The Canadian journal of cardiology
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For physicians working in emergency departments, optimum management of patients with arrhythmias is an important skill. To assess the learning needs of Canadian emergency physicians with respect to arrhythmias, the members of the Canadian Association of Emergency Physicians (CAEP) were surveyed. The survey assessed perceived learning needs and included 11 scenarios assessing physician knowledge. ⋯ The topic areas ranked most highly by respondents in terms of perceived learning needs were management of ventricular arrhythmias (especially electrical strom), and clinical use of oral and intravenous antiarrhythmic drugs, particularly the clinical use of intravenous amiodarone. The assessment of knowledge showed that the respondents managed most arrhythmias in accordance with published guidelines, although the management of some wide complex tachyarrhythmias was not optimal. These results will be used to guide an ongoing program of continuing medical education.
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While supraventricular tachycardia is a common condition and seldom leads to serious consequences, it can be challenging to treat. Optimal management requires an accurate diagnosis, especially in the distinction between regular and irregular tachycardias; as well as an understanding of the mechanism responsible for the arrhythmia. In this article, the acute management of supraventricular tachycardias as they present in the emergency department is discussed, based on the underlying electrophysiological principles of arrhythmias.