Arrhythmias. Principles of long and short term management of arrythmias. Arrythmias. Stability of the patient is primary Serious signs and symptoms (shock, hypotension, CHF,altered consciousness, severe SOB, MI, or ischeamic pain) require immediate treatment
Principles of long and short term management of arrythmias
Stability of the patient is primary
Serious signs and symptoms (shock, hypotension, CHF,altered consciousness, severe SOB, MI, or ischeamic pain) require immediate treatment
Stable patients can be further investigated
Immediate synchronized DC
Cardioconversion should be
Performed on all unstable patients
Stable patients are assessed
According to underlying rhythm and history
Sinus Tachycardia- faster than 100 bpm
Rarely primary- treat the underlying cause
Dehydration, fever, hypoxia
Paroxysmal superventricular tachycardia
arise from above the bifurcation of the His
bundle. Approximately 90% of these
arrhythmias occur as a result of a reentrant
mechanism; the remaining 10% occur as a result
of increased automaticity.
Physical maneuvers- valsalva
In general, pharmacologic agents with AV nodal blocking properties such as adenosine, -blockers, calcium channel blockers, and digoxin are used for the acute management and prevention of AV nodal dependent PSVT. Other antiarrhythmic agents, such as procainamide and amiodarone, which exert effects at various levels of the cardiac conduction system are used for the management and prevention of AV nodal independent PSVT.
In stable patients with a rapid ventricular response, the initial goal is rate control. This can usually be achieved with -blockers, calcium channel blockers, or digoxin
Similar to AF
Patient are at less risk from coagulation
Ventricular tachycardia is the most common cause of wide QRS complex tachycardia. The term VT is used when six or more consecutive ventricular beats occur. The ventricular rate is usually 150–220 beats/min, although rates slower than 120 beats/min may occur.
Traditionally, patients with stable VT are administered an antiarrhythmic agent for chemical cardioversion. A number of medications are available. The choice for a particular patient is often based on physician preference and experience, findings of preserved or impaired cardiac function, and the underlying cause of the VT.
Unstable patients need transcutaneouspacemaking
Stable patients can be managed pharmcologically
Assymptomatic Sinus Bradycardia requires no treatment
Speed up the heart… atropine dopamine aminophylline