Management of electrical storm of unstable ventricular tachycardia in post myocardial infarction patients: A single centre experience

Abstract

In post myocardial infarction patients presenting with ES and unstable VT, a protocol driven approach involving substrate modification targeting abnormal electrograms improves outcomes.

In-hospital and intermediate term outcome of ventricular tachycardia storm

“…In comparison to published studies 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 the study cohort was similar in terms of age at presentation, male preponderance and scar VT as the predominant etiology. Data on VT Storm management from real-world setting is scarce, limited to studies on ICDs or specific to certain therapeutic interventions.…”

“… VT: Ventricular Tachycardia; High risk patients include patients presenting with hemodynamically unstable VT or stable VT with co-morbidities (LVEF 0.<3, chronic kidney disease or pulmonary disease) 1 , 2 ; Others include Long QT syndrome(2), idiopathic VT(2), fascicular VT(1) and congenital heart disease(1). The ∗ symbol denotes the number of cases.…”

“…Patients presenting with acute or recent myocardial infarction (MI) were excluded from the study Patients were enrolled from March 2017 to December 2018 VT storm was defined as occurrence of ≥2 hemodynamically stable or unstable VT within 24 h (patients without ICD) or ≥ 3 appropriate therapies for ventricular tachyarrhythmias, including anti-tachycardia pacing or shocks within a span of 24 h (patients with ICD). 2 VT was classified according to the QRS morphology as monomorphic (MMVT), pleomorphic and polymorphic. Pleomorphic VT was defined as >1 MMVT morphology, or a combination of MMVT and polymorphic VT. 3 The left ventricle ejection fraction (LVEF) was assessed by Simpson's method.…”

“…Ventricular tachycardia (VT) stormis characterized by > 2 episodes of VT or ventricular fibrillation within a span of 24 h. 1 VT storm carries a high mortalityrate even with current advancements in care. 2 Patients often require a multimodality approach using antiarrhythmic drugs, deep sedation, sympathetic blockade and radiofrequency ablation. Implantable cardiac defibrillator (ICD) is one of the mainstays for long-term management.…”

Genetic variants in post myocardial infarction patients presenting with electrical storm of unstable ventricular tachycardia

“…Study patients were managed by standard institutional protocol involving mechanical ventilation, hemodynamic support, anti-arrhythmic medications, radiofrequency ablation and stellate ganglionectomy as indicated. The management protocol and clinical outcomes of these patients have been detailed in a separate manuscript [ 3 ].…”