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Electrical storm refractory multiple antiarrhythmic medications was stopped by interatrial shunting procedure—A case report

Electrical storm (ES) remains a major dilemma for clinicians, often presenting as a medical emergency associated with significant adverse outcomes. The mechanisms behind triggering ES are complex. Although the increased activation of the sympathetic nervous system was widely accepted as a major mech...

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Autores principales: Han, Caiping, Qiu, Rujie, Li, Lei, Han, Min, Xu, Chengyi, Liu, Li, Liu, Chengwei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9714305/
https://www.ncbi.nlm.nih.gov/pubmed/36465460
http://dx.doi.org/10.3389/fcvm.2022.1012916
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author Han, Caiping
Qiu, Rujie
Li, Lei
Han, Min
Xu, Chengyi
Liu, Li
Liu, Chengwei
author_facet Han, Caiping
Qiu, Rujie
Li, Lei
Han, Min
Xu, Chengyi
Liu, Li
Liu, Chengwei
author_sort Han, Caiping
collection PubMed
description Electrical storm (ES) remains a major dilemma for clinicians, often presenting as a medical emergency associated with significant adverse outcomes. The mechanisms behind triggering ES are complex. Although the increased activation of the sympathetic nervous system was widely accepted as a major mechanism in initiating and maintaining ES, it's thought that the interaction between mechanical and electrical substrates may play an important role in some situations. Here we present a case of ES that was refractory to multiple antiarrhythmic medications but was stopped by interatrial shunting. We aim to highlight the importance of mechano-electric feedback (MEF) as the pathophysiological mechanisms of some types of ES and the utility of interatrial shunting as an alternative therapeutic strategy for patients with ES initially refractory to antiarrhythmic medications when there is evidence to indicate increased left ventricular filling pressure or left atrial pressure.
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spelling pubmed-97143052022-12-02 Electrical storm refractory multiple antiarrhythmic medications was stopped by interatrial shunting procedure—A case report Han, Caiping Qiu, Rujie Li, Lei Han, Min Xu, Chengyi Liu, Li Liu, Chengwei Front Cardiovasc Med Cardiovascular Medicine Electrical storm (ES) remains a major dilemma for clinicians, often presenting as a medical emergency associated with significant adverse outcomes. The mechanisms behind triggering ES are complex. Although the increased activation of the sympathetic nervous system was widely accepted as a major mechanism in initiating and maintaining ES, it's thought that the interaction between mechanical and electrical substrates may play an important role in some situations. Here we present a case of ES that was refractory to multiple antiarrhythmic medications but was stopped by interatrial shunting. We aim to highlight the importance of mechano-electric feedback (MEF) as the pathophysiological mechanisms of some types of ES and the utility of interatrial shunting as an alternative therapeutic strategy for patients with ES initially refractory to antiarrhythmic medications when there is evidence to indicate increased left ventricular filling pressure or left atrial pressure. Frontiers Media S.A. 2022-11-17 /pmc/articles/PMC9714305/ /pubmed/36465460 http://dx.doi.org/10.3389/fcvm.2022.1012916 Text en Copyright © 2022 Han, Qiu, Li, Han, Xu, Liu and Liu. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Han, Caiping
Qiu, Rujie
Li, Lei
Han, Min
Xu, Chengyi
Liu, Li
Liu, Chengwei
Electrical storm refractory multiple antiarrhythmic medications was stopped by interatrial shunting procedure—A case report
title Electrical storm refractory multiple antiarrhythmic medications was stopped by interatrial shunting procedure—A case report
title_full Electrical storm refractory multiple antiarrhythmic medications was stopped by interatrial shunting procedure—A case report
title_fullStr Electrical storm refractory multiple antiarrhythmic medications was stopped by interatrial shunting procedure—A case report
title_full_unstemmed Electrical storm refractory multiple antiarrhythmic medications was stopped by interatrial shunting procedure—A case report
title_short Electrical storm refractory multiple antiarrhythmic medications was stopped by interatrial shunting procedure—A case report
title_sort electrical storm refractory multiple antiarrhythmic medications was stopped by interatrial shunting procedure—a case report
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9714305/
https://www.ncbi.nlm.nih.gov/pubmed/36465460
http://dx.doi.org/10.3389/fcvm.2022.1012916
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