Electrical storm: Prognosis and management

Prog Cardiovasc Dis. 2021 May-Jun:66:70-79. doi: 10.1016/j.pcad.2021.06.007.

Abstract

Electrical storm is present when a cluster of ventricular arrhythmias (VAs) occurs within a short time frame. The most widely accepted definition is 3 or more episodes of VA within a 24-h period, although prognostic risk begins to rise when 2 or more events occur within 3months. Electrical storm often presents as a medical emergency in the form of recurrent implantable cardiac defibrillator (ICD) shocks, recurrent syncope in patients with no ICD or low cardiac output symptoms. Management often requires a multimodality approach including ICD management, pharmacologic therapy, catheter ablation and modulations of the autonomic nervous system. In this article, we review the definition, prognosis and management of electrical storm.

Keywords: Antiarrhythmic Drugs; Cardiac Arrhythmia; Catheter Ablation; Electrical Storm; Ventricular Tachycardia.

Publication types

  • Review

MeSH terms

  • Action Potentials / drug effects
  • Anti-Arrhythmia Agents / adverse effects
  • Anti-Arrhythmia Agents / therapeutic use*
  • Autonomic Denervation* / adverse effects
  • Autonomic Denervation* / mortality
  • Cardiac Pacing, Artificial* / adverse effects
  • Cardiac Pacing, Artificial* / mortality
  • Catheter Ablation* / adverse effects
  • Catheter Ablation* / mortality
  • Clinical Decision-Making
  • Decision Support Techniques
  • Extracorporeal Membrane Oxygenation* / adverse effects
  • Extracorporeal Membrane Oxygenation* / mortality
  • Heart Conduction System / drug effects
  • Heart Conduction System / physiopathology
  • Heart Conduction System / surgery
  • Heart Rate / drug effects
  • Humans
  • Pacemaker, Artificial
  • Recurrence
  • Risk Assessment
  • Risk Factors
  • Tachycardia, Ventricular / diagnosis
  • Tachycardia, Ventricular / mortality
  • Tachycardia, Ventricular / physiopathology
  • Tachycardia, Ventricular / therapy*
  • Treatment Outcome
  • Ventricular Fibrillation / diagnosis
  • Ventricular Fibrillation / mortality
  • Ventricular Fibrillation / physiopathology
  • Ventricular Fibrillation / therapy*

Substances

  • Anti-Arrhythmia Agents