The clinical characteristics and treatment of 20 cases of ventricular electrical storm
10.3760/cma.j.cn112148-20250908-00637
- VernacularTitle:20例室性电风暴患者的临床特征及治疗
- Author:
Junqi WANG
1
;
Mingyu SUN
1
;
Zulu WANG
1
;
Ming LIANG
1
Author Information
1. 解放军北部战区总医院心血管内科，沈阳 110016
- Publication Type:Journal Article
- Keywords:
Ventricular electrical storm;
Myocardial infarction;
Implantable Cardioverter Defibrillator;
Radio frequency ablation
- From:
Chinese Journal of Cardiology
2025;53(11):1263-1270
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical characteristics, diagnostic and therapeutic strategies, and clinical outcomes of ventricular electrical storm.Methods:This study was a descriptive cross-sectional analysis. Patients with ventricular electrical storm admitted to the Department of cardiology, General Hospital of Northern Theater command between July 1, 2022 and July 31, 2023 were enrolled. A retrospective analysis was conducted on their demographic data, clinical characteristics, etiology, diagnosis, treatment, and outcome.Results:A total of 20 patients with ventricular electrical storm were enrolled, aged (62.4±12.0) years, including 13 males. There were 11 cases of acute myocardial infarction (AMI), 1 case of previous myocardial infarction complicated with ischemic cardiomyopathy, 4 cases of dilated cardiomyopathy, and 4 cases of valvular disease. Electrocardiographic manifestations comprised monomorphic ventricular tachycardia in 3 cases, polymorphic ventricular tachycardia in 6 cases, ventricular fibrillation in 4 cases, and polymorphic ventricular tachycardia combined with ventricular fibrillation in 7 cases. Antiarrhythmic therapy primarily involved amiodarone, combined with β-blockers and adjunctive agents such as lidocaine and nifekalant, along with sedation, hypothermia, and anti-heart failure treatment. Ten out of 11 AMI patients underwent successful revascularization, while 1 received medical therapy due to small vessel size. Ten patients met indications for implantable cardioverter-defibrillator (ICD) therapy, with 9 receiving ICD implantation during hospitalization and 1 refusing. Three patients underwent radiofrequency ablation. Two in-hospital deaths occurred due to refractory malignant arrhythmias. During a follow-up of (7.36±2.74) months, 10 out of 11 AMI patients remained free from recurrent ventricular tachycardia and ICD discharges, while 1 was hospitalized twice for heart failure. Both ICD-treated patients with DCM had appropriate shocks for ventricular tachycardia and ventricular fibrillation confirmed by device interrogation. Two additional deaths occurred during follow-up: 1 AMI patient (who refused ICD implantation) died from arrhythmia, and 1 post-mitral valve replacement patient succumbed to heart failure.Conclusion:Ventricular electrical storm represents a life-threatening emergency with poor prognosis, requiring a comprehensive treatment strategy that includes identification and management of triggers, treatment of the underlying disease, standardized drug therapy, and when necessary, adjunctive interventions such as catheter ablation, ICD implantation, and extracorporeal membrane oxygenation may contribute to reduce mortality and improve prognosis.
