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[Electrical storm].

C Barnay1, J Taieb, R Morice

  • 1Service de cardiologie, centre hospitalier du Pays d'Aix, avenue des Tamaris, 13616 Aix-en-Provence, France. cbarnay@ch-aix.fr

Annales De Cardiologie Et D'Angeiologie
|October 9, 2007
PubMed
Summary
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Electrical storm, characterized by recurrent ventricular arrhythmias, affects patients with defibrillators, during heart attacks, and in Brugada syndrome. Treatment involves antiarrhythmic drugs, cardioversion, and in severe cases, ablation or transplantation.

Area of Science:

  • Cardiology
  • Electrophysiology

Context:

  • Electrical storm involves recurrent, life-threatening ventricular arrhythmias.
  • It occurs in patients with implantable cardioverter-defibrillators (ICDs), acute myocardial infarction, and Brugada syndrome.

Purpose:

  • To define electrical storm and outline its clinical circumstances, precipitating factors, and predictive factors.
  • To review current management strategies, including electrical therapies and pharmacologic treatments.

Summary:

  • Electrical storm affects 10-15% of ICD patients within two years, often caused by ventricular tachycardia.
  • Precipitating factors include heart failure, electrolyte imbalances, and drugs; predictors are age, low ejection fraction, and renal insufficiency.
  • Management involves eliminating inappropriate shocks, beta-blockers, amiodarone, lidocaine, sedation, and in refractory cases, ablation or transplantation. Quinidine is effective for Brugada syndrome.

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Impact:

  • Provides a comprehensive overview of electrical storm diagnosis and management.
  • Highlights key risk factors and treatment modalities for improved patient outcomes.
  • Informs clinical practice regarding the complex management of severe ventricular arrhythmias.