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This book delineates the state of the art of the diagnosis and treatment of J wave syndromes, as well as where future research needs to be directed. It covers basic science, translational and clinical aspects of these syndromes. The authors are leading experts in their respective fields, who have contributed prominently to the literature concerning these topics.J wave syndromes are one of the hottest topics in cardiology today. Cardiac arrhythmias associated with Brugada syndrome (BrS) or an early repolarization (ER) pattern in the inferior or infero-lateral ECG leads are thought to be mechanistically linked to accentuation of transient outward current (Ito)-mediated J waves. Although BrS and ER syndrome (ERS) differ with respect to magnitude and lead location of abnormal J waves, they are thought to represent a continuous spectrum of phenotypic expression termed J wave syndromes. ERS is divided into three subtypes with the most severe, Type 3, displaying an ER pattern globally in the inferior, lateral and right precordial leads. BrS has been linked to mutations in 19 different genes, whereas ERS has been associated with mutations in 7 different genes.There is a great deal of confusion as to how to properly diagnose and treat the J wave syndromes as well as confusion about the underlying mechanisms. The demonstration of successful epicardial ablation of BrS has provided new therapeutic options for the management of this syndrome for which treatment alternatives are currently very limited, particularly in the case of electrical storms caused by otherwise uncontrollable recurrent VT/VF. An early repolarization pattern is observed in 2-5% of the US population. While it is clear that the vast majority of individuals exhibiting an ER pattern are not at risk for sudden cardiac death, the challenge moving forward is to identify those individuals who truly are at risk and to design safe and effective treatments.

In der Sportmedizin und Kardiologie gewinnt die Sportkardiologie zunehmend an Bedeutung mit den Bestrebungen eine Subspezialisierung zu etablieren. Derzeit ist sie in Lehre und Klinik jedoch unterrepräsentiert und Sportmedizinern und Kardiologen, die Sportler betreuen, stellen sich häufig sportkardiologische Fragen, auf die sie bisher keine Antworten finden. Dieses Buch will diese Lücke schließen, in dem es umfassend die Methoden der sportkardiologischen Untersuchungen vom EKG über die Spiroergometrie bis hin zum MRT beschreibt und unter anderem die Frage beanwortet, was Sportler mit kardiovaskulären Problemen tun dürfen. Der inhaltliche Bogen reicht von der Prävention kardialer Erkrankungen bis hin zu speziellen sportkardiologischen Aspekten im Rehabilitations-, Breiten- und Leistungssport. Geschrieben wurde es von Mitgliedern der Deutschen oder Österreichischen Gesellschaften für Kardiologie und Sportmedizin.

This book describes the most recent insights into heart failure and the role played by autonomic nervous system pathophysiology in it, discussing the therapeutic implications. While current therapeutic approaches are able to control the effects of excessive adrenergic activation in heart failure syndrome, the underlying abnormalities of adrenergic control remain unaltered and can still cause progression to unmanageable end-stage heart failure. New therapeutic pathways are therefore being explored with a view to developing interventions that can directly modulate adrenergic over-activity and restore a more appropriate balance in neural control of the cardiovascular system. The book opens by examining current heart failure therapies. Advances in our understanding of autonomic regulation/dysregulation in heart failure are then discussed in detail, in the context of the search for more effective therapies. A concluding section addresses the role of autonomic nervous system denervation in heart failure. The authors are top scientists from leading research centers.

The refined pathophysiologal understanding of the heart failure syndrome together with the surge of new technological advances led to innovative medical and interventional treatment strategies improving the outcome of heart failure patients. However the complex interplay between the clinical presentation and the array of the interventions requires a coordinated multidisciplinary “heart team” approach involving various specialists in the cardiovascular field including clinicians, interventionalists, surgeons and cardiac intensivists. In this book, opinion leaders will review of state-of-the-art management of heart failure with particular emphasis on burning clinical questions and challenges faced by the heart team. New medical and interventional therapies for chronic and acute heart failure are addressed by bridging bench to bedside translation in science and technology into practical clinical application and guidance.

Cardiovascular diseases are the most important causes of death in the world today. In adults, the most frequent heart disease is acute myocardial infarction, which can lead to sudden death. To prevent these diseases we need to fight against their main risk factors, which include smoking, lipid disorders, hypertension, diabetes and a sedentary life-style, among others. It has been demonstrated that physical exercise or sports at any age provide notable benefits and can help to decrease other risk factors and reduce the incidence of cardio­ vascular diseases. Exercise can be simply walking or cycling. Aerobic exercise con­ tributes to weight loss and also helps to control blood pressure, cholesterol and diabetes. It therefore plays an important role in prevention of heart diseases. Sports for young people are of great value and advisable not only because they con­ tribute to physical fitness but also because they help in psychological well-being. Young people should be encouraged to include general exercise, and particularly sports, into their daily activities. The following points however, should be kept in mind: I. Although winning at a sport is important, this is only so if it is achieved in natural physical conditions and with the correct training. Therefore, it is advisable to keep well away from any type of activity which artificially increases physical performance, that is, drug taking.

Ventricular arrhythmias are the main cause of sudden arrhythmic death, a devastating situation that is tied to heart failure and its incidence is increasing despite current available therapies. This book reviews and explores the pathophysiology of ventricular arrhythmia and currently available therapeutic modalities including ion channel blockades, catheter ablation and defibrillators, with the hope that the wealth of accumulated science and knowledge have grown to the point that with the help of current advanced technology which allows targeting cellular, molecular and genetic components, a paradigm shift in treatment of these deadliest arrhythmias becomes possible. The book also provides chapters on currently available pharmacological options, defibrillation and catheter ablation as well as chapters on new treatments and technologies such as cell and gene therapies and what may be the future of arrhythmia therapy.

