Practical Management of Pediatric Cardiac Arrhythmias is a concise, practical, up-to-date resource for the diagnosis and management of pediatric arrhythmias.
The 1st chapter sets the tone with an introduction to the mechanisms of arrhythmias and to the diagnostic tools, both noninvasive and invasive, that are available for the evaluation of children. The strengths and weaknesses of each technique are discussed, as is the practicality of its use in children. This chapter also has a useful discussion of psychosocial issues, intended to empower both the caregiver and the patient's family.
The 2 chapters that follow describe supraventricular and ventricular arrhythmias, with the aid of well-developed classification systems and easy-to-follow tables. The discussion of each arrhythmia is broken down into clinical presentation, electrocardiographic characteristics, diagnostic tools, and management strategies, which together provide a detailed understanding of pediatric arrhythmias. Perhaps the most useful section of each chapter is Implications for Clinicians, which provides succinct information about important aspects of care at all levels of training.
The next 2 chapters describe a comprehensive list of therapeutic interventions available for both immediate- and long-term management of pediatric arrhythmias. Each treatment is reviewed in detail, including its mechanism of action, a description of the amenable arrhythmias, and implications for the clinician. The highly useful chapter on immediate management discusses the appropriateness of vagal maneuvers, pharmacologic therapy, temporary pacing, and cardioversion-defibrillation in the management of acute arrhythmias. A well-written chapter on long-term drug therapy offers useful information about specific antiarrhythmic medications, taking into account special considerations like the conversion of standard adult formulations into those conducive to pediatric administration.
The book concludes with more advanced topics in electrophysiology—radiofrequency catheter ablation, permanent pacemakers, and implantable cardioverter-defibrillators—which get a chapter each.
Although this volume at times becomes a little overwhelming for the uninitiated, it is well edited and full of insights from experienced contributors. Undoubtedly, Practical Management of Pediatric Cardiac Arrhythmias will be a valuable resource to those of us who care for children with arrhythmias.