Drug-related cardiac iatrogenic illness as the cause for admission to the intensive cardiac care unit

Background: Iatrogenic illness, defined as a disease that results from a di agnostic procedure or from any form of therapy, is a well-recognized phenom enon in clinical practice. Objectives: To study and evaluate major cardiac iatrogenic disease as the c ause of admission to the intensive cardiac care unit in the modern era. Methods: We assessed 64 critically ill patients suffering from major cardia c iatrogenic problems among a total of 2,559 patients admitted to the inten sive cardiac care unit during 3 years. Iatrogenic illness was defined as an y problem that resulted from therapy. Only cardiac problems were included i n the study. Complications of interventional cardiovascular procedures, sui cide attempts or accidental intoxications were excluded. Results: There was evidence of a major cardiac iatrogenic problem as the ca use for admission in 64 patients (2.5%): 58 (91%) suffered from arrhythmias (mainly bradyarrhythmias) secondary to beta-blockers, amiodarone, calcium antagonists, electrolyte imbalance ora combination, and 6 (9%) had non-arrh ythmic events (hypotension, syncope or acute heart failure). In 41 patients (64%) the iatrogenic event was considered preventable. Conclusions: Major cardiac iatrogenic complications are an important factor among patients admitted to the intensive cardiac care unit. Most of the ev ents are bradyarrhythmias related to anti-arrhythmic agents. Almost two-thi rds of events are preventable.