Survival after prolonged resuscitation with 99 defibrillations due to Torsade De Pointes cardiac electrical storm: a case report.
A 48-year-old previously healthy woman suffered witnessed cardiac arrest in hospital. She achieved return of spontaneous circulation and was transferred to the intensive care unit. During the following 3 hours, she suffered a cardiac electrical storm with 98 episodes of Torsade de Pointes ventricular tachycardia rapidly degenerating to ventricular fibrillation. She was converted with a total of 99 defibrillations. There was no response to the use of any recommended anti arrhythmic drugs. However, the use of bretylium surprisingly stabilized her heart rhythm and facilitated placing of a temporary pacemaker. Overdrive pacing prevented further arrhythmias and was life saving. A number of beneficial factors may have contributed to the good neurological outcome. Further investigations gave no explanation for her cardiac electrical storm.
Nakstad
Anders Rostrup
AR
Department of Anesthesia and Air Ambulance Department, Oslo University Hospital - Ullevål, Oslo, Norway. andersrn@akuttmedisin.info
Eek
Christian
C
Aarhus
Dag
D
Larsen
Anne
A
Haugaa
Kristina Hermann
KH
D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001949:Bretylium Compounds / Q000627:therapeutic use; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D005260:Female; D006323:Heart Arrest / Q000150:complications / Q000628:therapy*; D006801:Humans; D007362:Intensive Care Units; D008875:Middle Aged; D012640:Seizures / Q000150:complications*; D016171:Torsades de Pointes / Q000150:complications* / Q000209:etiology / Q000628:therapy; D014693:Ventricular Fibrillation / Q000175:diagnosis / Q000209:etiology / Q000628:therapy
D000889:Anti-Arrhythmia Agents; D001949:Bretylium Compounds; C045166:bretylium