Management of paroxysmal atrioventricular nodal reentrant tachycardia in the critically ill surgical patient

Critical Care Medicine
O C KirtonJ M Civetta

Abstract

Paroxysmal atrioventricular nodal reentrant tachycardia is an infrequently encountered supraventricular arrhythmia that continues to present difficult management problems in the critically ill surgical patient. The purpose of this study was to evaluate the efficacy of a new treatment algorithm involving the sequential administration of different classes of antiarrhythmic agents until conversion to sinus rhythm was achieved. Nonrandomized, consecutive, protocol-driven descriptive cohort. University hospital surgical and trauma intensive care unit (ICU). During an 11-month period, we prospectively evaluated all hemodynamically stable patients who sustained new-onset atrioventricular nodal reentrant tachycardia. Vagal maneuver, followed by the rapid, sequential infusion of antiarrhythmic agents (i.e., adenosine, verapamil, and esmolol, respectively) until the arrhythmia was terminated. Twenty-seven patients (4% of all admissions) were evaluated, including 16 trauma patients (injury Severity Score of 20 +/- 8) and 11 general surgical patients (Acute Physiology and Chronic Health Evaluation II score of 17 +/- 7). Time from ICU admission to onset of atrioventricular nodal reentrant tachycardia was 4.5 +/- 5 days (median 2.5). Arrhyth...Continue Reading

References

Aug 1, 1992·Archives of Surgery·P D WoolfC Cox
Dec 5, 1991·The New England Journal of Medicine·A J Camm, C J Garratt
May 1, 1991·Circulation·B B Lerman, L Belardinelli
Oct 1, 1985·Critical Care Medicine·W A KnausJ E Zimmerman
Jan 1, 1985·The Journal of Trauma·L GreenspanH Greig
Jul 1, 1974·Postgraduate Medical Journal·D M Krikler, R A Spurrell
Jan 1, 1994·The American Journal of Cardiology·M R LauerR J Sung

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Citations

Dec 1, 2012·Therapeutic Hypothermia and Temperature Management·Patrick M KochanekJimmy Windsor
Feb 11, 2003·Critical Care Medicine·Karl D Donovan, Bernard E F Hockings
Apr 29, 1998·Critical Care Medicine·G Heinz
Mar 20, 2002·Australian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses·A Evans-Murray
Jun 23, 2000·The Journal of Surgical Research·T Blinman, M Maggard
Mar 23, 2007·Anesthesia and Analgesia·Sergei GoodmanCharles Weissman
Sep 22, 2001·The Medical Clinics of North America·S B Sloan, H H Weitz

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