The electrical storm （ES） is defined as a state of electrical instability with three or more sustained ventricular arrhythmias （VAs） occurring within twenty-four hours, which needs intravenous antiarrhythmic medic...The electrical storm （ES） is defined as a state of electrical instability with three or more sustained ventricular arrhythmias （VAs） occurring within twenty-four hours, which needs intravenous antiarrhythmic medications and frequent defibrillation. Recently, radiofrequency catheter ablation evolved as a sole therapy to terminate ES in patients with ICD, and the survival has been reported to be improved with successful ablation during follow-up. In this review, we briefly summarize substrate mapping and substrate ablation strategy in patients with ES, and discuss the reason of recurrence after ablation.展开更多
Electrical storm, defined as 3 or more separate episodes of ventricular tachycardia or ventricular fibrillation within 24 hours, carries significant morbidity and mortality. These unstable ventricular arrhythmias have...Electrical storm, defined as 3 or more separate episodes of ventricular tachycardia or ventricular fibrillation within 24 hours, carries significant morbidity and mortality. These unstable ventricular arrhythmias have been described with a variety of conditions including ischemic heart disease, structural heart disease, and genetic conditions. While implantable cardioverter defibrillator implantation and ablation may be indicated and required, anti- arrhythmic medication remains an important adjunctive therapy for these persons.展开更多
Objective： To present a case of electrical storm （ES） in a female patient with rheumatic valve disease. Methods： A female patient with severe rheumatic valve disease suffered an unexpected ES. She received more th...Objective： To present a case of electrical storm （ES） in a female patient with rheumatic valve disease. Methods： A female patient with severe rheumatic valve disease suffered an unexpected ES. She received more than 50 electrical shocks for repeated cardiac arrests due to ES over 16 hours. Then she received beta-blocking agent treatment and had an operation of double valves replacement. Results： ES was suppressed by sympathetic blockade with beta-receptor blocker and finally disappeared after the double pathological valves had been replaced. Conclusion： Increased sympathetic activity plays an important role in the genesis of electrical storm and sympathetic blockade may effectively suppress ES. However, the most important thing in the treatment of ES is to identify and eliminate the underlying cause of ES.展开更多
Objective: to analyze the influence of routine nursing and nursing intervention on patients' self-care ability, emotion and quality of life by using grouping control theory, and to explore the practical applicatio...Objective: to analyze the influence of routine nursing and nursing intervention on patients' self-care ability, emotion and quality of life by using grouping control theory, and to explore the practical application value of nursing intervention. Methods: total sample selection: 54 cases;Sample selection time: June 2020-June 2021. All samples were taken from patients with electrical storm caused by implantable cardioverter-defibrillator receiving treatment in our hospital. The samples were randomly divided into two groups, and the study was conducted by grouping control method, namely, the control group (27 cases, routine nursing) and the observation group (27 cases, routine nursing intervention). The application effects of the two groups were compared. Results: the self-care ability score of the observation group was higher (P < 0.05). Before intervention, the comparison of emotional state between groups was P > 0.05;After treatment, the mood of both groups improved, and the index of the observation group was better, compared with P < 0.05. The quality of life score of the patients in the observation group was better than that of the other groups (P < 0.05). Conclusion: nursing intervention in patients with implantable cardioverter defibrillator electrical storm application effect is significant.展开更多
Electrical storm(ES) is a medical emergency characterized by repetitive episodes of sustained ventriculararrhythmias(VAs) in a limited amount of time(at least 3 within a 24-h period) leading to repeated appropriate im...Electrical storm(ES) is a medical emergency characterized by repetitive episodes of sustained ventriculararrhythmias(VAs) in a limited amount of time(at least 3 within a 24-h period) leading to repeated appropriate implantable cardioverter defibrillator therapies. The occurrence of ES represents a major turning point in the natural history of patients with structural heart disease being associated with poor short-and longterm survival particularly in those with compromised left ventricular ejection fraction(LVEF) that can