Heart arrhythmia, also known as irregular heartbeat or cardiac dysrhythmia, is a group of conditions where the heartbeat is irregular, too slow, or too fast
To diagnose a heart arrhythmia, your doctor will review your symptoms and your medical history and conduct a physical examination. Your doctor may ask about or test for conditions that may trigger your arrhythmia, such as heart disease or a problem with your thyroid gland. Your doctor may also perform heart-monitoring tests specific to arrhythmias. These may include:
· Start Amiodarone infusion,
· Loading dose of 5 mg/kg over 1-2 hours in at least 250 MLs 5% Dextrose,
· Maintenance IV dose 15 mg/kg in 500 mLs 5% Dextrose over next 24 hours to amaximum dose of 1200 mg in 24 hours.
SINUS BRADY CARDIA:
· Check BP,
· If hypotensive treat,
· Atropine 0.3 mg IV,
· May be repeated up to 1.2 mg,
· Consider pacing, Isoprenaline IV.
· Treat if multifocal, Ratio to sinus beat > 1:5, Salvos of 10 or more or “R on T”,
· Lignocaine IV,
· If refractory consider Procainamide IV 50mg/min up to 400 mg.
· Treatment often not required,
· Consider low dose Metoprolol 0.5-1.0 mg (if not contraindicated).
· DC conversion if hypotensive,
· Otherwise consider Digoxin 0.5 mg IV over 30 minutes.
2nd OR 3rd DEGREE HEART BLOCKS:
· If hypotensive and heart rate < 50 bpm Atropine 0.6 – 3.0 mg IV,
· Consider Isoprenaline infusion and pacing.
RECURRENT Ventricular Tachycardia:
· Manage as Ventricular Fibrillation if pulseless,
· Lignocaine 1.5 mg/kg IV bolus followed by IV infusion,
· If no response procainamide 50 mg/min up to 400 mg,
· Stop if develops hypotension or QRS widens,
· If no response consider Bretyllium 5 mg/kg IV over 5 mins followed by infusion at 1-2 mg/min.