ArticleIndian heart journal
Management of electrical storm of unstable ventricular tachycardia in post myocardial infarction patients: A single centre experience.
Article in Indian heart journal. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Stellate ganglion ablation by conventional radiofrequency in patients with electrical storm.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 · 2023Article
- Genetic variants in post myocardial infarction patients presenting with electrical storm of unstable ventricular tachycardia.Indian pacing and electrophysiology journalArticle
- Substrate ablation for post-infarct and Brugada storm: Triggering the calm.Indian heart journalArticle
- In-hospital and intermediate term outcome of ventricular tachycardia storm.Indian heart journalArticle
- Electrical storm of short coupled ventricular fibrillation- management by neuromodulation and trigger ablation.Indian pacing and electrophysiology journalArticle
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Authors and funding
3 authors.
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Abstract
objectiveThis is a case series of consecutive patients with past myocardial infarction presenting with Electrical Storm (ES) of unstable ventricular tachycardia (VT) treated by a protocol directed algorithm.
methodsManagement protocol involved treatment of reversible causes, ventilatory & hemodynamic support, administration of antiarrhythmic drugs (AAD) & maximally tolerated doses of beta-blockers, stellate ganglionectomy and Radiofrequency ablation (RFA) guided by Electro Anatomic Mapping (EAM). Patients were followed up periodically with review of device data logs.
resultsThere were 12 patients (mean age=61.38±6.48years & mean LVEF=31.92±4.23%). Presentation was recurrent ICD shocks (n=5) or VT (n=7). All were mechanically ventilated. Reversible causes were identified in 4 patients and appropriately addressed. Totally 8 patients underwent endocardial substrate modification by EAM & RFA. Endocardial LV Voltage mapping demonstrated a mean scar area of 70.04±17.63 sq.cm (27.04±6.20% of mapped area). The electrograms targeted for ablation included late potentials, fractionated electrograms, double potentials and channels within the scar. Two patients had stellate ganglionectomy in addition. Ten patients (83.3%) survived to discharge, all of whom are alive at a follow up of 30.12±19months free of ES. VT free survival at end of follow up was 80%. No patient had hospitalization related to VT. Single episode of VT recurrence was seen in 2 patients at 7 months and 1year of follow up respectively.
conclusionIn post myocardial infarction patients presenting with ES and unstable VT, a protocol driven approach involving substrate modification targeting abnormal electrograms improves outcomes.
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