The significance of peri-operative tachycardic rhythm disorders for pe
ri-operative cardiac mortality has not been definitively clarified. Ne
vertheless, the anaesthetist will be obliged to treat a tachyarrhythmi
a that leads to an impairment of the patient's haemodynamics, or is li
kely to make him/her susceptible to a threatening rhythm disturbance.
In the vast majority of cases, causal treatment of the arrhythmia will
elicit a positive response. This appears to be of particular importan
ce in view of the fact that drug treatment is always associated with c
onsiderable risks. All antiarrhythmic medications are potentially pro-
arrhythmic and most have a myocardio-depressive effect. After introduc
ing a number of important intravenously administrable anti-arrhythmic
agents, the diagnosis and medical treatment of sinus tachycardia, atri
al flutter, atrial flimmer, paroxysmal supraventricular tachycardias,
WPW syndrome and ventricular tachycardias (including ''torsades de poi
nt'') are discussed.