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Therapeutic strategy in tachyarrhythmias 

Therapeutic strategy in tachyarrhythmias
Chapter:
Therapeutic strategy in tachyarrhythmias
Author(s):

Allan J. Walkey

and Jared Magnani

DOI:
10.1093/med/9780199600830.003.0156
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date: 23 February 2020

The therapeutic approach to tachyarrhythmias in the critically-ill patient involves rapid diagnosis and haemodynamic assessment. Patients who become haemodynamically unstable due to tachyarrhythmia warrant direct current cardioversion. Effects of direct current cardioversion during critical illness are often transient unless the underlying arrhythmia precipitant is eliminated and longer-acting rate- or rhythm-controlling medications are instituted. Atrial fibrillation often responds favourably to a rate-control strategy and treatment of the underlying precipitants. After initial clinical stabilization, clinical management involves elimination of potential arrhythmogenic triggers and administration of appropriate rate or rhythm control medications. Assessment of the QT interval in patients with polymorphic ventricular tachycardia is important in determining the underlying aetiology and treatment strategy. This chapter presents an evidence-based review of the therapeutic approach to tachyarrhythmias.

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