Tachyarrhythmia: Difference between revisions
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Tachyarrhythmias can be anywhere from asymptomatic to causing haemodynamic instability and cardiac arrest. Palpitation is a common symptom, as is dizziness. Signs of haemodynamic instability include hypotension, altered mental status, signs of shock, chest pain, or acute decompensated heart failure. | Tachyarrhythmias can be anywhere from asymptomatic to causing haemodynamic instability and cardiac arrest. Palpitation is a common symptom, as is dizziness. Signs of haemodynamic instability include hypotension, altered mental status, signs of shock, chest pain, or acute decompensated heart failure. | ||
== | == Acute management == | ||
Regardless of whether the tachyarrhythmia is wide or narrow complex, the management for tachycardia which causes haemodynamic instability but has a pulse is electrical [[cardioversion]]. The cardioverter is put in synchronised mode and an energy level of 150-200 J in biphasic mode. Cardioversion may be attempted 3 times. If there is no effect, a loading dose (300 mg IV) of the anti-arrhythmic [[amiodarone]] can be given. It is never wrong to cardiovert an unstable tachycardia, but if the tachycardia is narrow complex one may consider trying to give [[adenosine]] first. | Regardless of whether the tachyarrhythmia is wide or narrow complex, the management for tachycardia which causes haemodynamic instability but has a pulse is electrical [[cardioversion]]. The cardioverter is put in synchronised mode and an energy level of 150-200 J in biphasic mode. Cardioversion may be attempted 3 times. If there is no effect, a loading dose (300 mg IV) of the anti-arrhythmic [[amiodarone]] can be given. It is never wrong to cardiovert an unstable tachycardia, but if the tachycardia is narrow complex one may consider trying to give [[adenosine]] first. | ||