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Cardiac Arrhythmias pp 293–304Cite as

Electrical Storm: Clinical Management

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Abstract

Electrical storm (ES) is defined as three or more sustained episodes of ventricular tachycardia (VT), ventricular fibrillation (VF), or appropriate implantable cardioverter-defibrillator (ICD) therapies during a period of 24 h. Electrical storm is a life-threatening situation presenting during the acute phase of myocardial infarction or in patients with various forms of ischemic or nonischemic cardiomyopathy. It requires hospitalization to ensure management of hemodynamically unstable patients and optimization of pharmacologic or non-pharmacologic therapy. Certain triggers or risk factors have been identified for patients presenting with ES, and, in general, ES has been associated with increased mortality and might be an independent risk factor for cardiac death.

The cornerstone of ES treatment is the reduction of elevated sympathetic tone by maximizing the dose of beta-blockers, usually in combination with amiodarone and other antiarrhythmic drugs or invasive adrenergic blockade and implantation of an intra-aortic balloon pump. The implantation of ICDs for primary and secondary prevention reduces mortality in patients at high risk for arrhythmic death, yet the rate of ES recurrences is high during follow-up, probably due to advanced structural heart disease. Advances in technology and in our understanding of ventricular tachycardia substrates have led to suppression of malignant arrhythmias by catheter ablation therapy and resynchronization therapy, with acceptable efficacy and safety.

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References

  1. Kowey PR. An overview of anti-arrhythmic drug management of electrical storm. Can J Cardiol. 1996;12(Suppl B):3B–8.

    PubMed  Google Scholar 

  2. Dorian P, Cass D. An overview of the management of electrical storm. Can J Cardiol. 1997;13(Suppl A):13A–7.

    PubMed  Google Scholar 

  3. Zipes DP, Camm AJ, Borggrefe M, et al. ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College Of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management Of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death). J Am Coll Cardiol. 2006;48:e247–346.

    Article  PubMed  Google Scholar 

  4. Exner DV, Pinski SL, Wyse G, et al. Electrical storm presaged nonsudden death. The antiarrhythmics versus implantable defibrillators (AVID) Trial. Circulation. 2001;103:2066–71.

    Article  CAS  PubMed  Google Scholar 

  5. Credner SC, Klingenheben T, Mauss O, Sticherling C, Hohnloser SH. Electrical storm in patients with transvenous implantable cardioverter-defibrillators. J Am Coll Cardiol. 1998;32:1909–15.

    Article  CAS  PubMed  Google Scholar 

  6. Israel CW, Barold SS. Electrical storm in patients with an implanted defibrillator: a matter of definition. Ann Noninvasive Electrocardiol. 2007;12:375–82.

    Article  PubMed  Google Scholar 

  7. Arya A, Haghjoo M, Dehghani MR, et al. Prevalence and predictors of electrical storm in patients with implantable cardioverter defibrillators. Am J Cardiol. 2006;97:389–92.

    Article  PubMed  Google Scholar 

  8. Brigadeau F, Kouakam C, Klug D, et al. Clinical predictors and prognostic significance of electrical storm in patients with implantable cardioverter defibrillators. Eur Heart J. 2006;27:700–7.

    Article  PubMed  Google Scholar 

  9. Bansch D, Bocker D, Brunn J, Weber M, Breithardt G, Block M. Clusters of ventricular tachycardia signify impaired survival in patients with idiopathic dilated cardiomyopathy and implantable cardioverter defibrillators. J Am Coll Cardiol. 2000;36:566–73.

    Article  CAS  PubMed  Google Scholar 

  10. Fries R, Heisel A, Huwer H, et al. Incidence and clinical significance of short-term recurrent ventricular tachyarrhythmias in patients with implantable cardioverter-defibrillator. Int J Cardiol. 1997;59:281–4.

    Article  CAS  PubMed  Google Scholar 

  11. Gasparini M, Lunati M, Landolina M, et al. Electrical storm in patients with biventricular implantable cardioverter defibrillator: incidence, predictors and prognostic implications. Am Heart J. 2008;156:847–54.

    Article  PubMed  Google Scholar 

  12. Gatzoulis KA, Andrikopoulos GK, Apostolopoulos T, et al. Electrical storm is an independent predictor of adverse long-term outcome in the era of implantable defibrillator therapy. Europace. 2005;7:184–92.

