Abstract
Cardiac arrhythmias may be a mere cosmetic blemish, may cause symptoms, may be hemodynamically significant or may be of prognostic significance. Those arrhythmias which have an immediate hemodymanic effect are serious and may threaten life. Examples include rapid tachyarrhythmias, asystole and complete heart block. Initial management in the presence of a sustained event must be to restore a normal rhythm or to reduce the hemodynamic consequences of the abnormal rhythm. When the acute situation has resolved, continuing management may be necessary as a protection against repetitive events. As in all areas of medical endeavour, treatment should be profiled for efficacy and safety. In the management of life-threatening cardiac arrhythmias a moderate incidence of unwanted effects and perhaps even quite serious risks of therapy may be acceptable as the price to pay for protection.
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References
Waxman HL, Myerburg RJ, Appel R, Sung RJ (1981) Verapamil for control of ventricular rate in paroxysmal supraventricular tachycardia and atrial fibrillation or flutter. Ann Intern Med 94:1–6.
Cowan JC, Gardiner P, Reid DS, Newell DJ, Campbell RWF (1986) A comparison of amiodarone and digoxin in the tratment of atrial fibrillation complicating suspected acute myocardial infarction. J Cardiovasc Pharmacol 8:252–256.
Campbell RWF, Smith RA, Gallagher JJ, Pritchett ELC, Wallace AG (1977) Atrial fibrillation in the pre-excitation syndrome. Am J Cardiol 40:514–520.
Gulamhusein S, Ko P, Klein GJ (1983) Ventricular fibrillation following verapamil in the Wolff-Parkinson-White syndrome. Am Heart J 106:145–147.
Scheinman BD, Evans T (1982) Acceleration of ventricular rate by fibrillation associated with the Wolff-Parkinson-White syndroma. Br Med J 285:999–1000.
Koster RW, Dunning AJ (1985) Intramuscular lidocaine for prevention of lethal arrhythmias in the prehospitalisation phase of acute myocardial infarction. N Engl J Med 313:1105–1110.
Buxton AE, Marchlinski FE, Doherty JU, Flores B, Josephson ME (1987) Hazards of intravenous verapamil for sustained ventricular tachycardia. Am J Cardiol 59:1107–1110.
Rankin AC, Rae AP, Cobbe SM (1987) Inappropriate use of intravenous verapamil in patients with ventricular tachycardia. Br Heart J 57:591–595.
Moskowitz RM, Schwartz AB (1987) Spontaneous termination of prolonged ventricular fibrillation after acute myocardial infarction. Arch Int Med 147:171–172.
Sanna G, Arcidicacono R (1973) Chemical ventricular defibrillation of the human heart with bretylium tosylate. Am J Cardiol 32:982–987.
Wellens HJJ, Bar F, Gorgels AP, Farre L (1978) Electrical management of arrhythmias with emphasis on the tachycardias. Am J Cardiol 41:1025–1034.
Rasmussen K, Lunde PI, Lie M (1987) Coronary bypass surgery in exercise induced ventricular tachycardia. Eur Heart J 8:444–448.
Gallagher, Sealy WC, Cox JL, Kasell JH, German LD (1983) Anatomic substrates of the Wolff-Parkinson-White syndrome. In: Elizari MV, Rosenbaum MB, (eds) Frontiers of Cardiac Electrophysiology. Martinus Nijhoff Boston, pp 689-701.
Bourke JP, Tansuphaswadikul S, Cowan JC, Hilton CJ, Campbell RWF (1987) Role of surgical therapy for sustained ventricular tachycardia and fibrillation early after myocardial infarction. In: Breithardt G, Borggrefe M, Zipes DP (eds) Non Pharmacological Therapy of Tachyarrhythmias. New York, Futura.
DiMarco JP, Lerman BB, Kron IL, Sellers TD (1985) Sustained ventricular tachyarrhythmias within two months of acute myocardial infarction; results of medical and surgical therapy in patients resuscitated from the initial episode. J Am Coll Cardiol 6:759–768.
Wellens HJJ, Bar FWHM, Vanagt EJDM, Brugada P (1982) Medical treatment of ventricular tachycardia: Considerations in the selection of patients for surgical treatment. Am J Cardiol 49:186–193.
Horowitz LN, Josephson ME, Koster JA (1980) Intracardiac electrophysiological study as a method of optimization of drug therapy in chronic VT. Prog Cardiovasc Res 2:381–389.
Horowitz LN, Greenspan AM, Spielman SR, et al (1985) Usefulness of electrophysiologic testing in evaluation of amiodarone therapy for sustained ventricular tachyarrhythmias associated with coronary heart disease. Am J Cardiol 55:367–371.
Naccarelli GV, Fineberg NS, Zipes DP, Heger JJ, Duncan G, Prystowsky EN (1985) Amiodarone: risk factors for recurrence of symptomatic ventricular tachycardia identified at electrophysiologic study. J Am Coll Cardiol 6:814–821.
Gabry MD, Brodman R, Johnston D, et al (1987) Automatic implantable cardioverter — defibrillation: Patient survival battery depletion and shock delivery analysis. J Am Coll Cardiol 9:1349–1356.
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© 1988 Springer-Verlag Berlin Heidelberg
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Campbell, R.W.F. (1988). Treatment of Serious Cardiac Arrhythmias. In: Vincent, J.L. (eds) Update 1988. Update in Intensive Care and Emergency Medicine, vol 5. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-83392-2_42
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DOI: https://doi.org/10.1007/978-3-642-83392-2_42
Publisher Name: Springer, Berlin, Heidelberg
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