Skip to main content
SpringerLink
Log in

Management of Bradyarrhythmias in Emergency

  • Chapter
  • First Online:
The Arrhythmic Patient in the Emergency Department

  • 1662 Accesses

Abstract

The sudden appearance in patients of changes in heart rhythm is a situation that requires rapid diagnosis and treatment in emergency departments and intensive care units. The slowdown and block of cardiac impulse conduction form the basis of symptomatic bradycardia.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 74.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 99.00
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Bibliography

  1. Vàzquez Ruiz de Castroviejo E, Munoz Bellino J, Lozano Cabezas C, et al. Analysis of the frequency of cardiac arrhythmias and conduction disturbances from a health-care perspective. Rev Esp Cardiol. 2005;58(6):657–65.

    Article  PubMed  Google Scholar 

  2. Sutton R, Kenny RA. The natural history of sinus sick syndrome. Pacing Clin Electrophysiol. 1986;9(6):1110–4.

    Article  CAS  PubMed  Google Scholar 

  3. Mandel WJ, Jordan JL, Karagueuzian HS. Disorders of sinus function. Curr Treat Options Cardiovasc Med. 1999;1:179–86.

    Article  CAS  PubMed  Google Scholar 

  4. Alboni P, Brignole M, Menozzi C, Scarfò S. Is sinus bradycardia a factor facilitating overt heart failure? Eur Heart J. 1999;20:252–5.

    Article  CAS  PubMed  Google Scholar 

  5. Amar D. Strategies for perioperative arrhythmias. Best Pract Res Clin Anaesthesiol. 2004;18(4):565–77.

    Article  PubMed  Google Scholar 

  6. Heintz KM, Hollenberg SM. Perioperative cardiac issues: postoperative arrhythmias. Surg Clin North Am. 2005;85(6):1103–14.

    Article  PubMed  Google Scholar 

  7. Swart G, Brady Jr WJ, DeBehnke DJ, Ma OJ, Aufderheide TP. Acute myocardial infarction complicated by hemodynamically unstable bradyarrhythmia: prehospital and ED treatment with atropine. Am J Emerg Med. 1999;17:647–52.

    Article  CAS  PubMed  Google Scholar 

  8. Brady WJ, Swart G, DeBehnke DJ, Ma OJ, Aufderheide TP. The efficacy of atropine in the treatment of hemodynamically unstable bradycardia and atrioventricular block: prehospital and emergency department considerations. Resuscitation. 1999;41:47–55.

    Article  CAS  PubMed  Google Scholar 

  9. Schwartz B, Vermeulen MJ, Idestrup C, Datta P. Clinical variables associated with mortality in out-of-hospital patients with hemodynamically significant bradycardia. Acad Emerg Med. 2004;11:656–61; Delise P. ARITMIE. C.E.S.I. srl; 2004.

    Article  PubMed  Google Scholar 

  10. Demoulin JC, Kulbertus HE. Histopathological correlates of sick sino-atrial disease. Br Heart J. 1978;40:1384.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Shaw DB, Linker NJ, Heaver PA, Evans R. Chronic sinoatrial disorder (sick sinus syndrome): a possible result of cardiac ischemia. Br Heart J. 1987;58:598.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Oreto G. riconoscimento del blocco seno atriale di I grado all’ elettrocardiogramma standard. G Ital Cardiol. 1982;12:762–6.

    CAS  PubMed  Google Scholar 

  13. Rosenquist M, Brandt J, Schuller H. Atrial versus ventricular pacing in sinus node disease: a treatment comparison study. Am Heart J. 1986;111:292.

    Article  Google Scholar 

  14. Andersen HR, Nielsen JC, Thomen PE, et al. Long term follow-up of patients from a randomised trial of atrial versus ventricular pacing for sick-sinus syndrome. Lancet. 1997;350:1210–6.

    Article  CAS  PubMed  Google Scholar 

  15. Zipes DP. Second degree atrioventricular block. Circulation. 1979;60:465–72.

    Article  CAS  PubMed  Google Scholar 

  16. Braunwald E, Zipes DP, Libby P, editors. Heart disease: a textbook of cardiovascular medicine. 6th ed. Philadelphia: WB Saunders; 2001.

    Google Scholar 

  17. Strasberg B, Amat-Y-Leon F, Dhingra RC, et al. Natural history of chronic second-degree atrioventricular nodal block. Circulation. 1981;63:1043–9.

    Article  CAS  PubMed  Google Scholar 

  18. Meytes I, Kaplinsky E, Yahini JH, Hanne-Paparo N, Neufeld HN. Wenckebach A-V block: a frequent feature following heavy physical training. Am Heart J. 1975;90:426–30.

    Article  CAS  PubMed  Google Scholar 

  19. Schweitzer P, Mark H. The effect of atropine on cardiac arrhythmias and conduction. Am Heart J. 1980;100:225–61.

    Google Scholar 

  20. Lee TH. Use of cardiac pacemakers and antiarrhythmic devices: ACC/AHA guidelines summary. In: Braunwald E, Zipes DP, Libby P, editors. Heart disease: a textbook of cardiovascular medicine. 6th ed. Philadelphia: WB Saunders; 2001. p. 810–4.

