Podcast 669: VTach Storm

<p><strong>Contributor:  Gretchen Hinson, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Three episodes of ventricular tachycardia within 24 hours or two episodes back-to-back</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Treat with IV amiodarone and IV beta-blockers initially as well as IV lidocaine</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Correct underlying causes: </span></li> <li style="list-style: none; display: inline;"> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">IV magnesium for QT prolongation</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Replete potassium in hypokalemia</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Urgent revascularization in ischemia</span></li> </ul> </li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">For refractory vtach, urgent radiofrequency ablation or stellate ganglion block can be done</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Last resort is placing on the patient on ECMO</span></li> </ul> <p><strong>References</strong></p> <p><span style="font-weight: 400;">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</span></p> <p><span style="font-weight: 400;">Eifling M, Razavi M, Massumi A. The evaluation and management of electrical storm. Tex Heart Inst J. 2011;38(2):111-121.</span></p> <p><em><span style="font-weight: 400;">Summarized by John Spartz, MS3 </span></em></p> <p> </p> <p><span style="font-weight: 400;">The Emergency Medical Minute is excited to announce that we are now offering</span> <em><span style="font-weight: 400;">AMA PRA Category 1 credits™</span