Podcast 669: VTach Storm

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Contributor: Gretchen Hinson, MD

Educational Pearls:

  • Three episodes of ventricular tachycardia within 24 hours or two episodes back-to-back
  • Treat with IV amiodarone and IV beta-blockers initially as well as IV lidocaine
  • Correct underlying causes:
    • IV magnesium for QT prolongation
    • Replete potassium in hypokalemia
    • Urgent revascularization in ischemia
  • For refractory vtach, urgent radiofrequency ablation or stellate ganglion block can be done
  • Last resort is placing on the patient on ECMO

References

Muser D, Santangeli P, Liang JJ. Management of ventricular tachycardia storm in patients with structural heart disease. World J Cardiol. 2017;9(6):521-530. doi:10.4330/wjc.v9.i6.521

Eifling M, Razavi M, Massumi A. The evaluation and management of electrical storm. Tex Heart Inst J. 2011;38(2):111-121.

Summarized by John Spartz, MS3

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