Episode 190: Electrical Storm

We discuss Electrical Storm (VT storm) and how to care for the very irritable heart.

Hosts:
Brian Gilberti, MD
Reed Colling, MD

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Background/Overview of VT:

• Definition: What makes it a storm 
  • Three or more sustained episodes of VF, VT, or appropriate ICD shocks in a 24-hour period
• Pathophysiology: Understanding the origin and mechanism
  • Sympathetic drive/adrenergic surge
  • Underlying pathology: Sodium channelopathies, infiltrative disease like cardiac sarcoidosis, etc.
• RF’s / trigger / population (reversible cause in ~25% of patients)
  • MI
  • Electrolyte Derangements (emphasis on potassium and magnesium)
  • New/worsening heart failure
  • Catecholamine Surge
  • Drugs (stimulants, cocaine, amphetamines, etc)
  • QT Prolongation