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288 P R I N C I P L E S A N D P R A C T I C E O F C R I T I C A L C A R E

Learning activities
1. List the major ECG criteria for each of the major arrhythmias 4. Discuss the antiarrhythmic therapies available for the treat-
described in this chapter ment of atrial and ventricular arrhythmias.
2. Describe the general approaches to management of bradyar- 5. Describe the indications, mechanisms of action, dose and side
rhythmias, tachyarrhythmias and AV block effect of the major antiarrhythmics in classes I – IV.
3. Describe the ECG features which would allow differentiation of
the various supraventricular and atrial arrhythmias.

ONLINE RESOURCES 16. Shah D. Catheter ablation for atrial fibrillation: mechanism-based curative
treatment. Exp Rev Cardiovasc Ther 2004; 2(6): 925–33.
European Heart Rhythm Association (EHRA), http://www.escardio.org/ 17. Schuchert A. Contributions of permanent cardiac pacing in the treatment of
communities/EHRA/Pages/welcome.aspx atrial fibrillation. Europace 2004; 5(Suppl1): S36–41.
European Resuscitation Council, https://www.erc.edu/index.php/mainpage/en/ 18. Kaushik V, Leon AR, Forrester JS Jr, Trohman RG. Bradyarrhythmias,
ECG temporary and permanent pacing. Crit Care Med 2000; 28(10Suppl):
ECG quizzes and teaching materials: http://library.med.utah.edu/kw/ecg/, N121–8.
http://ekgreview.com/, http://biotel.ws/quizzes/ekgs/ekgs.htm, http://www. 19. Corcoran SJ, Pressley L. The slow pulse: is a pacemaker necessary? Med J Aust
ecglibrary.com/ecghome.html 1999; 170(11): 556–61.
Arrhythmia and cardiac device presentations, manuals, and learning resources, 20. Ilia R, Amit G, Cafri C, Gilutz H, Abu-Ful A et al. Reperfusion arrhythmias
http://www.hrsonline.org/ during coronary angioplasty for acute myocardial infarction predict
Pacing resources, http://www.sjmprofessional.com/, http://www.medtronic.com/ ST-segment resolution. Coron Artery Dis 2003; 14(6): 439–41.
for-healthcare-professionals/education-training 21. Bonnemeier H, Ortak J, Wiegand UK, Eberhardt F, Bode F et al. Accelerated
idioventricular rhythm in the post-thrombolytic era: incidence, prognostic
FURTHER READING implications, and modulating mechanisms after direct percutaneous
coronary intervention. Ann Noninvas Electrocardiol 2005; 10(2): 179–87.
22. Hales M. Keep up the pace: the prevention, identification and management
Drew B, Ackerman M, Funk M, Gibler B, Kligfield P et al. Prevention of torsades of common temporary epicardial pacing pitfalls following cardiac surgery.
de pointes in hospital settings: A scientific statement from The American Heart World Crit Care Nurs 2005; 4(1): 11–19.
Association and The American College of Cardiology Foundation. J Am Coll 23. Brady WJ, Swart G, DeBehnke DJ, Ma OJ, Aufderheide TP. The efficacy of
Cardiology 2010; 55(9): 934–47.
atropine in the treatment of hemodynamically unstable bradycardia and
atrioventricular block: prehospital and emergency department consider-
REFERENCES ations. Resuscitation 1999; 41(1): 47–55.
24. Brady WJ Jr, Harrigan RA. Evaluation and management of bradyarrhythmias
1. Novak B, Filer L, Hatchett R. The applied anatomy and physiology of the in the emergency department. Emerg Med Clin North Am 1998;16(2):
cardiovascular system. In: Hatchett R, Thompson D, eds. Cardiac nursing: 361–88.
a comprehensive guide. Philadelphia: Churchill Livingstone Elsevier; 2002. 25. Ghi S, Constantin C, Klersy C et al. Interventricular and intraventricular
2. Guyton A. Textbook of medical physiology, 8th edn. Philadelphia: WB Saunders; dyssynchrony are common in heart failure patients, regardless of QRS dura-
1991. tion. Eur Heart J 2004; 25: 571–8.
