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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 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.
"EACPR, European Association for Cardiovascular Prevention and Rehabilitation -- European Society of Cardiology."
The aim of this textbook is to give guidance in prevention, lifestyle counselling and rehabilitation for cardiologists, other physicians and many different categories of health professionals in cardiac rehabilitation teams.
In this book the lectures of the first course of the International School of Cardiology at Ettore Majorana are presented. It is difficult to reflect in a publication of this kind the atmosphere and spirit of this postgraduate course. Moreover, the beautiful scenery of Erice and its surroundings, celebrated by ancient Greek poets, can never be described by the editors of this book. The purpo~e of this course was to deepen our knowledge accumulated todate on the subjects of non-invasive cardio circulatory assessment and the analysis of the comprehensive approach to cardiac rehabilitation. The clinical value of exercise testing, echo-cardiography, scintigraphy, systolic time intervals have been discussed, as well as the tasks of exercise training, surgery and drugs in the secondary prevention of coronary heart disease. The problems of arrhythmias and the prevention of sudden death have been touched on, as well as early m~bilization after myocardial infarction, the use of digoxin and beta blockers and finally, the controversies in cardiac rehabilitation.
Controversies in Cardiac Electrophysiology are examined in this issue of Cardiac Electrophysiology Clinics. Difficult cases are presented and esteemed leaders in the field debate the pros and cons of various forms of management and treatment.
In recent years, research has demonstrated that exercise programs can benefit patients with chronic obstructive pulmonary disease (COPD) and patients with congestive heart failure (CHF). Yet many physicians do not refer such patients to any kind of exercise or rehabilitation program. Advances in Cardiopulmonary Rehabilitation examines the history of how pulmonary and cardiac diseases have been treated and shows how that history tends to constrain contemporary thinking in spite of significant advances in treatment. -Why do only a small percentage of eligible patients enroll in cardiopulmonary rehab programs? -What percentage of patients can be helped, and in what ways? -What are the most cost-efficient allocations of scarce financial resources for cardiac and pulmonary patients? The contributors to this book address these questions and provide answers that are challenging and often quite surprising. The First Québec International Symposium on Cardiopulmonary Rehabilitation was held in Québec City in May 1999, bringing together experts from around the world to discuss every aspect of cardiopulmonary rehabilitation. Editors Jean Jobin, PhD, François Maltais, MD, Pierre LeBlanc, MD, and Clermont Simard, PhD, selected the most groundbreaking papers presented at the conference and expanded on several of them for this reference. The book offers review articles and some original research. The editors' comprehensive introduction and conclusion provide an invaluable synthesis and overview of current understanding and future directions for cardiopulmonary rehabilitation. Whether you are a clinician, a researcher, an educator, or an administrator, Advances in Cardiopulmonary Rehabilitation will give you -an understanding of how trends in cardiopulmonary rehabilitation during the past century affect current practices, -hard data that will help you determine the best practices in cardiopulmonary rehabilitation, -data that will enhance your ability to treat patients you may have assumed were untreatable, and -a clear overview of recent research in cardiopulmonary rehabilitation. Part I explains not only what has happened in the past, but how past and current practices may influence the future. Part II offers thorough scientific reviews of pharmacological treatment for CHF and COPD. Part III, offers the clearest discussion available--accompanied by extensive data--of how to decide who should be referred and who should not. Part IV discusses peripheral muscle limitations and dysfunction. Part V addresses risks and benefits for different kinds of patients, home exercise programs for COPD patients, interactions between exercise and left ventricular remodeling, and effects of temperature extremes on people with cardiovascular disease. Part VI explains how cardiopulmonary illness, as well as various rehab approaches, affect a patient's psychosocial health, and examines economic evaluations of rehab programs. Part VII deals with factors that affect quality of life and how to measure outcomes of treatment in terms of quality of life. Finally, part VIII looks to the future--what is likely to happen in the areas of technology, pharmacology, psychosocial factors, and self-help care. This well-researched volume (more than 2,200 bibliographical references) is essential for anyone who deals with cardiac or pulmonary patients. This is the only single volume that probes the scientific, clinical, economic, and even psychosocial frontiers of cardiac and pulmonary rehabilitation.
The aim of the 2nd Course of the International School of Cardi ology at "Ettore Majorana" was the discussion, scientific analysis, and critical appraisal of primary and secondary prevention in cardi ology, especially concerning the coronary artery disease. The predictive value of different risk factors, the problem of heredity, sociological and psychological perspectives, the impact of antiarrhythmic therapy, and the prevention of sudden death were only some of the many topics discussed. Others, such as physical activity in primary and secondary prevention, the role of coronary bypass surgery in decreasing the mortality rate, the effects of drugs and comprehensive intervention programmes, as well as a critical appraisal of therapy in cardiac failure were given special attention. In organizing this second Course, it was again a privilege and a challenge for the programme directors to conduct a scientific event which, as was demonstrated at the first course, represented an original and new approach to teaching. The illustrious international faculty, composed of well known scientists and experts in their fields, has contributed to the high academic level and quality of the lectures and the following discussions. In our opinion, this successful undertaking would not have achieved its purpose and originality without the beautiful surround ing scenery and tranquility of Erice. We should like to express our gratitude to the director of the Centre, Prof. Zichichi, and the Secretary of "Ettore Majorana," Dr.
The ESC Textbook of Intensive and Acute Cardiovascular Care is the official textbook of the Acute Cardiovascular Care Association (ACVC) of the ESC. Cardiovascular diseases (CVDs) are a major cause of premature death worldwide and a cause of loss of disability-adjusted life years. For most types of CVD early diagnosis and intervention are independent drivers of patient outcome. Clinicians must be properly trained and centres appropriately equipped in order to deal with these critically ill cardiac patients. This new updated edition of the textbook continues to comprehensively approach all the different issues relating to intensive and acute cardiovascular care and addresses all those involved in intensive and acute cardiac care, not only cardiologists but also critical care specialists, emergency physicians and healthcare professionals. The chapters cover the various acute cardiovascular diseases that need high quality intensive treatment as well as organisational issues, cooperation among professionals, and interaction with other specialities in medicine. SECTION 1 focusses on the definition, structure, organisation and function of ICCU's, ethical issues and quality of care. SECTION 2 addresses the pre-hospital and immediate in-hospital (ED) emergency cardiac care. SECTIONS 3-5 discuss patient monitoring, diagnosis and specific procedures. Acute coronary syndromes (ACS), acute decompensated heart failure (ADHF), and serious arrhythmias form SECTIONS 6-8. The main other cardiovascular acute conditions are grouped in SECTION 9. Finally SECTION 10 is dedicated to the many concomitant acute non-cardiovascular conditions that contribute to the patients' case mix in ICCU. This edition includes new chapters such as low cardiac output states and cardiogenic shock, and pacemaker and ICDs: troubleshooting and chapters have been extensively revised. Purchasers of the print edition will also receive an access code to access the online version of the textbook which includes additional figures, tables, and videos to better to better illustrate diagnostic and therapeutic techniques and procedures in IACC. The third edition of the ESC Textbook of Intensive and Acute Cardiovascular Care will establish a common basis of knowledge and a uniform and improved quality of care across the field.