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2015 ; 7
(9
): 555-61
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Electrical storm: A clinical and electrophysiological overview
#MMPMID26413232
Conti S
; Pala S
; Biagioli V
; Del Giorno G
; Zucchetti M
; Russo E
; Marino V
; Dello Russo A
; Casella M
; Pizzamiglio F
; Catto V
; Tondo C
; Carbucicchio C
World J Cardiol
2015[Sep]; 7
(9
): 555-61
PMID26413232
show ga
Electrical storm (ES) is a clinical condition characterized by three or more
ventricular arrhythmia episodes leading to appropriate implantable
cardioverter-defibrillator (ICD) therapies in a 24 h period. Mostly, arrhythmias
responsible of ES are multiple morphologies of monomorphic ventricular
tachycardia (VT), but polymorphic VT and ventricular fibrillation can also result
in ES. Clinical presentation is very dramatic in most cases, strictly related to
the cardiac disease that may worsen electrical and hemodynamic decompensation.
Therefore ES management is challenging in the majority of cases and a high
mortality is the rule both in the acute and in the long-term phases. Different
underlying cardiomyopathies provide significant clues into the mechanism of ES,
which can arise in the setting of structural arrhythmogenic cardiomyopathies or
rarely in patients with inherited arrhythmic syndrome, impacting on
pharmacological treatment, on ICD programming, and on the opportunity to apply
strategies of catheter ablation. This latter has become a pivotal form of
treatment due to its high efficacy in modifying the arrhythmogenic substrate and
in achieving rhythm stability, aiming at reducing recurrences of ventricular
arrhythmia and at improving overall survival. In this review, the most relevant
epidemiological and clinical aspects of ES, with regard to the acute and
long-term follow-up implications, were evaluated, focusing on these novel
therapeutic strategies of treatment.