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## Meet the editor

Prof. Endre Zima, MD, Ph.D., is the chief of the cardiac ICU at Semmelweis University Heart and Vascular Center, Budapest, Hungary. He is a consultant in anesthesiology, intensive care, and cardiology. He achieved a Ph.D. and a medical habilitation degree from Semmelweis University in 2006 and 2017, respectively. As a professor, he holds graduate and postgraduate lectures and practices in anesthesiology, intensive care and car-

diology. He is a full Instructor of the European Resuscitation Council in Advanced Life Support (ALS) and Basic Life Support (BLS). Dr. Zima is a fellow of the European Society of Cardiology, the European Heart Rhythm Association (EHRA), and the Acute Cardiovascular Care Association. He achieved the EHRA accreditation for Cardiac Pacing and Implantable Cardioverter Defibrillators. He is past president of the Working Group on Cardiac Arrhythmias and Pacing and board member of the Hungarian Society of Cardiology and Working Group of Heart Failure. He is a member of the Hungarian Society of Resuscitation and the Hungarian Society of Anesthesiology and Intensive Therapy. He has developed protocols for cardiac intensive care and anesthesia for special critical cardiac procedures, such as treatment of cardiogenic shock, electrical storm, protocol of target temperature management (TTM) of post-cardiac arrest syndrome (PCAS), anesthesia for ablations, transcatheter aortic valve replacement (TAVR), subcutaneous implantable cardioverter defibrillator (S-ICD), barostimulator implantations, and more. His fields of research are cardiopulmonary resuscitation, post-cardiac arrest intensive care, arrhythmias, ICDs/implantable pulse generators (IPGs), cardiac resynchronization therapy (CRT) therapy, defibrillator development, acute and intensive cardiac care, cardiogenic shock/acute heart failure, and invasive hemodynamic monitoring. He is currently supervising the scientific research work of four Ph.D. students and three medical students. Professor Zima and his co-authors have two accepted patents to their credit. He is the author of thirteen book chapters, sixty-six international journal articles, and fifty-six native-language papers (26 papers in D1, and 46 in Q1 category) with a total citation of 3234, Hirsch-index of 18, g-index of 27.

## Contents


**Chapter 6 87** The Influence of Transthoracic Impedance on Electrical Cardioversion and Defibrillation: Current Data *by Adam Pal-Jakab, Bettina Nagy, Boldizsar Kiss and Endre Zima*

Preface

*Updates on Cardiac Defibrillation, Cardioversion and AED Development* delves deeply into the world of cardiac tachyarrhythmia treatment. Through various approaches, the chapters detail special arrays of electrical and pharmacological methods to prevent tachyarrhythmias or to convert tachyarrhythmia to normal rhythm.

Chapter 1, "Cardioversion" by Mevlut Demir, discusses the procedure of cardioversion, which employs electrical or medical methods to restore normal sinus rhythm during tachyarrhythmic events. Electrical cardioversion, employing QRSsynchronized direct current is the favored approach for tachyarrhythmias with QRS complexes when pharmacological interventions fail or hemodynamic instability occurs. The chapter also highlights its differentiation from defibrillation, focusing on common indications such as atrial fibrillation and flutter while cautioning against its

Chapter 2, "History of the Development of Automated External Defibrillators", by Oskars Kalejs et al., raises curiosity about the historical journey that led to these life-saving devices becoming commonplace. The chapter's structure as a historical excursion invites readers to explore the evolution of cardiac electrical therapies, particularly defibrillation. It also depicts the pioneers behind it and the progression of

Chapter 3, "ICD for Sudden Cardiac Death Prevention and New Pharmaceutical Treatment Options in Hypertrophic Obstructive Cardiomyopathy", by Antonio da Silva Menezes Junior et al., discusses the intricate nature of hypertrophic cardiomyopathy (HCM), primarily caused by autosomal dominant sarcomeric gene mutations, resulting in reduced heart compliance, myofibrillar disarray, and fibrosis. The chapter highlights evolved management strategies that enable HCM patients to expect a normal lifespan without invasive interventions. While curative treatments for hypertrophy and heart dysfunction are lacking, drug-based therapies aim to alleviate symptoms and decelerate disease progression. The study introduces mavacamten, a reversible cardiac myosin allosteric modulator showing promising potential for improving obstructive HCM patients' health. Crucially, implantable cardioverterdefibrillators are pivotal for preventing sudden cardiac death in HCM cases, alongside the challenges of managing atrial arrhythmias and the growing utilization of anti-

AEDs from initial concepts to their pivotal role in modern resuscitation.

arrhythmic drugs and, as least resort, radiofrequency ablations.

Chapter 4, "Atrial Fibrillation and Cardioversion Drugs", by Taomin Su et al., addresses the detrimental impact of atrial arrhythmias, particularly tachyarrhythmias, on heart function and their potential contribution to heart failure. Atrial

fibrillation, a prominent type of atrial arrhythmia, is characterized by disrupted atrial contractions and is a prevalent and serious condition in clinical practice, associated with significant complications such as hemodynamic alterations and systemic

use in certain cases.
