Troubleshooter in electrical storm: Mechanical unloading leads to heart rhythm stabilization

J Electrocardiol. 2017 Sep-Oct;50(5):678-680. doi: 10.1016/j.jelectrocard.2017.04.002. Epub 2017 Apr 18.

Abstract

The electrical storm is a life-threatening situation which causes a complex antiarrhythmic treatment. We firstly report a rhythmological stabilization through mechanical unloading of the left ventricle in a health patient who developed electrical storm after endo- and epicardiac re-ablation and who previously underwent 27 unsuccessful defibrillations. No evidence for a specific etiology of the rhythm disturbances was found. After implantation of a percutaneous left ventricular assist device (pLVAD) a single additional defibrillation was needed to terminate ventricular fibrillation. This unique application of pLVAD might be an unprecedented escape strategy for patients who have exhausted all other commonly recommended therapy options.

Keywords: Cardiac arrest; Electrical storm; Percutaneous left ventricular assist device; Ventricular fibrillation.

Publication types

  • Case Reports

MeSH terms

  • Catheter Ablation / methods
  • Coronary Angiography
  • Defibrillators, Implantable*
  • Electrocardiography
  • Female
  • Heart-Assist Devices*
  • Humans
  • Prognosis
  • Tachycardia, Supraventricular / physiopathology
  • Tachycardia, Supraventricular / surgery
  • Ventricular Fibrillation / physiopathology
  • Ventricular Fibrillation / therapy*
  • Young Adult