Electrophysiological Foundations of Cardiac Arrhythmias

Electrophysiological Foundations of Cardiac Arrhythmias
Electrophysiological Foundations of Cardiac Arrhythmias

Electrophysiological Foundations of Cardiac Arrhythmias

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by Andrew L. Wit, PhD; Hein J. Wellens, MD, PhD; and Mark E. Josephson, MD

Product Details:
Published May 2017
ISBN: 9780979016455
Trim size: 7 x 10 inches
672 pages, full color interior
Format: Hardcover and eBook set; eBook


Print book includes a free digital edition.

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This book teaches the fundamental concepts of cardiac electrophysiology with an emphasis on the relationship of basic mechanisms to clinical arrhythmias. Understanding this relationship and the underlying mechanisms of arrhythmogenesis will be valuable to medical students in general and physicians entering the fields of cardiology and clinical electrophysiology, as well as those scientists and clinicians already working in this field.

The foundations of electrophysiology are explained in a way that will enable the student/reader to go on to more advanced texts such as Josephson’s Clinical Cardiac Electrophysiology by Mark E. Josephson (Wolters Kluwer), who is one of the authors of this book. It is not a complete review of basic cellular electrophysiology and only focuses on aspects that are relevant to the arrhythmogenic mechanisms. Similarly, it is not a complete compendium on electrophysiology of clinical arrhythmias. Only selected arrhythmias are described that best illustrate the translation of the basic electrophysiological mechanism to the clinic.

The book is divided into three parts that cover the major mechanisms of arrhythmogenesis: Part I – Automaticity, Part II – Afterdepolarizations and Triggered Activity, and Part III – Abnormal Impulse Conduction and Reentry. Each part starts with a chapter that describes the basic science principles related to that particular mechanism. Topics include: impulse initiation and rate control, membrane currents, conduction, and the effects of programmed electrical stimulation and pharmacologic agents. Subsequent chapters in each part are organized around examples of clinical arrhythmias and then focus on the relevant EP mechanisms and the characteristic responses to interventions. The characteristics of the three different mechanisms are compared and contrasted throughout the text.

Each example works through these three key questions:

  1. What are the ECG characteristics of the arrhythmia?
  2. What is the underlying electrophysiological mechanism?
  3. What are the characteristic properties of the arrhythmia that point to its mechanism?

Throughout the book, the aspects of basic EP mechanisms and examples from EP studies and pharmacologic interventions are paired with clinical examples. The end result is enhanced understanding of how EP mechanisms and testing relate to arrhythmogenesis in a way that can be applied broadly to a variety of situations in a clinical setting.

This definitive book also includes:

  • More than 300 figures, including ECGs and original diagrams that illustrate essential electrophysiology concepts.
  • Case studies of clinical arrhythmias with explanations of how ECG characteristics and the responses to electrical stimulation denote arrhythmogenic mechanisms.


"This is a gem of a resource on the electrophysiologic underpinnings of cardiac arrhythmias. Three master teachers discuss the bridge between scientific mechanisms and practical clinical electrophysiology. The textbook is brilliantly illustrated with attractive color images and informative case ECGs acquired over many years from the legendary courses and publications by Drs. Mark Josephson and Hein Wellens.  The scientific principles discussed derive from their unique partnership with their lifelong friend and colleague, Dr. Andrew Wit, who has made major discoveries of fundamental mechanisms of cardiac arrhythmogenesis.  This compendium of clinical and scientific knowledge is a “must read” for students, fellows, and faculty alike in this critically important discipline in cardiology."

~Richard L. Verrier, Ph.D; Associate Professor of Medicine, Harvard Medical School, Harvard-Thorndike Electrophysiology Institute, Beth Israel Deaconess Medical Center, Division of Cardiovascular Medicine



Find the review in Pacing and Clinical Electrophysiology by Melvin Scheinman, MD.

Table of Contents:

Part I – Automaticity
Chapter 1.  Basic Principles of Normal Automaticity
Chapter 2. Sinus Node Normal Automaticity and Automatic Arrhythmias
Chapter 3. Atrial, A-V Junctional, and Ventricular Normal Automaticity and Automatic Arrhythmias
Chapter 4. Abnormal Automaticity: Principles and Arrhythmias

Part II – Afterdepolarizations and Triggered Activity
Chapter 5. Basic Principles of Delayed Afterdepolarization
Chapter 6. Delayed Afterdepolarization: Triggered Arrhythmias
Chapter 7. Basic Principles of Early Afterdepolarization
Chapter 8. Early Afterdepolarization: Triggered Arrhythmias

Part III - Abnormal Impulse Conduction and Reentry
Chapter 9. Basic Principles of Reentry    
Chapter 10. Reentrant Arrhythmias in the Atria
Chapter 11. Reentrant Arrhythmias in the AV Junction
Chapter 12. Reentrant Arrhythmias in the Ventricles        


Andrew L. Wit, PhD, FACC
Emeritus Professor of Pharmacology, Department of Pharmacology
College of Physicians and Surgeons of Columbia University
New York, New York

Hein J. Wellens, MD, PhD, FACC, FAHA, FESC
Emeritus Professor of Cardiology, University of Maastricht
Maastricht, The Netherlands

Mark E. Josephson, MD, FACC, FHRS, FAHA
Director, Harvard-Thorndike Electrophysiology Institute and Arrhythmia Service
Chief Emeritus, Division of Cardiovascular Medicine
Beth Israel Deaconess Medical Center
Herman C. Dana Professor of Medicine
Harvard Medical School
Boston, Massachusetts