Quelling the Storm: A Review of the Management of Electrical Storm
Heightened sympathetic input to the myocardium potentiates cardiac electrical instability and may herald an electrical storm. An electrical storm is characterized by 3 or more episodes of ventricular tachycardia, ventricular fibrillation, or appropriate internal cardiac defibrillator shocks within 2...
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| Veröffentlicht in: | Journal of cardiothoracic and vascular anesthesia 2023-09, Vol.37 (9), p.1776-1784 |
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| container_end_page | 1784 |
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| container_issue | 9 |
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| container_title | Journal of cardiothoracic and vascular anesthesia |
| container_volume | 37 |
| creator | McCabe, Melissa D. Cervantes, Richard Kewcharoen, Jakrin Sran, Jasmine Garg, Jalaj |
| description | Heightened sympathetic input to the myocardium potentiates cardiac electrical instability and may herald an electrical storm. An electrical storm is characterized by 3 or more episodes of ventricular tachycardia, ventricular fibrillation, or appropriate internal cardiac defibrillator shocks within 24 hours. Management of electrical storms is resource-intensive and inevitably requires careful coordination between multiple subspecialties. Anesthesiologists have an important role in acute, subacute, and long-term management. Identifying the phase of an electrical storm and understanding the characteristics of each morphology may help the anesthesiologist anticipate the management approach. In the acute phase, management of an electrical storm is aimed at providing advanced cardiac life support and identifying reversible causes. After initial stabilization, subacute management focuses on dampening the sympathetic surge with sedation, thoracic epidural, or stellate ganglion blockade. Definitive long-term management with surgical sympathectomy or catheter ablation also may be warranted. Our objective is to provide an overview of electrical storms and the anesthesiologist's role in management. |
| doi_str_mv | 10.1053/j.jvca.2023.05.029 |
| format | Article |
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An electrical storm is characterized by 3 or more episodes of ventricular tachycardia, ventricular fibrillation, or appropriate internal cardiac defibrillator shocks within 24 hours. Management of electrical storms is resource-intensive and inevitably requires careful coordination between multiple subspecialties. Anesthesiologists have an important role in acute, subacute, and long-term management. Identifying the phase of an electrical storm and understanding the characteristics of each morphology may help the anesthesiologist anticipate the management approach. In the acute phase, management of an electrical storm is aimed at providing advanced cardiac life support and identifying reversible causes. After initial stabilization, subacute management focuses on dampening the sympathetic surge with sedation, thoracic epidural, or stellate ganglion blockade. Definitive long-term management with surgical sympathectomy or catheter ablation also may be warranted. 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An electrical storm is characterized by 3 or more episodes of ventricular tachycardia, ventricular fibrillation, or appropriate internal cardiac defibrillator shocks within 24 hours. Management of electrical storms is resource-intensive and inevitably requires careful coordination between multiple subspecialties. Anesthesiologists have an important role in acute, subacute, and long-term management. Identifying the phase of an electrical storm and understanding the characteristics of each morphology may help the anesthesiologist anticipate the management approach. In the acute phase, management of an electrical storm is aimed at providing advanced cardiac life support and identifying reversible causes. After initial stabilization, subacute management focuses on dampening the sympathetic surge with sedation, thoracic epidural, or stellate ganglion blockade. Definitive long-term management with surgical sympathectomy or catheter ablation also may be warranted. Our objective is to provide an overview of electrical storms and the anesthesiologist's role in management.