    Google Scholar 

  21. Kusomoto FM, Goldschlager N. Cardiac pacing. N Engl J Med. 1996;334:89–98.

    Article  Google Scholar 

  22. Siegman-Igra Y, Yahini JH, Goldbourt U. Intraventricular conduction disturbances: a review of prevalence, etiology, and progression for 10 years within a stable population of Israeli adult males. Am Heart J. 1978;96:669.

    Article  CAS  PubMed  Google Scholar 

  23. Rowland E. SA node dysfunction, AV block and intraventricular conduction disturbances. Eur Heart J. 1992;13(Suppl H):130–5.

    Article  PubMed  Google Scholar 

  24. Scheinman MM, Peters RW, Modin G, et al. Prognostic value of infranodal conduction time in patients with chronic bundle branch block. Circulation. 1977;56:240–4.

    Article  CAS  PubMed  Google Scholar 

  25. Harrigan RA, Perron AD, Brady WJ. Atrioventricular dissociation. Am J Emerg Med. 2001;19:218–22.

    Article  CAS  PubMed  Google Scholar 

  26. Clemmensen P, Bates ER, Califf RM. Complete atrioventricular block complicating inferior wall acute myocardial infarction treated with reperfusion therapy. Am J Cardiol. 1991;67:225–30.

    Article  CAS  PubMed  Google Scholar 

  27. Priori SG, Aliot E, Blomstrom-Lundqvist C. Task Force on Sudden Cardiac Death of the European Society of Cardiology. Europace. 2002;4:3–18.

    Article  CAS  PubMed  Google Scholar 

  28. Myerburg RJ, Kessler KM, Castellanos A. Sudden cardiac death: epidemiology, transient risk, and intervention assessment. Ann Intern Med. 1993;119(12):1187–97.

    Article  CAS  PubMed  Google Scholar 

  29. Cummins RO, Graves JR, Larsen MP. Out-of-hospital transcutaneous pacing by emergency medical technicians in patients with asystolic cardiac arrest. N Engl J Med. 1993;328(19):1377–82.

    Article  CAS  PubMed  Google Scholar 

  30. Alpert MA, Flaker GC. Arrhythmias associated with sinus node disease. Circulation. 1971;43:836–44.

    Article  Google Scholar 

  31. Silver M, Goldschlager N. Temporary transvenous cardiac pacing in the critical care setting. Chest. 1988;93(3):607–13.

    Article  CAS  PubMed  Google Scholar 

  32. Elmqvist R. Review of early pacemaker development. Pacing Clin Electrophysiol. 1978;1:535–6.

    Article  CAS  PubMed  Google Scholar 

  33. Mond HG, Irwin M, Morillo C, et al. The world survey of cardiac pacing and cardioconvertor defibrillators: calendar 2001. Pacing Clin Electrophysiol. 2004;27:955–64.

    Article  PubMed  Google Scholar 

  34. Lamas GA, Lee KL, Sweeney MO, et al. Ventricular pacing or dual chamber pacing for sinus node dysfunction. N Engl J Med. 2002;346:1854–62.

    Article  PubMed  Google Scholar 

  35. Edhag O, Swahn A. Prognosis of patients with complete heart block or arrhythmic syncope who were not treated with artificial pacemakers. A long term follow up study of 101 patients. Acta Med Scand. 1976;200:457–63.

    Article  CAS  PubMed  Google Scholar 

  36. Edhag O. Long term cardiac pacing: experience of fixed rate pacing with an endocardial electrode in 260 patients. Acta Med Scand. 1969;502:64.

    Google Scholar 

  37. Brignole M, et al. ESC guidelines on cardiac pacing and cardiac resynchronization therapy. Eur Heart J. 2013; doi:10.1093/eurheartj/eht150.

  38. Epstein EE, et al. ACC/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities. J Am Coll Cardiol. 2008; doi:10.1016/j.jacc.2008.02.032.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Cardiovascular Department, Ospedali Riuniti and University of Trieste, Trieste, Italy

    Luca Salvatore, Silvia Magnani, Gerardina Lardieri & Elena Zambon

Authors
  1. Luca Salvatore
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Silvia Magnani
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gerardina Lardieri
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Elena Zambon
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Luca Salvatore .

Editor information

Editors and Affiliations

  1. Cardiovascular Department, Cattinara University Hospital, Trieste, Italy

    Massimo Zecchin

  2. Cardiovascular Department, Cattinara University Hospital Cardiovascular Department, Trieste, Italy

    Gianfranco Sinagra

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Salvatore, L., Magnani, S., Lardieri, G., Zambon, E. (2016). Management of Bradyarrhythmias in Emergency. In: Zecchin, M., Sinagra, G. (eds) The Arrhythmic Patient in the Emergency Department. Springer, Cham. https://doi.org/10.1007/978-3-319-24328-3_3

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-24328-3_3

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-24326-9

  • Online ISBN: 978-3-319-24328-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation