Key result
Multimodality approach to electrical storm in ICD patients linked to improved outcomes over standard care.
A multimodality approach, including device reprogramming, antiarrhythmic therapy, and sedation, is essential for managing electrical storm in patients with implantable cardioverter defibrillators.
May support multimodality care for electrical storm in ICD patients; leaves open confirmation versus standard approaches in prospective studies.
Electrical storm is the occurrence of at least three episodes of malignant ventricular arrhythmia (sustained ventricular tachycardia/ventricular fibrillation) during 24 hours, most commonly in patients with an implanted cardioverter defibrillator. We present a 48-year-old patient with an implanted cardioverter defibillator in the secondary prevention of sudden cardiac death and the occurrence of an electrical storm in the form of polymorphic ventricular tachycardia with degeneration into ventricular fibrilation treated by the delivery of 10 intracardiac DC shocks in a several hours period. A multimodality approach to the patient was applied, which included the initial search for precipitating factors, electronic interrogation and changes in device programming, antiarrhythmic drug therapy and patient sedation. The applied measures are discussed in the context of the available literature. A multimodality approach to patients with electrical storm in specialized centers improves outcomes of such complex patients.
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Nikolić et al. (2023) studied this question. A multimodality approach to treating electrical storm in patients with an implanted cardioverter defibrillator improves outcomes compared to standard care.
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