    Article  PubMed  Google Scholar 

  13. Greene M, Newman D, Geist M, Paquette M, Heng D, Dorian P. Is electrical storm in ICD patients the sign of a dying heart? Outcome of patients with clusters of ventricular tachyarrhythmias. Europace. 2000;2:263–9.

    Article  CAS  PubMed  Google Scholar 

  14. Hohnloser SH, Al-Khalidi HR, Pratt CM, et al., SHock Inhibition Evaluation with AzimiLiDe (SHIELD) Investigators. Electrical storm in patients with an implantable defibrillator: incidence, features and preventive therapy: insights from a randomized trial. Eur Heart J. 2006;27:3027–32.

    Google Scholar 

  15. Sesselberg HW, Moss AJ, McNitt S, et al. Ventricular arrhythmia storms in postinfarction patients with implantable defibrillators for primary prevention indications: a MADIT-II substudy. Heart Rhythm. 2007;4:1395–402.

    Article  PubMed  Google Scholar 

  16. Stuber T, Eigenmann C, Delacretaz E. Characteristics and relevance of clustering ventricular arrhythmias in defibrillator recipients. Pacing Clin Electrophysiol. 2005;28:702–7.

    Article  PubMed  Google Scholar 

  17. Verma A, Kilicaslan F, Marrouche NF, et al. Prevalence, predictors and mortality significance of the causative arrhythmia in patients with electrical storm. J Cardiovasc Electrophysiol. 2004;15:1265–70.

    Article  PubMed  Google Scholar 

  18. Villacastin J, Almendral J, Arenal A, et al. Incidence and clinical significance of multiple consecutive, appropriate, high-energy discharges in patients with implanted cardioverter-defibrillators. Circulation. 1996;93:753–62.

    Article  CAS  PubMed  Google Scholar 

  19. Wood MA, Simpson PM, Stambler BS, Herre JM, Bernstein RC, Ellenbogen KA. Long-term temporal patterns of ventricular tachyarrhythmias. Circulation. 1995;91:2371–7.

    Article  CAS  PubMed  Google Scholar 

  20. Eifling M, Razavi M, Massumi A. The evaluation and management of electrical storm. Tex Heart Inst J. 2011;38:111–21.

    PubMed Central  PubMed  Google Scholar 

  21. Proietti R, Sagone A. Electrical storm: incidence, prognosis and therapy. Indian Pacing Electrophysiol J. 2011;11:34–42.

    PubMed Central  PubMed  Google Scholar 

  22. Gatzoulis K, Sideris S, Kallikazaros I, Stefanadis C. Electrical storm: a new challenge in the age of implantable defibrillators. Hellenic J Cardiol. 2008;49:86–91.

    PubMed  Google Scholar 

  23. Bardy GH, Lee KL, Mark DB, et al., Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) Investigators. Amiodarone or an implantable cardioverter defibrillator for congestive heart failure. N Engl J Med. 2005;352:225–37.

    Google Scholar 

  24. Soman SS, Sandberg KR, Borzak S, Hudson MP, Yee J, McCullough PA. The independent association of renal dysfunction and arrhythmias in critically ill patients. Chest. 2002;122:669–77.

    Article  PubMed  Google Scholar 

  25. Saksena S, Ciccone JM, Craelius W, Pantopoulos D, Rothbart ST, Werres R. Studies on left ventricular function during sustained ventricular tachycardia. J Am Coll Cardiol. 1984;4:501–8.

    Article  CAS  PubMed  Google Scholar 

  26. Schweizer PA, Becker R, Katus HA, Thomas D. Successful acute and long-term management of electrical storm in Brugada syndrome using orciprenaline and quinine/quinidine. Clin Res Cardiol. 2010;99:467–70.

    Article  PubMed  Google Scholar 

  27. Ohgo T, Okamura H, Noda T, et al. Acute and chronic management in patients with Brugada syndrome associated with electrical storm of ventricular fibrillation. Heart Rhythm. 2007;4:695–700.

    Article  PubMed  Google Scholar 

  28. Robertson D, Hollister AS, Forman MB, Robertson RM. Reflexes unique to myocardial ischemia and infarction. J Am Coll Cardiol. 1985;5:99B–104.

    Article  CAS  PubMed  Google Scholar 

  29. Barber MJ, Mueller TM, Davies BG, Gill RM, Zipes DP. Interruption of sympathetic and vagal-mediated afferent responses by transmural myocardial infarction. Circulation. 1985;72:623–31.

