Podcast 669: VTach Storm

Contributor: Gretchen Hinson, MD

Educational Pearls:

• Three episodes of ventricular tachycardia within 24 hours or two episodes back-to-back
• Treat with IV amiodarone and IV beta-blockers initially as well as IV lidocaine
• Correct underlying causes:
• • IV magnesium for QT prolongation
  • Replete potassium in hypokalemia
  • Urgent revascularization in ischemia
• For refractory vtach, urgent radiofrequency ablation or stellate ganglion block can be done
• Last resort is placing on the patient on ECMO

References

Muser D, Santangeli P, Liang JJ. Management of ventricular tachycardia storm in patients with structural heart disease. World J Cardiol. 2017;9(6):521-530. doi:10.4330/wjc.v9.i6.521

Eifling M, Razavi M, Massumi A. The evaluation and management of electrical storm. Tex Heart Inst J. 2011;38(2):111-121.

Summarized by John Spartz, MS3

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