T. Tsirlis, K Liverdos.
Odostomatological Progress 2006, 60 (1) 125-136.
Abstract:
Cardiac arrhythmias are disturbances of cardiac rhythm and they are defined as cardiac rhythms that differ from the normal sinus rhythm. They cover a broad spectrum of situations from clinically insignificant changes to lethal disturbances of cardiac rhythm. They are present in a significant percentage of patients seeking dental treatment. They may be asymptomatic (without hemodynamic changes); they can however influence the cardiac output varying from little to sometimes so serious even leading to death. The majority of arrhythmias that are present in patients seeking dental treatment are substantially of little concern and without clinical importance. Nevertheless, the small probability of the appearance of serious arrhythmias during dental treatment constitutes a reality that requires the proportional attention of the clinician. In this review the various forms of arrhythmias are presented, the therapeutic approach to arrhythmias is reported and finally, the management of arrhythmic patients from the clinical dentist is presented as well as the mode of action in the case of an arrhythmic crisis. The prevention of the appearance of an arrhythmia in the dental office requires the application of a sequence of actions. Some of these are: reduction of stress and anxiety of the patient, short duration of appointments early in the morning or early in the afternoon, attention using local anesthesia and limiting the use of vasoconstrictor and avoiding general anesthesia. Furthermore, use of electrosurgical units, ultrasonic cleaners and ultrasonic scalers in individuals with pacemakers should also be avoided. Even if the proper sequence of actions is followed for the management of high-risk patients, the occurrence of a serious and life-threatening arrhythmic crisis in the dental office is not excluded.