    Article  CAS  PubMed  Google Scholar 

  30. Inoue H, Zipes DP. Results of sympathetic denervation in the canine heart: supersensitivity that may be arrhythmogenic. Circulation. 1987;75:877–87.

    Article  CAS  PubMed  Google Scholar 

  31. Zipes DP. Influence of myocardial ischemia and infarction on autonomic innervation of heart. Circulation. 1990;82:1095–105.

    Article  CAS  PubMed  Google Scholar 

  32. Anderson JL, Rodier HE, Green LS. Comparative effects of beta-adrenergic blocking drugs on experimental ventricular fibrillation threshold. Am J Cardiol. 1983;51:1196–202.

    Article  CAS  PubMed  Google Scholar 

  33. Lombardi F, Verrier RL, Lown B. Relationship between sympathetic neural activity, coronary dynamics and vulnerability to ventricular fibrillation induced by myocardial ischemia and reperfusion. Am Heart J. 1983;105:958–65.

    Article  CAS  PubMed  Google Scholar 

  34. Schwartz PJ, Motolese M, Pollavini G, et al., The Italian Sudden Death Prevention Group. Prevention of sudden cardiac death after a first myocardial infarction by pharmacologic or surgical antiadrenergic interventions. J Cardiovasc Electrophysiol. 1992;3:2–16.

    Google Scholar 

  35. Nademanee K, Taylor R, Bailey WE, Rieders DE, Kosar EM. Treating electrical storm: sympathetic blockade versus advanced cardiac life support-guided therapy. Circulation. 2000;102:742–7.

    Article  CAS  PubMed  Google Scholar 

  36. Gottlieb SS, McCarter RJ, Vogel RA. Effect of beta-blockade on mortality among high-risk and low-risk patients after myocardial infarction. N Engl J Med. 1998;339:489–97.

    Article  CAS  PubMed  Google Scholar 

  37. Chadda K, Goldstein S, Byington R, Curb JD. Effects of propranolol after acute myocardial infarction in patients with congestive heart failure. Circulation. 1986;73:503–10.

    Article  CAS  PubMed  Google Scholar 

  38. Ryden L, Ariniego R, Arnman K, et al. A double-blind trial of metoprolol in acute myocardial infarction. Effects on ventricular tachyarrhythmias. N Engl J Med. 1983;308:614–8.

    Article  CAS  PubMed  Google Scholar 

  39. The MIAMI Trial Research Group. Metoprolol in acute myocardial infarction. Arrhythmias. Am J Cardiol. 1985;56:35G–8.

    Article  Google Scholar 

  40. Yu JB, Yang B, Xu DJ, et al. Impact of metoprolol use in the treatment of patients with electrical storm after cardioverter defibrillators implantation. Zhonghua Xin Xue Guan Bing Za Zhi. 2011;39:717–20.

    PubMed  Google Scholar 

  41. Tsagalou EP, Kanakakis J, Rokas S, Anastasiou-Nana MI. Suppression by propranolol and amiodarone of an electrical storm refractory to metoprolol and amiodarone. Int J Cardiol. 2005;99:341–2.

    Article  PubMed  Google Scholar 

  42. Miwa Y, Ikeda T, Mera H, et al. Effects of landiolol, an ultra-short-acting β1-selective blocker, on electrical storm refractory to class III antiarrhythmic drugs. Circ J. 2010;74:856–63.

    Article  CAS  PubMed  Google Scholar 

  43. Pinter A, Dorian P. Approach to antiarrhythmic therapy in patients with ICDs and frequent activations. Curr Cardiol Rep. 2005;7:376–81.

    Article  PubMed  Google Scholar 

  44. Connoly ST, Dorian P, Roberts RS, Gent M, Bailin S, Fuin ES. Comparison of b-blockers, amiodarone plus b-blockers or sotalol for prevention of shocks from implantable cardioverter defibrillators: the OPTIC study: a randomized trial. JAMA. 2006;295:165–71.

    Article  Google Scholar 

  45. Van Herendael H, Dorian P. Amiodarone for the treatment and prevention of ventricular fibrillation and ventricular tachycardia. Vasc Health Risk Manag. 2010;6:465–72.

    PubMed Central  PubMed  Google Scholar 

  46. Kudenchuk PJ, Cobb LA, Copass MK, et al. Amiodarone for resuscitation after out-of-hospital cardiac arrest due to ventricular fibrillation. N Engl J Med. 1999;341:871–8.

