Recent Insights Into Mechanisms and Clinical Approaches to Electrical Storm

Elsokkari, Ihab; Tsuji, Yukiomi; Sapp, John L.; Nattel, Stanley

doi:10.1016/j.cjca.2021.12.015

Cited by 17 publications

(22 citation statements)

References 129 publications

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“…Although the increased activation of the sympathetic nervous system was widely accepted as a major mechanism in initiating and maintaining ES ( 4 , 5 , 13 ), mechanically initiated ES via MEF should also be taken into consideration when attempted treatments were ineffective in resolving ES. In such patients, decreasing LV stretch can obtain unexpected effectiveness.…”

Section: Discussionmentioning

confidence: 99%

“…The precise mechanisms behind triggering ES are complex and still remain elusive. It's thought that the interaction between mechanical and electrical substrates may play an important role in some situations ( 4 , 5 ). Acute mechanical stretch of the heart can depolarize the cell membrane and shorten the action potential duration by activating mechano-sensitive ion channels, inducing the onset of arrhythmias through the modulation of the myocardial electrophysiological properties ( 5 , 6 ).…”

Section: Introductionmentioning

confidence: 99%

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Electrical storm refractory multiple antiarrhythmic medications was stopped by interatrial shunting procedure—A case report

Han

Qiu

et al. 2022

Front. Cardiovasc. Med.

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Electrical storm (ES) remains a major dilemma for clinicians, often presenting as a medical emergency associated with significant adverse outcomes. The mechanisms behind triggering ES are complex. Although the increased activation of the sympathetic nervous system was widely accepted as a major mechanism in initiating and maintaining ES, it's thought that the interaction between mechanical and electrical substrates may play an important role in some situations. Here we present a case of ES that was refractory to multiple antiarrhythmic medications but was stopped by interatrial shunting. We aim to highlight the importance of mechano-electric feedback (MEF) as the pathophysiological mechanisms of some types of ES and the utility of interatrial shunting as an alternative therapeutic strategy for patients with ES initially refractory to antiarrhythmic medications when there is evidence to indicate increased left ventricular filling pressure or left atrial pressure.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Electrical storm refractory multiple antiarrhythmic medications was stopped by interatrial shunting procedure—A case report

Han

Qiu

et al. 2022

Front. Cardiovasc. Med.

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“…In structurally normal hearts with occurrence of idiopathic VT, the underlying mechanism frequently might be delayed after depolarization-mediated ectopy in outflow tract or papillary muscles [ 31 ].…”

Section: Causesmentioning

confidence: 99%

“…It has been recommended as a first line treatment for ES in Brugada syndrome. Good results have been seen also in SQTS, ERS or J-wave syndromes [ 31 , 55 , 56 , 57 ]. Dan L Lin et al conducted a retrospective analysis of 37 patients who were referred to their tertiary referral center after other therapies failed for VA suppression.…”

Section: Medical Therapymentioning

confidence: 99%

Emergency Management of Electrical Storm: A Practical Overview

et al. 2023

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Electrical storm is a medical emergency characterized by ventricular arrythmia recurrence that can lead to hemodynamic instability. The incidence of this clinical condition is rising, mainly in implantable cardioverter defibrillator patients, and its prognosis is often poor. Early acknowledgment, management and treatment have a key role in reducing mortality in the acute phase and improving the quality of life of these patients. In an emergency setting, several measures can be employed. Anti-arrhythmic drugs, based on the underlying disease, are often the first step to control the arrhythmic burden; besides that, new therapeutic strategies have been developed with high efficacy, such as deep sedation, early catheter ablation, neuraxial modulation and mechanical hemodynamic support. The aim of this review is to provide practical indications for the management of electrical storm in acute settings.

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“…Electrical storm (ES) is a common type of arrhythmia in critically severe patients requiring urgent electrical cardioversion or de brillation [1]. However, simple sedation and antiarrhythmic therapy are, in some cases, unsuccessful, especially with patients experiencing ventricular tachycardia (VT)/ventricular brillation (VF) induced by ventricular premature.…”

Section: Introductionmentioning

confidence: 99%

Bedside zero-fluoroscopy temporary permanent pacemaker implantation in the electrical storm treatment under the guidance of EnSite 3D system: A case report

Wang

Li²,

et al. 2022

Preprint

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Background: Electrical storm (ES) is a clinical emergency characterized by multiple malignant ventricular arrhythmias or ICD discharges within 24 h, requiring early rational management. Case presentation: we report a 55-year-old man who underwent aortic valve replacement experienced recurrent ventricular tachycardia/ventricular fibrillation. A temporary permanent pacemaker with the EnSite system was implanted, and significant inhibition of the electrical storm, attributed to the atrial overdrive pacing, ensued. Conclusions: In emergency regarding an electrical storm, the bedside temporary permanent pacemaker implantation with the EnSite system is concluded to be feasible and safe.

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Recent Insights Into Mechanisms and Clinical Approaches to Electrical Storm

Cited by 17 publications

References 129 publications

Electrical storm refractory multiple antiarrhythmic medications was stopped by interatrial shunting procedure—A case report

Electrical storm refractory multiple antiarrhythmic medications was stopped by interatrial shunting procedure—A case report

Emergency Management of Electrical Storm: A Practical Overview

Bedside zero-fluoroscopy temporary permanent pacemaker implantation in the electrical storm treatment under the guidance of EnSite 3D system: A case report

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