LIFE-THREATENING CARDIAC ARRYTHMIAS Raluca Tat, Adela Golea
Educational objectives What you need to know What is a life-threatening arrhythmia How life-threatening arrhythmias are classified What are the signs/symptoms of hemodynamic instability What are the therapeutic options What are the indications of synchronized electrical cardioversion What are the indications of cardiac pacing What are the main indications of antiarrhythmic drugs used in the management patients with arrhythmia What is the antiarrhythmic dosing recommended for the management of patients with arrhythmia
What you need to do Identify arrhythmia Identify patients with instability signs/symptoms Choose the appropriate therapeutic option for treating arrhythmia in accordance with the clinical status of the patient and the type of identified arrhythmia
Definition Cardiac arrhythmia is a disturbance of the heart rate which may affect the frequency (the alteration of the succession of heartbeats), the regularity of cardiac frequency (the alteration of the ratio between atrial and ventricular rhythms) or both. These changes occur due to a disturbance of myocardial automatism, excitability and contractility, as the heart (body) is subjected to a wide range of pathological (stress) events, such as ischemia, hypoxia, acidosis, electrolyte imbalances, excessive intake of catecholamines, toxic substances etc.
Classification: according to origin: sinus, atrial, junctional and ventricular
Treatment principles The initial assessment and treatment ABCDE principle o o o o o o – o Figure 1.