Electrical Storm in Acute Heart Failure Patients: How to Juggle the Lightning in Rural Area

Abstract

Background: Electrical storm, a life-threatening condition marked by recurrent ventricular arrhythmias, demands a multimodal approach for effective management. We present a case of acute heart failure in a rural setting, complicated by electrical storm, where COVID-19-related delays in referrals to tertiary health services are prevalent. Case Illustration: A 55-year-old male with a history of hypertension and previous cardiogenic shock presented with monomorphic ventricular tachycardia. Synchronized cardioversion was followed by intravenous amiodarone, but recurrent episodes persisted. Referral to a tertiary hospital revealed non-significant coronary disease, and ambulatory medication was prescribed. Discussion: Electrical storm, often linked to structural heart disease, requires a complex management algorithm addressing hemodynamics, recurrent shocks, and potential triggers. Psychological considerations are crucial. In rural settings lacking advanced cardiac facilities, adherence to advanced cardiac life support (ACLS) guidelines is vital before referral. Conclusion: In resource-limited rural settings, adhering to ACLS guidelines allows effective initial management of electrical storm cases. While advanced therapies are optimal in tertiary hospitals, timely interventions in rural settings significantly impact outcomes, compensating for the lack of advanced cardiac facilities.