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Electrical storm: definitions, clinical importance, and treatment
1QEII Health Sciences Centre, Halifax, Nova Scotia, Canada.
Current Opinion in Cardiology
|November 20, 2012
Summary
Managing recurrent ventricular tachycardia, or electrical storm, requires prompt intervention. Early catheter ablation or cardiac denervation offers better outcomes than prolonged drug therapy for refractory cases.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Implantable cardioverter defibrillators (ICDs) are increasingly used.
- Physicians face challenges managing recurrent ventricular tachycardia (VT), including electrical storm (VT storm).
Purpose of the Study:
- To review the management of electrical storm in patients with ICDs.
- To evaluate current therapeutic strategies for refractory VT storm.
Main Methods:
- Review of current literature on electrical storm management.
- Analysis of outcomes associated with antiarrhythmic drugs versus interventional procedures.
Main Results:
- Standard antiarrhythmic drug therapy can suppress some storms.
- Catheter ablation and surgical cardiac denervation are effective interventions for refractory VT storm.
- Early intervention may lead to better patient outcomes.
Conclusions:
- The definition of electrical storm is currently empirical.
- An outcome-derived definition could improve clinical guidance for treatment.
- An early interventional approach is generally preferred for electrical storm management.
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