    Article  CAS  PubMed  Google Scholar 

  47. Dorian P, Cass D, Shwartz B, et al. Amiodarone as compared with lidocaine for shock resistant ventricular fibrillation. N Engl J Med. 2002;346:884–90.

    Article  CAS  PubMed  Google Scholar 

  48. Levine JH, Massumi A, Scheinman MM, et al. Intravenous amiodarone for recurrent sustained hypotensive ventricular tachyarrhythmias. Intravenous Amiodarone Multicenter Trial Group. J Am Coll Cardiol. 1996;27:67–75.

    Article  CAS  PubMed  Google Scholar 

  49. Manolis AG, Katsivas AG, Vassilopoulos C, Tsatiris CG. Electrical storms in an ICD-recipient with 429 delivered appropriate shocks: therapeutic management with antiarrhythmic drug combination. J Interv Card Electrophysiol. 2002;6:91–4.

    Article  PubMed  Google Scholar 

  50. Waleffe A, Mary-Rabine L, Legrand V, Demoulin JC, Kulbertus HE. Combined mexiletine and amiodarone treatment of refractory recurrent ventricular tachycardia. Am Heart J. 1980;100:788–93.

    Article  CAS  PubMed  Google Scholar 

  51. Fuchs T, Groysman R, Meilichov I. Use of a combination of class III and class Ic antiarrhythmic agents in patients with electrical storm. Pharmacotherapy. 2008;28:14–9.

    Article  CAS  PubMed  Google Scholar 

  52. Furushima H, Chinushi M, Okamura K, et al. Effect of dl-sotalol on mortality and recurrence of ventricular tachyarrhythmias: ischemic compared to nonischemic cardiomyopathy. Pacing Clin Electrophysiol. 2007;30:1136–41.

    Article  PubMed  Google Scholar 

  53. Mason JW. A comparison of seven antiarrhythmic drugs in patients with ventricular tachyarrhythmias: Electrophysiologic Study versus Electrocardiographic Monitoring Investigators. N Engl J Med. 1993;329:452–8.

    Article  CAS  PubMed  Google Scholar 

  54. Waldo AL, Camm AJ, deRuyter H, et al. Effect of d-sotalol on mortality in patients with left ventricular dysfunction after recent and remote myocardial infarction: the SWORD Investigators (Survival With Oral d-Sotalol). Lancet. 1996;348:7–12.

    Article  CAS  PubMed  Google Scholar 

  55. Isomoto S, Konoe A, Centurion OA, et al. Electrophysiological effects of MS-551 in humans: a class III antiarrhythmic agent. Pacing Clin Electrophysiol. 1995;18:2022–7.

    Article  CAS  PubMed  Google Scholar 

  56. Washizuka T, Chinushi M, Watanabe H, et al. Nifekalant hydrochloride suppresses severe electrical storm in patients with malignant ventricular tachyarrhythmias. Circ J. 2005;69:1508–13.

    Article  CAS  PubMed  Google Scholar 

  57. Sahara M, Sagara K, Yamashita T, Iinuma H, Fu LT, Watanabe H. Nifekalant hydrochloride, a novel class III antiarrhythmic agent, suppressed postoperative recurrent ventricular tachycardia in a patient undergoing coronary artery bypass grafting and the Dor approach. Circ J. 2003;67:712–4.

    Article  PubMed  Google Scholar 

  58. Kurisu K, Hisahara M, Onitsuka H, et al. Nifekalant hydrochloride terminated electrical storms after coronary surgery. Ann Thorac Surg. 2010;89:1637–9.

    Article  PubMed  Google Scholar 

  59. VerNooy RA, Mangrum JM. Azimilide, a novel oral class III antiarrhythmic for both supraventricular and ventricular arrhythmias. Curr Drug Targets Cardiovasc Haematol Disord. 2005;5:75–84.

    Article  CAS  PubMed  Google Scholar 

  60. Dorian P, Borggrefe M, Al-Khalidi HR, et al., SHock Inhibition Evaluation with AzimiLiDe (SHIELD) investigators. Placebo-controlled, randomized clinical trial of azimilide for prevention of ventricular tachyarrhythmias in patients with an implantable cardioverter defibrillator. Circulation. 2004;110:3646–54.

