DIAGNOSIS AND MEDICAL-TREATMENT OF TACHYCARDIC RHYTHM DISORDERS

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.