Sudden cardiac death is the leading cause of non-traumatic mortality in young (<35 years old) athletes, with recent data suggesting the incidence to be higher than what was previously estimated. The vast majority of deaths are caused by silent hereditary or congenital cardiac disorders. Over the last decade, advances in our understanding of both the genetic and clinical mechanisms underlying these conditions, particularly those associated with a structurally normal heart, have led to advances in diagnosis and management including interventions and lifestyle modifications that aim to minimize the risk of sudden cardiac death (SCD). Coupled with effective screening programs, other strategies such as emergency response planning and the use of automated external defibrillators have also emerged as strategies in preventing and treating sudden cardiac arrest. This book aims to provide an overview of the genetic and clinical aspects of SCD in young athletes, with particular emphasis on the specific issues related to diagnosis and management that these unique group of individuals pose to a physician. Specific diagnostic and management dilemmas will be illustrated through clinical cases and the most up-to-date guidelines regarding participation in sport outlined.

Cardiovascular diseases account for about half of total mortality in industrialised societies. This figure has declined only slightly and in few countries over the past few decades, which is disturbing in view of our increasing insight into long-term risk factors of coronary heart disease and the dramatic improvement in the acute therapy of its manifestations. One important reason for this is the high fatality during the initial hours of a coronary event, i.e. before medical treatment can be provided. Approximately one quarter of all patients suffering an acute cardiac event die prior to admission to hospital. As a result, the focus of current research has shifted from after-the-fact therapy to the triggering phase of acute coronary disease. Epidemiological observations of recent trends and newly identified determinants of coronary disease and the results of substantial pathophysiological studies of the conversion from chronic coronary disease to an acute event provide the basis for new hypotheses about the triggering mechanisms. The ultimate goal is to design more effective preventive strategies for these deadly diseases. The present extensive summary of important scientific and clinical developments in the study of the triggering and prevention of coronary syndromes that have been seen over the last ten years contains the contributions of leading experts in the field. It presents a cooperative, balanced view derived from physicians and researchers in the U.S. and Europe.

Sudden cardiac death (SCD) is the number one killer in the United States, claiming the lives of more than 300,000 Americans every year. Thus, it is important for heart failure specialists to be knowledgeable about strategies to prevent, manage risk for, and treat conditions leading to sudden cawrdiac death. These topics and more are covered in this issue.

Clinical cardiologists are encountering an important challenge in the caring of families with inherited cardiac diseases. The majority of the inherited cardiac diseases causing sudden death express themselves at variable ages in the form of altered muscle function (i.e hypertrophic or dilated cardiomyopathy) or in the form of arrhythmias (i.e. Brugada syndrome, long QT syndrome). However, it is not uncommon that the first sign of the disease may actually be sudden cardiac death, even before the identification of clear clinical abnormalities. In this last decade, with more than 50 new disease-associated genes identified, the possibility of genetic testing has opened a new opportunity to disease diagnosis and prevention. Clinical and genetic research is continuously on-going not only to identify those at risk, but to better define their level or risk still with limited success.

Ventricular arrhythmias and sudden death are responsible for hundreds of thousands of deaths each year throughout the world. Covering the most recent developments in this field, this leading text serves as a guide to this area of increasing clinical importance, addressing a wide range of topics, including: basic mechanisms of ventricular tachycardia and ventricular fibrillation clinical syndromes and etiologies epidemiology and risk stratification pharmacologic therapy ablation and surgery implantable defibrillators Ventricular Arrhythmias and Sudden Cardiac Death provides the information that cardiologists, cardiac electrophysiologists, cardiac electrophysiology fellows, scientists, industry, and associated professionals need to know about current and evolving Ventricular Tachyarrhythmia treatment and diagnosis. As the most comprehensive book on this topic, it will serve as the text that this readership will turn to first.

Sportkardiologie – das medizinisch bedeutsame Thema stößt angesichts plötzlicher Todesfälle von Sportlern auch auf öffentliches Interesse. Dieses Buch gibt als erstes im deutschsprachigen Raum Empfehlungen zur Wettkampfsporttauglichkeit bei Herzkreislauferkrankungen. Die einzelnen Sportarten mit ihren Beanspruchungsprofilen werden differenziert beurteilt. Unter Berücksichtigung des Schweregrades werden Fragestellungen vom Top-Athleten bis zum vermindert belastbaren Patienten behandelt und daraus konkrete Empfehlungen für die Sportpraxis abgeleitet. Die Autoren wagen den Spagat zwischen Wettkampf- und Gesundheitssport im Sinne präventiver und rehabilitativer Betätigung. Sportmediziner und internistisch-kardiologisch tätige Ärzte finden hier Entscheidungshilfen bei der Beurteilung der Sporttauglichkeit und Tipps zu einer gezielten Anleitung ihrer Patienten. Neu in der 2. Auflage - Belastungsuntersuchungen - Kardiale Marker und körperliche Belastung - Belastbarkeit von Patienten mit Schrittmacher und ICD

Sudden cardiac death (SCD) is usually the result of a cardiac arrhythmia, mainly ventricular fibrillation, and is one of the leading causes of death in the occidental world, accounting for 300,000 to 500,000 deaths each year only in the United States. The scientific debate is still open about the risk factors leading to SCD; that knowledge represen