Electrical Storm in Children

Successful conversion of post-cardiac surgery electric storm in a child

BACKGROUND

The management of ventricular electrical storm can prove to be a challenge for the clinician given its complexity and life threatening consequences.

CASE CHARACTERISTICS

8-year-old boy with repeated life-threatening polymorphic ventricular tachycardia following aortic valve replacement surgery.

INTERVENTION

Defibrillated 45 times in addition to multiple antiarrhythmic drugs.

OUTCOME

Conversion to stable sinus rhythm with normal neurological outcome.

MESSAGE

Electric storm can be controlled by combination of multiple intravenous antiarrhythmic drugs.

Optimal antiarrhythmic drug therapy for electrical storm

Electrical storm, defined as 3 or more separate episodes of ventricular tachycardia or ventricular fibrillation within 24 hours, carries significant morbidity and mortality. These unstable ventricular arrhythmias have been described with a variety of conditions including ischemic heart disease, structural heart disease, and genetic conditions. While implantable cardioverter defibrillator implantation and ablation may be indicated and required, antiarrhythmic medication remains an important adjunctive therapy for these persons.