Associated Factors and Mortality of Arrhythmia in Emergency Department: A Narrative Review.

Autor:	Gaur U; Emergency Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND., Gadkari C; Emergency Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND., Pundkar A; Orthopedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Sep 04; Vol. 16 (9), pp. e68645. Date of Electronic Publication: 2024 Sep 04 (Print Publication: 2024).
DOI:	10.7759/cureus.68645
Abstrakt:	Cardiac arrhythmias represent a major concern in the emergency department (ED), particularly given their association with significant morbidity and mortality. This narrative review examines the various factors influencing arrhythmias and their impact on patient outcomes in emergency settings. Managing complex supraventricular and ventricular arrhythmias (VAs) during acute myocardial infarction (AMI) and severe cardiovascular conditions remains challenging, despite advancements in diagnostic and therapeutic techniques. Ventricular arrhythmias frequently forecast worse outcomes during hospital stays and heighten the chances of sudden cardiac death and cardiac arrest, especially within the initial 30 days after a heart attack. The incidence of arrhythmias in ED is increasing due to demographic changes and higher rates of chronic illnesses such as diabetes, hypertension, and chronic kidney disease. These comorbidities, coupled with lifestyle factors such as smoking and alcohol consumption, complicate arrhythmia management, especially among older adults and males. Rapid and precise ECG interpretation in the ED is crucial for identifying specific arrhythmia types and initiating appropriate treatments. Atrial fibrillation (AF), the most prevalent form of rapid heart rhythm originating above the ventricles, notably impacts patient outcomes, particularly in cases of AMI and heart failure. In the ED, managing AF focuses on preventing strokes with thromboprophylaxis and employing risk assessment tools such as CHA2DS2-VASc and HAS-BLED scores. The analysis highlights how risk factors like hypertension, obesity, obstructive sleep apnea (OSA), and diabetes intricately influence the development and worsening of AF. Optimizing AF treatment outcomes requires a multidisciplinary approach involving cardiologists, emergency physicians, and critical care specialists. Future research should prioritize evaluating the effectiveness of preventive and therapeutic interventions for AF, integrating new risk factors and genetic insights to enhance prediction and management strategies. Understanding the factors contributing to arrhythmias and mortality in the ED underscores the importance of timely and accurate diagnostic and therapeutic measures to improve patient care and outcomes. Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Gaur et al.)
Databáze:	MEDLINE
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