"I found the Garcia's Arrhythmias' text to be an excellent adjunct to current Paramedic Course textbooks. The process I used was to give the initial lecture from the Paramedic book, follow with the Garcia text, and finish with the ACLS lecture that pertained to that rhythm. The students were able to grasp each rhythms identity more clearly, leading to higher student success."

Ted Huffman
Program Manager
Fire Training Academy

Book Review:  Arrhythmia Recognition: The Art of Interpretation, By Tomas B. Garcia, MD, & Geoffrey T. Miller, NREMT-P: Jones and Bartlett Publishers, 2004

Appeared in the April, 2004 issue of JEMS Magazine.

The ability to rapidly and correctly interpret dysrhythmias is the cornerstone on which emergency cardiac care is built.  This melding of knowledge about cardiac anatomy and electrophysiology with the practical ability to read and constantly reassess a patient’s ECG rhythm makes all other emergency cardiac care interventions possible.

Any textbook that sets out to teach the recognition and interpretation of ECG rhythms must seamlessly integrate anatomy and electrophysiology and then immerse the student in the resultant ECGs.  Arrhythmia Recognition: The Art of Interpretation by Garcia and Miller is such a book. 

Much like Dale Dubin’s landmark Rapid Interpretation of EKGs, Arrhythmia Recognition: The Art of Interpretation is logical and pragmatic in its approach to teaching dysrhythmias.  What most clearly sets this book miles apart from Dubin’s is its rich and vibrant illustrations, which make the pages feel about three-dimensional.  To compare the visual impact of this book to Dubin’s classic is akin to comparing a color laser printer to a dot matrix printer.

This book is far more thorough in its approach to teaching the subject matter than most other books on the market.  It’s a highly “readable” textbook that keeps your attention.

If I had to make improvements in the contents of this excellent text, it would be in two areas.  First, although the book includes 75 unknown ECG rhythm strips in its “Final Test” section for recognition practice, I’d like to see even more practice ECGs because more is always better for a learning student.  (Gail Walraven’s Basic Arrhythmias book, from which I learned about dysrhythmias in 1981, has 220 practice strips.)  Finally, it would also be great to see a subsequent edition of this text address the basics of 12-lead ECG’s, including injury and ischemia in the same colorful and dynamic format of the current text.  The lack of 12-lead ECG interpretation makes this excellent book fall short as a one-stop shopping for a supplemental ECG text to the standard paramedic course textbooks. 

  -Edward T. Dickinson, MD, NREMT-P, FACEP, JEMS Medical Editor 

Editors' note: Lead author Tomas Garcia, along with Neil Holtz, EMT-P, has already tackled the topic of 12-leads in two books: Introduction to 12-Lead ECG: The Art of Interpretation and 12-Lead ECG: The Art of Interpretation, both from Jones and Bartlett. 

"Arrhythmia Recognition uses graphics to simplify and explain some of the more challenging topics. I know this will be a great benefit to students who are having a hard time "seeing" what's happening. The text also introduces topics that have previously not been included in Basic EKG books, such as vectors and 12 leads. It appears that there is a good balance, and it should help and not overwhelm new students.

I like the "real world" approach that Dr. Garcia utilizes in writing the text. It eliminates some of the sterile aspects of many medical texts. He stresses not to make interpretations in a vacuum, and to always treat the patient, not the monitor. This is profoundly important in getting newer clinicians off to the right start.  Plus, the self-tests at the end of each chapter are vital to reinforce newly learned material."

—William E. Aiken, MHA, NREMT-P
Lieutenant, Henrico County (VA) Division of Fire

“I have been instructing Paramedic students since 1992.  Every year I teach the Cardiology semester, and we have used several different texts to teach cardiac dysrhythmias.  This is our first semester using Arrhythmia Recognition: The Art of Interpretation by Dr. Garcia.  This is the best text I have ever used to teach this part of the Cardiology course.  It is well written, full of valuable information, and has excellent Instructor support materials. The illustrations and rhythm strips are extremely well presented.  One added bonus: my students love this book!  Bravo to Jones-Bartlett Publishing for providing this outstanding textbook!”

—Ronald Johnson, D.O.
Program/Medical Director, EMS Programs
Department of Nursin, Central Texas College