Management of Severe Tachyarrhythmias

  • P. Schoenfeld
Conference paper
Part of the Yearbook of Intensive Care and Emergency Medicine 1993 book series (YEARBOOK, volume 1993)


In recent years, prompt and accurate therapy of life–threatening arrhythmias has considerably improved by patients information, continuing education, general practicioners and development of emergency rooms, intensive care units (ICU) and emergency rescue systems. This leaves us with a growing group of patients at risk of recurrence of disabling arrhythmias after the initial episode, especially in the case of survivors of sudden death.


Atrial Fibrillation Ventricular Tachycardia Atrial Flutter Atrial Tachycardia Accessory Pathway 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Commerford PJ, Lloyd EA (1984) Arrhythmias in patients with drug toxicity, electrolyte, and endocrine distrubances. Med Clin North Am 68: 1051–1078PubMedGoogle Scholar
  2. 2.
    Velebit V, Podrid P, Lown B, Cohen BH, Graboys TB (1982) Aggravation and provocation of ventricular arrhythmias by antiarrhythmic drugs. Circulation 65: 886–894PubMedCrossRefGoogle Scholar
  3. 3.
    Stanton MS, Prystowsky EN, Fineberg NS, Miles WM, Zipes PD, Heger JJ 81989) Arrhythmogenic effects of antiarrhythmic drugs: A study of 506 patients treated for ventricular tachycardia or fibrillation. J Am Coli Cardiol 14:209–215Google Scholar
  4. 4.
    Levine JH, Morganroth J, Kadish AH (1989) Mechanisms and risk factors for proarrhythmia with type Ia compared with Ic antiarrhythmic drug therapy. Circulation 80: 1063–1069PubMedCrossRefGoogle Scholar
  5. 5.
    Ruskin JN (1989) The cardiac arrhythmia suppression trial. N Engl J Med 10: 321–386Google Scholar
  6. 6.
    Falk RH (1989) Flecainide–induced ventricular tachycardia and fibrillation in patients treated for atrial fibrillation. Ann Intern Med 111: 107–111PubMedGoogle Scholar
  7. 7.
    Hurley DM, Hunter AN, Hewett MJ, et al. (1981) Atrial fibrillation and arterial embolism in hyperthyroidism. Aust NZ J Med 11: 391–393CrossRefGoogle Scholar
  8. 8.
    Ettinger PO, Wu CF, De La Cruz C, et al. (1978) Arrhythmias and the “Holiday Heart”: Alcohol associated cardiac rhythm disorders. Am Heart J 95: 555–563PubMedCrossRefGoogle Scholar
  9. 9.
    Faniel R, Schoenfeld P (1983) Efficacy of IV amiodarone in Converting atrial fibrillation and flutter to sinus rhythm in intensive care patients. Eur Heart J 4: 180–185PubMedGoogle Scholar
  10. 10.
    Strasberg B, Arditti A, Sclarovsky S, Lewin RF, Buimovici B, Agmon J (1985) Efficacy of intravenous amiodarone in the management of paroxysmal or new atrial fibrillation with fast ventricular response. Int J Cardiol 7: 47–55PubMedCrossRefGoogle Scholar
  11. 11.
    Goy JJ, Maendly R, Grbic M, Finci L, Sigwart U (1985) Cardioversion with flecainide in patients with atrial fibrillation of recent onset. Eur J Clin Pharmacol 27: 737–739PubMedCrossRefGoogle Scholar
  12. 12.
    Berns E, Rinkenberger RL, Jeang MK, Doughertery AH, Jenkins M, Nacarelli GV (1987) Efficacy and safety of flecainide acetate for atrial tachycardia or fibrillation. Am J Cardiol 59: 1337–1341PubMedCrossRefGoogle Scholar
  13. 13.
    Camm AJ, Paul V (1990) Sotalol for paroxysmal supraventrikulär tachycardias. Am J Cardiol 65: 67A–73APubMedCrossRefGoogle Scholar
  14. 14.
    Josephson ME, Wellens HJJ (1990) Differential diagnosis of supraventricular tachycardia. Cardiol Clin 8: 411–442PubMedGoogle Scholar
  15. 15.
    Waldo AL, MacLean W, Karp RB, et al. (1977) Entrainment and interruption of atrial flutter with atrial pacing. Circulation 56: 737PubMedGoogle Scholar
  16. 16.
    Waxman MB, Wald RW, Sharma AD (1980) Vagal techniques for termination of paroxysmal supraventricular tachycardia. Am J Cardiol 46: 655–667PubMedCrossRefGoogle Scholar
  17. 17.
    Binkenberger RL, Prystowsky EN, Heger JJ, et al. (1980) Effects of intravenous and chronic oral Verapamil administration in patients with supraventricular tachyarrhythmias. Circulation 62: 996Google Scholar
  18. 17.
    DiMarco JP, Seilers TD, Lerman BB, et al. (1985) Diagnostic and therapeutic use of adenosine in patients with supraventricular tachyarrhythmias. J Am Coli Cardiol 6: 417–424CrossRefGoogle Scholar
  19. 19.
    Wellens HJJ, Atie J, Penn OC, Gorgels APM, Brugada P, Smeets J (1990) Diagnosis and treatment of patients with accessory pathways. Cardiol Clin 8: 503–521PubMedGoogle Scholar
  20. 20.
    Wellens HJJ, Durrer D (1974) Relation between the refractory period of the accessory pathway and ventricular frequency during atrial fibrillation in patients with the Wolff–Parkinson–White Syndrome. Am J Cardiol 34: 777–782PubMedCrossRefGoogle Scholar
