Management of electrical storm: The mechanism matters

Abstract

An electrical storm is a life‐threatening syndrome that is characterized by clustering of recurrent episodes of ventricular tachycardia (VT) or ventricular fibrillation (VF) within a relatively short period of time. Electrical storms occur in a wide variety of conditions, and successful treatment depends on a correct understanding of the mechanism underlying the recurrent arrhythmias. Management of electrical storms is challenging, but classifying patients according to the type of recurrent arrhythmia (monomorphic VT or polymorphic VT/VF) and the presence or absence of structural heart disease would aid differential diagnosis and allow for more specific therapies.

Electrical storm treated successfully in a patient with TANGO2 gene mutation and long QT syndrome: A case report

“…In fact, avoidance of both long pauses and bradycardia through pacing has been considered as a reliable way to prevent as well as stop TdP episodes by several experienced centers and authors. [10][11][12][13] Interestingly, Viskin and colleagues 14 have described that pediatric TdP is not always pause-dependent, although this is still the major mechanism. Their article reports that TdP, which is not pause-dependent, is present especially in patients with severe forms of LQTS.…”

Beyond Advanced Cardiac Life Support: Dual-sequential Defibrillation for Refractory Ventricular Fibrillation after Witnessed Cardiac Arrest in the Emergency Department

“…Cardiac arrest due to refractory ventricular fibrillation is a rare, life-threatening condition, seen in less than 10% of out-of-hospital cardiac arrests [ 1 ]. The term refractory ventricular fibrillation is used when there have been multiple failed attempts (two or more) at correcting ventricular fibrillation during cardiopulmonary resuscitation (CPR) [ 2 ]. Advanced cardiac life support (ACLS) guidelines help providers with clinical decisions while managing cardiac arrest patients but provide no recommendations for refractory ventricular fibrillation.…”

Complex management of electrical storm in a patient with non-ischemic dilated cardiomyopathy

“…The term "electrical storm" represents a state of electrical heart instability characterized by several recurrent episodes of ventricular arrhythmias over a short period of time [1,2]. Both ventricular tachycardia (VT) and ventricular fibrillation (VF) could be the triggers for this life-threating condition.…”