Arrhythmia basics: How often we need to know the mechanism of arrhythmia ?

How many times you have treated cardiac arrhythmia in both emergency & non-emergency situations? Infinite times. How many times did you really bother to know the mechanism of a given arrhythmia before ordering medication or shocking? Hmm,.. let me think. (Except for AVNRT/ AVRT, and few VTs, very rarely I have worried about the mechanism  !) Why is it so? because treatment takes priority and we are able to tame the arrhythmia even without knowing the real mechanism. The following slide is a gross summary of the cardiac arrhythmia mechanism Understanding cardiac arrhythmia is vitally important for a few reasons in a few settings. In acute settings, we need to know automatic tachycardias will not respond to shocks. Reentry tachycardias will respond more promptly. (Of course, we may not know it till we shock ) Calcium blockers like verapamil might block triggered activity in MAT. Overdrive pacing is the answer for many automatic tachycardias and some refractory reentrant tachycardias (ATP protocols in ICD has taught us this )  In the chronic setting when you contemplate mapping, locating, and ablating arrhythmias, mechanisms are important. The task here is locating slow conduction paths and decoding the diastolic circuit around the scar  (If you plan ICD, knowledge about mechanism  becomes redundant again) Finally, knowing the mechanism of arrhythmia is a fascination by itself to help understand the great s...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: Basic science -Physiology Brugada syndrome cardiac electrophysiology cardiology -Therapeutics Cardiology-Arrhythmias brady dependent vt eads dads early and late after depolarisation enhanced automaticity vs triggerred activity vs reentry Source Type: blogs