Atrial Fibrillation and Other Supraventricular Tachycardias

  • Daniel SedehiEmail author


Management of atrial fibrillation and other supraventricular tachycardias, whether as the primary admitting diagnosis or a secondary diagnosis is a key skill in the critical care setting. A primary strategy of rhythm or rate control may be adopted and tailored to the individual clinical circumstances. Reduction of cardioembolic risk in atrial fibrillation is a central goal in the management of this disease, even after sinus rhythm has resumed.


Atrial fibrillation Supraventricular tachycardia Rate control Rhythm control Embolic risk Hemodynamics Direct current cardioversion Transesophageal echocardiography guided cardioversion 


  1. 1.
    Fuster V, Rydén LE, Asinger RW, Cannom DS, Crijns HJ, Frye RL, et al. ACC/AHA/ESC guidelines for the management of patients with atrial fibrillation: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines and Policy Conferences (Committee to Develop Guidelines for the Management of Patients With Atrial Fibrillation) Developed in Collaboration With the North American Society of Pacing and Electrophysiology. J Am Coll Cardiol. 2001;38(4):1231–65.CrossRefGoogle Scholar
  2. 2.
    Maganti K, Rigolin VH, Sarano ME, Bonow RO. Valvular heart disease: diagnosis and management. Mayo Clin Proc. 2010;85(5):483–500.CrossRefGoogle Scholar
  3. 3.
    Olivotto I, Cecchi F, Casey SA, Dolara A, Traverse JH, Maron BJ. Impact of atrial fibrillation on the clinical course of hypertrophic cardiomyopathy. Circulation. 2001;104(21):2517–24.CrossRefGoogle Scholar
  4. 4.
    Healey JS, Connolly SJ, Gold MR, Israel CW, Van Gelder IC, Capucci A, et al. Subclinical atrial fibrillation and the risk of stroke. N Engl J Med. 2012;366(2):120–9.CrossRefGoogle Scholar
  5. 5.
    Lip G, Nieuwlaat R, Pisters R. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation. Chest. 2010;137(2):263–72.CrossRefGoogle Scholar
  6. 6.
    Ntaios G, Lip GYH, Makaritsis K, Papavasileiou V, Vemmou A, Koroboki E, et al. CHADS2, CHA2DS2-VASc, and long-term stroke outcome in patients without atrial fibrillation. Neurology. 2013;80(11):1009–17.CrossRefGoogle Scholar
  7. 7.
    Pisters R, Lane DA, Nieuwlaat R, de Vos CB, Crijns HJGM, GYH L. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey. Chest. 2010;138(5):1093–100. American College of Chest PhysiciansCrossRefGoogle Scholar
  8. 8.
    Wyse DG, Waldo AL, DiMarco JP, Domanski MJ, Rosenberg Y, Schron EB, et al. A comparison of rate control and rhythm control in patients with atrial fibrillation. N Engl J Med. 2002;347(23):1825–33.CrossRefGoogle Scholar
  9. 9.
    Van Gelder IC, Groenveld HF, Crijns HJGM, Tuininga YS, Tijssen JGP, Alings AM, et al. Lenient versus strict rate control in patients with atrial fibrillation. N Engl J Med. 2010;362(15):1363–73.CrossRefGoogle Scholar
  10. 10.
    Connolly SJ, Ezekowitz MD, Yusuf S, Eikelboom J, Oldgren J, Parekh A, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009;361(27):1139–51.CrossRefGoogle Scholar
  11. 11.
    Granger CB, Alexander JH, McMurray JJ, Lopes RD, Hylek EM, Hanna M, et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011;365(11):981–92.CrossRefGoogle Scholar
  12. 12.
    Patel MR, Mahaffer KW, Garg J, Pan G, Singer DE, Hacke W, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med. 2011;365(10):883–91.CrossRefGoogle Scholar
  13. 13.
    Gugliano RP, Ruff CT, Braunwald E, Murphy SA, Wiviott SD, Halperin JL, et al. Edoxaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2013;369(22):2093–104.CrossRefGoogle Scholar
  14. 14.
    Klein AL. Cardioversion guided by transesophageal echocardiography: the ACUTE Pilot Study: a randomized, controlled trial. Ann Intern Med. 1997;126(3):200–9. American College of PhysiciansCrossRefGoogle Scholar
  15. 15.
    Klein AL, Murray RD, Grimm RA. Role of transesophageal echocardiography-guided cardioversion of patients with atrial fibrillation. J Am Coll Cardiol. 2001;37(3):691–704.CrossRefGoogle Scholar
  16. 16.
    McManus DD, Rienstra M, Benjamin EJ. An update on the prognosis of patients with atrial fibrillation. Circulation. 2012;126(10):e143–6.CrossRefGoogle Scholar
  17. 17.
    Imazio M, Brucato A, Ferrazzi P, Rovere ME, Gandino A, Cemin R, et al. Colchicine reduces postoperative atrial fibrillation. Circulation. 2011;124(21):2290–5.CrossRefGoogle Scholar
  18. 18.
    Mathew JP, Parks R, Savino JS, Friedman AS, Koch C, Mangano DT, et al. Atrial fibrillation following coronary artery bypass graft surgery: predictors, outcomes, and resource utilization. MultiCenter Study of Perioperative Ischemia Research Group. JAMA. 1996;276(4):300–6.CrossRefGoogle Scholar
  19. 19.
    Mitchell LB, Exner DV, Wyse DG, Connolly CJ, Prystai GD, Bayes AJ, et al. Prophylactic oral amiodarone for the prevention of arrhythmias that begin early after revascularization, valve replacement, or repair: PAPABEAR: a randomized controlled trial. JAMA. 2005;294(24):3093–100.CrossRefGoogle Scholar
  20. 20.
    Guglin M, Chen R, Curtis AB. Sinus rhythm is associated with fewer heart failure symptoms: insights from the AFFIRM trial. Heart Rhythm. 2010;7(5):596–601.CrossRefGoogle Scholar
  21. 21.
    Gasparini M, Leclercq C, Lunati M, Landolina M, Auricchio A, Santini M, et al. Cardiac resynchronization therapy in patients with atrial fibrillation: the CERTIFY study (Cardiac Resynchronization Therapy in Atrial Fibrillation Patients Multinational Registry). JACC Heart Fail. 2013;1(6):500–7.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Cardiovascular MedicineSt Charles Heart and Lung InstituteBendUSA

Personalised recommendations