develop hemodynamic decompensation and multi-organ failure. Management of ES is challenging with limited available evidence coming from small retrospective series and a substantial lack of randomized-controlled trials. In general, a multidisciplinary approach including medical therapies such as anti-arrhythmic drugs, sedation, as well as interventional approaches like catheter ablation, may be required. Accurate patient risk stratification at admission for ES is pivotal and should take into account hemodynamic tolerability of VAs as well as comorbidities like low LVEF, advanced NYHA class and chronic pulmonary disease. In high risk patients, prophylactic mechanical circulatory support with left ventricular assistance devices or extracorporeal membrane oxygenation should be considered as bridge to ablation and recovery. In the present manuscript we review the available strategies for management of ES and the evidence supporting them.展开更多
BACKGROUND Ventricular arrhythmia is a common type of arrhythmia observed in clinical practice.It is primarily characterized by premature ventricular contractions,ventricular tachycardia,and ventricular fibrillation.A...BACKGROUND Ventricular arrhythmia is a common type of arrhythmia observed in clinical practice.It is primarily characterized by premature ventricular contractions,ventricular tachycardia,and ventricular fibrillation.Abnormal formation or transmission of cardiac electrical impulses in patients affects cardiac ejection function.It may present with symptoms such as palpitations,dyspnea,chest discomfort,and reduced exercise tolerance.In severe cases,ventricular arrhy-thmia can even lead to death.Therefore,prompt treatment is very much essential upon diagnosis.The symptoms did not improve after previous conventional drugs and electrical defibrillation treatment,but the ventricular arrhythmia was prevented after the addition of nicorandil.CASE SUMMARY A 75-year-old female patient was admitted to the hospital because of intermittent chest tightness,shortness of breath for 10 days,and fainting once for 7 days.Combined with laboratory tests and auxiliary examination,the patient was tentatively diagnosed with coronary heart disease or arrhythmia-atrial fibrillation.After admission,the patient had intermittent ventricular arrhythmia,which was uncontrolled with lidocaine,defibrillation,and amiodarone.However,when she was treated with nicorandil,the ventricular arrhythmia stopped.Nicorandil mitigates the action potential duration by facilitating the opening of potassium ion channels,thereby regulating the likelihood of premature and delayed depolar-ization in two distinct phases and subsequently averting the onset of malignant ventricular arrhythmia.Nicorandil may inhibit ventricular arrhythmia by dilating coronary arteries,improving coronary microcirculation and reducing myocardial fibrosis.CONCLUSION option for inhibiting ventricular arrhythmias.展开更多
文摘The electrical storm （ES） is defined as a state of electrical instability with three or more sustained ventricular arrhythmias （VAs） occurring within twenty-four hours, which needs intravenous antiarrhythmic medications and frequent defibrillation. Recently, radiofrequency catheter ablation evolved as a sole therapy to terminate ES in patients with ICD, and the survival has been reported to be improved with successful ablation during follow-up. In this review, we briefly summarize substrate mapping and substrate ablation strategy in patients with ES, and discuss the reason of recurrence after ablation.
文摘Electrical storm, defined as 3 or more separate episodes of ventricular tachycardia or ventricular fibrillation within 24 hours, carries significant morbidity and mortality. These unstable ventricular arrhythmias have been described with a variety of conditions including ischemic heart disease, structural heart disease, and genetic conditions. While implantable cardioverter defibrillator implantation and ablation may be indicated and required, anti- arrhythmic medication remains an important adjunctive therapy for these persons.
文摘Objective： To present a case of electrical storm （ES） in a female patient with rheumatic valve disease. Methods： A female patient with severe rheumatic valve disease suffered an unexpected ES. She received more than 50 electrical shocks for repeated cardiac arrests due to ES over 16 hours. Then she received beta-blocking agent treatment and had an operation of double valves replacement. Results： ES was suppressed by sympathetic blockade with beta-receptor blocker and finally disappeared after the double pathological valves had been replaced. Conclusion： Increased sympathetic activity plays an important role in the genesis of electrical storm and sympathetic blockade may effectively suppress ES. However, the most important thing in the treatment of ES is to identify and eliminate the underlying cause of ES.
