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Archives of cardiovascular diseases
Volume 112, n° 12
pages 781-791 (décembre 2019)
Doi : 10.1016/j.acvd.2019.10.002
Received : 16 Mars 2019 ;  accepted : 2 October 2019

Management of sustained arrhythmias for patients with cardiogenic shock in intensive cardiac care units
Prise en charge des arythmies chez les patients en choc cardiogénique en unité de soins cardiaques intensifs

Philippe Maury a, , Jacques Mansourati b, Laurent Fauchier c, Xavier Waintraub d, Serge Boveda e, Frederic Sacher f
a University hospital Rangueil (and unité Inserm U1048), 1, avenue du Pr Jean-Poulhès, TSA 50032, 31059 Toulouse cedex, France 
b University hospital of Brest, 2, avenue Foch, 29200 Brest, France 
c Centre hospitalier universitaire Trousseau (and université François-Rabelais), avenue de la République, 37170 Chambray-lès-Tours, France 
d Institut de cardiologie, groupe hospitalier Pitié-Salpêtrière, AP–HP, 7-83, boulevard de l’Hôpital, 75013 Paris, France 
e Clinique Pasteur, 45, avenue de Lombez, BP 27617, 31076 Toulouse, France 
f LIRYC institute, Bordeaux university, Bordeaux university hospital, 33000 Bordeaux, France 

Corresponding author at: Service de cardiologie, centre hospitalier universitaire Rangueil, 31000 Toulouse, France.Service de cardiologie, centre hospitalier universitaire RangueilToulouse31000France

Cardiac arrhythmias that occur in patients referred to intensive care units worsen symptoms and outcomes and need urgent correction, especially in patients admitted for refractory heart failure. Electrical storm is a frequent reason for referral to an intensive care unit. Specific, efficient and rapid management of patients presenting with various arrhythmias is therefore mandatory and procedures should be known by any physician involved in an intensive care unit. This article reviews the current knowledge on the management of supraventricular and ventricular arrhythmias in this setting, from medications and sedation to ablation and more exceptional therapy. It also covers the occasional indications of resynchronization in refractory heart failure and the interest for haemodynamic assistance when specific therapy fails.

The full text of this article is available in PDF format.

Les arythmies cardiaques survenant chez les patients en Unité de Soins Intensifs aggravent les symptômes et le pronostic et nécessitent une correction urgente. L’orage rythmique est un motif fréquent d’admission aux Soins Intensifs. Une prise en charge rapide, efficace et spécifique de ces patients présentant des arythmies variées est donc indispensable et doit être connue de tout médecin impliqué dans les Unités de Soins Intensifs. Cet article résume les connaissances actuelles dans la prise en charge des arythmies supraventriculaires et ventriculaires qui peuvent nécessiter un traitement par antiarythmique, sédation et/ou ablation, ainsi que les indications occasionnelles de resynchronisation pour les patients en insuffisance cardiaque réfractaire et l’intérêt des assistances hémodynamiques quand ces thérapies sont insuffisantes.

The full text of this article is available in PDF format.

Keywords : Cardiogenic shock, Atrial fibrillation, Electrical storm, Catheter ablation

Mots clés : Choc cardiogénique, Fibrillation atriale, Orage rythmique, Ablation par cathéter

Abbreviations : AF, AVNRT, AVRT, CHA2 DS2 -VASc, CRT, ICD, LVEF, NYHA, PVC, VF, VT

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