Document Detail

Concept of the five 'A's for treating emergency arrhythmias.
MedLine Citation:
PMID:  20606789     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Cardiac rhythm disturbances such as bradycardia (heart rate < 50/min) and tachycardia (heart rate > 100/min) require rapid therapeutic intervention. The supraventricular tachycardias (SVTs) are sinus tachycardia, atrial tachycardia, AV-nodal reentrant tachycardia, and tachycardia due to accessory pathways. All SVTs are characterized by a ventricular heart rate > 100/min and small QRS complexes (QRS width < 0.12 ms) during the tachycardia. It is essential to evaluate the arrhythmia history, to perform a good physical examination, and to accurately analyze the 12-lead electrocardiogram. A precise diagnosis of the SVT is then possible in more than 90% of patients. In ventricular tachycardia (VT) there are broad QRS complexes (QRS width > 0.12 s). Ventricular flutter and ventricular fibrillation are associated with chaotic electrophysiologic findings. For acute therapy, we will present the new concept of the five 'A's, which refers to adenosine, adrenaline, ajmaline, amiodarone, and atropine. Additionally, there are the 'B,' 'C,' and 'D' strategies, which refer to beta-blockers, cardioversion, and defibrillation, respectively. The five 'A' concept allows a safe and effective antiarrhythmic treatment of all bradycardias, tachycardias, SVTs, VT, ventricular flutter, and ventricular fibrillation, as well as of asystole.
Hans-Joachim Trappe
Related Documents :
3401109 - An introduction to high-resolution ecg recordings of cardiac late potentials.
4008769 - Reentrant ventricular arrhythmias in the late myocardial infarction period. 12. spontan...
1598859 - Long term ecg recording with holter monitoring in clinically healthy horses.
665509 - Clinical, electrocardiographic and electrophysiologic observations in patients with par...
19623049 - Adenosine for wide-complex tachycardia: efficacy and safety.
6192409 - Macroreentry as a mechanism of atrial-induced ventricular ectopic beats: a laboratory c...
21766239 - Comparison of the temporal release pattern of copeptin with conventional biomarkers in ...
8721639 - Limiting lipid peroxidation in the nonischemic zone of infarcted rat hearts by indometh...
18006089 - Isolated right ventricular infarction--an uncommon cause of acute anterior st segment e...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of emergencies, trauma, and shock     Volume:  3     ISSN:  0974-519X     ISO Abbreviation:  J Emerg Trauma Shock     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-07-07     Completed Date:  2011-07-14     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101493921     Medline TA:  J Emerg Trauma Shock     Country:  India    
Other Details:
Languages:  eng     Pagination:  129-36     Citation Subset:  -    
Department of Cardiology and Angiology, University of Bochum, Germany.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  What an emergency physician needs to know about acute care of cardiac arrhythmias.
Next Document:  Tachyarrhythmias, bradyarrhythmias and acute coronary syndromes.