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Journal of Cardiovascular Pharmacology and Therapeutics
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Electrical Storm: Case Series and Review of Management

Uma N. Srivatsa, MD

Ramin Ebrahimi, MD

Adel El-Bialy, MD

Robin Y. Wachsner, MD

Department of Cardiology, West Los Angeles VA Medical Center and Department of Cardiology, Olive View Medical Center, Sylmar UCLA School of Medicine, Los Angeles, California

Electrical storm is defined as a recurrent episode of hemodynamically destabilizing ventricular tachyarrhythmia that usually requires electrical cardioversion or defibrillation. We describe three cases presenting with electrical storm under differing circumstances: (1) a 57-year-old man with ST-elevation myocardial infarction within 1 week of a posterior circulation stroke who developed refractory sustained ventricular tachycardia 10 days after an acute myocardial infarction; (2) a 65-year-old man who developed polymorphic ventncular tachycardia and ventricular fibrillation following dobutamine echocardiography; and (3) a 20-year-old woman who developed intractable ventricular fibrillation following an overdose of a weight-reduction pill. The management of electrical storm is discussed, and evolving literature supporting the routine use of intravenous amiodarone and ß-blockers in place of intravenous lidocaine is critically examined.

Key Words: ventricular tachycardia • ventricular fibrillation • intravenous amiodarone • sudden death • electrical storm

Journal of Cardiovascular Pharmacology and Therapeutics, Vol. 8, No. 3, 237-246 (2003)
DOI: 10.1177/107424840300800309
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