Suppression of refractory electrical storm by microtubule destabilization and dechanneling therapy in a patient with heart failure with reduced left ventricular ejection fraction and implantable cardioverter-defibrillator: A novel therapeutic approach. In most cases, the electrical storm occurs as a sustained monomorphic VT, associated with structural heart disease.
Electrical storms in the heart. However, it is not always easy to find and abolish Purkinje potentials during electrical storm. The technique for photographing all electrical storm is quite simple: once you have observed where the, lightning strikes are occurring, aim your camera and zoom lens. The perfect storm: most people see wild winter weather as the perfect excuse to stay indoors, but the season of storms brings with it a wealth of opportunities for intrepid photographers willing to brave the elements.
Eur Heart J ; — Clusters of ventricular tachycardias signify impaired survival in patients with idiopathic dilated cardiomyopathy and implantable cardioverter defibrillators. J Am Coll Cardiol ; — Treating electrical storm : sympathetic blockade versus advanced cardiac life support-guided therapy.
Is electrical storm in ICD patients the sign of a dying heart? Outcome of patients with clusters of ventricular tachyarrhythmias. Europace ; — Electrical storm in patients with transvenous implantable cardioverter-defibrillators: incidence, management and prognostic implications. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction.
What Happens During a Lightning Storm?
N Engl J Med ; — Incidence and clinical significance of multiple consecutive, appropriate, high-energy discharges in patients with implanted cardioverter-defibrillators. Prognostic importance of defibrillator shocks in patients with heart failure. Shock reduction using antitachycardia pacing for spontaneous rapid ventricular tachycardia in patients with coronary artery disease.
Differences in effects of electrical therapy type for ventricular arrhythmias on mortality in implantable cardioverter-defibrillator patients. Heart Rhythm ; — Educational and psychological interventions to improve outcomes for recipients of implantable cardioverter defibrillators and their families: a scientific statement From the American Heart Association.
Causes and consequences of heart failure after prophylactic implantation of a defibrillator in the multicenter automatic defibrillator implantation trial II. Randomized, double-blind comparison of intravenous amiodarone and bretylium in the treatment of patients with recurrent, hemodynamically destabilizing ventricular tachycardia or fibrillation.
Prevalence, predictors, and mortality significance of the causative arrhythmia in patients with electrical storm. J Cardiovasc Electrophysiol ; — Clinical predictors and prognostic significance of electrical storm in patients with implantable cardioverter defibrillators. Incidence and clinical significance of short-term recurrent ventricular tachyarrhythmias in patients with implantable cardioverter-defibrillator.
Int J Cardiol ; — Dose-ranging study of intravenous amiodarone in patients with life-threatening ventricular tachyarrhythmias. Long-term temporal patterns of ventricular tachyarrhythmias. Electrical storm is an independent predictor of adverse long-term outcome in the era of implantable defibrillator therapy. Ventricular arrhythmia storms in postinfarction patients with implantable defibrillators for primary prevention indications: a MADIT-II substudy. Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure.
Huang DT, Traub D. Recurrent ventricular arrhythmia storms in the age of implantable cardioverter defibrillator therapy: a comprehensive review. Prog Cardiovasc Dis ; — Prevalence and predictors of electrical storm in patients with implantable cardioverter-defibrillator. J Mol Cell Cardiol ; — Effects of repeated electrical defibrillations on cardiac troponin I levels.
Jones DL, Narayanan N. Defibrillation depresses heart sarcoplasmic reticulum calcium pump: a mechanism of postshock dysfunction. Detection of myocardial injury during transvenous implantation of automatic cardioverter-defibrillators. High-energy defibrillation increases the severity of postresuscitation myocardial dysfunction.
Left ventricular function after repeated episodes of ventricular fibrillation and defibrillation assessed by transoesophageal echocardiography.
Understanding implantable cardioverter defibrillator shocks and storms: medical and psychosocial considerations for research and clinical care. Clin Cardiol ; — Catheter ablation of electrical storm. Expert Rev Cardiovasc Ther ; — Comparison of beta-blockers, amiodarone plus beta-blockers, or sotalol for prevention of shocks from implantable cardioverter defibrillators: the OPTIC Study: a randomized trial. JAMA ; — Effects of beta-blockers on implantable cardioverter defibrillator therapy and survival in the patients with ischemic cardiomyopathy from the Multicenter Automatic Defibrillator Implantation Trial-II.
Prevention of implantable-defibrillator shocks by treatment with sotalol. Efficacy of metoprolol and sotalol in the prevention of recurrences of sustained ventricular tachyarrhythmias in patients with an implantable cardioverter defibrillator.
Pacing Clin Electrophysiol ; — View Full Text PubMed. Azimilide reduces emergency department visits and hospitalizations in patients with an implantable cardioverter-defibrillator in a placebo-controlled clinical trial.
