Intensive management of electrical storm and incessant ventricular arrhythmias

Research output: Contribution to journalArticle

Abstract

Electrical storm (ES) is defined as ventricular tachycardia or ventricular fibrillation occurring at least three times in 24 h leading to hemodynamic unstable state that needs cardioversion or defibrillation. ES may cause fast hemodynamic impairment, leading to "low-perfusion" or "no perfusion" state of the organs, a vicious circle pointing toward cardiogenic shock, multi-organ failure, and pulseless electrical activity. ES in ICD patients may be a strong predictor of arrhythmic and nonarrhythmic death, as well as of rehospitalization. The first step is to start cardiopulmonary resuscitation to achieve complete hemodynamic stabilization to prevent the low-flow or no-flow state. The patient has to be transported to an intensive care unit for further specific treatment. The arrhythmia should be treated with specific antiarrhythmic agents, for example, amiodarone, lidocain and bretylium, and then all the reversible causes have to be detected and treated as fast as possible. Underlying heart disease determines the specific treatment such as coronary revascularization, mechanical circulatory and respiratory support, and ablation of the arrhythmic foci.

Original languageEnglish
Pages (from-to)47-54
Number of pages8
JournalInterventional Medicine and Applied Science
Volume3
Issue number2
DOIs
Publication statusPublished - Jun 1 2011

Fingerprint

Cardiac Arrhythmias
Hemodynamics
Perfusion
Electric Countershock
Cardiogenic Shock
Amiodarone
Cardiopulmonary Resuscitation
Ventricular Fibrillation
Ventricular Tachycardia
Intensive Care Units
Heart Diseases
Therapeutics
bretylium

Keywords

  • electrical storm
  • intensive care
  • pathomechanism
  • ventricular tachyarrhythmias

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Intensive management of electrical storm and incessant ventricular arrhythmias. / Zima, E.

In: Interventional Medicine and Applied Science, Vol. 3, No. 2, 01.06.2011, p. 47-54.

Research output: Contribution to journalArticle

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