Department of Internal Medicine and Hypertension, Medical University of Białystok, Białystok, Poland.
Department of Invasive Cardiology, Medical University of Białystok, Białystok, Poland.
Am J Case Rep. 2022 Jun 14;23:e935710. doi: 10.12659/AJCR.935710.
BACKGROUND Ventricular electrical storm (VES) is a treatment-resistant ventricular arrhythmia associated with high mortality. This report is of a 39-year-old woman with VES treated with emergency cardiac defibrillation followed by multidisciplinary management. CASE REPORT A 39-year-old woman, previously diagnosed with eosinophilia of unknown origin and recurrent non-sustained ventricular tachycardias, was admitted to the Department of Invasive Cardiology with VES after an initial antiarrhythmic approach, analgesia, and defibrillation in the Emergency Department. The patient had a temporary pacing wire implanted, but overdrive therapy was not successful. The medical treatment and multiple defibrillations did not stop the arrythmia. Due to the hemodynamic instability, extracorporeal membrane oxygenation (ECMO) was performed at the Department of Cardiac Surgery. Consequently, the patient was stabilized and an electrophysiology exam and RF ablation of arrhythmogenic focus were conducted in the Department of Cardiology. One day after the procedure, the patient had pulmonary edema caused by pericardial tamponade. The patient was successfully operated on in the Department of Cardiac Surgery. Then, the next complication appeared - a femoral artery embolism - which was treated in the Department of Vascular Surgery. After patient stabilization and exclusion of serious neurological damage, an implantable cardioverter-defibrillator (ICD) was implanted for secondary prevention of sudden cardiac death (SCD). CONCLUSIONS This case has shown the importance of the rapid diagnosis of VES and emergency management with cardiac defibrillation. Multidisciplinary clinical follow-up is required to investigate and treat any reversible causes and to ensure long-term stabilization of cardiac rhythm.
电风暴（VES）是一种与高死亡率相关的治疗抵抗性室性心律失常。本报告介绍了一位 39 岁女性，因 VES 接受紧急心脏除颤治疗，并通过多学科管理进行治疗。
一位 39 岁女性，先前被诊断为原因不明的嗜酸性粒细胞增多症和反复非持续性室性心动过速，在急诊科接受初始抗心律失常治疗、镇痛和除颤后，因 VES 被收入心内科。患者植入了临时起搏导线，但超速治疗无效。药物治疗和多次除颤未能终止心律失常。由于血流动力学不稳定，在心脏外科行体外膜氧合（ECMO）。随后，患者病情稳定，在心血管科行电生理检查和致心律失常病灶射频消融术。术后 1 天，患者发生心包填塞引起的肺水肿。在心脏外科成功进行了手术。随后，出现了新的并发症——股动脉栓塞，在血管外科进行了治疗。在患者稳定并排除严重神经损伤后，植入了植入式心律转复除颤器（ICD），以预防心脏性猝死（SCD）的二次发生。
本病例表明快速诊断 VES 和紧急心脏除颤治疗的重要性。需要多学科临床随访，以调查和治疗任何可逆转的病因，并确保心脏节律的长期稳定。
