Recent Advances In Intraoperative Cardiac Arrhythmia Protocol of an Essa

Abstract

If a perioperative arrhythmia cannot be readily diagnosed, all available leads are displayed on the monitor, and a 12-lead ECG is obtained. Notably, artifact due to electrocautery or pacing spikes can mimic ventricular tachycardia (VT) or ventricular fibrillation (VF), and ventricular-paced rhythms also mimic VT. Stable waveforms from the pulse oximeter, intra-arterial catheter, and/or central venous catheter may be helpful to distinguish artifact from a true arrhythmia. Both atrial and ventricular arrhythmias are more likely to occur in the presence of myocardial ischemia or respiratory, metabolic, or electrolyte abnormalities, and during certain interventions (eg, intrathoracic surgery, intravascular interventions, electroconvulsive [ECT] therapy). Atrial tachyarrhythmias with a heart rate (HR) >100 beats per minute (bpm) may have a narrow QRS complex (QRS duration of <120 ms) or a wide QRS complex (QRS duration >120 ms).