Roukoz H, Saliba W. Dofetilide: a new class III antiarrhythmic agent.
Efficacy and safety of oral dofetilide in patients with an implantable defibrillator: a multicenter study. Circulation ; S2 Efficacy and safety of dofetilide in the treatment of frequent ventricular tachyarrhythmias after amiodarone intolerance or failure. Preliminary report: effect of encainide and flecainide on mortality in a randomized trial of arrhythmia suppression after myocardial infarction. Electrophysiologic mechanisms of antiarrhythmic efficacy of a sotalol and class Ia drug combination: elimination of reverse use dependence.
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Combined mexiletine and amiodarone treatment of refractory recurrent ventricular tachycardia. Am Heart J ; 6 Pt 1 — Long-term comparison of the implantable cardioverter defibrillator versus amiodarone: eleven-year follow-up of a subset of patients in the Canadian Implantable Defibrillator Study CIDS. Catheter ablation of recurrent scar-related ventricular tachycardia using electroanatomical mapping and irrigated ablation technology: results of the prospective multicenter Euro-VT-study. Irrigated radiofrequency catheter ablation guided by electroanatomic mapping for recurrent ventricular tachycardia after myocardial infarction: the Multicenter Thermocool Ventricular Tachycardia Ablation Trial.
What Happens During a Lightning Storm?
Prophylactic catheter ablation for the prevention of defibrillator therapy. Catheter ablation of stable ventricular tachycardia before defibrillator implantation in patients with coronary heart disease VTACH : a multicentre randomised controlled trial. Lancet ; — Electroanatomically guided catheter ablation of ventricular tachycardias causing multiple defibrillator shocks.
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.
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Catheter ablation of electrical storm in a collaborative hospital network. Catheter ablation of electrical storm in patients with structural heart disease. Radiofrequency catheter ablation for arrhythmic storm in patients with an implantable cardioverter defibrillator. Ventricular tachycardia ablation remains treatment of last resort in structural heart disease: argument for earlier intervention. Blomberg S, Ricksten SE. Thoracic epidural anaesthesia decreases the incidence of ventricular arrhythmias during acute myocardial ischaemia in the anaesthetized rat.
Acta Anaesthesiol Scand ; — Thoracic epidural anesthesia attenuates halothane-induced myocardial sensitization to dysrhythmogenic effect of epinephrine in dogs. Anesthesiology ; — Prevention of sudden cardiac death after a first myocardial infarction by pharmacologic or surgical antiadrenergic interventions. Left cardiac sympathetic denervation in the therapy of congenital long QT syndrome. A worldwide report. Left cardiac sympathetic denervation in the management of high-risk patients affected by the long-QT syndrome. Sympathetic blockade was withdrawn according to the medical team's criteria after the patient had been free of arrhythmias for 48 hours..
The effectiveness of the technique was estimated by comparing the number of episodes of sustained ventricular arrhythmia before and after TSB. The statistical significance of the reduction in the number of episodes after LSGB was assessed by the Wilcoxon test for paired data.. Baseline patient characteristics, the trigger for ES, and the initial treatment are summarized in the Table.. In 6 patients, the number of arrhythmia episodes declined during the first 24 hours after the initiation of sympathetic blockade Figure.
Of these patients, 2 responded to repeat LSGB. The third patient responded to conventional therapy and thus there was no further requirement for sympathetic blockade.. Number of electrical storm episodes, defined as the presence of sustained ventricular arrhythmias. The graph shows total episodes and episodes in the 24 hours before and after transient sympathetic blockade TSB: Transient sympathetic blockade.. Catheter ablation of ventricular tachycardia was performed in patient 4, and patient 5 underwent heart transplantation.
The follow-up of each patient is presented in the Table. In all patients, sympathetic blockade was transitory and its use did not interfere with conventional treatments, including definitive treatments such as catheter ablation and heart transplantation. There were no complications related to the procedure.. In our study, we used standard techniques for transient sympathetic blockade without having to resort to definitive methods.
This contrasts with other studies reporting the use of interventions such as surgical sympathectomy 5 or videothoracoscopy ablation of the sympathetic chain ganglia in the pleural cavity.. The main limitations of our study are the small sample size and its observational and retrospective nature. In addition, due to patient care and organizational issues, it was not possible to retrospectively determine the exact number of patients presenting with refractory ES during the study period March to December Home Articles in press Current Issue Archive.
ISSN: Previous article Next article. Issue 1. Pages January More article options. Download PDF. Corresponding author. This item has received. Article information. Sympathetic blockade was withdrawn according to the medical team's criteria after the patient had been free of arrhythmias for 48 hours.
The statistical significance of the reduction in the number of episodes after LSGB was assessed by the Wilcoxon test for paired data. Baseline patient characteristics, the trigger for ES, and the initial treatment are summarized in the Table.