Accidental hypothermia-induced electrical storm successfully treated with isoproterenol

Low room temperature can trigger ventricular fibrillation in J wave syndromes

“…They also examined the augmentation of J waves following variable RR intervals in such patients with atrial fibrillation, and found that J waves are augmented after a relatively short RR interval. Their findings suggest that there is a conduction delay induced by suppression of the sodium channels or I to suppression during very low temperatures, as demonstrated by the experimental work by Li et al 13 A similar J-wave augmentation with short RR intervals has also been reported in the case of a severe accidental hypothermia (27.5°C)–induced electrical storm successfully treated with isoproterenol 7 …”

“…However, as described above, Higuchi et al 12 and Takahiro et al 7 have demonstrated J-wave augmentation during short RR intervals in some hypothermic states, suggesting a difference in the Q10 for the activation of the I to , I Ca , and I Na channel currents, and that a balance might be responsible for, and also critical for, the rate dependency of the J waves.…”

“…In the recent report by Takahiro et al, 7 isoproterenol was effective for the treatment of accidental hypothermia–induced electrical storms. We also demonstrated the effectiveness of quinidine combined with a β 2 agonist in preventing low temperature-induced VF in J wave syndrome.…”

“…Current guidelines recommend mild therapeutic hypothermia to prevent neurologic damage following cardiac arrest 4 . However, several recent case reports have described J-wave augmentation and subsequent VF episodes induced by hypothermic therapy or hypothermia in early repolarization syndrome 5, 6, 7…”

Successful treatment of electrical storm in a child with early repolarization syndrome by orciprenaline and radiofrequency ablation

“…Currently, the isoproterenol infusion or rapid cardiac pacing is the most useful treatment approach in the early phase of an electrical storm (4). The drug of choice for the long-term treatment of recurrent idiopathic VF is quinidine, an inhibitor of fast sodium channel (I to ) (1, 4, 5). In our patient, we started with orciprenaline to control the electrical storm.…”