Kachboura S, Ben Halima A, Ben Miled M
Unité de recherche scientifique UR0904, service de cardiologie, CHU Abderrahmane Mami, Ariana, Tunisia.
Ann Cardiol Angeiol (Paris). 2010 Feb;59(1):54-8. doi: 10.1016/j.ancard.2009.07.010. Epub 2009 Aug 19.
Electrical storm in patients with implantable cardioverter defibrillator (ICDs) is a rhythmic emergency which can be immediately lethal. It occurs especially in patients with an advanced cardiomyopathy. Such arrhythmias predictor factors and triggers are rarely found. We report the case of a 73-year-old man with ischemic dilated cardiomyopathy, who underwent a complete surgical revascularisation six years ago. In 2003, this patient was hospitalised in cardiology because of a sustained ventricular tachycardia reduced by electrical shock. Because of the aggravation of the heart failure with a NYHA functional class III, electrical and echocardiographic criteria of ventricular dyssynchrony, a biventricular ICD was implanted. Three years after, the patient was hospitalized because of an electrical storm with 96 appropriate shocks. A severe hypokaliemia was the cause of this electrical storm, and the evolution was favourable after correction of the hypokaliemia. Hypokaliemia is rarely the trigger of such arrhythmias, it represents only 3 % of the causes. Its prevalence may be underestimated especially in patients with heart failure who receive high doses of diuretics.
植入式心脏复律除颤器（ICD）患者发生电风暴是一种节律性急症，可即刻致命。它尤其多见于晚期心肌病患者。此类心律失常的预测因素和触发因素鲜有发现。我们报告一例73岁患有缺血性扩张型心肌病的男性患者，其六年前接受了完全性外科血运重建术。2003年，该患者因持续性室性心动过速接受电击转复而入住心内科。由于心力衰竭加重，纽约心脏病协会（NYHA）心功能分级为Ⅲ级，且存在心室不同步的电学及超声心动图标准，遂植入双心室ICD。三年后，该患者因发生电风暴接受了96次恰当电击而住院。严重低钾血症是此次电风暴的病因，低钾血症纠正后病情转好。低钾血症很少是此类心律失常的触发因素，仅占病因的3%。其发生率可能被低估，尤其在接受大剂量利尿剂治疗的心力衰竭患者中。
