Electrical storm: Difference between revisions
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[[File:Storm_Tx_algorithm.png|thumb|Proposed treatment algorithm for electrical storm<ref name='texas tx'> | [[File:Storm_Tx_algorithm.png|thumb|Proposed treatment algorithm for electrical storm<ref name='texas tx'> | ||
Eifling M, Ravazi M, Massumi A. The Evaluation and Management of Electrical Storm. Tex Heart Inst J 2011;38(2):111-21</ref>]] | Eifling M, Ravazi M, Massumi A. The Evaluation and Management of Electrical Storm. Tex Heart Inst J 2011;38(2):111-21</ref>]] | ||
*ACC recommends repletion of K to 4.5 in all cases <ref name="ACC SCD"> | |||
Zipes DP et al. ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death. J Am Coll Card 2006;48(5):e247-346. </ref> | |||
==Disposition== | ==Disposition== | ||
Revision as of 02:15, 2 June 2015
Background
- Definition
- 3 or more episodes of sustained ventricular tachycardia, ventricular fibrilation, or ICD shocks within 24 hours
- Risk factors [1]
- CAD
- HFrEF
- Long QT
- DM2 is protective
- Causes
- Ischemia
- Electrolyte derangement
- Iatrogenic (i.e. QT prolonging medications)
- Hyperthyroidism
- Infection/Fever
Clinical Features
- Presentation as:
- Cardiac arrest
- Palpitations
- (Pre)Syncope
- ICD patient complaining of shock(s)
Differential Diagnosis
- Tachycardia (wide)
- ICD malfunction
- AF/SVT
- Oversensing
- Lead fracture
Diagnosis
Management
Proposed treatment algorithm for electrical storm[2]
- ACC recommends repletion of K to 4.5 in all cases [3]
Disposition
- CCU or cath lab
See Also
External Links
References
- ↑ Brigadeau F et al. Clinical predictors and prognostic significance of electrical storm in patients with implantable cardioverter defibrillators. Eur Heart J 2006;27:700-7.
- ↑ Eifling M, Ravazi M, Massumi A. The Evaluation and Management of Electrical Storm. Tex Heart Inst J 2011;38(2):111-21
- ↑ Zipes DP et al. ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death. J Am Coll Card 2006;48(5):e247-346.