Management of patients with an electrical storm or clustered ventricular arrhythmias: a clinical consensus statement of the European Heart Rhythm Association of the ESC-endorsed by the Asia-Pacific Heart Rhythm Society, Heart Rhythm Society, and Latin-American Heart Rhythm Society

Radosław Lenarczyk*, Katja Zeppenfeld, Jacob Tfelt-Hansen, Frank R Heinzel, Thomas Deneke, Elena Ene, Christian Meyer, Arthur Wilde, Elena Arbelo, Ewa Jędrzejczyk-Patej, Avi Sabbag, Markus Stühlinger, Luigi di Biase, Marmar Vaseghi, Ohad Ziv, William-Fernando Bautista-Vargas, Saurabh Kumar, Narayanan Namboodiri, Benhur Davi Henz, Jose Montero-CabezasNikolaos Dagres, Petr Peichl, Antonio Frontera, Stylianos Tzeis, Jose Luis Merino, Kyoko Soejima, Christian de Chillou, Roderick Tung, Lars Eckardt, Philippe Maury, Peter Hlivak, Larisa G Tereshchenko, Pipin Kojodjojo, Jacob Atié

*Corresponding author af dette arbejde

Abstract

Electrical storm (ES) is a state of electrical instability, manifesting as recurrent ventricular arrhythmias (VAs) over a short period of time (three or more episodes of sustained VA within 24 h, separated by at least 5 min, requiring termination by an intervention). The clinical presentation can vary, but ES is usually a cardiac emergency. Electrical storm mainly affects patients with structural or primary electrical heart disease, often with an implantable cardioverter-defibrillator (ICD). Management of ES requires a multi-faceted approach and the involvement of multi-disciplinary teams, but despite advanced treatment and often invasive procedures, it is associated with high morbidity and mortality. With an ageing population, longer survival of heart failure patients, and an increasing number of patients with ICD, the incidence of ES is expected to increase. This European Heart Rhythm Association clinical consensus statement focuses on pathophysiology, clinical presentation, diagnostic evaluation, and acute and long-term management of patients presenting with ES or clustered VA.

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