Cardiac arrhythmias are frequently seen in routine primary care practice, and “palpitations” or patient concerns about “skipped heartbeats” are among the most common presenting complaints in primary care. Surprisingly, many symptomatic patients do not have significant cardiac arrhythmias, whereas a substantial proportion of clinically significant arrhythmias are detected in asymptomatic patients. As more information has become available regarding the natural history of many arrhythmias in the primary care setting, we are moving from an era of overtreatment via aggressive pharmacologic management to an era of selective treatment with increased use of nonpharmacologic interventions such as surgical or catheter ablation.
KeywordsAtrial Fibrillation Cardiac Arrhythmia Atrial Flutter Sick Sinus Syndrome Advance Cardiac Life Support
Unable to display preview. Download preview PDF.
- 5.Waldo AL. An approach to therapy of supraventricular tachyarrhythmias: an algorithm versus individualized therapy. Clin Cardiol 1994;17 Suppl II:21–6.Google Scholar
- 13.Cardiac Arrhythmia Suppression Trial (CAST) Investigators. Preliminary report: effect of encainide and flecanide on mortality in a randomized trial of arrhythmia suppression after myocardial infarction. N Engl J Med 1989;321:406–12.Google Scholar
- 14.Cardiac Arrhythmia Suppression Trial-II Investigators. Effect of the antiarrhythmic agent moricizine on survival after myocardial infarction. N Engl J Med 1992;327:227–33.Google Scholar
- 15.Beta-Blocker Heart Attack Trial Research Group. A randomized trial of propranolol in patients with acute myocardial infarction. JAMA 1982;247:1707–14.Google Scholar
- 18.CASCADE Investigators. Randomized antiarrhythmic drug therapy in survivors of cardiac arrest (the CASCADE study). Am J Cardiol 1991;67:578–84.Google Scholar
- 20.Kirschenbaum HL, Rosenberg JM. Clinical experience with sotalol in the treatment of cardiac arrhythmias. Clin Ther 1994;16:347–65.Google Scholar
- 27.Cox J, Ferguson BT, Lindsay BD, et al. Perionodal cryosurgery for atrioventricular node reentry tachycardia in 23 patients. J Thorac Cardiovasc Surg 1990;90:490–6.Google Scholar
- 40.Stroke Prevention in Atrial Fibrillation Investigators. Stroke Prevention in Atrial Fibrillation Study: final results. Circulation 1991;84:527–39.Google Scholar
- 41.Boston Area Anticoagulation Trial for Atrial Fibrillation Investigators. The effect of low-dose warfarin on the risk of stroke in patients with nonrheumatic atrial fibrillation. N Engl J Med 1990;323:1505–11.Google Scholar
- 42.Atrial Fibrillation Investigators. Risk factors for stroke and efficacy of antithrombotic therapy in atrial fibrillation: analysis of pooled data from five randomized controlled trials. Arch Intern Med 1994;154:1449–57.Google Scholar