Electrical storm: clinical manifestations and management.
Electrical storm is the clustering of hemodynamically destabilizing ventricular tachycardia or ventricular fibrillation that typically requires multiple electrical cardioversions or defibrillations within a 24-hour period. Electrical storm is frequently seen in the acute phase of myocardial infarction, in patients with the genetic arrhythmia syndromes, and in patients with implanted cardioverters-defibrillators. The evaluation and management should focus on the immediate suppression of the arrhythmia, a search for possible reversible causes, and attempts to prevent recurrences. In this review we present the most common conditions associated with electrical storm, therapeutic options for suppression of electrical storm, and new investigational techniques emerging for the treatment of electrical storm in refractory cases. The management of this life threatening arrhythmia typically requires the coordinated efforts of emergency medicine, critical care, cardiology, cardiac electrophysiology, and pacemaker experts.
Littmann
L
L
Department of Internal Medicine, Carolinas Medical Center, Charlotte, NC 28232, USA. Laszlo.Littmann@carolinashealthcare.org
Rennyson
S L
SL
D053840:Brugada Syndrome / Q000628:therapy; D017115:Catheter Ablation / Q000379:methods; D017147:Defibrillators, Implantable; D004554:Electric Countershock; D006801:Humans; D009203:Myocardial Infarction / Q000503:physiopathology; D017202:Myocardial Ischemia / Q000503:physiopathology; D012008:Recurrence; D026941:Sodium Channel Blockers / Q000627:therapeutic use; D017180:Tachycardia, Ventricular / Q000503:physiopathology / Q000628:therapy; D014693:Ventricular Fibrillation / Q000503:physiopathology / Q000628:therapy
D026941:Sodium Channel Blockers