Dose-Ranging Study of Intravenous Amiodarone in Patients With Life-Threatening Ventricular Tachyarrhythmias

Scheinman, Melvin M.; Levine, Joseph; Cannom, David S.; Friehling, Ted D.; Kopelman, H.; Chilson, Donald A.; Platia, Edward V.; Wilber, David J.; Kowey, Peter R.

doi:10.1161/01.cir.92.11.3264

Cited by 236 publications

(101 citation statements)

References 20 publications

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“…One definition of electrical storm is recurrent ventricular tachycardia or fibrillation occurring two or more times in a 24-h period, usually requiring electrical cardioversion or defibrillation. 10,11 A broader use of the term ICD storm includes those patients who receive multiple shocks inappropriately for atrial fibrillation, lead fracture, electromagnetic noise, and so forth. The incidence of true ICD storm is estimated to occur in between 10 and 30% of all ICD recipients.…”

Section: Definition and Incidence Of Icd Stormmentioning

confidence: 99%

Understanding implantable cardioverter defibrillator shocks and storms: Medical and psychosocial considerations for research and clinical care

Sears¹,

Conti²

2003

Clinical Cardiology

149

111

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Summary:The experience of shock is the distinguishing feature for patients with implantable cardioverter defibrillators (ICDs) and is associated with diminished psychological functioning and quality of life. Multiple shocks and ICD storm are a relatively common event among patients with ICDs (10-20%) and may present specific challenging medical and psychological management for the attending health care providers. This paper examines the medical and psychological aspects of ICD shocks and storms and describes a model of biopsychosocial management for patients following the experience of ICD storm. Successful management of patients post shock includes the use of antiarrhythmic medications and careful attention to the causality of the shocks via stored electrograms. The psychological management includes specific attention to debriefing post-shock feelings and attributions, preventing avoidance behavior, and facilitating positive "return to life" actions. Preliminary research examining formal psychosocial treatment supports a cognitive behavioral strategy to reduce psychological distress and facilitate quality of life. Collectively, these data suggest that interdisciplinary management of patients with multiple ICD shocks or the experience of ICD storm is advised, and routine psychological consultation may be indicated for the patient post ICD storm to reduce the possibility of symptoms of post-traumatic stress.

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Section: Definition and Incidence Of Icd Stormmentioning

confidence: 99%

Understanding implantable cardioverter defibrillator shocks and storms: Medical and psychosocial considerations for research and clinical care

Sears¹,

Conti²

2003

Clinical Cardiology

149

111

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“…A wider range of amiodarone doses (125, 500, and 1000 mg/d) was evaluated by Sheinman et al, 59 including a low dose that was expected to be subtherapeutic. This stronger study design, however, was also confounded by open-label bolus amiodarone injections given by study investigators.…”

Section: Short-term Control Of Vt/vfmentioning

confidence: 99%

Evidence-Based Analysis of Amiodarone Efficacy and Safety

1999

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“…Unspecific emergency therapy is guided by the current ERC guidelines: If there are signs of unstable circulation (ongoing ischemia, angina, hypotension, alteration of consciousness, heart failure), electrical synchronized cardioversion is the first choice of therapy. In the presence of stable circulation, drug therapy, especially of beta-receptor blocker and amiodarone, is to be chosen first [25,46].…”

Section: Sustained Monomorphic Vt (Smvt)mentioning

confidence: 99%

Intensive management of electrical storm and incessant ventricular arrhythmias

Zima

2011

IMAS

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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.

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Dose-Ranging Study of Intravenous Amiodarone in Patients With Life-Threatening Ventricular Tachyarrhythmias

Abstract: Intravenous amiodarone is effective for the treatment of recurrent, life-threatening ventricular tachyarrhythmias.

Cited by 236 publications

References 20 publications

Understanding implantable cardioverter defibrillator shocks and storms: Medical and psychosocial considerations for research and clinical care

Understanding implantable cardioverter defibrillator shocks and storms: Medical and psychosocial considerations for research and clinical care

Evidence-Based Analysis of Amiodarone Efficacy and Safety

Intensive management of electrical storm and incessant ventricular arrhythmias

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