Recent update of management of arrhythmia in intensive care unit

Abstract

Cardiac arrhythmias are one of the most common causes of admission in ICU. The decision of the treatment of arrhythmia differs according to the type and underlying rhythm and the hemodynamic state of the patient and whether the arrhythmia cause symptoms or not. Arrhythmia is broad classified to tachyarrhythmia and bradyarrhythmia. Tachyarrhythmias are also classified to narrow complex and wide complex tachyarrhythmia and the mechanism of tachyarrhythmias is either triggered activity or reentry. Atrial fibrillation is the most common and prevalence type of tachyarrhythmia worldwide and is also associated with longer stay in ICU. The management of AF is either rhythm control or rate control and there are a lot of new studies to reach to the most effective and safest drugs and way of management. The new pharmacological drugs for management are dorendarone and vernaklant are used todays for management. Cather ablation is one of new modalities of management of AF. New oral anticoagulant is recently used for prevention of Thromboembolic complication in non-valvular AF and it is better than warfarin as it not require montioring to therapeutic level. Narrow complex tachycardia can cause to hemodynamic instability and treatment in this situation the only synchronized DC shock is mandatory and need ICU admission. Wide complex tachycardias are either Supraventricular tachycardia with aberrant conduction or ventricular tachycardia intravenous adenosine can give to differentiate between two types.