[Electrical storm secondary to hypokaliemia in a patient with implantable cardioverter defibrillator].
Electrical storm in patients with implantable cardioverter defibrillator (ICDs) is a rhythmic emergency which can be immediately lethal. It occurs especially in patients with an advanced cardiomyopathy. Such arrhythmias predictor factors and triggers are rarely found. We report the case of a 73-year-old man with ischemic dilated cardiomyopathy, who underwent a complete surgical revascularisation six years ago. In 2003, this patient was hospitalised in cardiology because of a sustained ventricular tachycardia reduced by electrical shock. Because of the aggravation of the heart failure with a NYHA functional class III, electrical and echocardiographic criteria of ventricular dyssynchrony, a biventricular ICD was implanted. Three years after, the patient was hospitalized because of an electrical storm with 96 appropriate shocks. A severe hypokaliemia was the cause of this electrical storm, and the evolution was favourable after correction of the hypokaliemia. Hypokaliemia is rarely the trigger of such arrhythmias, it represents only 3 % of the causes. Its prevalence may be underestimated especially in patients with heart failure who receive high doses of diuretics.
Kachboura
S
S
Unité de recherche scientifique UR0904, service de cardiologie, CHU Abderrahmane Mami, Ariana, Tunisia.
Ben Halima
A
A
Ben Miled
M
M
D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000628:therapy; D017147:Defibrillators, Implantable; D003937:Diagnosis, Differential; D004562:Electrocardiography; D004630:Emergencies; D019544:Equipment Failure Analysis; D006801:Humans; D007008:Hypokalemia / Q000150:complications* / Q000175:diagnosis*; D017202:Myocardial Ischemia / Q000150:complications / Q000628:therapy; D012307:Risk Factors; D017180:Tachycardia, Ventricular / Q000150:complications / Q000628:therapy; D018754:Ventricular Dysfunction / Q000150:complications / Q000628:therapy