    Google Scholar 

  61. Kowey PR, Levine JH, Herre JM, et al. Randomized, double-blind comparison of intravenous amiodarone and bretylium in the treatment of patients with recurrent, hemodynamically destabilizing ventricular tachycardia or fibrillation. Circulation. 1995;92:3255–63.

    Article  CAS  PubMed  Google Scholar 

  62. Kapoor JR, Batsford WP, Foody JM. Refractory electrical storm suppression by bretylium. Int J Cardiol. 2006;113:E111–2.

    Article  PubMed  Google Scholar 

  63. European Heart Rhythm Association, Heart Rhythm Society, Zipes DP, Camm AJ, Borggrefe M, et al. ACC/AHA/ESC 2006 guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention Of Sudden Cardiac Death). J Am Coll Cardiol. 2006;48:e247–346.

    Article  PubMed  Google Scholar 

  64. Jongman JK, Jepkes-Bruin N, RamdatMisier AR, et al. Electrical storms in Brugada syndrome successfully treated with isoproterenol infusion and quinidine orally. Neth Heart J. 2007;15:151–5.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  65. Kyriazis K, Bahlmann E, van der Schalk H, Kuck KH. Electrical storm in Brugada syndrome successfully treated with orciprenaline; effect of low-dose quinidine on the electrocardiogram. Europace. 2009;11:665–6.

    Article  PubMed  Google Scholar 

  66. Sharif-Kazemi MB, Emkanjoo Z, Tavoosi A, et al. Electrical storm in Brugada syndrome during pregnancy. Pacing Clin Electrophysiol. 2011;34:e18–21.

    Article  PubMed  Google Scholar 

  67. Burjorjee JE, Milne B. Propofol for electrical storm: a case report of cardioversion and suppression of ventricular tachycardia by propofol. Can J Anaesth. 2002;49:973–7.

    Article  PubMed  Google Scholar 

  68. Mahajan A, Moore J, Cesario DA, Shivkumar K. Use of thoracic epidural anesthesia for management of electrical storm: a case report. Heart Rhythm. 2005;2:1359–62.

    Article  PubMed  Google Scholar 

  69. Buxton AE, Lee KL, Fisher JD, Josephson ME, Prystowsky EN, Hafley G. A randomized study of the prevention of sudden death in patients with coronary artery disease. Multicenter Unsustained Tachycardia Trial Investigators. N Engl J Med. 1999;341:1882–90.

    Article  CAS  PubMed  Google Scholar 

  70. Streitner F, Kuschyk J, Veltmann C, et al. Predictors of electrical storm recurrences in patients with implantable cardioverter-defibrillators. Europace. 2011;13:668–74.

    Article  PubMed  Google Scholar 

  71. Song PS, Kin JS, Shin DH, et al. Electrical storms in patients with an implantable cardioverter defibrillator. Yonsei Med J. 2011;52:26–32.

    Article  PubMed Central  PubMed  Google Scholar 

  72. Wathen MS, DeGroot PJ, Sweeney MO, et al., PainFREE Rx II Investigators. Prospective randomized multicenter trial of empirical antitachycardia pacing versus shocks for spontaneous rapid ventricular tachycardia in patients with implantable cardioverter-defibrillators: Pacing Fast Ventricular Tachycardia Reduces Shock Therapies (PainFREE Rx II Investigators) trial results. Circulation. 2004;110:2591–6.

    Google Scholar 

  73. Ellenbogen KA, Levine JH, Berger RD, et al. Are implantable cardioverter defibrillator shocks a surrogate for sudden cardiac death in patients with nonischemic cardiomyopathy? Circulation. 2006;113:776–82.

    Article  PubMed  Google Scholar 

  74. Wilkoff BL, Cook JR, Epstein AE, et al., Dual Chamber and VVI Implantable Defibrillator Trial Investigators. Dual-chamber pacing or ventricular backup pacing in patients with an implantable defibrillator: the Dual Chamber and VVI Implantable Defibrillator (DAVID) Trial. JAMA. 2002;288:3115–23.

    Google Scholar 

  75. Aliot EM, Stevenson WG, Almendral-Garrote JM, et al., EHRA/HRS Expert Consensus on Catheter Ablation of Ventricular Arrhythmias. Developed in a partnership with the European Heart Rhythm Association (EHRA), a Registered Branch of the European Society of Cardiology (ESC), and the Heart Rhythm Society (HRS); in collaboration with the American College of Cardiology (ACC) and the American Heart Association. Europace. 2009;11:771–817.

