L. Seipel – författare

The first cardiovascular operation in Duesseldorf, a ligation of an open ductus arteriosus (Botallo), was performed in 1938 by E. K. Frey. During the Second World War and the subsequent years many difficulties hindered cardiovascular surgery in Duesseldorf. However, it was resumed on 3 May 1949 by Prof. Ernst Derra, again by ligating an open ductus arteriosus. This was the starting pOint of the successful cooperation between the cardiological and surgical working groups - the "birthday" of the Duesseldorf Heart Centre. Further highlights in cardiac surgery were the introduction of open heart surgery by means of surface-cool- ing hypothermia (9 February 1955) and extracorporeal circulation (21 February 1959) . In addition to cardiac catheterization and surgery in patients with acquired and congenital heart disease, the diagnosis and treatment of arrhythmias was one of the focal points of the centre. On 3 October 1961 the first pacemaker was implanted in a patient with a third-degree AV-block after he had been treated using an external device for about 1 year. In recent years interest has increasingly turned to the tachy- arrhythmias.Close cooperation between the medical and surgical teams made possible the application of new pacing techniques for the treat- ment of tachycardia. In patients with intractable arrhythmias, surgical interventions were made to eliminate the "focus" of the arrhythmia. In the past 2 years intraoperative electrophysiologic studies (endo-cardi- al and epicardial mapping) were applied to enhance the success of the surgical procedures.

The detection of ischemic myocardium is one of the major problems in modern cardiology. Exercise has long been used to detect latent myocardial ischemia by enhancing oxygen de­ mand, but different cardiologists perform exercise tests in dif­ ferent ways. In addition, many new techniques for detection of ischemia have been developed in the past decade. For these reasons, a symposium on this topic was organized in Dusseldorf under the auspices of the European Society of Cardiology. The papers from this symposium contained herein provide an up-to-date review of the different forms of exercise tests, including their advantages and disadvantages. Indications for study, recording techniques and evaluation of exercise ECG, including computer techniques, are extensively discussed. The results of exercise ECG are compared with those of other me­ thods, especially coronary angiography. Finally, the prognostic value of exercise ECG is assessed. Additional chapters deal with complementary methods for detection of myocardial ischemia, presenting techniques and results of angiographic, isotopic and metabolic studies under exercise. The symposium demonstrates that exercise testing has a primary role in the detection of the disease, but there is still no unanimity on how to carry it out. The results of some new approaches are promising, even if their clinical relevance has not yet been fully established. We hope that this book will be of interest to all our colleagues taking care of cardiac patients. We wish especially to thank Mr. M. Giicker and Mrs. B.