title: Ventricular tachycardia storm: a case series and literature review.
abstract: BACKGROUND
  Ventricular tachycardia (VT) storm is an uncommon but life-threatening condition. We describe the incidence, causes and management of VT storm among patients admitted to the coronary care unit of a large tertiary hospital.
  
  
  METHODS
  Between 1 November 2009 and 30 April 2010, 198 patients were admitted to the coronary care unit and 7 (3.5%) presented with VT storm. A retrospective review of their records was conducted. The mean follow-up period was 268 (196 to 345) days.
  
  
  RESULTS
  The mean age was 67 years and 4 patients were male. One patient had a previous myocardial infarction. All had abnormal left ventricular ejection fraction, median of 30%. Acute myocardial infarction (4 patients) was the most common trigger, followed by decompensated heart failure (1), systemic inflammatory response syndrome on a background of non-ischemic dilated cardiomyopathy (1) and bradycardia-induced polymorphic VT (1). Three patients had polymorphic VT and the rest had monomorphic VT. Intravenous amiodarone, lignocaine, overdrive pacing and intra-aortic balloon pump counterpulsation were useful in arrhythmia control. Three patients underwent coronary revascularization, 3 patients received implantable cardioverter-defibrillators, 1 had a permanent cardiac pacemaker, 1 died during the acute episode. Five out of the 6 survivors were prescribed oral beta-blockers upon discharge. On follow-up, none of the patients had a recurrence of the tachyarrhythmia.
  
  
  CONCLUSIONS
  Acute myocardial infarction was the main trigger of VT storm in our patients. Intravenous amiodarone, lignocaine, overdrive pacing and intra-aortic balloon pump counterpulsation were useful at suppressing VT storm.
authors.affiliation: Tan Tock Seng Hospital, Dept of Cardiology, 11 Jalan Tan Tock Seng, Singapore 308433. powlichia@gmail.com.
authors.forename: P L
authors.initials: PL
authors.lastname: Chia
authors.forename: S Y
authors.initials: SY
authors.lastname: Loh
authors.forename: D
authors.initials: D
authors.lastname: Foo
mesh_terms: D017147:Defibrillators, Implantable; D005500:Follow-Up Studies; D006333:Heart Failure; D006801:Humans; D009203:Myocardial Infarction; D012189:Retrospective Studies; D017180:Tachycardia, Ventricular