Management of arrhythmic storm: What is its clinical signifcance?
DOI:
https://doi.org/10.37711/rpcs.2024.6.3.538Keywords:
Tachycardia Ventricular, Arrhythmias Cardiac, Mortality, Myocardial Infarction, Cardiopulmonary resuscitation, arrhythmic stormAbstract
Arrhythmic storm is characterized by the occurrence of three or more distinct episodes of ventricular tachycardia or ventricular fibrillation within a 24-hour period, posing a signifcant risk for cardiovascular complications and resulting in high morbidity and mortality. The objective of this review article is to provide recommendations for the management and pharmacological treatment with the greatest impact on patients with arrhythmic storm, based on the latest global literature. A literature search was conducted in the PubMed and Scielo databases,
focusing on updated and relevant articles in English or Spanish published within the last 10 years, detailing the clinical signifcance of arrhythmic storm, its implications, and therapeutic approaches. This condition is multifactorial, highlighting the importance of timely diagnosis to control the triggering cause. Given its high recurrence and mortality rates, patients must be closely monitored in an intensive care unit. The management of arrhythmic storm is a current challenge, as it involves a clinical situation with both early and late high mortality. The most important techniques for addressing this condition include antiarrhythmic pharmacological treatment, defbrillator programming, and catheter ablation.
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Aksu T, Guler TE, Ozcan KS, Bozyel S, Yalin K. Renal sympathetic denervation assisted treatment of electrical storm due to polymorphic ventricular tachycardia in a patient with cathecolaminergic polymorphic ventricular tachycardia. Turk Kardiyol Dern Ars. [Internet]. 2017 [Consultado el 4 de octu- bre de 2023];45(5):441-449. doi: 10.5543/tkda.2017.72773
Nayyar S, Ganesan AN, Brooks AG, Sullivan T, Roberts-Thomson KC, Sanders P. Venturing into ventricular arrhythmia storm: a systematic review and meta-analysis. Eur Heart J. [Internet]. 2013 [Consultado el 8 de octubre de 2023];34(8):560-71. doi: 10.1093/eurheartj/ehs453
Bhaskaran A, Downar E, Chauhan VS, Lindsay P, Nair K, Ha A, et al. Electroanatomical mapping-guided stereotactic radiotherapy for right ventricular tachycardia storm. HeartRhythm Case Rep. [Internet]. 2019 [Consultado el 12 de octubre de 2023];5(12):590-592. doi: 10.1016/j.hrcr.2019.09.007
Meng L, Tseng CH, Shivkumar K, Ajijola O. Efficacy of Stellate Ganglion Blockade in Managing Electrical Storm: A Systematic Review. JACC Clin Electrophysiol. [Internet]. 2017 [Consultado el 12 de octubre de 2023];3(9):942–949. doi: 10.1016/j.jacep.2017.06.006
Shah R, Assis F, Alugubelli N, Okada DR, Cardoso R, Shivkumar K, et al. Cardiac sympathetic denervation for refractory ventricular arrhythmias in patients with structural heart disease: A systematic review. Heart Rhythm [Internet]. 2019 [Consultado el 15 de octubre de 2023];16(10):1499-1505. doi: 10.1016/j.hrthm.2019.06.018
Prochnau D, Hoyme M. Renal denervation as a second-line option in a patient with electrical storm resistant to me treatment and conventional radiofrequency catheter ablation. J Electrocardiol. [Internet]. 2018 [Consultado el 15 de octubre de 2023];51(3):475-478. doi: 10.1016/j.jelectrocard.2018.01.004
Martins RP, Urien JM, Barbarot N, Rieul G, Sellal JM, Borella L, Clementy N, et al. Effectiveness of Deep Sedation for Patients With Intractable Electrical Storm Refractory to Antiarrhythmic Drugs. Circulation [Internet]. 2020 [Consultado el 15 de octubre de 2023];142(16):1599-1601. doi: 10.1161/CIRCULATIONAHA.120.047468
Márquez MF, Bonny A, Hernández-Castillo E, De Sisti A, Gómez-Flores J, Nava S, et al. Long-term efficacy of low doses of quinidine on malignant arrhythmias in Brugada syndrome with an implantable cardioverter-defibrillator: a case series and literature review. Heart Rhythm [Internet]. 2012 [Consultado el 15 de octubre de 2023];9(12):1995-2000. doi: 10.1016/j.hrthm.2012.08.027
Takahiro T, Kou S, Toshinobu Y, Yuichi H. Accidental hypothermia-induced electrical storm successfully treated with isoproterenol. Heart Rhythm [Internet]. 2015 [Consultado el 15 de octubre de 2023];12(3):644-647. doi: 10.1016/j.hrthm.2014.11.020
Behere SP, Weindling SN. Catecholaminergic polymorphic ventricular tachycardia: An exciting new era. Ann Pedia-tr Cardiol. [Internet]. 2016 [Consultado el 15 de octubre de 2023];9(2):137-46. doi: 10.4103/0974-2069.180645
Guerra F, Palmisano P, Dell'Era G, Ziacchi M, Ammendola E, Bonelli P, et al. Implantable cardioverter-defibrillator programming and electrical storm: Results of the OBSERVa- tional registry On long-term outcome of ICD patients (OBSERVO-ICD). Heart Rhythm [Internet]. 2016 [Consultado el 17 de octubre de 2023];13(10):1987-92. doi: 10.1016/j.hr-thm.2016.06.007

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Copyright (c) 2024 Gabriel Fernando Ruiz Hernandez, Jorge Mario Palmezano Diaz, Luis David Moreno Useche, Gianmarco Camelo Pardo

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