Interv Akut Kardiol. 2009;8(6):297-301

Arrhythmic storm - a life-threatening condition

Petr Peichl1,2, Josef Kautzner1
1 Klinika kardiologie IKEM, Praha
2 LF UK Plzeň

Electric storm is defined as three or more episodes of ventricular tachyarrhythmias within 24 hours that require interruption. It’s incidence

in patients with implanted cardioverter-defibrillator ranges between 10–20 % per one year. Electric storm occurs suddenly and mostly

without indentifiable precipitating factor. The therapeutic approach is complex. From pharmacotherapy, sedation and combination of

betablockers and amiodarone is recommended. In case of recurrent arrhythmias despite this treatment, catheter ablation and modification

of arrhythmogenic substrate is indicated. If the electric storm is caused by polymorphic ventricular tachycardias, it is possible in

selected patients to perform ablation of the triggering ectopy. Electric storm is severe, life-threatening situation that adversely impacts

prognosis. Catheter ablation should be in these patients indicated early and may become life-saving therapy.

Keywords: ventricular tachycardias, ventricular fibrillation, implantable cardioverter-defibrillator, catheter ablation

Published: December 12, 2009  Show citation

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Peichl P, Kautzner J. Arrhythmic storm - a life-threatening condition. Interv Akut Kardiol. 2009;8(6):297-301.
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    References

