Therapy in cardiology has advanced enormously in recent years. This has resulted in the organization of many meetings and the publication of numerous books dedicated to examining the latest aspects of, for instance, pharmacolog­ ic, electrical and surgical treatment. However, only a few of these meetings and publications have attempted to present an overall review of all advances that have taken place in the field of therapy. In the last years the Spanish Society of Cardiology has shown a great interest in the continuous medical education in cardiology. The Society has organized various meetings and has published several books on the above-mentioned topics. Consequently, the Society has decided to publish this book, an update of the therapeutics in cardiology, of which a Spanish version is also available. World renowned experts and outstanding Spanish cardiologists were invited to review all aspects of therapy in cardiology. We would like to thank the Spanish Society of Cardiology and the Catalan Cardiac Society for the generous assistance they have given us during all stages of book preparation. We also would like to express our appreciation to all the authors for their valuable contributions. Their combined efforts enable us to put this volume in the hands of the reader.

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1. Severe Arrhythmias and Sudden Death.- 1.1 Introduction.- 1.2 Influence of circadian rhythm on the electrophysiological properties of the human heart.- 1.3 Sudden arrhythmic death - picture of the possible candidate.- 1.4 Sudden death in cardiomyopathies.- 1.5 Sudden death in the Wolff-Parkinson-White syndrome.- 1.6 Conclusions.- 2. The Pharmacological Treatment of Severe Arrhythmias.- 2.1 Introduction.- 2.2 Torsades de pointe.- 2.3 Non-invasive assessment of antiarrhythmic drugs.- 2.4 An electrophysiological approach to drug therapy of ventricular arrhythmias.- 2.5 Application of plasma level determinations to antiarrhythmic drug management.- 2.6 Amiodarone as drug of first choice in the prevention of sustained ventricular tachycardia (VT) and/or ventricular fibrillation (VF).- 2.7 Conclusions.- 3. The Surgical Treatment of the Arrhythmias.- 3.1 Introduction.- 3.2 The role of left stellectomy in the prevention of lethal arrhythmias.- 3.3 Surgical treatment of the cardiac arrhythmias.- 3.4 Early experience in endocardial fulguration for the treatment of ventricular tachycardia.- 3.5 The implantable cardioverter-defibrillator.- 3.6 Conclusions.- 4. Pacemakers.- 4.1 Introduction.- 4.2 Electrophysiological studies in patients with syncope of unknown cause.- 4.3 Tachylog P43 in the control of tachyarrhythmias.- 4.4 Control of the pacemaker patient.- 4.5 Conclusions.- 5. Arterial Hypertension.- 5.1 Introduction.- 5.2 The value of treatment in the prevention of hypertension complications.- 5.3 Use of ?-adrenergic blocking agents in arterial hypertension.- 5.4 Other antihypertensive drugs.- 5.5 Problems in the treatment of chronic primary arterial hypertension.- 5.6 Conclusions.- 6. Heart Failure.- 6.1 Introduction.- 6.2 Patients with heart failure and normal sinus rhythm: who should receive digitalis?.- 6.3 Vasodilators in the treatment of congestive heart failure.- 6.4 The new inotropic agents.- 6.5 Right ventricular failure in ischaemic heart disease.- 6.6 Conclusions.- 7. Heart-Lung Transplantation.- 7.1 Introduction.- 7.2 Transplantation of the heart and lungs.- 7.3 Heart transplantation.- 8. Valvulopathies.- 8.1 Introduction.- 8.2 Bioprosthesis versus mechanical devices.- 8.3 Conservative mitral valve surgery.- 8.4 Chronic valvular heart disease: timing of surgery.- 8.5 Diagnosis of prosthetic dysfunction by means of echocardiography and Doppler ultrasound.- 8.6 Conclusions.- 9. Surgical Correction of Tetralogy of Fallot: Mid-Term Results.- 9.1 Introduction.- 9.2 Mid-term postoperative cardiac catheterization studies after corrective surgery for tetralogy of Fallot.- 9.3 Mid- and long-term postoperative results of tetralogy of Fallot cases operated on in the Hospital Infantil, Ciudad Sanitaria 'Vall d'Hebron' (1971-1983).- 9.4 Cardiac dysrhythmias after surgical treatment of tetralogy of Fallot.- 9.5 Tetralogy of Fallot: present status of corrective surgery and midterm follow-up.- 10. Angina Pectoris (I).- 10.1 Introduction.- 10.2 Coronary reserve and angina therapy.- 10.3 Nitrates in the treatment of angina pectoris.- 10.4 Comparison of four calcium antagonists with placebo and propranolol.- 10.5 Pathophysiology of unstable angina pectoris: clinical, angiographic and therapeutic observations.- 10.6 Treatment of primary angina.- 10.7 Conclusions.- 11. Angina Pectoris (II): Instrumental Procedures.- 11.1 Introduction.- 11.2 Current status of coronary angioplasty in Spain.- 11.3 Coronary angioplasty: a new way to revascularization of the heart.- 11.4 Long-term results of coronary artery bypass graft surgery: experience of the Montreal Heart Institute.- 11.5 The Netherlands coronary surgery study (N.C.S.): coronary bypass surgery in patients with mild angina pectoris.- 11.6 Laser treatment of coronary artery disease.- 11.7 Conclusions.- 12. Myocardial Infarction (I).- 12.1 Introduction.- 12.2 Recanalization of coronary arteries by thrombolytic agents in acute myocardial infarction.- 12.3 Rupture of the free ventricular wall during the acute phase of myocardial infarction: diagnosis and treatment.- 12.4 Myocardial revascularization with acute myocardial infarction.- 12.5 Twenty-five years of Coronary Units: perspectives for the future.- 12.6 Thrombolysis in acute myocardial infarction.- 12.7 Conclusions.- 13. Myocardial Infarction (II): Primary and Secondary Prevention.- 13.1 Introduction.- 13.2 How, when and who to treat for dyslipemia.- 13.3 Prophylactic ?-blocking treatment after myocardial infarction.- 13.4 Criticism of long-term preventive treatment after myocardial infarction.- 13.5 Strategies for postinfarction treatment.- 13.6 Conclusions.- Index of Subjects.