Riata lead failure presenting as a life-threatening electrical storm: A novel manifestation of electrical lead failure

AbstractElectrical storm due to the development of repetitive sustained ventricular tachycardias (VT) is a potentially life-threatening clinical entity. Acute catheter ablation can be lifesaving. Electrical storm (ES) can be characterized as a period of severe cardiac electrical instability manifested by recurrent ventricular arrhythmias. ES adversely affects short and long term prognosis. The highest mortality risk is in the first 3 months after the occurrence of the index event as shown by the AVID trial. The appearance of a ventricular tachycardia (VT) storm is associated with a rather high mortality despite the presence of an internal cardioverter defibrillator. Catheter ablation (CA) in VT storm is evolving as a standard of care therapy. The increased utilization of CA is partly driven by data suggesting that ICD shocks may be associated with increased mortality, partly due to the limited possibilities and adverse events of medical therapy. The aim of this review is to summarize recent advances in CA of VTs in emergency setting.

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Electrical storm – still an extremely poor prognosis. Do these acute states of life-threatening arrhythmias require a multidirectional approach from the start?

Advances in Interventional Cardiology ◽

10.5114/aic.2019.83769 ◽

2019 ◽

Vol 15 (1) ◽

pp. 1-12

Author(s):

Elżbieta Gadula-Gacek ◽

Mateusz Tajstra ◽

Mariusz Gąsior

Keyword(s):

Poor Prognosis ◽

Electrical Storm ◽

Life Threatening

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Resistant Ventricular Arrhythmia and the Role of Overdrive Pacing in the Suppression of the Electrical Storm

Case Reports in Cardiology ◽

10.1155/2019/6592927 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4

Author(s):

Mohamed Magdi ◽

Mahmood Mubasher ◽

Hakam Alzaeem ◽

Tahir Hamid

Keyword(s):

Myocardial Infarction ◽

Ventricular Arrhythmia ◽

Ventricular Arrhythmias ◽

Coronary Intervention ◽

Electrical Storm ◽

Electrical Instability ◽

Percutaneous Coronary ◽

Life Threatening ◽

Overdrive Pacing ◽

Antiarrhythmic Medications

Ventricular arrhythmia storm is a state of cardiac instability characterized by multiple ventricular arrhythmias or multiple ICD therapies within a 24-hour duration. Management of this life-threatening state depends on the reversal of the cause besides either electrical or medical management of the arrhythmia. We report a case of a 54-year-old male who underwent a percutaneous coronary intervention following massive acute myocardial infarction. Afterwards, he developed frequent life-threatening ventricular arrhythmias that required multiple shocks and antiarrhythmic medications. Despite all these interventions, it was very difficult to control the electrical instability, but after overdrive ventricular pacing, the storm subsided and within a few days the case was stabilized. Overdrive pacing is an easy temporary modality to control the resistant arrhythmia following myocardial infarction.

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Riata lead failure with normal electrical lead parameters and normal fluoroscopic appearance

Journal of Interventional Cardiac Electrophysiology ◽

10.1007/s10840-012-9739-5 ◽

2012 ◽

Vol 36 (1) ◽

pp. 87-89 ◽

Cited By ~ 7

Author(s):

Umashankar Lakshmanadoss ◽

David Lahoda ◽

Pramod Deshmukh

Keyword(s):

Lead Failure ◽

Electrical Lead

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Ventricular fibrillation storm after revascularization of chronic total occlusion of the left anterior descending artery: is this reperfusion arrhythmia?

Journal of International Medical Research ◽

10.1177/0300060521997618 ◽

2021 ◽

Vol 49 (3) ◽

pp. 030006052199761

Author(s):

Xingji Liu ◽

Binay Kumar Adhikari ◽

Tianlong Chen ◽

Yonggang Wang ◽

Quan Liu ◽

...