    Google Scholar 

  76. Dagres N, Cantu F, Geelen P, Lewalter T, Proclemer A, Blomstrom-Lundqvist C. Current practice of ventricular tachycardia ablation in patient with implantable cardioverter-defibrillators. Europace. 2012;14:135–7.

    Article  PubMed  Google Scholar 

  77. Della Bella P, Brugada J, Zeppenfeld K, et al. Epicardial ablation for ventricular tachycardia: a European multicenter study. Circ Arrhythm Electrophysiol. 2011;4:653–9.

    Article  PubMed  Google Scholar 

  78. Carbucicchio C, Santamaria M, Trevisi N, et al. Catheter ablation for the treatment of electrical storm in patients with implantable cardioverter-defibrillators: short- and long-term outcomes in a prospective single-center study. Circulation. 2008;117:462–9.

    Article  PubMed  Google Scholar 

  79. Peichl P, Cihak R, Kozeluhova M, Wichterle D, Vancura V, Kautzner J. Catheter ablation of arrhythmic storm triggered by monomorphic ectopic beats in patients with coronary artery disease. J Interv Card Electrophysiol. 2010;27:51–9.

    Article  PubMed  Google Scholar 

  80. Kozeluhova M, Peichl P, Cihak R, et al. Catheter ablation of electrical storm in patients with structural heart disease. Europace. 2011;13:109–13.

    Article  PubMed  Google Scholar 

  81. Stevenson WG, Wilber DJ, Natale A, et al. Irrigated radiofrequency catheter ablation guided by electroanatomic mapping for recurrent ventricular tachycardia after myocardial infarction: the Multicenter Thermocool Ventricular Tachycardia Ablation Trial. Circulation. 2008;118:2773–82.

    Article  PubMed  Google Scholar 

  82. Tanner H, Hindricks G, Volkmer M, et al. Catheter ablation of recurrent scar-related ventricular tachycardia using electroanatomical mapping and irrigated ablation technology: results of the prospective multicenter Euro-VT-Study. J Cardiovasc Electrophysiol. 2010;21:47–53.

    Article  PubMed  Google Scholar 

  83. Tung R, Josephson ME, Reddy V, Reynolds MR, SMASH-VT Investigators. Influence of clinical and procedural predictors on ventricular tachycardia ablation outcomes: an analysis from the substrate mapping and ablation in Sinus Rhythm to Halt Ventricular Tachycardia Trial (SMASH-VT). J Cardiovasc Electrophysiol. 2010;21:799–803.

    PubMed  Google Scholar 

  84. Furushima H, Chinushi M, Iijima K, et al. Is the coexistence of sustained ST-segment elevation and abnormal Q waves a risk factor for electrical storm in implanted cardioverter defibrillator patients with structural heart disease? Europace. 2012;14(5):675–81.

    Article  PubMed  Google Scholar 

  85. Dickstein K, Vardas PE, Auricchio A, et al. 2010 Focused Update of ESC Guidelines on device therapy in heart failure. An update of the 2008 guidelines for the diagnosis and treatment of acute and chronic heart failure and the 2007 ESC guidelines for cardiac and resynchronization therapy. Developed with the special contribution of the Heart Failure Association and the European Heart Rhythm Association. Europace. 2010;31:2677–87.

    Google Scholar 

  86. Bristow MR, Saxon LA, Bochmer J, et al. Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. N Engl J Med. 2004;350:2140–50.

    Article  CAS  PubMed  Google Scholar 

  87. Guerra JM, Wu J, Miller JM, Groh WJ. Increase in ventricular tachycardia frequency after biventricular implantable cardioverter defibrillator upgrade. J Cardiovasc Electrophysiol. 2003;14:1245–7.

    Article  PubMed  Google Scholar 

  88. Kantharia BK, Patel JA, Nagra BS, Ledley GS. Electrical storm of monomorphic ventricular tachycardia after a cardiac-resynchr-onization therapy-defibrillator upgrade. Europace. 2006;8:625–8.

    Article  PubMed  Google Scholar 

  89. Shukla G, Chaudhry GM, Orlov M, Hoffmeister P, Haffajee C. Potential proarrhythmic effect of biventricular pacing: fact or myth? Heart Rhythm. 2005;2:951–6.

    Article  PubMed  Google Scholar 

  90. Combes N, Marijon E, Boveda S, Albenque JP. Electrical storm after CRT implantation treated by AV delay optimization. J Cardiovasc Electrophysiol. 2010;21:211–3.

