The primary tool for diagnosis of arrhythmias is the ECG. Table 34-2 lists common arrhythmias, their likely mechanisms, and approaches that should be considered for their acute termination and for long-term therapy to prevent recurrence. Some arrhythmias, notably ventricular fibrillation (VF), are best treated not with drugs but with direct current (dc) cardioversion—the application of a large electric current across the chest. Implantable cardioverter-defibrillators (ICDs), devices that are capable of detecting VF and automatically delivering a defibrillating shock, are used increasingly in patients judged to be at high risk for VF.
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