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Emergency Medicine Journal 2003;20:e4; doi:10.1136/emj.20.3.e4
© 2003 BMJ Publishing Group Ltd and the College of Emergency Medicine.

CASE REPORT

Successful resuscitation of a patient with electrical storm

P K Moulik, M N Attar, E L Rose, A A Khaleeli

Department of Medicine, Halton General Hospital, Runcorn, UK

Correspondence to:
Correspondence to:
Dr P K Moulik, 39 Coniston House, University Hospital Aintree, Longmoor Lane, Liverpool L9 7AL, UK;
p.moulik{at}virgin.net

ABSTRACT

A 41 year old woman with type 2 diabetes, hypertension, and hyperlipidaemia but no known heart disease received 130 DC shocks for repeated cardiac arrests due to ventricular tachyarrhythmias over 48 hours. She was stabilised by intravenous amiodarone and had a defibrillator implanted. Serial ECGs did not change, but raised troponin I confirmed myocardial infarction as the underlying cause. Electrical storm is an uncommon and dramatic but usually treatable syndrome of recurrent ventricular arrhythmias. Frequent precipitants of electrical storm include recent worsening heart failure, hypokalaemia, hypomagnesaemia and myocardial ischaemia. Amiodarone is the antiarrhythmic agent of choice and implantable cardioverter defibrillator improves long term outcome.

Keywords: electrical storm; myocardial infarction; defibrillation; amiodarone


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