Das Konzept der "5A" für die Intensiv- und Notfallmedizin

Bradycardia (heart rate < 60/min) (BR) and tachycardia rhythm disturbances (heart rate > 100/min) (TR) require rapid therapeutic strategies. Supraventricular tachycardias (SVT) are sinus tachycardia, atrial tachycardia, AV-nodal reentrant tachycardia and tachycardia due to accessory pathways. All SVT are characterized by a ventricular heart rate > 100/min and small QRS complexes (QRS width < 0.12 ms) during tachycardia. It is essential to evaluate the arrhythmia history and to perform a careful physical examination with exact analysis of the 12-lead electrocardiogram. An exact SVT diagnosis is then possible in >90% of SVT patients. Ventricular tachycardia (VT) have a broad QRS complex (QRS width ≥ 0.12 s), while ventricular flutter (VFlut) and ventricular fibrillation (VF) are associated with chaotic electrophysiologic findings. For acute therapy, we will present the new "5A" concept that includes adenosine, adrenaline, ajmaline, amiodarone and atropine. Additional "B, C and D strategies" include betablocking agents, cardioversion as well as defibrillation. The "5A" concept allows a safe and effective antiarrhythmic treatment of all BR, TR, SVT, VT, VFlut, VF and asystole.