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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

R. Lenarczyk, K. Zeppenfeld, J. Tfelt-Hansen, FR. Heinzel, T. Deneke, E. Ene, C. Meyer, A. Wilde, E. Arbelo, E. Jędrzejczyk-Patej, A. Sabbag, M. Stühlinger, L. di Biase, M. Vaseghi, O. Ziv, WF. Bautista-Vargas, S. Kumar, N. Namboodiri, BD. Henz,...

. 2024 ; 26 (4) : . [pub] 20240330

Language English Country England, Great Britain

Document type Journal Article

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.

Albert Einstein College of Medicine at Montefiore Hospital New York NY USA

Amsterdam Cardiovascular Sciences Heart Failure and arrhythmias Amsterdam the Netherlands

Arrhythmia and Robotic EP Unit Hospital Universitario La Paz Madrid Spain

Arrhythmia Section Cardiology Department Hospital Clínic Universitat de Barcelona Barcelona Spain

Asian Heart and Vascular Center Singapore Singapore

Cardiac Electrophysiology Fundacion CardioInfantil La Cardio Bogota Colombia

Cardiology Angiology Intensive Care Städtisches Klinikum Dresden Campus Friedrichstadt Dresden Germany

Cardiology University Hospital Rangueil Toulouse Toulouse France

Cardoilogy Department Mitera General Hospital Hygeia Group Athens Greece

Case Western Reserve University Cleveland OH USA

Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares Madrid Spain

Clinic for Electrophysiology Klinikum Nuernberg University Hospital of the Paracelsus Medical University Nuernberg Germany

Clinic for Interventional Electrophysiology Heart Center RHÖN KLINIKUM Campus Bad Neustadt Bad Neustadt an der Saale Germany

Department of Arrhythmias and Pacing National Institute of Cardiovascular Diseases and the Slovak Medical University School of Medicine Bratislava Slovakia

Department of Cardiology Amsterdam UMC University of Amsterdam Amsterdam the Netherlands

Department of Cardiology Congenital Heart Diseases and Electrotherapy Silesian Centre for Heart Diseases Zabrze Poland

Department of Cardiology Electrophysiology University of Münster Münster Germany

Department of Cardiology IKEM Prague Czech Republic

Department of Cardiology Leiden University Medical Center Leiden The Netherlands

Department of Cardiology University Hospital Nancy Vandoeuvre les Nancy France

Department of Cardiology Westmead Hospital Westmead Applied Research Centre University of Sydney Sydney Australia

Department of Cardiovascular Medicine Heart Vascular and Thoracic Institute Department of Quantitative Health Sciences Lerner Research Institute Cleveland Clinic Cardiology USA

Department of Cardiovascular Medicine Kyorin University Hospital Tokyo Japan

Department of Electrophysiology Great Metropolitan Hospital Niguarda Milan Italy

Department of Internal Medicine 3 Cardiology and Angiology Medical University of Innsbruck Innsbruck Austria

Division of Cardiology Angiology Intensive Care EVK Düsseldorf Teaching Hospital University of Düsseldorf Düsseldorf Germany

Division of Cardiology Cardiovascular Clinical Research Banner Heart Institute The University of Arizona College of Medicine Phoenix AZ USA

German Heart Center of the Charite Berlin Germany

Hospital São Vicente Rede Dor Department of Cardiology Federal University of Rio de Janeiro Rio de Janeiro Brazil

IDIBAPS Institut d'Investigació August Pi i Sunyer Barcelona Spain

Instituto Brasilia de Arritmias Hospital do Coração do Brasil Rede Dor São Luiz Brasilia Brazil

Medical University of Silesia Division of Medical Sciences Department of Cardiology and Electrotherapy Silesian Center for Heart Diseases Skłodowskiej Curie 9 41 800 Zabrze Poland

School of Medicine Faculty of Medical and Health Sciences Tel Aviv University Tel Aviv Israel

The Davidai Center for Rhythm Disturbances and Pacing Chaim Sheba Medical Center Tel Hashomer Israel

The Department of Cardiology The Heart Centre Copenhagen University Hospital Rigshospitalet Copenhagen Denmark

The Department of Forensic Medicine Copenhagen University Hospital Rigshospitalet Copenhagen Denmark

The MetroHealth System Campus Cleveland OH USA

UCLA Cardiac Arrythmia Center Division of Cardiology Department of Medicine University of California Los Angeles CA USA

University of Science and Technology Kochi Kerala India

References provided by Crossref.org

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$a 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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