Management of Intractable Supra-Ventricular Arrhythmias in the ICU
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Supraventricular or atrial tachyarrhathmias — paroxysmal supraventricular tachycardia (PSVT) and atrial fibrillation (AF) can complicate the course of any acute illness. For instance, one study of patients admitted to an intensive care unit (ICU) for septic shock recorded an incidence of AF of up to 30% . There is little information on the incidence of such arrhythmias in patients with adult respiratory distress syndrome (ARDS) but unpublished observations on our own unit suggest that it may lie between 10 and 20%. Before a consideration of the principles of management of atrial tachycardias in such patients it is worth reviewing their undesirable effects, mediated by an uncontrolled, rapid, ventricular rate on gas exchange and organ perfusion.
KeywordsAtrial Fibrillation Adult Respiratory Distress Syndrome Atrial Tachycardia Hypoxic Pulmonary Vasoconstriction Pulmonary Artery Occlusion Pressure
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