Abstract
Disorders of cardiac rhythm may be described as supraventricular or ventricular in origin. The former for the most part are innocuous. Ventricular premature systoles may be the forerunner of ventricular tachycardia or ventricular fibrillation. Ventricular tachycardia if persistent is accompanied by failing circulation. The majority of the arrhythmias observed during anaesthesia can be attributed to hypoxia or accumulation of carbon dioxide. In the opinion of certain anaesthetists, if these two causes of arrhythmia are avoided there is no need for an antiarrhythmia drug. Procaine amide has proven of value in the control of the ventricular arrhythmias which occur during cyclopropane anaesthesia. Rapidly acting digitalis preparations, particularly acetyl strophanthidin, may be needed to slow a rapidly beating heart (supraventricular tachycardias). The ventricular arrhythmias which accompany digitalis toxicity are caused by loss of intracellular potassium. Potassium chloride is effective in the control of digitalis-induced arrhythmias and should be considered in other instances as well.
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