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COMMENTARY The Old New Initiatives EDICAL knowl- pathological findings, the evolu- rhythm. Electrocardiographic ar- edge progresses tion of cellular pathology, fresh tech- rhythmia monitoring came of age. by small steps, nological developments, patterns of Special coronary care units were es- but sudden tech- clinical findings, and revolutionary tablished to provide 24-hour care of M nological and therapeutic options have modified the patient and recognize and man- therapeutic advances produce a quan- the classic targets, improving the age potentially dangerous arrhyth- tum leap in thinking. An existing care and prognosis of patients. Car- mias. These units, once experimen- paradigm is exhausted and a new diology is passing through a golden tal, are now part of the daily life of conceptual framework emerges. age. It is like a pumping heart in sys- every large hospital. This article describes the evo- tole and diastole in which periods of Sudden death became prevent- lution of successive paradigms in sudden rapid forward motion alter- able (partially) and the warning har- cardiology: each has revolution- nate with periods of relative rest. bingers (ventricular premature beats, ized practice. Herein we describe these new ventricular tachycardia, and first- Diagnostic algorithms and trajectories and the paradigm shifts and
JAMA Internal Medicine – American Medical Association
Published: May 11, 1998
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