Controversies In Cardiology

This book will consider several clinical and interventional topics for which there is uncertainty, continued debate and/or no consensus based on current guidelines. While there are numerous guidelines in cardiology, new and on-going trials that address new drugs treatments and procedures raise many unanswered questions. Furthermore, most practicing cardiologist taking care of the patients are likely unable to digest all of these studies or guidelines and necessarily correctly apply them to their patients. If one considers in the guidelines the frequent use of Level C (consensus), there are many areas or situations where no trial exists. Also, when applying the results of a trial to an individual patient, there can be uncertainty of how this patient should be managed based on the present body of evidence.

This book contains the proceedings of a conference organized by the Klinik Hohenried at the Evangelische Akademie in Tutzing under the patronage of the International Society of Cardiology - Council on Rehabilitation - from Febr. 12-14, 1981. The purpose of the meeting on Current Problems in Cardiac Rehabili tation was to come closer to answering the questions posed in the fol lowing pages, and to make some opinions about cardiac rehabili tation less contoversial. To comment briefly on the interesting question of why opinions in the field of cardiac rehabilitation seem more controversial than in other fields of cardiology, we would like to propose the following explanation: 1. Lack of personal experience and lack of special training in cardiac rehabilitation are a major source of misunderstandings and differ ences of vocabulary between cardiologists engaged in clinical practice and in rehabilitation. 2. Emotional problems in accepting a new kind of partnership between coronary patients and their physicians and a "nihilistic attitude" towards therapy of behaviour play an important role in the scepti cism of cardiologists. 3. Fear of an expensive "overmedication" (I. Illich) is another argu ment concerning rehabilitation.

This book addresses the tough clinical issues faced by electrophysiologists and cardiologists who treat patients with Cardiac Implantable Electrical Devices (CIEDs) in real-world practice. With contributions from widely recognized international leaders in the field, this 10-chapter resource covers a variety of controversies with CIEDs, from discerning what device is appropriate to use for heart failure to ethical issues in their use at the end of a patient’s life. To supplement these discussions, chapters review opposing positions on both sides of a controversy and present clinical material to illustrate the different perspectives. Clinical Controversies in Device Therapy for Cardiac Arrhythmias is an essential resource not only for physicians, residents, and fellows in cardiac electrophysiology and cardiology but also for associated professionals including nurses and technicians who work with CIEDs.

Debates and controversies about how to treat difficult problems or conditions abound in cardiac electrophysiology. This issue attempts to bring together a variety of controversial subjects and to present differing views on how to resolve these questions so clinicians will have a handy guide to the most current thinking about these difficult subjects.