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Published on: August 26, 2021
[Electrical storm management in the cardiac care unit]
Veronica Dusi1, Gaetano Maria De Ferrari1, Pasquale Vergara2
1Divisione di Cardiologia, Dipartimento Cardiovascolare e Toracico, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino - Dipartimento di Scienze Mediche, Università degli Studi, Torino.
Electrical storm (ES), a serious ventricular arrhythmia (VA) complication, demands prompt multidisciplinary care. Early recognition and treatment of ES in cardiomyopathy patients improve outcomes, though research is limited.
Area of Science:
- Cardiology
- Electrophysiology
Context:
- Electrical storm (ES) is defined by recurrent ventricular arrhythmias (VA) within 24 hours, often seen in patients with implantable cardioverter-defibrillators (ICDs).
- ES signifies a critical event in cardiomyopathy patients, leading to a poorer prognosis.
Purpose:
- To provide a comprehensive overview of electrical storm management.
- To highlight the challenges and current limitations in ES treatment strategies.
Summary:
- ES management requires a multidisciplinary approach, including clinical assessment, resuscitation, ICD reprogramming, ablation, and neuromodulation.
- Prompt recognition and treatment are crucial for therapeutic success.
- Limited evidence from prospective trials and a narrow spectrum of effective antiarrhythmic drugs present ongoing challenges.
Impact:
- This decalogue aims to guide clinicians in managing ES, emphasizing the need for early intervention.
- Future research focusing on larger prospective studies is essential to optimize pharmacologic strategies, invasive treatment timing, and neuromodulation indications.
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