    Article  PubMed  Google Scholar 

  91. Nordbeck P, Seidl B, Bauer WR, Ritter O. Effect of cardiac resynchronization therapy on the incidence of electrical storm. Int J Cardiol. 2010;143:330–6.

    Article  PubMed  Google Scholar 

  92. Whang W, Mittleman MA, Rich DQ, et al., TOVA Investigators. Heart failure and the risk of shocks in patients with implantable cardioverter defibrillators: results from the Triggers Of Ventricular Arrhythmias (TOVA) study. Circulation. 2004;109:1386–91.

    Google Scholar 

  93. Kowal RC, Wasmund SL, Smith ML, et al. Biventricular pacing reduces the induction of monomorphic ventricular tachycardia: a potential mechanism for arrhythmia suppression. Heart Rhythm. 2004;1:295–300.

    Article  PubMed  Google Scholar 

  94. Fotopoulos GD, Mason MJ, Walker S, et al. Stabilization of medically refractory ventricular arrhythmia by intra-aortic balloon counterpulsation. Heart. 1999;82:96–100.

    CAS  PubMed Central  PubMed  Google Scholar 

  95. Hansen DE, Grig CS, Hondenghem LM. Stretch-induced arrhythmias in the isolated canine ventricle. Evidence for the importance of mechano-electrical feedback. Circulation. 1990;81:1094–105.

    Article  CAS  PubMed  Google Scholar 

  96. Ryu YG, Baek MJ, Kim HJ. Alternative salvage technique during postcardiotomy electrical storm. Thorac Cardiovasc Surg. 2010;58:311–2.

    Article  CAS  PubMed  Google Scholar 

  97. Ajijola O, Lellouche N, Bourke T, et al. Bilateral cardiac sympathetic denervation for the management of electrical storm. J Am Coll Cardiol. 2012;59:91–2.

    Article  PubMed Central  PubMed  Google Scholar 

  98. Mine JR, Ward DE, Spurrell RA, Camm AJ. The long QT syndrome; effects of drugs and left stellate ganglion block. Am Heart J. 1982;104:194–8.

    Article  Google Scholar 

  99. Patel RA, Priore DL, Szeto WY, Slevin KA. Left stellate ganglion blockade for the management of drug-resistant electrical storm. Pain Med. 2011;12:1196–8.

    Article  PubMed  Google Scholar 

  100. Krum H, Schlaich M, Whitbourn R, et al. Catheter-based renal sympathetic denervation for resistant hypertension: a multicenter safety and proof-of-principle cohort study. Lancet. 2009;361:932–4.

    Google Scholar 

  101. Ukena C, Bauer A, Mahfoud F, et al. Renal sympathetic denervation for treatment of electrical storm: first-in-man experience. Clin Res Cardiol. 2012;101:63–7.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Cardiology, Evagelismos General Hospital of Athens, Athens, Greece

    Sofia Metaxa MD, Spyridon Koulouris MD & Antonis S. Manolis MD

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  1. Sofia Metaxa MD
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  2. Spyridon Koulouris MD
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  3. Antonis S. Manolis MD
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Correspondence to Antonis S. Manolis MD .

Editor information

Editors and Affiliations

  1. Department of Cardiology, Center Hospitalier Coutances, Coutances, France

    Ambrose S. Kibos

  2. Department of Internal Medicine Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA

    Bradley P. Knight

  3. Division of Cardiology, McGill University Health Center, Montreal, Québec, Canada

    Vidal Essebag

  4. Department of Cardiology, Miami Children's Hospital, Miami, Florida, USA

    Steven B. Fishberger

  5. School of Biology, Chemistry and Health, Manchester Metropolitan University, Manchester, United Kingdom

    Mark Slevin

  6. “Acad. Vasile Candea” Emergency Clinical Center for Cardiovascular Diseases, “Carol Davila” University of Medicine and Pharmacy, “Titu Maiorescu” University Faculty of Medicine,, Bucharest, Romania

    Ion C. Țintoiu

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Metaxa, S., Koulouris, S., Manolis, A.S. (2014). Electrical Storm: Clinical Management. In: Kibos, A., Knight, B., Essebag, V., Fishberger, S., Slevin, M., Țintoiu, I. (eds) Cardiac Arrhythmias. Springer, London. https://doi.org/10.1007/978-1-4471-5316-0_23

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