Les troubles du rythme supraventriculaires en réanimation

Supraventricular arrhythmias are frequent in intensive care patients; they are causes or consequences of many diseases with different mechanisms. Because they may worsen outcome and trigger adverse hemodynamic consequences, they can need emergency cardioversion. In many cases, a simple clinical examination associated with an accurate ECG analysis allow clinicians to reverse cardiac rhythm when predisposing conditions (hypokalaemia, hypovolemia and hypoxia…) are controlled. Pharmacologic intervention by antiarrhythmics is the most advisable treatment in critically ill patients with supraventricular arrhythmias, but the use of currently available agents is limited by risks that may offset the benefits of sinus rhythm. The development of antiarrhythmic agents with the potential for fewer adverse ventricular effects and less extracardiac toxicity is a primary aim of current investigations.