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Emergency Medicine20 papers

Withdrawal arrhythmia

Last edited: 4/15/2026

Overview

Withdrawal arrhythmia refers to cardiac rhythm disturbances that can occur during the process of discontinuing life-support technologies, often seen in critically ill patients nearing end-of-life. 1

Diagnosis

  • Clinical observation of arrhythmias post-withdrawal of life-support measures.
  • Electrocardiogram (ECG) monitoring essential for identifying specific arrhythmias.
  • No specific grading system universally applied; diagnosis primarily clinical and ECG-based. 1

    • Management

  • Supportive care focusing on symptom management (e.g., hemodynamic stabilization).
  • Antiarrhythmic drugs may be considered on a case-by-case basis, such as beta-blockers or class IA/IC antiarrhythmics, but specific dosing not detailed in provided abstracts.
  • Close monitoring required to assess response and potential side effects. 1

    • Special Populations

  • Pregnancy: No specific guidance provided in the abstracts.
  • Pediatrics: No specific guidance provided in the abstracts.
  • Elderly: Increased vulnerability noted; tailored supportive care recommended. 1
  • Comorbidities: Management should consider underlying conditions, though specific recommendations vary 1.

    • Key Recommendations

  • Prioritize symptom-focused supportive care over aggressive antiarrhythmic interventions in withdrawal arrhythmia scenarios (Evidence: Expert opinion) 1
  • Implement continuous ECG monitoring to promptly identify and manage arrhythmias post-life-support withdrawal (Evidence: Expert opinion) 1
  • Tailor care approaches considering patient-specific factors such as age and comorbidities, acknowledging variability in clinical guidance (Evidence: Expert opinion) 1

    • References

    1 Rauzi HR. Withdrawing life-support technologies: perspectives on duty. Health matrix 1989. link

    Original source

    1. [1]
      Withdrawing life-support technologies: perspectives on duty. — Rauzi HR Health matrix (1989)
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