ArticleJournal of the American College of Cardiology2018
Propranolol Versus Metoprolol for Treatment of Electrical Storm in Patients With Implantable Cardioverter-Defibrillator.
Article in Journal of the American College of Cardiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers, 4 of them syntheses that pooled it.
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Who cites it
56 citing papers in PubMed, 4 syntheses or guidelines pooled it, 118 citations in OpenAlex.
- Efficacy of stellate ganglion block in treatment of electrical storm: a systematic review and meta-analysis.Scientific reports · 2024Pooled it
- Continuous stellate ganglion block for ventricular arrhythmias: case series, systematic review, and differences from thoracic epidural anaesthesia.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Pooled it
- Incidence, recurrence and management of electrical storm in Brugada syndrome.Frontiers in cardiovascular medicine · 2022Pooled it
- Pooled it
- Beta-Blockers for the Treatment of Arrhythmias: Which Drug for Which Arrhythmia? A State-of-the-Art Narrative Review.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2026Review
- Cardiogenic Shock Centers and Protocols for Acute Cardiovascular Care: Bridging the Gap Between Spoke and Hub Sites.Cardiology and therapy · 2026Review
- Catheter Ablation Outcomes in Electrical Storm Versus Non-Electrical Storm Ventricular Tachycardia: A Systematic Review and Meta-Analysis.Journal of arrhythmia · 2026Article
- Position Statement on the Diagnosis and Treatment of Electrical Storm - 2026.Arquivos brasileiros de cardiologia · 2026Article
- Multidisciplinary Approach to Ventricular Arrhythmias in the CICU: Integrating Mechanical Circulatory Support, Ablation, and Emerging Therapies.Journal of clinical medicine · 2026Review
- A practical 5-stage clinical scale for electrical storm: the STORM classification.European heart journal. Acute cardiovascular care · 2026Article
- The CCL11-CCR3 Axis Regulates the Aggravation of Neuroinflammation in Astrocytic Necroptosis After Cerebral Ischemia.FASEB journal : official publication of the Federation of American Societies for Experimental Biology · 2026Article
- Prognostic Value of Antiarrhythmic Drug Suppression of Electrical Storm Prior to Ventricular Tachycardia Ablation.Journal of cardiovascular electrophysiology · 2025Article
- Practical compendium of antiarrhythmic drugs: a clinical consensus statement of the European Heart Rhythm Association of the European Society of Cardiology.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Review
- The lack of evidence-based management in electrical storm: a scoping review.BMC cardiovascular disorders · 2025Article
- A Comprehensive Review of a Mechanism-Based Ventricular Electrical Storm Management.Journal of clinical medicine · 2025Review
- The role of antiarrhythmic drugs and stellate ganglion block in the acute management of electrical storm.European heart journal supplements : journal of the European Society of Cardiology · 2025Article
- Ventricular arrhythmias in acute heart failure: a clinical consensus statement of the Association for Acute CardioVascular Care, the European Heart Rhythm Association, and the Heart Failure Association of the European Society of Cardiology.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Article
- Neuro- and immuno-modulation mediated by the cardiac sympathetic nerve: a novel insight into the anti-ischemic efficacy of acupuncture.Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan · 2024Review
- Beta-Blockers as an Immunologic and Autonomic Manipulator in Critically Ill Patients: A Review of the Recent Literature.International journal of molecular sciences · 2024Review
- The point on the treatment of arrhythmic storm.European heart journal supplements : journal of the European Society of Cardiology · 2024Article
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundElectrical storm (ES), characterized by unrelenting recurrences of ventricular arrhythmias, is observed in approximately 30% of patients with implantable cardioverter-defibrillators (ICDs) and is associated with high mortality rates.
objectivesSympathetic blockade with β-blockers, usually in combination with intravenous (IV) amiodarone, have proved highly effective in the suppression of ES. In this study, we compared the efficacy of a nonselective β-blocker (propranolol) versus a β
methodsBetween 2011 and 2016, 60 ICD patients (45 men, mean age 65.0 ± 8.5 years) with ES developed within 24 h from admission were randomly assigned to therapy with either propranolol (160 mg/24 h, Group A) or metoprolol (200 mg/24 h, Group B), combined with IV amiodarone for 48 h.
resultsPatients under propranolol therapy in comparison with metoprolol-treated individuals presented a 2.67 times decreased incidence rate (incidence rate ratio: 0.375; 95% confidence interval: 0.207 to 0.678; p = 0.001) of ventricular arrhythmic events (tachycardia or fibrillation) and a 2.34 times decreased rate of ICD discharges (incidence rate ratio: 0.428; 95% CI: 0.227 to 0.892; p = 0.004) during the intensive care unit (ICU) stay, after adjusting for age, sex, ejection fraction, New York Heart Association functional class, heart failure type, arrhythmia type, and arrhythmic events before ICU admission. At the end of the first 24-h treatment period, 27 of 30 (90.0%) patients in group A, while only 16 of 30 (53.3%) patients in group B were free of arrhythmic events (p = 0.03). The termination of arrhythmic events was 77.5% less likely in Group B compared with Group A (hazard ratio: 0.225; 95% CI: 0.112 to 0.453; p < 0.001). Time to arrhythmia termination and length of hospital stay were significantly shorter in the propranolol group (p < 0.05 for both).
conclusionsThe combination of IV amiodarone and oral propranolol is safe, effective, and superior to the combination of IV amiodarone and oral metoprolol in the management of ES in ICD patients.
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