Gabriela Kaliská
Arrhythmic storm is a severe complication in patients with ICD. It is defined with at least 3 single episodes of ventricular tachycardia or fibrillation/24 hrs. It is manifested by multiple interventions of ICD. Trigger factors – acute ischemia, acute myocardial infarction, heart failure deterioration, hyperpyrexia, mineral disintegration and thyreotoxicosis – are found in 1/3 of afflicted patients. Older patients with left ventricle dysfunction and structural heart disease are at risk. Management is complex – it is therapy with beta blockers, amiodaron, rejecting of triggers and re-programming of ICD. Class I antiarrhythmics are rarely needed. Radiofrequent catheter ablation of substrate in ventricles can reduce the number of intervention of ICD. Non-pharmacological interventions are rarely needed.