Management of Arrhythmic Patients in the Emergency Department: General Principles

  • Alessandro SurianEmail author
  • Luca Visintin


Arrhythmic patients are a common task in the duty of the emergency physician and the cardiology consultant. Both specialists, with their different approach and method, well know the clinical and statistical relevance of arrhythmias.


Atrial Flutter Sinus Tachycardia Atrial Tachycardia Electrical Cardioversion Arrhythmic Patient 
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  1. 1.
    Neumar RW, Otto CW, Link MS, Kronick SL, Shuster M, Callaway CW, Kudenchuk PJ, Ornato JP, McNally B, Silvers SM, Passman RS, White RD, Hess EP, Tang W, Davis D, Sinz E, Morrison LJ. Adult advanced cardiovascular life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122(18):S729–67.CrossRefPubMedGoogle Scholar
  2. 2.
    Hood RE, Shorofsky SR. Management of arrhythmias in the emergency department. Cardiol Clin. 2006;24:125–33.CrossRefPubMedGoogle Scholar
  3. 3.
    Delacrétaz E. Supraventricular tachycardia. N Engl J Med. 2006;354:1039–51.CrossRefPubMedGoogle Scholar
  4. 4.
    Gross JB, Farmington CT, Bailey PL, Rochester NY, Connis RT, Woodinville WA, Cote´ CJ, Chicago IL, Davis FG, Burlington MA, Epstein BS, Washington DC, Gilbertson L, Boston MA, Nickinovich DG, Bellevue WA, Zerwas JM, Houston TX, Zuccaro G, Cleveland OH. Practice guidelines for sedation and analgesia by non-Anesthesiologists: an updated report by The American Society of Anesthesiologists Task Force on Sedation And Analgesia By Non-Anesthesiologists. Anesthesiology. 2002;96:1004–17Google Scholar
  5. 5.
    Tan G, Irwin MG. Recent advances in using propofol by non-anesthesiologists. F1000 Med Rep. 2010 Nov 11,2:79. doi: 10.3410/M2-79.
  6. 6.
    Godwin SA, Burton JH, Gerardo CJ, Hatten BW, Mace SE, Silvers SM, Fesmire FM. Procedural sedation and analgesia in the emergency department. Ann Emerg Med. 2014;63:247–58.CrossRefPubMedGoogle Scholar
  7. 7.
    Link MS. Evaluation and initial treatment of supraventricular tachycardia. N Engl J Med. 2012;367:1438–48.CrossRefPubMedGoogle Scholar
  8. 8.
    January CT, Wann LS, Alpert JS, Calkins H, Cigarroa JE, Cleveland Jr JC, Conti JB, Ellinor PT, Ezekowitz MD, Field ME, Murray KT, Sacco RL, Stevenson WG, Tchou PJ, Tracy CM, Yancy CW. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2014;64:e1–76.CrossRefPubMedGoogle Scholar
  9. 9.
    Oreto G, Luzza F, Satullo G, Donato A, Carbone V, Calabrò MP. Tachicardia a QRS larghi: un problema antico e nuovo. G Ital Cardiol. 2009;10:580–95.Google Scholar
  10. 10.
    Brugada P, Brugada J, Mont L, Smeets J, Andries EW. A new approach to the differential diagnosis of a regular tachycardia with a wide QRS complex. Circulation. 1991;83:1649–59.CrossRefPubMedGoogle Scholar
  11. 11.
    Grantham HJ. Emergency management of acute cardiac arrhythmias. Aust Fam Physician. 2007;36:492–7.PubMedGoogle Scholar
  12. 12.
    Brady WJ, Harrigan RA. Evaluation and management of bradyarrhythmias in the emergency department. Emerg Med Clin North Am. 1998;16:361–88.CrossRefPubMedGoogle Scholar
  13. 13.
    Lewalter T, Lickfett L, Schwab JO, Yang A, Lüderitz B. The emergency management of cardiac arrhythmia. Dtsch Arztebl. 2007;104:1172–80.Google Scholar
  14. 14.
    Semelka M, Gera J, Usman S. Sick sinus syndrome: a review. Am Fam Physician. 2013;87:691–6.PubMedGoogle Scholar
  15. 15.
    Crisel RK, Farzaneh-Far R, Na B, Whooley MA. First-degree atrioventricular block is associated with heart failure and death in persons with stable coronary artery disease: data from the Heart and Soul Study. Eur Heart J. 2011;32:1875–80.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Brignole M, Auricchio A, Baron-Esquivias G, Bordachar P, Boriani G, Breithardt OA, et al. 2013 ESC guidelines on cardiac pacing and cardiac resynchronization therapy: the Task Force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA). Eur Heart J. 2013;34:2281–329.CrossRefPubMedGoogle Scholar
  17. 17.
    Edhag O, Swahn A. Prognosis of patients with complete heart block or arrhythmic syncope who were not treated with artificial pacemakers. A long-term follow-up study of 101 patients. Acta Med Scand. 1976;200:457–63.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Emergency Medicine Unit, Cardiovascular DepartmentCattinara University HospitalTriesteItaly

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