How to Prevent and Provide Emergency Care for Malignant Arrhythmia

Immediate Actions During a Malignant Arrhythmia Episode

When a patient experiences malignant arrhythmia, the first step is to have them lie down immediately and rest. Eliminating potential triggers is crucial during this time. Oxygen therapy via mask at a rate of 3–5 liters per minute should be administered to ensure adequate oxygenation and maintain clear airways. Continuous electrocardiogram (ECG) monitoring is essential to assess heart rhythm, along with regular monitoring of blood pressure and oxygen saturation levels.

Medical Interventions Based on Heart Rate

If the heart rate exceeds 150 beats per minute, urgent electrical cardioversion should be performed. The specific treatment approach should be tailored according to the type and severity of the arrhythmia. In cases of cardiac arrest, immediate cardiopulmonary resuscitation (CPR) is necessary, followed by the application of unsynchronized electrical defibrillation to restore normal heart rhythm.

Managing Specific Types of Arrhythmias

Atrial Fibrillation or Atrial Flutter

For patients experiencing atrial fibrillation or atrial flutter, intravenous administration of antiarrhythmic medications such as amiodarone or digoxin (Lanoxin) can help control heart rate and restore normal rhythm. These medications should be given under close medical supervision to ensure safety and effectiveness.

Paroxysmal Supraventricular Tachycardia (PSVT)

In the case of paroxysmal supraventricular tachycardia, vagal stimulation techniques—such as the Valsalva maneuver or carotid sinus massage—may be attempted first. If these are ineffective, intravenous administration of verapamil or propafenone can be used to slow the heart rate and stabilize the rhythm.

Severe Sinus Bradycardia with Syncope

For patients suffering from severe sinus bradycardia accompanied by fainting episodes, atropine can be administered orally or intravenously. Alternatively, intravenous infusion of isoproterenol may be used to increase heart rate and prevent further episodes of syncope.

Conclusion

Effective prevention and emergency care for malignant arrhythmia involve a combination of rapid response, proper diagnosis, and targeted treatment. Healthcare providers must be well-equipped to handle different types of arrhythmias with appropriate interventions to improve survival rates and long-term outcomes.