Key result
Emergency cardiac defibrillation followed by multidisciplinary management including ECMO, catheter ablation, and ICD implantation successfully stabilized a 39-year-old woman with refractory ventricular electrical storm.
Why the study?
Ventricular electrical storm is a treatment-resistant ventricular arrhythmia associated with high mortality.
Case Report (n=1)
This case highlights the importance of rapid defibrillation and multidisciplinary management, including ECMO and RF ablation, for treating refractory ventricular electrical storm.
Multidisciplinary care may stabilize eosinophilia-associated VES; leaves open need for prospective studies on etiology and targeted therapy.
BACKGROUND Ventricular electrical storm (VES) is a treatment-resistant ventricular arrhythmia associated with high mortality. This report is of a 39-year-old woman with VES treated with emergency cardiac defibrillation followed by multidisciplinary management. CASE REPORT A 39-year-old woman, previously diagnosed with eosinophilia of unknown origin and recurrent non-sustained ventricular tachycardias, was admitted to the Department of Invasive Cardiology with VES after an initial antiarrhythmic approach, analgesia, and defibrillation in the Emergency Department. The patient had a temporary pacing wire implanted, but overdrive therapy was not successful. The medical treatment and multiple defibrillations did not stop the arrythmia. Due to the hemodynamic instability, extracorporeal membrane oxygenation (ECMO) was performed at the Department of Cardiac Surgery. Consequently, the patient was stabilized and an electrophysiology exam and RF ablation of arrhythmogenic focus were conducted in the Department of Cardiology. One day after the procedure, the patient had pulmonary edema caused by pericardial tamponade. The patient was successfully operated on in the Department of Cardiac Surgery. Then, the next complication appeared - a femoral artery embolism - which was treated in the Department of Vascular Surgery. After patient stabilization and exclusion of serious neurological damage, an implantable cardioverter-defibrillator (ICD) was implanted for secondary prevention of sudden cardiac death (SCD). CONCLUSIONS This case has shown the importance of the rapid diagnosis of VES and emergency management with cardiac defibrillation. Multidisciplinary clinical follow-up is required to investigate and treat any reversible causes and to ensure long-term stabilization of cardiac rhythm.
No takes yet. Share an insight, caveat, or question.
Sielatycki et al. (2022) conducted a case report in Ventricular electrical storm (n=1). Emergency cardiac defibrillation and multidisciplinary management (ECMO, catheter ablation, ICD) was evaluated on Survival and stabilization of cardiac rhythm. Emergency cardiac defibrillation followed by multidisciplinary management including ECMO, catheter ablation, and ICD implantation successfully stabilized a 39-year-old woman with refractory ventricular electrical storm.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: