Ventricular Tachycardia Electrical Storm

Abstract

The term “electrical storm” (ES) indicates a life-threatening clinical condition characterized by the recurrence of hemodynamically unstable ventricular tachycardia (VT) and/or ventricular fibrillation (VF). We are presenting a case of ES in hemodynamically unstable VT treated at pre-hospital and hospital level.

Seventy-one-year-old patient with a previous history of hypertension, insulin-dependent diabetes, congestive stroke and myocardial infarction, severe three-vessel coronary artery disease and myocardial revascularization, diabetic nephropathy, chronic kidney failure, and chronic ischemic cardiomyopathy, collapses at home. After examination and diagnostic procedures, the emergency medical physician (EMS) diagnoses hemodynamically unstable VT, which he treats with medication and gets the patient urgently transported to a hospital. In the next 24 h, during hospitalization, there are five more separate episodes of VT with pulse treated with DC shock and antiarrhythmics. On the twelfth day of hospitalization, an implantable cardioverter-defibrillator is implanted to prevent sudden cardiac death. On the seventeenth day, the patient is discharged from hospital in stable condition.

The question arises of further best pharmacological and non-pharmacological therapy of ES in hemodynamically unstable VT. It is necessary to educate EMS physicians in the practical application of synchronized cardioversion at the prehospital level.