    1. Bardy GH, Lee KL, Mark DB, Poole JE, Packer DL, Boineau R, et al. Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. N Engl J Med 2005; 352(3): 225-237. Go to original source... Go to PubMed...
    2. Bansch D, Bocker D, Brunn J, Weber M, Breithardt G, Block M. Clusters of ventricular tachycardias signify impaired survival in patients with idiopathic dilated cardiomyopathy and implantable cardioverter defibrillators. J Am Coll Cardiol 2000; 36(2): 566-573. Go to original source... Go to PubMed...
    3. Brigadeau F, Kouakam C, Klug D, Marquie C, Duhamel A, Mizon-Gerard F, et al. Clinical predictors and prognostic significance of electrical storm in patients with implantable cardioverter defibrillators. Eur Heart J 2006; 27(6): 700-707. Go to original source... Go to PubMed...
    4. Credner SC, Klingenheben T, Mauss O, Sticherling C, Hohnloser SH. Electrical storm in patients with transvenous implantable cardioverter-defibrillators: incidence, management and prognostic implications. J Am Coll Cardiol 1998; 32(7): 1909-1915. Go to original source... Go to PubMed...
    5. Gatzoulis KA, Andrikopoulos GK, Apostolopoulos T, Sotiropoulos E, Zervopoulos G, Antoniou J, et al. Electrical storm is an independent predictor of adverse long-term outcome in the era of implantable defibrillator therapy. Europace 2005; 7(2): 184-192. Go to original source... Go to PubMed...
    6. Greene M, Newman D, Geist M, Paquette M, Heng D, Dorian P. Is electrical storm in ICD patients the sign of a dying heart? Outcome of patients with clusters of ventricular tachyarrhythmias. Europace 2000; 2(3): 263-269. Go to original source... Go to PubMed...
    7. Hohnloser SH, Al-Khalidi HR, Pratt CM, Brum JM, Tatla DS, Tchou P, et al. Electrical storm in patients with an implantable defibrillator: incidence, features, and preventive therapy: insights from a randomized trial. Eur Heart J 2006; 27(24): 3027-3032. Go to original source... Go to PubMed...
    8. Verma A, Kilicaslan F, Marrouche NF, Minor S, Khan M, Wazni O, et al. Prevalence, predictors, and mortality significance of the causative arrhythmia in patients with electrical storm. J Cardiovasc Electrophysiol 2004; 15(11): 1265-1270. Go to original source... Go to PubMed...
    9. Sesselberg HW, Moss AJ, McNitt S, Zareba W, Daubert JP, Andrews ML, et al. Ventricular arrhythmia storms in postinfarction patients with implantable defibrillators for primary prevention indications: a MADIT-II substudy. Heart Rhythm 2007; 4(11): 1395-1402. Go to original source... Go to PubMed...
    10. Stuber T, Eigenmann C, Delacretaz E. Seasonal variations of ventricular arrhythmia clusters in defibrillator recipients. Pacing Clin Electrophysiol 2006; 29(8): 816-820. Go to original source... Go to PubMed...
    11. Wilson CM, Allen JD, Bridges JB, Adgey AA. Death and damage caused by multiple direct current shocks: studies in an animal model. Eur Heart J 1988; 9(11): 1257-1265. Go to original source... Go to PubMed...
    12. Kowey PR, Levine JH, Herre JM, Pacifico A, Lindsay BD, Plumb VJ, et al. Randomized, double-blind comparison of intravenous amiodarone and bretylium in the treatment of patients with recurrent, hemodynamically destabilizing ventricular tachycardia or fibrillation. The Intravenous Amiodarone Multicenter Investigators Group. Circulation 1995; 92(11): 3255-3263. Go to original source... Go to PubMed...
    13. Pacifico A, Hohnloser SH, Williams JH, Tao B, Saksena S, Henry PD, et al. Prevention of implantable-defibrillator shocks by treatment with sotalol. d,l-Sotalol Implantable Cardioverter-Defibrillator Study Group. N Engl J Med 1999; 340(24): 1855-1862. Go to original source... Go to PubMed...
    14. Dorian P, Borggrefe M, Al-Khalidi HR, Hohnloser SH, Brum JM, Tatla DS, et al. Placebo-controlled, randomized clinical trial of azimilide for prevention of ventricular tachyarrhythmias in patients with an implantable cardioverter defibrillator. Circulation 2004; 110(24): 3646-3654. Go to original source... Go to PubMed...
    15. Hohnloser SH, Dorian P, Roberts R, Gent M, Israel CW, Fain E, et al. Effect of amiodarone and sotalol on ventricular defibrillation threshold: the optimal pharmacological therapy in cardioverter defibrillator patients (OPTIC) trial. Circulation 2006; 114(2): 104-109. Go to original source... Go to PubMed...
    16. Nademanee K, Taylor R, Bailey WE, Rieders DE, Kosar EM. Treating electrical storm: sympathetic blockade versus advanced cardiac life support-guided therapy. Circulation 2000; 102(7): 742-747. Go to original source... Go to PubMed...
