Complications of emergency treatment of arrhythmia and their prevention
Nedostup, A.V.; Syrikin, A.L.; Makolkin, V.I.
Terapevticheskii Arkhiv 52(10): 17-22
1980
ISSN/ISBN: 0040-3660 PMID: 7444776 Document Number: 159460
Patients with acute myocardial pathology and hypoxia, patients with deep metabolic and electrolyte disturbances, acute pulmonary insufficiency or hyperthyroidism, patients with cardiac glycoside intoxication or diuretic overdosing and patients with basic and other rhythm and conduction disturbances with preexisting thromboembolism were most likely to have complications during emergency antiarrhythmic therapy. General recommendations for prevention of complications or a decrease of their occurrence probability included application of antiarrhythmic therapy simultaneously with intensified correction of metabolic disturbances and oxygenation, conduction of electric impulse therapy only according to vital signs (in digitalis intoxication and diuretic overdosing), i.v. application of antiarrhythmic drugs only with constant control of cardiac rhythm and hemodynamic state (preferably cardioscopy and ECG) and application of an electrocardiostimulation method for slowing the pulse (in combined tachycardia and tachyarrhythmia with high myocardial excitation, intracardiac conductivity disturbance and for patients with sick sinus node syndrome). Cardiac glycosides and isoptin were contraindicated for patients with tachycardia. The necessity for knowledge of previous treatment used by the patient before applying antiarrhythmic therapy was stressed. The complications arising from the tendency to apply massive doses of antiarrhythmic drugs (quinidine, novocainamide, lidocaine, .beta.-adrenergic receptor blockers, isoptin, cardiac glycosides and sympathomimetic drugs) in emergency centers were discussed, and correct dosages and methods of application were recommended.