Keyword(s):

Percutaneous Coronary Intervention ◽

Ventricular Fibrillation ◽

Collateral Circulation ◽

Chronic Total Occlusion ◽

Coronary Intervention ◽

Electrical Storm ◽

Total Occlusion ◽

Reperfusion Arrhythmia ◽

Percutaneous Coronary ◽

Life Threatening

Electrical storm is a life-threatening emergency condition defined as three or more episodes of ventricular tachycardia or ventricular fibrillation (VF) within 24 hours requiring anti-tachycardia therapy, electrical cardioversion, or defibrillation. However, studies of the incidence of electrical storm after chronic total occlusion-percutaneous coronary intervention (CTO-PCI) are limited, 7 and post-procedural VF after revascularization of CTO has not been described. The purpose of this article was to present a case of post-operative VF electrical storm after revascularization of CTO of the left anterior descending (LAD) artery to determine whether the electrical storm was caused by reperfusion arrhythmia or compromise of either branch vessels or the collateral circulation during intervention.

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Riata lead failure manifests as electrical storm with lead parameters showing unique postural variations, a case report

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytab491 ◽

2021 ◽

Author(s):

Abhimanyu Uppal ◽

Sanjeev Kathuria ◽

Bhushan Shah ◽

Vijay Trehan

Keyword(s):

Case Report ◽

Electrical Storm ◽

Lead Failure

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RECURRENT SYNCOPE AS A SYMPTOM OF ELECTRICAL STORM – CASE PRESENTATION

Emergency Medical Service ◽

10.36740/emems202104111 ◽

2021 ◽

Vol 8 (4) ◽

pp. 271-273

Author(s):

Przemysław Skoczyński ◽

Paweł Pochciał

Keyword(s):

Ventricular Arrhythmias ◽

Electrical Storm ◽

Monitoring Equipment ◽

Case Presentation ◽

Diffi Cult ◽

Patient Reported ◽

Cardiology Clinic ◽

Life Threatening ◽

History Of

Dangerous ventricular arrhythmias leading to sudden cardiac death (SCD) are some of the most diffi-cult diagnostic challenges. They are often mildly symptomatic. Their often self-limiting nature means that they are difficult to capture on ECG. A 75-year old woman with chronic heart failure due to nonis-chemic cardiomyopathy reported to the cardiology clinic for a scheduled routine follow-up of the ICD, implanted three years prior as primary prevention of SCD. The patient reported recent episodes of sud-den weakness and described the episodes as hypotension. The patient associated it with too aggressive treatment of arterial hypertension. During the visit the patient experienced one of these episodes that she had previously described. The monitoring equipment in the clinic revealed ventricular tachycardia (VT). The history of the implanted ICD revealed many similar previous episodes including 5 episodes in the last 24 hours which led to a diagnosis of electrical storm. Dangerous ventricular arrhythmias may be mildly symptomatic and they are often underestimated by the patient. Fainting, especially in situa-tions unusual for the vasovagal reflex or orthostatic hypotension, should always arouse vigilance to-wards life-threatening ventricular arrhythmia.

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Treatment of Electrical Storm – the Electrophysiologist’s Point of View

In a good rythm ◽

10.5604/01.3001.0010.3965 ◽

2017 ◽

Vol 2 (43) ◽

pp. 4-8

Author(s):

Aleksander Bardyszewski ◽

Jacek Kuśnierz ◽

Paweł Derejko

Keyword(s):

Catheter Ablation ◽

Ventricular Arrhythmia ◽

Initial Treatment ◽

Technological Progress ◽

Point Of View ◽

Electrical Storm ◽

Electroanatomical Mapping ◽

Threatening Condition ◽

Life Threatening

Electrical storm is a life-threatening condition and requires immediate treatment. In most cases ventricular arrhythmia originates from previously formed lesions in the cardiac muscle. Such patients, following the necessary initial treatment, should be forwarded to catheter ablation, which is proven to reduce arrhythmia recurrence and to improve overall morbidity. Along with the technological progress related to electroanatomical mapping the growing role of meticulous substrate mapping and modification for successful ablation is being recognized.

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