To investigate the treatment of supraventricular tachyarrhythmias in a medical intensive care unit (MICU).
We investigated in a prospective study the treatment for 48 hours of patients with supraventricular tachyarrhythmias (ventricular rates of > 130–180 beats/minute) at admission to a MICU supervised by a pulmonary critical care specialist. The housestaff taking care of the patients were unaware that their treatment of supraventricular tachyarrhythmias was being investigated. The 92 consecutive patients with supraventricular tachyarrhythmias included 54 men and 38 women, mean age 71 years.
Of 6 patients with supraventricular tachycardia, 3 were treated with intravenous adenosine, 1 with direct-current cardioversion, and 2 with intravenous beta blockers. Six of 6 patients (100%) with supraventricular tachycardia converted to sinus rhythm. Of 7 patients with atrial flutter, 1 was treated with direct-current cardioversion, 2 with intravenous amiodarone, 2 with intravenous diltiazem, 1 with intravenous beta blockers, and 1 with oral beta blockers. Four of 7 patients (57%) with atrial flutter converted to sinus rhythm, and 3 (43%) slowed to < 75 beats/minute. Of 79 patients with atrial fibrillation, 7 were treated with direct-current cardioversion, 32 with intravenous beta blockers, 11 with intravenous diltiazem, 5 with intravenous amiodarone, 2 with intravenous digoxin, 12 with oral beta blockers, 7 with oral amiodarone, and 3 with oral diltiazem. Of 79 patients with atrial fibrillation, 42 (53%) converted to sinus rhythm, and 37 (47%) slowed to < 75 beats/minute.
Supraventricular tachyarrhythmias can be satisfactorily treated in a MICU supervised by a pulmonary critical care specialist with 52 of 92 patients (57%) with supraventricular tachyarrhythmias converting to sinus rhythm and adequate ventricular rate control in the other 40 patients (43%).
Supraventricular tachyarrhythmias can be satisfactorily treated in a MICU supervised by a pulmonary critical care specialist.
Arunabh Sekhri, No Financial Disclosure Information; No Product/Research Disclosure Information