Rhythm and rate control in the context of resuscitation and periarrest states

Abstract

Cardiovascular mortality has declined significantly in recent years, however, sudden cardiac death remains the leading cause of death in a range of different mortality indicators, very often caused by cardiac arrhythmias. The electrophysiological causes of sudden cardiac death include ventricular tachycardia, ventricular fibrillation, asystole and pulseless electrical activity. In addition, other cardiac arrhythmias may also trigger sudden cardiac death, periarrest arrhytmias. The rapid and accurate recognition of the various arrhythmias and their appropriate management are major challenges at both prehospital and hospital care levels. In these conditions, prompt recognition of life-threatening conditions, rapid response and proper treatment are critical. This publication reviews the various device and drug treatment modalities for the management of periarrest arrythmic conditions in the light of the 2021 guidelines of the European Resuscitation Council. This article highlights the epidemiology and aetiology of periarrest arrythmic states, and outlines the state-of-the-art treatment options for various tachy- and bradyarrhythmias, providing guidance in the management of these conditions both in hospital and out-of-hospital settings. Orv Hetil. 2023; 164(13): 504-509.