Electrical storm: case series and review of management.
Electrical storm is defined as a recurrent episode of hemodynamically destabilizing ventricular tachyarrhythmia that usually requires electrical cardioversion or defibrillation. We describe three cases presenting with electrical storm under differing circumstances: (1) a 57-year-old man with ST-elevation myocardial infarction within 1 week of a posterior circulation stroke who developed refractory sustained ventricular tachycardia 10 days after an acute myocardial infarction; (2) a 65-year-old man who developed polymorphic ventricular tachycardia and ventricular fibrillation following dobutamine echocardiography; and (3) a 20-year-old woman who developed intractable ventricular fibrillation following an overdose of a weight-reduction pill. The management of electrical storm is discussed, and evolving literature supporting the routine use of intravenous amiodarone and beta-blockers in place of intravenous lidocaine is critically examined.
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000638:Amiodarone / Q000008:administration & dosage* / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D019440:Anti-Obesity Agents / Q000506:poisoning; D020520:Brain Infarction / Q000150:complications; D002986:Clinical Trials as Topic; D016757:Death, Sudden, Cardiac; D025401:Echocardiography, Stress / Q000009:adverse effects; D004554:Electric Countershock; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008012:Lidocaine / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D013578:Synephrine / Q000506:poisoning; D017180:Tachycardia, Ventricular / Q000188:drug therapy* / Q000209:etiology / Q000628:therapy; D014693:Ventricular Fibrillation / Q000188:drug therapy* / Q000209:etiology / Q000628:therapy
D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents; D019440:Anti-Obesity Agents; D008012:Lidocaine; D000638:Amiodarone; D013578:Synephrine