that are helping to identify patients at risk for sudden deathContaining nearly 2300 key literature citations and over 300 helpful drawings, photographs, equations, and tables, Foundations of Cardiac Arrhythmias serves as a thorough and inspiring reference for clinical and research cardiologists, clinical and basic electrophysiologists, pharmacologists, molecular and cell physiologists, biologists, biochemists, molecular geneticists, biomedical and electrical engineers, and biophysicists, as well as an important text for graduate students, residents, and fellows in these disciplines.