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J R Soc Med. 2002 February; 95(2): 108.
PMCID: PMC1279328

Risk of Arrhythmia and Sudden Death

Reviewed by Gregory Y H Lip

Editor: Marek Malik
412 pp Price £125 ISBN 0-7279-1581-9 (h/b)
London: BMJ Books .

Cardiac arrhythmias are common, and some have a regrettable tendency to cause sudden cardiac death. Greater efforts are needed in defining the clinical epidemiology, pathophysiology, risk stratification, risk assessment and therapeutic strategies in this area. Sudden death is not simply due to ventricular arrhythmias: other arrhythmias can be associated, as can certain drug therapies and congenital syndromes.

Professor Malik has assembled a comprehensive treatise on this theme, with subject-matter ranging from risk stratification and assessment to trials of antiarrhythmic agents. The contributors do their topics justice while not assuming too much knowledge in the reader; so non-specialists will find the book useful. An enjoyable section on clinical assessment starts by reminding us that ‘one should never manage arrhythmias but patients with arrhythmias’.

The section on clinical studies is impressive, ranging from myocardial infarction and chronic heart failure to atrial fibrillation. With my personal biases towards irregularly irregular things, my book reviews tend to focus on irregular rhythms. A criticism of the chapter on persistent atrial fibrillation is that it deals more with ‘how to manage the problem’ rather than the specific issue of preventing sudden death. Regarding drug-resistant paroxysmal atrial fibrillation, enthusiasm for ablate-and-pace should be tempered by the knowledge that this intervention itself can cause sudden death.

Overall this is an impressive tome: the editor and contributors are to be congratulated for assembling a wealth of material in a digestible form. Most cardiologists (irregularly irregular ones, or otherwise) and their departments should have a copy.

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press