Cardiac electrophysiology has emerged as an exciting area of cardiology. Antiarrhythmic medications, radiofrequency ablation, and technical advancements in pacemakers and implantable cardioverter-defibrillators have all improved the quality of life of patients with cardiovascular disease. However, cardiology, in common with many other medical specialties, is moving towards investigations of the genetic and molecular basis for disease. In particular, an important emphasis in electrophysiology is the critical role played by genetic abnormalities in myocardial repolarization and arrhythmogenesis. Myocardial Repolarization: From Gene to Bedside, edited by Ali Oto and Günter Breithardt, attempts to introduce these complex topics to the clinician.
The book divides topics into 5 areas of interest: basic mechanisms of myocardial repolarization; the genetic basis of the QT interval and clinical and diagnostic implications; distinct genetic entities such as long QT and Brugada syndromes; acquired long QT syndrome; and various other clinical topics, including the use of implantable cardioverter-defibrillators in patients with repolarization abnormalities. The chapters are relatively short and many are written by experts in their fields. Most serve as nice synopses and try to emphasize, in accordance with the book's purpose, the clinical relevance of the basic-science findings. Indeed, the book does an excellent job of reviewing the more recent clinical tools, such as the analysis of QT dispersion and T wave alternans, which is used in the diagnosis of cardiac arrhythmias. Here the authors give a complete overview of the mechanical and methodologic aspects of these markers of arrhythmia susceptibility.
Some of the chapters can intimidate the clinician, for they delve in some detail into the molecular genetics of animal models in the laboratory. Even so, the information is presented concisely and with the purpose of providing mere introductions to topics that are clearly complex. The authors do an excellent job of summarizing past and current research at the basic-science level and of indicating possible future directions.
In reviewing the role of molecular biology and genetics in cardiac electrophysiology, this book gives the clinician a glimpse into the captivating world of genetic research and its current and future clinical applications. More importantly, it serves as a concise reference for clinical cardiologists who want to learn more about the mechanisms of arrhythmogenesis and myocardial repolarization.