Title

Refractory Electrical Storm in the Absence of Structural Ischemic Heart Disease

Division

Gulf Coast

Hospital

Corpus Christi

Document Type

Case Report

Publication Date

2-5-2020

Keywords

electrical storm, ventricular fibrillation, vantricular tachycardia, monomorphic tachycardia, polymorphic tachycardia, life threatening arrhythmia, catheter ablation

Disciplines

Cardiology | Cardiovascular Diseases | Internal Medicine

Abstract

Ventricular tachycardia (VT) is characterized as a ventricular rhythm with a QRS >120 milliseconds (ms) and >100 beats-per-minute (BPM) in the absence of an aberrant conduction. It is classified as sustained when lasting >30 seconds. Risk factors associated with the development of VT include increasing age and coronary artery disease with concurrent left ventricular dysfunction, other forms of structural heart disease and acquired or congenital abnormalities in the cardiac sodium, potassium or calcium channels. Diagnosing VT is challenging based on history and physical exam alone. Combination of electrocardiogram (EKG), electrolytes and cardiac enzymes, echocardiogram, cardiac catheterization, and electrophysiology testing are required to appropriately diagnose and characterize the etiology. The case below describes an 84-year-old female with a known history of symptomatic bradycardia status post pacemaker who presented to the emergency department (ED) after a routine device check which revealed VT with associated dyspnea. The patient did not do well with medical therapy and required ablative therapy to resolve VT.

Publisher or Conference

Cureus

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