Cardiovascular system: Edited by Gerasimos S. FilippatosUpdate on cardiac arrhythmias in the ICUGoodman, Sergei; Weiss, Yoram; Weissman, CharlesAuthor Information Department of Anesthesiology and Critical Care Medicine, Hadassah–Hebrew University Medical Center, Hebrew University–Hadassah School of Medicine, Jerusalem, Israel Correspondence to Charles Weissman, MD, Department of Anesthesiology and Critical Care Medicine, Hadassah University Hospital, Kiryat Hadassah, POB 12000, Jerusalem, Israel 91120 Tel: +972 2 677 7269; fax: +972 2 642 9392; e-mail: [email protected] Current Opinion in Critical Care: October 2008 - Volume 14 - Issue 5 - p 549-554 doi: 10.1097/MCC.0b013e32830a4c5d Buy Metrics Abstract Purpose of review To explore recent findings on the treatment and outcome of cardiac arrhythmias and how they affect ICU activities. Recent findings The rate vs. rhythm control debate for the treatment of chronic atrial fibrillation continues. It is still unclear whether the postcardiac surgery inflammatory response contributes to the development of atrial fibrillation. In noncardiothoracic surgery/trauma patients hospitalized in an ICU, new-onset supraventricular arrhythmias are associated with markedly elevated mortality when compared with patients with a prior history of such arrhythmias and patients who do not develop arrhythmias. The onset of new supraventricular arrhythmias in such patients appears to be a manifestation of multiple system organ failure as it is closely associated with sepsis. Cardioversion of supraventricular arrhythmias with biphasic waveforms is being studied to determine whether it is more effective than cardioversion with monophasic waveforms. Summary Supraventricular arrhythmias, especially atrial fibrillation, occur frequently in ICU patients. Intensivists not only treat atrial fibrillation itself but also its complications and the complications of the therapies used to prevent these complications. In ICU patients, ventricular arrhythmias have ominous implications because they usually portend either a major cardiac or a systemic dysfunction or both. © 2008 Lippincott Williams & Wilkins, Inc.