How to manage various arrhythmias and sudden cardiac death in the cardiovascular intensive care

Abstract

In the clinical practice of cardiovascular critical care, we often observe a variety of arrhythmias in the patients either with (secondary) or without (idiopathic) underlying heart diseases. In this manuscript, the clinical background and management of various arrhythmias treated in the CCU/ICU will be reviewed.The mechanism and background of lethal ventricular tachyarrhythmias vary as time elapses after the onset of MI that should be carefully considered to select a most suitable therapy. In the category of non-ischemic cardiomyopathy, several diseases are known to be complicated by the various ventricular tachyarrhythmias with some specific mechanisms.According to the large-scale registry data, the most common arrhythmia is atrioventricular block. It is essential for the decision of permanent pacemaker indication to rule out the presence of transient causes such as ischemia and electrolyte abnormalities.The prevalence of atrial fibrillation (AF) is very high in the patients with heart failure (HF) and myocardial infarction (MI). AF and HF have a reciprocal causal relationship; thus, both are associated with the poor prognosis. Paroxysmal AF occurs in 5 to 20% during the acute phase of MI and triggered by several specific factors including pump failure, atrial ischemia, and autonomic instability.After the total management of patients with various arrhythmias and basic heart diseases, the risk of sudden cardiac death should be stratified for each patient to assess the individual need for preventive therapies.Finally, it is recommended that the modalities of the treatment and prophylaxis should be selected on a case-by-case basis in the scene of critical care.

Elevated plasma Sirtuin2 level predicts heart failure after acute myocardial infarction

“…were also associated with malignant arrhythmia 28,29 , and higher plasma SIRT2 level was noted to have higher percentage of malignant arrhythmia and cardiac arrest in the present study.…”

Elevated plasma Sirtuin2 level predicts heart failure after acute myocardial infarction

“…Overexpression of SIRT2 suppressed inflammatory responses and reactive oxygen species-induced macrophage cytotoxicity (28)(29)(30). Inflammatory responses in AMI patients were also associated with malignant arrhythmia (31,32), and higher plasma SIRT2 level was noted to have higher percentage of malignant arrhythmia and cardiac arrest in the present study.…”

Hidden Ovulation

“…It is also known as cardiac arrhythmias; dysrhythmias or heart arrhythmias are a group of condition in which heart contracts too fast/too slow or with irregular pattern (Kobayashi 2018). Dysrhythmias are grouped from where they occurin the upper chambers or receiving chambers of the heart (known as the right and left atrium of the heart), in lower chambers or contracting chambers of the heart (right and left ventricle of the heart), or in both chambers (Antzelevitch and Burashnikov 2011).…”