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Electrical Storm: Current Evidence, Clinical Implications, and Future Perspectives

  • Invasive Electrophysiology and Pacing (EK Heist, Section Editor)
  • Published:
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Abstract

Purpose of Review

Electrical storm (ES) is a life-threatening medical emergency of repetitive episodes of sustained ventricular arrhythmias within a short period. Its occurrence is associated with poor short- and long-term survival, even in patients with implantable cardioverter defibrillators (ICD). Management of ES is challenging and mainly based on retrospective studies. This article reviews the existing literature on ES, presents the available data regarding its management, and proposes a new algorithm based on current evidence.

Recent Findings

Recent research could modify the management of ES supporting the role of non-selective β1 and β2 blockade and the early intervention with catheter ablation as well as strengthening the role of cardiac sympathetic denervation.

Summary

A multipronged approach should be considered for the management of ES including identification and correction of reversible causes, ICD reprogramming, drug therapy (beta-blockers—especially non-selective ones—and other anti-arrhythmic drugs) and non-pharmacologic therapies such as catheter ablation and techniques of neuroaxial modulation. Although current data suggest early aggressive management, further research is required to clarify the optimal order and combination of therapies for the prevention of future events.

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Authors and Affiliations

  1. Department of Clinical Therapeutics, “Alexandra” Hospital, School of Medicine, National and Kapodistrian University of Athens, 80 Vassilisis Sofias str, Athens, Greece

    Christos Kontogiannis, Konstantinos Tampakis, Georgios Georgiopoulos, Christos Papageorgiou, Hector Anninos, Ioannis Paraskevaidis & Sofia Chatzidou

  2. Electrophysiology Unit, Clinique Pasteur, Toulouse, France

    Konstantinos Tampakis & Stefano Bartoletti

  3. Clinical, Experimental Surgery & Translational Research, Biomedical Research Foundation Academy of Athens, 11527, Athens, Greece

    Alkistis Kapelouzou & Michael Spartalis

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  1. Christos Kontogiannis
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Christos Kontogiannis, Konstantinos Tampakis, Georgios Georgiopoulos, Stefano Bartoletti, Christos Papageorgiou, Hector Anninos, Alkistis Kapelouzou, Michael Spartalis, Ioannis Paraskevaidis, and Sofia Chatzidou declare that they have no conflict of interest.

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Kontogiannis, C., Tampakis, K., Georgiopoulos, G. et al. Electrical Storm: Current Evidence, Clinical Implications, and Future Perspectives. Curr Cardiol Rep 21, 96 (2019). https://doi.org/10.1007/s11886-019-1190-0

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