Abstract
Ventricular tachycardias (VT) represents worldwide one of the leading causes of sudden cardiac death. The increasing number of implanted ICDs have reduced signifi cantly the number of sudden cardiac deaths SCDs); however recurrent VTs episodes might lead to a rapid deterioration of patient’s clinical status and systolic function. An early intervention after a successful patient stabilization in a dedicated VT unit is mandatory for the mid- and long term prognosis of the patient. Nevertheless, a tight collaboration between general hospitals and highly specialized centers in treatment of patients with electrical storm is essential for an effi cient and successful outcome.
Highlights
The increasing number of implanted ICDs have led worldwide to a tremendous reduction of SCDs due to malignant ventricular tachycardia
Recurrent VTs might lead to a rapid deterioration progression of underlying heart disease, reduction of systolic function due to the tachymyopathie component and have a negative psychological impact which further reduces the patient clinical status
Electrical storm is defined as a number of at least 3 sustained VTs or ventricular fibrillation (VFs) episodes in 24 hours which requires an immediate intervention for termination
Summary
The increasing number of implanted ICDs have led worldwide to a tremendous reduction of SCDs due to malignant ventricular tachycardia. Electrical storm is defined as a number of at least 3 sustained VTs or ventricular fibrillation (VFs) episodes in 24 hours which requires an immediate intervention for termination (cardioversion/ defibrillation or ICD intervention). Electrical storm – very often not an isolated event requiring highly qualified management Electrical storm is a standalone predictor of mid- and long term mortality in patients coronary artery disease and VT/VFs an indicated by a substudy of MADIT II1 the patients presenting with VT storm have higher PAAINESD score which is further associated with a high early and midterm mortality[2]. In more than half of the patients presenting with ES a trigger could be identified and this one should be carefully primary treated. The management of patients with ES should be ideally undergone in a tertiary center, on a dedicated unit (i..e VT unit) with a preexisting strong collaboration between structural heart disease respectively heart failure specialist and electrophysiologists
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