3. Rubart M and Zipes DP. Genesis of cardiac arrhythmias: Electrophysiologic 26. Littmann L, Symanski JD. Hemodynamic implications of left bundle branch
considerations. In: Braunwald E, Zipes DP, Libby P, Eds. Heart disease:a block. J Electrocardiol 2000; 33(Suppl1): 115–21.
textbook of cardiovascular medicine, 6th edn. Philadelphia: WB Saunders; 2001. 27. Connolly SJ, Kerr CR, Gent M et al. Effects of physiologic pacing versus
4. Waldo AL, Wit AL. Mechanisms of cardiac arrhythmias and conduction ventricular pacing on the risk of stroke and death due to cardiovascular
disturbances. In: Alexander RW, Schlant RC, Fuster V, eds. Hurst’s The Heart causes. N Engl J Med 2000; 342: 1385–91.
Arteries and Veins, 9th edn. New York: McGraw-Hill; 1998. 28. Lough ME. Cardiovascular diagnostic procedures. In: Urden L, Stacy KM,
5. Conover MB. Understanding electrocardiography, 7th edn. St Louis: Mosby; Lough ME, eds. Thelan’s critical care nursing: diagnosis and management.
1996. St Louis: Mosby; 2002.
6. Mines GR: On dynamic equilibrium in the heart. J Physiol 1913; 46: 349. 29. Lown B, Calvert AF, Armington R, Ryan M. Monitoring for serious arrhyth-
7. Dunn MI, Lipman BS. Lipmann-Massie clinical electrocardiography, 8th edn. mias and high risk of sudden death. Circulation 1975; 52(6Suppl):
Chicago: Year Book Medical; 1989. 189–98.
8. Josephson ME. Clinical cardiac electrophysiology. Philadelphia: Lippincott, 30. Francis J, Watanabe M, Schmidt G. Heart rate turbulence: a new predictor
Williams & Wilkins; 2002. for risk of sudden cardiac death. Ann Noninvas Electrocardiol 2005;10(1):
9. Wagner GS, Marriott HJL. Marriott’s practical electrocardiography, 10th edn. 102–9.
Baltimore: Lippincott, Williams & Wilkins; 2000. 31. Fries R, Steuer M, Schafers HJ et al. The R-on-T phenomenon in patients
10. Chen-Scarabelli C. Supraventricular arrhythmias: an electrophysiology with implantable cardioverter defibrillators. Am J of Cardiol 2003; 91(6):
primer. Prog Cardiovasc Nurs 2005; 20(1): 24–31. 752–5.
11. McCord J, Borzak S. Multifocal atrial tachycardia. Chest 1998; 113(1): 32. Varma N, Vassilikos V. Electrocardiography of tachycardias. London: Chapman
203–9. & Hall; 1993
12. Heeringa J, van der Kuip D, Hofman A, Kors JA, van Herpen G et al. Preva- 33. Brady WJ, Skiles J. Wide QRS tachycardia: ECG differential diagnosis. Am
lence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study. J Emerg Med 1999; 17: 376–81.
Euro Heart J 2006; 27: 949–53. 34. Sweeney MO. Antitachycardia pacing for ventricular tachycardia using
13. Maglana MP, Kam RM, Teo WS. The differential diagnosis of supraventricular implantable cardioverter defibrillators. Pacing Clin Electrophysiol 2004; 27(9):
tachycardia using clinical and electrocardiographic features. Ann Acad Med 1292–305.
Singapore 2000; 29(5): 653–7. 35. Finch NJ, Leman RB. Clinical trials update: sudden cardiac death prevention
14. Haghi D, Schumacher B. Current management of symptomatic atrial fibril- by implantable device therapy. Crit Care Nurs Clin North Am 2005; 17(1):
lation. Am J Cardiovasc Drugs 2001; 1(2): 127–39. 33–8.
15. Naccarelli GV, Wolbrette DL, Khan M, Batta L, Khan M et al. Old and new 36. Goldenberg I, Moss AJ. Long QT syndrome. J Am Coll Cardiol 2008, 51(24),
antiarrhythmic drugs for converting and maintaining sinus rhythm in atrial 2291–300.
fibrillation: comparative efficacy and results of trials. Am J Cardiol 2003; 20; 37. Wellens, HJ, Conover, MB. The ECG in emergency decision making, 2nd edn.
91(6A): 15D–26D. St Louis: Saunders Elsevier; 2006.