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George Edward Billman ed. 573 pages. Hoboken, NJ, USA: John Wiley and Sons, Inc, 2010. $149.95. ISBN: 978-0-470-26100-2When I read about the evils of drinking, I gave up reading.” —Henny YoungmanAll of us who see patients are frustrated by the paucity of antiarrhythmic drug options. There are many reasons for this unfortunate situation, some of which, like projected sales volumes and patent issues, are situational and irrelevant to science. Perhaps the most important reason for the lack of choices is an inadequate understanding of pathophysiology. Our inability to appropriately target therapies has led to overtreatment. In essence, we have had to resort to broad spectrum or shotgun therapy to be able to quell arrhythmias in as many people as possible. The situation is analogous to treating pneumonia without knowing the pathogen. The consequence of poorly focused treatment is unintended toxicities, including proarrhythmia. And nobody wants to develop or approve unsafe drugs.Clearly, there is a need for a more targeted approach to the development and deployment of antiarrhythmic drugs, and this book is an admirable attempt to find a way. The editor solicited ideas from eminent scientists, and their chapters are illuminating and far reaching. In addition to the traditional categorization by ion channel effect, the chapters consider more global issues, such as understanding repolarization reserve and the genetics underlying drug response. Most importantly, the editor has encouraged blue sky thinking in …

circulation

Novel Therapeutic Targets for Antiarrhythmic DrugsBillmanGeorge Edward ed. 573 pages. Hoboken, NJ, USA: John Wiley and Sons, Inc, 2010. $149.95. ISBN: 978-0-470-26100-2