    17. Ohgo T, Okamura H, Noda T, Satomi K, Suyama K, Kurita T, et al. Acute and chronic management in patients with Brugada syndrome associated with electrical storm of ventricular fibrillation. Heart Rhythm 2007; 4(6): 695-700. Go to original source... Go to PubMed...
    18. Stevenson WG, Soejima K. Catheter ablation for ventricular tachycardia. Circulation 2007; 115(21): 2750-2760. Go to original source... Go to PubMed...
    19. Zeppenfeld K, Stevenson WG. Ablation of ventricular tachycardia in patients with structural heart disease. Pacing Clin Electrophysiol 2008; 31(3): 358-374. Go to original source... Go to PubMed...
    20. Brugada J, Berruezo A, Cuesta A, Osca J, Chueca E, Fosch X, et al. Nonsurgical transthoracic epicardial radiofrequency ablation: an alternative in incessant ventricular tachycardia. J Am Coll Cardiol 2003; 41(11): 2036-2043. Go to original source... Go to PubMed...
    21. Cao K, Gonska BD. Catheter ablation of incessant ventricular tachycardia: acute and long-term results. Eur Heart J 1996; 17(5): 756-763. Go to original source... Go to PubMed...
    22. Schreieck J, Zrenner B, Deisenhofer I, Schmitt C. Rescue ablation of electrical storm in patients with ischemic cardiomyopathy: a potential-guided ablation approach by modifying substrate of intractable, unmappable ventricular tachycardias. Heart Rhythm 2005; 2(1): 10-14. Go to original source... Go to PubMed...
    23. Silva RM, Mont L, Nava S, Rojel U, Matas M, Brugada J. Radiofrequency catheter ablation for arrhythmic storm in patients with an implantable cardioverter defibrillator. Pacing Clin Electrophysiol 2004; 27(7): 971-975. Go to original source... Go to PubMed...
    24. Carbucicchio C, Santamaria M, Trevisi N, Maccabelli G, Giraldi F, Fassini G, et al. Catheter ablation for the treatment of electrical storm in patients with implantable cardioverter-defibrillators: short- and long-term outcomes in a prospective single-center study. Circulation 2008; 117(4): 462-469. Go to original source... Go to PubMed...
    25. Koželuhová M, Peichl P, Čihák R, Bytešník J, Kautzner J. Katetrizační ablace incesantních forem komorové tachykardie po infakrtu myokardu za podpory elektroanatomického mapování. Interv Akut Kardiol 2005; 4: 205-209.
    26. Reddy VY, Reynolds MR, Neuzil P, Richardson AW, Taborsky M, Jongnarangsin K, et al. Prophylactic catheter ablation for the prevention of defibrillator therapy. N Engl J Med 2007; 357(26): 2657-2665. Go to original source... Go to PubMed...
    27. Haissaguerre M, Shoda M, Jais P, Nogami A, Shah DC, Kautzner J, et al. Mapping and ablation of idiopathic ventricular fibrillation. Circulation 2002; 106(8): 962-967. Go to original source... Go to PubMed...
    28. Haissaguerre M, Extramiana F, Hocini M, Cauchemez B, Jais P, Cabrera JA, et al. Mapping and ablation of ventricular fibrillation associated with long-QT and Brugada syndromes. Circulation 2003; 108(8): 925-928. Go to original source... Go to PubMed...
    29. Mlcochova H, Saliba WI, Burkhardt DJ, Rodriguez RE, Cummings JE, Lakkireddy D, et al. Catheter ablation of ventricular fibrillation storm in patients with infiltrative amyloidosis of the heart. J Cardiovasc Electrophysiol 2006; 17(4): 426-430. Go to original source... Go to PubMed...
    30. Szumowski L, Sanders P, Walczak F, Hocini M, Jais P, Kepski R, et al. Mapping and ablation of polymorphic ventricular tachycardia after myocardial infarction. J Am Coll Cardiol 2004; 44(8): 1700-1706. Go to original source... Go to PubMed...
    31. Bansch D, Oyang F, Antz M, Arentz T, Weber R, Val-Mejias JE, et al. Successful catheter ablation of electrical storm after myocardial infarction. Circulation 2003; 108(24): 3011-3016. Go to original source... Go to PubMed...
    32. Peichl P, Kettner J, Kautzner J. Úspěšné řešení arytmické bouře časně po infarktu myokardu pomocí katetrizační ablace spouštěcího ložiska. Interv Akut Kardiol 2007; 6: 31-33.
    33. Pirk J, Bytesnik J, Kautzner J, Peichl P, Vancura V, Lefflerova K, et al. Surgical ablation of post-infarction ventricular tachycardia guided by mapping in sinus rhythm: long term results. Eur J Cardiothorac Surg 2004; 26(2): 323-329. Go to original source... Go to PubMed...
    34. Samuels LE, Holmes EC, Hagan K, Boova RS, Janzer S, Kocovic D. Cardiogenic shock: collaboration between cardiac surgery and cardiology subspecialties to bridge to recovery. Ann Thorac Surg 2007; 83(5): 1863-1864. Go to original source... Go to PubMed...
    35. Dandamudi G, Ghumman WS, Das MK, Miller JM. Endocardial catheter ablation of ventricular tachycardia in patients with ventricular assist devices. Heart Rhythm 2007; 4(9): 1165-1169. Go to original source... Go to PubMed...

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