Electrical storms in an ICD-recipient with 429 delivered appropriate shocks: therapeutic management with antiarrhythmic drug combination.
The case of a 65 year old man with ischemic cardiomyopathy, an ICD device and recurrent electrical storms is presented. The patient had been implanted with an ICD device due to aborted sudden death. The first electrical storm occurred 12 months later. It was terminated by the administration of intravenous amiodarone and the patient was discharged on maintenance dose amiodarone and b-blocker. After a period of 3 months during which the patient remained asymptomatic, a second arrhythmic clustering occurred and it was controlled by the addition of mexiletine. A total number of 429 appropriate shocks had been delivered by the device. Thereafter and for a seven month follow-up period, the patient remains asymptomatic under this combination of antiarrhythmic drugs.
Manolis
Athanasios G
AG
Hellenic Red Cross Hospital of Athens, 27 Venizelou Street, 17123 Athens, Greece. agmanoli@otenet.gr
Katsivas
Apostolos G
AG
Vassilopoulos
Charis
C
Tsatiris
Costas G
CG
D000368:Aged; D000638:Amiodarone / Q000008:administration & dosage*; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis / Q000628:therapy*; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D004562:Electrocardiography; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008801:Mexiletine / Q000008:administration & dosage*; D018570:Risk Assessment; D017180:Tachycardia, Ventricular / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000188:drug therapy* / Q000209:etiology
D008801:Mexiletine; D000638:Amiodarone