title: An approach to the management of outpatients with cardiac arrhythmias.
abstract: A working knowledge of the anatomic and electrophysiologic concepts of the specialized conducting system of the heart combined with an understanding of the hemodynamic consequences of rhythm disorders provides the framework from which the office-based physician can logically approach management of patients with cardiac arrhythmias. The approach includes initial identification of the rhythm disturbance followed by classification on the basis of anatomic site of origin, electrophysiologic mechanism, and rate. The need for therapy is dependent on the presence of unacceptable symptoms and the potential for significant morbidity and mortality. Since intervention has the potential for harm as well as benefit, therapeutic goals should be predefined and then reevaluated so that the decision regarding continuation of specific modes of therapy can be justified. Electrocardiographic recording techniques and other scientific advances have provided the office-based physician with the diagnostic and therapeutic tools that were previously limited to in-hospital practice. There is promise of continued rapid advancement in defining the frequency, significance, mechanism, and appropriate therapy for clinical disorders of the heart beat.
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D001794:Blood Pressure; D001919:Bradycardia / Q000175:diagnosis / Q000628:therapy; D004562:Electrocardiography; D006327:Heart Block / Q000175:diagnosis / Q000628:therapy; D006329:Heart Conduction System / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D008297:Male; D013599:Systole; D013610:Tachycardia / Q000175:diagnosis / Q000628:therapy; D014693:Ventricular Fibrillation / Q000175:diagnosis / Q000628:therapy
chemical_list: D000889:Anti-Arrhythmia Agents