Successful treatment of cardiac electrical storm in dilated cardiomyopathy using esmolol: A case report

Abstract

The present study reports a case of electrical storm occurring in a 43-year-old woman with dilated cardiomyopathy. The patient suffered from a cardiac electrical storm, with 98 episodes of ventricular tachycardia rapidly degenerating to ventricular fibrillation in hospital. The patient was converted with a total of 120 defibrillations. Recurrent ventricular tachycardia/fibrillation was initiated by premature ventricular beats. The patient did not respond to the use of amiodaronum. However, the administration of esmolol stabilized the patient's heart rhythm. A moderate dose of the β-blocker esmolol, administered as an 0.5-mg intravenous bolus injection followed by an infusion at a rate of 0.15 mg/kg/min, inhibited the recurrence of ventricular fibrillation and normalized the electrocardiographic pattern. The results suggest that esmolol may be able to improve the survival rate of patients with electrical storm in dilated cardiomyopathy and should be considered as a primary therapy in the management of cardiac electrical storms.

Emergency Management of Electrical Storm: A Practical Overview

“…Short acting beta blockers, such as esmolol [ 72 ], or ultra-short-acting beta1-selective blockers, such as landiolol [ 73 ], could be used in ES, particularly in a compromised hemodynamic situation.…”

Star in the storm: percutaneous stellate ganglion blockade for drug-refractory electrical storm in the emergency department

“…It may be precipitated by acute myocardial ischemia, electrolyte disturbances (e.g., hypokalemia, hypomagnesemia, hyperkalemia), worsening heart failure, sepsis, and poor compliance with antiarrhythmic medications [ 4 , 5 ]. Antiarrhythmic medication along with β-blockers (intravenous propranolol) remain the standard treatment for ES, although evidence has shown esmolol also to be effective [ 6 , 7 ].…”