Author(s): Debashis Mohapatra, Sunita Mishra, Asish Kumar Dash

Email(s): dmohapatra911@gmail.com

DOI: 10.5958/2321-5836.2020.00024.5   

Address: Debashis Mohapatra*, Sunita Mishra, Asish Kumar Dash
College of Pharmaceutical Sciences, Marine drive Road, Baliguali, Puri, Odisha-752002.
*Corresponding Author

Published In:   Volume - 12,      Issue - 3,     Year - 2020


ABSTRACT:
Cardiac arrhythmic disorders are defined as bradycardia or tachycardia on the basis of ventricular response that is less than 60 beats/minute for bradyarrhythmias and more than 100 beats/minute for tachyarrhythmias. Arrhythmias are a common cause of syncope and must be considered in all patients in whom syncope occurs, particularly when cardiac disease is present. Either extreme of ventricular rate, bradycardia or tachycardia, can depress cardiac output to the point of critical hypotension and syncope. Pulse rates outside this range may reduce cerebral circulation. The most common arrhythmias producing syncope or presyncope are profound sinus bradycardia, high-grade atrioventricular (AV) block, supraventricular tachycardia (SVTs), ventricular tachycardia, pacemaker malfunction, pacemaker induced arrhythmias, and pacemaker syndrome. The supraventricular tachycardias (SVTs) are sinus tachycardia, atrial tachycardia, AV-nodal re-entrant tachycardia, and tachycardia due to accessory pathways. It is essential to evaluate the arrhythmia history, to perform a good physical examination, and to accurately analyze the 12-lead electrocardiogram. In ventricular tachycardia there are broad QRS complexes (QRS width > 0.12 s). For acute management of arrhythmia there may be a new concept of the five 'A' strategy, which refers to “Adenosine, Adrenaline, Ajmaline, Amiodarone, and Atropine”. The five 'A' concept may revolutionise the treatment and effective management of all bradycardias, tachycardias, SVT, VT.


Cite this article:
Debashis Mohapatra, Sunita Mishra, Asish Kumar Dash. A Review article on “Concept of the five ‘A’s in the treatment of Cardiac Arrhythmia”. Res. J. Pharmacology and Pharmacodynamics.2020; 12(3):133-136. doi: 10.5958/2321-5836.2020.00024.5


REFERENCES:
1.    Trappe HJ. Diagnosis and treatment of tachycardias. In: Vincent JL (ed) Yearbook of intensive care and emergency medicine. Berlin-Heidelberg-New York: Springer; 2000:638-48.    
2.    Trappe HJ, Schuster HP: Clinical findings and surface ECG in emergency decision making. In: Trappe HJ, Schuster HP, NotfalltherapiebeiakutenHerzrhythmusstörungen. Darmstadt: Steinkopff-Verlag; 2001:314    
3.    Trappe HJ, Rodriguez LM, Smeets JLRM, Weismüller P. Diagnosis and therapy in narrow QRS tachycardia. In: Trappe HJ, Schuster HP (eds) Die NotfalltherapiebeiakutenHerzrhythmusstörungen. Darmstadt: SteinkopffVerlag; 2001:15-27.    
4.    Trappe HJ, Rodriguez LM, Smeets JLRM, Pfitzner P. Diagnosis and therapy in wide QRS tachycardia. In: Schuster HP (eds) Die NotfalltherapiebeiakutenHerzrhythmusstörungen. Darmstadt: Steinkopff-Verlag; 2001:2839    
5.    Wellens HJJ, Gorgels APM, Doevendans PA. Conduction disturbances in acute myocardial infarction. In: Wellens HJJ, Gorgels APM, Doevendans PA (eds) The ECG in acute myocardial infarction and unstable angina. Diagnosis and risk stratification. Kluwer Academic Publishers, New York: Mount Kisco; 2003:43-64  
6.    Wellens HJJ, Conover B. Wide QRS tachycardia. In: Wellens HJJ, Conover B (eds) The ECG in emergency decision making. Philadelphia: WB Saunders Company; 2006:129-157  
7.    Berger PB, Ruocco NA Jr, Ryan TJ, Frederick MM, Jacobs AK, Faxon DP. Incidence and prognostic implications of heart block complicating inferior myocardial infarction treated with thrombolytic therapy: results from TIMI II. J Am Coll Cardiol 1992; 20:533-40.    
8.    Wellens HJJ, Conover B. The ECG in acute ST segment elevation in MI. In. Wellens HJJ, Conover B (eds) The ECGin emergency decision making. WB Saunders Company, St. Louis; 2006:1-53    
9.    International Liaison Committee on resuscitation 2005 International consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Resuscitation 2005; 67:157-337.    
10.    Kudenchuk PJ. Advanced cardiac life support antiarrhythmic drugs. Cardiol Clin 2002; 20:79-87.    
11.    Heusch G. Molecular basis of cardioprotection: signal transduction in ischemic pre-, post-, and remote conditioning. Circulation research. 2015 Feb 13; 116(4):674-99.    
12.    Trappe HJ. Acute therapy of tachyarrhythmias: adenosine or ajmaline? Intensive med 1997; 34:452-61.

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