文摘Objective: to analyze the influence of routine nursing and nursing intervention on patients' self-care ability, emotion and quality of life by using grouping control theory, and to explore the practical application value of nursing intervention. Methods: total sample selection: 54 cases;Sample selection time: June 2020-June 2021. All samples were taken from patients with electrical storm caused by implantable cardioverter-defibrillator receiving treatment in our hospital. The samples were randomly divided into two groups, and the study was conducted by grouping control method, namely, the control group (27 cases, routine nursing) and the observation group (27 cases, routine nursing intervention). The application effects of the two groups were compared. Results: the self-care ability score of the observation group was higher (P < 0.05). Before intervention, the comparison of emotional state between groups was P > 0.05;After treatment, the mood of both groups improved, and the index of the observation group was better, compared with P < 0.05. The quality of life score of the patients in the observation group was better than that of the other groups (P < 0.05). Conclusion: nursing intervention in patients with implantable cardioverter defibrillator electrical storm application effect is significant.
文摘Electrical storm(ES) is a medical emergency characterized by repetitive episodes of sustained ventriculararrhythmias(VAs) in a limited amount of time(at least 3 within a 24-h period) leading to repeated appropriate implantable cardioverter defibrillator therapies. The occurrence of ES represents a major turning point in the natural history of patients with structural heart disease being associated with poor short-and longterm survival particularly in those with compromised left ventricular ejection fraction(LVEF) that can develop hemodynamic decompensation and multi-organ failure. Management of ES is challenging with limited available evidence coming from small retrospective series and a substantial lack of randomized-controlled trials. In general, a multidisciplinary approach including medical therapies such as anti-arrhythmic drugs, sedation, as well as interventional approaches like catheter ablation, may be required. Accurate patient risk stratification at admission for ES is pivotal and should take into account hemodynamic tolerability of VAs as well as comorbidities like low LVEF, advanced NYHA class and chronic pulmonary disease. In high risk patients, prophylactic mechanical circulatory support with left ventricular assistance devices or extracorporeal membrane oxygenation should be considered as bridge to ablation and recovery. In the present manuscript we review the available strategies for management of ES and the evidence supporting them.
文摘BACKGROUND Ventricular arrhythmia is a common type of arrhythmia observed in clinical practice.It is primarily characterized by premature ventricular contractions,ventricular tachycardia,and ventricular fibrillation.Abnormal formation or transmission of cardiac electrical impulses in patients affects cardiac ejection function.It may present with symptoms such as palpitations,dyspnea,chest discomfort,and reduced exercise tolerance.In severe cases,ventricular arrhy-thmia can even lead to death.Therefore,prompt treatment is very much essential upon diagnosis.The symptoms did not improve after previous conventional drugs and electrical defibrillation treatment,but the ventricular arrhythmia was prevented after the addition of nicorandil.CASE SUMMARY A 75-year-old female patient was admitted to the hospital because of intermittent chest tightness,shortness of breath for 10 days,and fainting once for 7 days.Combined with laboratory tests and auxiliary examination,the patient was tentatively diagnosed with coronary heart disease or arrhythmia-atrial fibrillation.After admission,the patient had intermittent ventricular arrhythmia,which was uncontrolled with lidocaine,defibrillation,and amiodarone.However,when she was treated with nicorandil,the ventricular arrhythmia stopped.Nicorandil mitigates the action potential duration by facilitating the opening of potassium ion channels,thereby regulating the likelihood of premature and delayed depolar-ization in two distinct phases and subsequently averting the onset of malignant ventricular arrhythmia.Nicorandil may inhibit ventricular arrhythmia by dilating coronary arteries,improving coronary microcirculation and reducing myocardial fibrosis.CONCLUSION option for inhibiting ventricular arrhythmias.
