Acute Myocardial Infarction Complicated By Storming Dysrhythmia: Vt Storm

Electrical storm refers to a state of cardiac electrical instability characterized by multiple episodes of ventricular tachycardia (vt storm) or ventricular fibrillation (vf storm) over a short period of time, typically 24 hrs. Patients with acute myocardial infarction are particularly at a higher risk. The disease has a very high mortality and hence an early recognition with prompt treatment is warranted. We report a case of a 47 year old male who had a vt storm following extensive anterolateral wall myocardial infarction. He initially had an unstable vt and was cardioverted by dc shock. However, he continued to have multiple episodes of monomorphic vt within the next 24 hours. He was initially treated with dc shock (under sedation) and amiodarone. He continued to have stable monomorphic vt for which intravenous amiodarone and metoprolol was administered. He still continued to have a dysrhythmia and intravenous lidocaine was tried which finally controlled his arrhythmia. Later, he was later put on icd for secondary prevention and had no further episodes.