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Current Cardiology Reports

, 21:96 | Cite as

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

  • Christos KontogiannisEmail author
  • Konstantinos Tampakis
  • Georgios Georgiopoulos
  • Stefano Bartoletti
  • Christos Papageorgiou
  • Hector Anninos
  • Alkistis Kapelouzou
  • Michael Spartalis
  • Ioannis Paraskevaidis
  • Sofia Chatzidou
Invasive Electrophysiology and Pacing (EK Heist, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Invasive Electrophysiology and Pacing

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.

Keywords

Electrical storm Ventricular arrhythmias Implantable cardioverter defibrillator Recurrent ventricular tachycardia Beta-blockers 

Notes

Compliance with Ethical Standards

Conflict of Interest

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.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Christos Kontogiannis
    • 1
    Email author
  • Konstantinos Tampakis
    • 1
    • 2
  • Georgios Georgiopoulos
    • 1
  • Stefano Bartoletti
    • 2
  • Christos Papageorgiou
    • 1
  • Hector Anninos
    • 1
  • Alkistis Kapelouzou
    • 3
  • Michael Spartalis
    • 3
  • Ioannis Paraskevaidis
    • 1
  • Sofia Chatzidou
    • 1
  1. 1.Department of Clinical Therapeutics, “Alexandra” Hospital, School of MedicineNational and Kapodistrian University of AthensAthensGreece
  2. 2.Electrophysiology UnitClinique PasteurToulouseFrance
  3. 3.Clinical, Experimental Surgery & Translational Research, Biomedical Research Foundation Academy of AthensAthensGreece

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