</description><subject>Arrhythmias, Cardiac</subject><subject>catheter ablation</subject><subject>Catheter Ablation - adverse effects</subject><subject>Defibrillators, Implantable - adverse effects</subject><subject>electrical storm</subject><subject>Heart</subject><subject>Humans</subject><subject>multidisciplinary approach</subject><subject>sympathectomy</subject><subject>Tachycardia, Ventricular - surgery</subject><subject>Treatment Outcome</subject><subject>ventricular arrhythmia</subject><subject>Ventricular Fibrillation - etiology</subject><subject>ventricular tachycardia</subject><issn>1053-0770</issn><issn>1532-8422</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kLtOxDAQRS0E4v0DFCglTcJ4HMcOooEVLwmEeNWW15lAVnmAnQXx93hZoKQa6-rM1fgwtsch4yDF4SybvTubIaDIQGaA5Qrb5FJgqnPE1fiOVApKwQbbCmEGwLmUap1tCIVlAVhsstO7ObVt0z8n4wslD-Pgu6PkJLmn94Y-kqH-jm9sb5-po35cJGctudE3zrZLfoet1bYNtPszt9nT-dnj5DK9vr24mpxcpy4HGNOpraTCqeBF7UpCBU5zqQt0UEKtOCnISw1TBRKFtkJVVa6RO6QYCdAottnBsvfVD29zCqPpmuDi9banYR4MaswLrcqijCguUeeHEDzV5tU3nfWfhoNZWDEzs3BnFu4MSBPdxaX9n_75tKPqb-VXVgSOlwDFX0Y_3gTXUO-oanxUYqqh-a__C7Q2fS8</recordid><startdate>202309</startdate><enddate>202309</enddate><creator>McCabe, Melissa D.</creator><creator>Cervantes, Richard</creator><creator>Kewcharoen, Jakrin</creator><creator>Sran, Jasmine</creator><creator>Garg, Jalaj</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7317-5395</orcidid></search><sort><creationdate>202309</creationdate><title>Quelling the Storm: A Review of the Management of Electrical Storm</title><author>McCabe, Melissa D. ; Cervantes, Richard ; Kewcharoen, Jakrin ; Sran, Jasmine ; Garg, Jalaj</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-bad572b316fc9e270c815862c090f71e704980b705238a37dd4821c2eb7030823</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Arrhythmias, Cardiac</topic><topic>catheter ablation</topic><topic>Catheter Ablation - adverse effects</topic><topic>Defibrillators, Implantable - adverse effects</topic><topic>electrical storm</topic><topic>Heart</topic><topic>Humans</topic><topic>multidisciplinary approach</topic><topic>sympathectomy</topic><topic>Tachycardia, Ventricular - surgery</topic><topic>Treatment Outcome</topic><topic>ventricular arrhythmia</topic><topic>Ventricular Fibrillation - etiology</topic><topic>ventricular tachycardia</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>McCabe, Melissa D.</creatorcontrib><creatorcontrib>Cervantes, Richard</creatorcontrib><creatorcontrib>Kewcharoen, Jakrin</creatorcontrib><creatorcontrib>Sran, Jasmine</creatorcontrib><creatorcontrib>Garg, Jalaj</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiothoracic and vascular anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>McCabe, Melissa D.</au><au>Cervantes, Richard</au><au>Kewcharoen, Jakrin</au><au>Sran, Jasmine</au><au>Garg, Jalaj</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Quelling the Storm: A Review of the Management of Electrical Storm</atitle><jtitle>Journal of cardiothoracic and vascular anesthesia</jtitle><addtitle>J Cardiothorac Vasc Anesth</addtitle><date>2023-09</date><risdate>2023</risdate><volume>37</volume><issue>9</issue><spage>1776</spage><epage>1784</epage><pages>1776-1784</pages><issn>1053-0770</issn><eissn>1532-8422</eissn><abstract>Heightened sympathetic input to the myocardium potentiates cardiac electrical instability and may herald an electrical storm. 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| identifier | ISSN: 1053-0770 |
| ispartof | Journal of cardiothoracic and vascular anesthesia, 2023-09, Vol.37 (9), p.1776-1784 |
| issn | 1053-0770 1532-8422 |
| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Arrhythmias, Cardiac catheter ablation Catheter Ablation - adverse effects Defibrillators, Implantable - adverse effects electrical storm Heart Humans multidisciplinary approach sympathectomy Tachycardia, Ventricular - surgery Treatment Outcome ventricular arrhythmia Ventricular Fibrillation - etiology ventricular tachycardia |
| title | Quelling the Storm: A Review of the Management of Electrical Storm |
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