Key result
Pharmacological therapy remains the gold standard for acute emergency arrhythmia management over invasive strategies.
Why the study?
Arrhythmias are common in emergency medicine and there is a great need for effective diagnostic and therapeutic algorithms to aid emergency physicians in acute arrhythmia care.
Pharmacological treatment should remain first-line for acute emergency arrhythmias; Level 5 evidence leaves open the need for prospective validation.
The treat of cardiac arrhythmias has been studied extensively in the last decades. There has been a major shift in antiarrhythmia treatment from drugs to interventional electrophysiological procedures and implantable devices. Published data indicate that for long-term treatment of arrhythmias, non-pharmacological treatment is more effective than drugs in many patients. Similarly, the overhelming success of radiofrequency catheter ablation of supraventricular tachycardias has almost eliminated the need for chronic drug treatment. Today, catheter ablation plays an increasingly important role in the prevention of atrial fibrillation recurrences. However, in the emergency room or in the intensive care unit, drug treatment remains the gold standard for the treatment of cardiac arrhythmias. Arrhythmias are very common in emergency medicine, occurring in 12% to 20% of all patients in an intensive care unit and there is great need for good diagnostic and therapeutic algorithms to aid the emergency physician dealing with patients suffering from arrhythmias.
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Christoph Stellbrink (2010) conducted an editorial in Cardiac arrhythmias. Antiarrhythmic drugs, catheter ablation, and implantable devices was evaluated. While long-term arrhythmia management has shifted toward implantable devices and catheter ablation, pharmacological treatment remains the gold standard in the acute emergency setting.
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