Cardiac arrhythmias in the critically ill

Cardiac arrhythmias are a common cause of potentially life-threatening, haemodynamic compromise in critically ill patients. This article describes a systematic approach to the management of the four general characteristics of arrhythmia (broad or narrow complex and tachycardia or bradycardia) as it is important to treat the patient and the general type of rhythm rather than considering each disturbance in detail. Successful management of all cardiac arrhythmias should be approached in stages, each of which is covered in this article: rapidly assess the haemodynamic status of the patient; identify the origin of the arrhythmia; correct predisposing factors (e.g. hypoxia, electrolyte imbalance); consider specific therapy (e.g. drugs, DC cardioversion); prevent further arrhythmias.