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Le Ruz R, Lande G, Lepoivre T, David CH, Michel M, Gourraud JB. Electrical Storm Ablation in a Patient in Cardiogenic Shock Supported by Impella 5.0. JACC Case Rep 2021; 3:486-490. [PMID: 34317564 PMCID: PMC8311017 DOI: 10.1016/j.jaccas.2020.12.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 12/03/2020] [Accepted: 12/14/2020] [Indexed: 11/27/2022]
Abstract
Intra-axial pumps are increasingly used to support cardiogenic shock. The occurrence of electrical storms in this setting is a rising issue, and data remain scarce about optimal management. We report the feasibility of ventricular tachycardia ablation in the presence of a recent surgically inserted Impella 5.0 device (Abiomed, Danvers, Massachusetts). (Level of Difficulty: Intermediate.)
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Affiliation(s)
- Robin Le Ruz
- Department of Cardiology, Nantes University Hospital Center, Saint-Herblain, France
- Address for correspondence: Robin Le Ruz, Department of Cardiology, Centre Hospitalo-Universitaire de Nantes, Boulevard Professeur Jacques Monod, 44800 Saint-Herblain, France. @CHUnantes
| | - Gilles Lande
- Department of Cardiology, Nantes University Hospital Center, Saint-Herblain, France
| | - Thierry Lepoivre
- Department of Cardiac Anesthesiology and Intensive Care, Nantes University Hospital Center, Saint-Herblain, France
| | - Charles-Henri David
- Department of Cardiac Surgery, Nantes University Hospital Center, Saint-Herblain, France
| | - Magali Michel
- Department of Cardiology, Nantes University Hospital Center, Saint-Herblain, France
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Kontogiannis C, Georgiopoulos G, Papageorgiou C, Anninos H, Tampakis K, Kosmopoulos M, Vasileiou P, Kanakakis I, Paraskevaidis I, Chatzidou S. A Recalcitrant Electrical Storm and Implantable Defibrillator Exhaustion: Treatment Implications According to and Beyond Guidelines. JACC Case Rep 2019; 1:602-606. [PMID: 34316888 PMCID: PMC8288686 DOI: 10.1016/j.jaccas.2019.09.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 08/10/2019] [Accepted: 09/04/2019] [Indexed: 12/07/2022]
Abstract
A 60-year-old patient presented with recalcitrant electrical storm (ES). Mild sedation and initial antiarrhythmic combination of esmolol and amiodarone did not affect the intensity of ES, which resulted in battery exhaustion. Oral propranolol in addition to intravenous amiodarone might be preferred in hemodynamically stable patients before interventional therapies. (Level of Difficulty: Intermediate.)
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Affiliation(s)
- Christos Kontogiannis
- Department of Clinical Therapeutics, "Alexandra" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Georgiopoulos
- Department of Clinical Therapeutics, "Alexandra" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Christos Papageorgiou
- Department of Clinical Therapeutics, "Alexandra" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Hector Anninos
- Department of Clinical Therapeutics, "Alexandra" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Tampakis
- Department of Clinical Therapeutics, "Alexandra" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Marinos Kosmopoulos
- Department of Clinical Therapeutics, "Alexandra" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis Vasileiou
- Department of Clinical Therapeutics, "Alexandra" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Kanakakis
- Department of Clinical Therapeutics, "Alexandra" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Paraskevaidis
- Department of Clinical Therapeutics, "Alexandra" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Sofia Chatzidou
- Department of Clinical Therapeutics, "Alexandra" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Aizawa Y, Takatsuki S, Kaneko Y, Noda T, Katsumata Y, Nishiyama T, Kimura T, Nishiyama N, Fukumoto K, Niwano S, Kurita T, Mitsuhashi T, Kamakura S, Shimizu A, Horie M, Aizawa Y, Fukuda K. Comparison of circadian, weekly, and seasonal variations of electrical storms and single events of ventricular fibrillation in patients with Brugada syndrome. Int J Cardiol Heart Vasc 2016; 11:104-10. [PMID: 28616534 DOI: 10.1016/j.ijcha.2016.05.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 05/02/2016] [Indexed: 02/07/2023]
Abstract
In patients with Brugada syndrome (BS), VF occurred predominantly during the nocturnal period. Some patients also developed ESs. In addition to the circadian rhythm, patients showed weekly and seasonal patterns. The patients with ESs had peak episodes of VF on Saturday and in the winter and spring, while episodes of VF in patients with single VF events occurred most often on Monday with smaller seasonal variation. Except for age, there was no difference in the clinical or ECG characteristics between the patients with ESs and those with single VF episodes.
