Successful bridge to recovery using a microaxial blood pump in a patient with electrical storm and cardiogenic shock.
A 59-year-old patient with dilated cardiomyopathy and incessant ventricular tachycardia leading to progressive cardiogenic shock is presented. Due to hemodynamic instability, high dose catecholamines were required in addition to the implantation of an intraaortic balloon pump (IABP), which, however, appeared to further augment the frequency and duration of ventricular tachycardias. The implantation of a microaxial blood pump allowed catecholamine administration to be terminated, thereby, ending this vicious circle of catecholamine-driven electrical storm. Within 5 days, the patient was hemodynamically stabilized and kidney and liver function recovered with the support of intensive antiarrhythmic therapy (amiodarone, mexiletine, sotalol). During a 24-month follow-up, the patient had no further ICD shocks and no rehospitalization was required for treatment of congestive heart failure.
Medizinische Klinik, Universitaetsklinikum Tuebingen, Germany. andreas.henning@med.uni-tuebingen.de
A
A
Henning
J
J
Schreieck
R
R
Riessen
M
M
Gawaz
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AE
May
D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D002303:Cardiac Output, Low / Q000628:therapy; D002311:Cardiomyopathy, Dilated / Q000628:therapy*; D017115:Catheter Ablation; D003131:Combined Modality Therapy; D016757:Death, Sudden, Cardiac / Q000517:prevention & control; D017147:Defibrillators, Implantable; D004562:Electrocardiography; D005500:Follow-Up Studies; D006353:Heart-Assist Devices; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000295:instrumentation*; D007677:Kidney Function Tests; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D012770:Shock, Cardiogenic / Q000628:therapy*; D012815:Signal Processing, Computer-Assisted; D017180:Tachycardia, Ventricular / Q000628:therapy*
D000889:Anti-Arrhythmia Agents