arrhythmias
ARRHYTHMIAS
Arrhythmia is a disorder in which the heart beats irregularly. It may be too slow or too fast.
Bradycardia is having a heart rate of <50 beats/minute that may not affect the hemodynamic status of some patients.
Clinically significant bradycardia is having a heart rate that is inadequate for the patient's current condition and may not be able to support life.
Tachycardia is having serious signs and symptoms that are often demonstrated at ventricular rates of >150 beats/minute.
Signs and symptoms related to rapid heart rate are altered sensorium, angina, shortness of breath, myocardial infarction, hypotension and other signs of shock (eg cold clammy skin, low urine output), heart failure or pulmonary congestion.

Monitoring

Control Strategy for Atrial Fibrillation

  • Lenient HR control, compared to strict HR control, may be beneficial in patients w/ persistent A-fib who have stable ventricular function (LV ejection fraction >0.40) &/or no symptoms related to A-fib
    • LV function should be monitored in these patients
    • Lenient HR control is defined as achieving resting HR <110 bpm; strict HR control is <80 bpm at rest & HR <110 bpm during a 6-min walk
  • One trial revealed that in patients w/ A-fib & systolic heart failure (HF), routine strategy of rhythm control is not beneficial compared to rate control strategy
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