What is the old adage in electrocardiography?

• A. Do not treat rhythms, you treat patients
• B. Slow the heart rate
• C. Increase conduction through the AV node
• D. Oxygen and IV access

Answer: (A)

Treat the patient, not the rhythm. In electrocardiography, the electrical pattern on the ECG tells you what the heart is doing, but management hinges on how the patient is doing overall. A rhythm can appear concerning on the monitor yet the patient may be stable and well perfused, requiring only observation or treatment of underlying causes. Conversely, the same rhythm can signify a dangerous situation in a hemodynamically unstable patient, prompting urgent interventions like pacing or synchronized cardioversion. So clinical status—blood pressure, mental status, chest pain, signs of poor perfusion—drives the treatment, while the ECG guides you but doesn’t dictate it. Oxygen and IV access are important supportive steps, but the guiding principle remains addressing the patient’s condition rather than chasing a rhythm.