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Journal of Intensive Care Medicine, Vol. 22, No. 1, 3-13 (2007)
DOI: 10.1177/0885066606295225

Reviews

Life-Threatening Arrhythmias in the Intensive Care Unit

Scott Reising, MD

Department of Community Internal Medicine, Mayo Clinic, Jacksonville, Florida

Fred Kusumoto, MD

Electrophysiology and Pacing Service, Division of Cardiovascular Disease, Department of Medicine, Mayo Clinic, Jacksonville, Florida; Electrophysiology and Pacing Service, Division of Cardiovascular Disease, Mayo Clinic, 4500 San Pablo Avenue, Jacksonville, FL 32224; kusumoto.fred{at}mayo.edu

Nora Goldschlager, MD

Cardiology Division, Department of Medicine, San Francisco General Hospital, San Francisco, California; Department of Medicine, University of California, San Francisco

Symptomatic arrhythmias are frequently observed in the intensive care unit and often lead to significant hemodynamic compromise because of the presence of multisystem disease. In particular, prompt evaluation of patients with tachycardia is critical because treatment depends on the accurate diagnosis of the arrhythmia mechanism. The electrocardiogram remains the most important diagnostic tool for the evaluation of both wide complex and narrow complex tachycardia. For wide complex tachycardia, evaluation of the atrioventricular relationship and QRS morphology are critical, and for narrow QRS complex tachycardias, evaluation focuses on identification of the location and morphology of P waves. Bradycardia can arise from sinus node dysfunction or atrioventricular conduction block.

Key Words: tachycardia • bradycardia • wide complex tachycardia


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