  21. 21.
    Wellens HJJ, Brugada P, Roy D, et al. (1982) Effect of isoproterenol on the antegrade refractory period of the accessory pathway in patients with the Wolff–Parkinson–White Syndrome. Am J Cardiol 50: 180–184PubMedCrossRefGoogle Scholar
  22. 22.
    Sage PT, Bhandari AK (1991) Wide complex tachycardias: Differential diagnosis and management. Cardiol Clin 9: 595–618Google Scholar
  23. 23.
    Macmahon S, Collins R, Peto R, et al. (1988) Effects of prophylactic lidocaine in suspected acute myocardial infarction. JAMA 260: 1910–1917PubMedCrossRefGoogle Scholar
  24. 24.
    Helmby I, Herre JM, Gee G, et al. (1988) Use of intravenous amiodarone for emergency treatment of life–threatening ventricular arrhythmias. J Am Coli Cardiol 12: 1015–1021CrossRefGoogle Scholar
  25. 25.
    Morady F, Sauve MJ, Malone P, et al. (1983) Long–term efficacy and toxicity of high–dose amiodarone therapy for ventricular tachycardia or ventricular fibrillation. Am J Cardiol 52: 957–965CrossRefGoogle Scholar
  26. 26.
    Eisenberg MS, Copass MK, Hallstrom AP, et al. (1980) Treatment of out–of–hospital cardiac arrests with rapid defibrillation by emergency medieal technicians. New Engl J Med 302: 1379–1383PubMedCrossRefGoogle Scholar
  27. 27.
    Thompson RG, Hallstrom AP, Cobb LA (1979) Bystander–initiated cardiopulmonary resuscitation in the management of ventricular fibrillation. An Intern Med 90: 737–740Google Scholar
  28. 28.
    Myerburg RJ, Conde CA, Sung RJ (1980) Clinical, electrophysiologic and hemodynamic profi– le of patients resuscitated from prehospital cardiac arrest. Am J Med 68: 568–576PubMedCrossRefGoogle Scholar
  29. 29.
    Liberthson RR, Nagel EL, Hirschman JC, Nussenfeld SR (1974) Prehospital ventricular fibrillation: Prognosis and follow–up course. N Engl J Med 291: 317–321Google Scholar
  30. 30.
    Baum RS, Alvarez H, Cobb LA (1974) Survival after resuscitation from out–of hospital ventricular fibrillation. Circulation 50: 1231–1235PubMedGoogle Scholar
  31. 31.
    Brugada P, Talajic M, Smeets J, Mulleneers R, Wellens HJJ (1989) The value of the clinical hi– story to assess prognosis of patients with ventricular tachycardia or ventricular fibrillation after myocardial infaretion. Eur Heart J 10: 747–752PubMedGoogle Scholar
  32. 32.
    Kuchar DL, Thornburn CW, Sammel NL, et al. (1987) Prediction of serious arrhythmic events after myocardial infaretion. J Am Coli Cardiol 9: 531–538CrossRefGoogle Scholar
  33. 33.
    Kanovsky CS, Falcone R, Dresden CA, et al. (1984) Identification of patients with ventricular tachycardia after myocardial infaretion: Signal–averaged ECG, Holter monitoring and cardiac catheterization. Circulation 70: 264–270PubMedCrossRefGoogle Scholar
  34. 34.
    Wilbur DJ, Garan H, Ruskin JN (1987) Electrophysiologic testing in survivors of cardiac arrest. Circulation 75: 146CrossRefGoogle Scholar
  35. 35.
    Denniss AR, Richards DA, Cody DV, et al. (1986) Prognostic significance of ventricular tachycardia and fibrillation induced at programmed Stimulation and delayed potentials detected on the signal–averaged electrocardiograms of survivors of acute myocardial infaretion. Circulation 74: 731PubMedCrossRefGoogle Scholar
  36. 36.
    Wellens HJJ, Brugada P, Stevenson WG (1985) Programmed electrical Stimulation of the heart in patients with life–threatening ventricular arrhythmias. J Am Coli Cardiol 5: 1292–1301CrossRefGoogle Scholar
  37. 37.
    Anderson JL (1990) Clinical implications of new studies in the treatment of benign, potentially malignant and malignant ventricular arrhythmias. Am J Cardiol 62: 241–271Google Scholar
  38. 38.
    Winkle RA, Mead HR, Ruder MA, et al. (1989) Long–term outcome with the automatic implantable cardioverter–defibrillator. J Am Coli Cardiol 13: 1353–1361CrossRefGoogle Scholar
  39. 39.
    Fogoros RN, Elson JJ, Bonnet CA, et al. (1990) Efficacy of the automatic implantable cardioverter–defibrillator in prolonging survival in patients with severe underlying cardiac disease. J Am Coli Cardiol 16: 381–386CrossRefGoogle Scholar
  40. 40.
    Hargrove WC, Josephson ME, Marschlinski FE, et al. (1989) Surgical decisions in the management of sudden cardiac death and malignant ventricular arrhythmias. J Thorac Cardiovasc Surg 97: 923–928PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1993

Authors and Affiliations

  • P. Schoenfeld

There are no affiliations available

Personalised recommendations