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Key Words
- BS, Brugada syndrome
- Brugada syndrome
- CRBBB, complete right bundle branch block
- ECG, electrocardiogram
- ES, electrical storm
- Electrical storm
- ICD, implantable cardioverter defibrillator
- IVF, idiopathic ventricular fibrillation
- MRI, magnetic resonance imaging
- Rhythmicity
- SD, standard deviation
- Sudden death
- VF, ventricular fibrillation
- VT, ventricular tachycardia
- Ventricular fibrillation
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Suzuki A, Yoshida A, Takei A, Fukuzawa K, Kiuchi K, Takami K, Itoh M, Imamura K, Fujiwara R, Nakanishi T, Yamashita S, Matsumoto A, Shimane A, Okajima K, Hirata KI. Prophylactic catheter ablation of ventricular tachycardia before cardioverter-defibrillator implantation in patients with non-ischemic cardiomyopathy: Clinical outcomes after a single endocardial ablation. J Arrhythm 2015; 31:122-9. [PMID: 26336545 DOI: 10.1016/j.joa.2014.09.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Revised: 08/27/2014] [Accepted: 09/05/2014] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Outcomes related to prophylactic catheter ablation (PCA) for ventricular tachycardia (VT) before implantable cardioverter-defibrillator (ICD) implantation in non-ischemic cardiomyopathy (NICM) are not well characterized. We assessed the efficacy of single endocardial PCA in NICM patients. METHODS We retrospectively analyzed 101 consecutive NICM patients with sustained VT. We compared clinical outcomes of patients who underwent PCA (ABL group) with those who did not (No ABL group). Successful PCA was defined as no inducible clinical VT. We also compared the clinical outcomes of patients with successful PCA (PCA success group) with those of the No ABL group. Endpoints were appropriate ICD therapy (shock and anti-tachycardia pacing) and the occurrence of electrical storm (ES). RESULTS PCA was performed in 42 patients, and it succeeded in 20. The time to ES occurrence was significantly longer in the ABL group than in the No ABL group (p=0.04). The time to first appropriate ICD therapy and ES occurrence were significantly longer in the PCA success group than in the No ABL group (p=0.02 and p<0.01, respectively). CONCLUSION Single endocardial PCA can decrease ES occurrence in NICM patients. However, high rates of VT recurrence and low success rates are issues to be resolved; therefore, the efficacy of single endocardial PCA is currently limited.
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Affiliation(s)
- Atsushi Suzuki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akihiro Yoshida
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan ; Section of Arrhythmia, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Asumi Takei
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Koji Fukuzawa
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan ; Section of Arrhythmia, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kunihiko Kiuchi
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kaoru Takami
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Mitsuaki Itoh
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kimitake Imamura
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ryudo Fujiwara
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tomoyuki Nakanishi
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Soichiro Yamashita
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akinori Matsumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akira Shimane
- Division of Cardiovascular Medicine, Hyogo Brain and Heart Center, Himeji, Japan
| | - Katsunori Okajima
- Division of Cardiovascular Medicine, Hyogo Brain and Heart Center, Himeji, Japan
| | - Ken-Ichi Hirata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan ; Section of Arrhythmia, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
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