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BJA Advance Access originally published online on May 14, 2004
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British Journal of Anaesthesia, 2004, Vol. 93, No. 1 86-94
© 2004 The Board of Management and Trustees of the British Journal of Anaesthesia

Perioperative cardiac arrhythmias

A. Thompson1 and J. R. Balser*,1,2

1 Department of Anesthesiology and 2 Department of Pharmacology, D3300 Medical Center North, Vanderbilt University School of Medicine, Nashville, TN 37232, USA

*Corresponding author. Department of Anesthesiology. E-mail: jeff.balser@vanderbilt.edu

Keywords: complications, arrhythmia; heart, arrhythmia

The first 150 words of the full text of this article appear below.

Cardiac arrhythmias are a significant cause of morbidity and mortality in the perioperative period. While literature on antiarrhythmic agent use in postoperative and non-surgical intensive care settings is expanding, randomized clinical trials examining the use of these agents in the perioperative period are scarce. Nonetheless, as our understanding of the relevant molecular targets for manipulating cardiac excitability grows, the range of options for treating arrhythmias during surgery expands. In the sections that follow, these molecular targets are used as a basis for clinical management strategies for arrhythmias in adults during surgery and anaesthesia. In addition, the controversy surrounding droperidol and its reported proarrhythmic effects will be addressed. Finally, since pacemakers and implantable cardioverter-defibrillators (ICD) have gained widespread use in the treatment of tachyarrhythmias and bradyarrhythmias, a basic understanding of their perioperative function and management is discussed.

Basic science

Ion channel mechanisms
Antiarrhythmic pharmacology is focused primarily on the cardiac ion channels and adrenergic receptors as . . . [Full Text of this Article]

Re-entry, automaticity and arrhythmias
Re-entry
Automaticity
Supraventricular arrhythmias

Acute management of perioperative supraventricular arrhythmias
Chemical cardioversion of SVT
Ventricular arrhythmias

Non-sustained ventricular arrhythmias
Drug selection for acute management of unstable VT and VF
Droperidol and ventricular arrhythmias
I.V. pacemakers and implantable cardioverter defibrillators


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