Behind The Knife: The Surgery Podcast

Clinical Challenges in Surgical Critical Care: Arrhythmias

Nov 29, 2021
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ADVICE

Approach ICU Arrhythmia Workup

  • Start arrhythmia workup fresh postoperatively, considering surgical, volume, cardiac, or pulmonary causes.
  • Obtain 12-lead ECG and full labs, assess hemodynamic stability, and review patient trend and history.
ADVICE

Prioritize Rate Control

  • Prioritize rate control in postoperative atrial fibrillation to reduce tachycardia and help wean vasopressors.
  • Use beta blockers or calcium channel blockers as first-line medications for rate control in stable patients.
ADVICE

Medications for Rate Control

  • Use beta blockers first for rate control especially if patient was previously on them.
  • Consider amiodarone cautiously if beta blockers insufficient, avoiding it early in postoperative patients.
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