The term "electrical storm" ( @entity15262 ) indicates a state of cardiac electrical instability manifested by several episodes of @entity1165 ( @entity1165 ) within a short time. In @entity1 with an @entity737 ( @entity737 ), @entity15262 is best defined as 3 appropriate VT detections in 24 h, treated by antitachycardia pacing, shock or eventually untreated but sustained in a VT monitoring zone. The number of @entity1457 and inappropriate detections are irrelevant for the definition. @entity15262 occurs in approximately 25% of @entity737 @entity1 within 3 years, with typically 5-55 individual @entity1165 within one storm. Potential triggers can be found in approximately 66% of @entity1 and include new/worsened @entity712 , changes in antiarrhythmic medication, context with other illness, @entity1642 , @entity294 , and @entity1371 . In most @entity1 , @entity15262 consists of monomorphic VT indicating the presence of reentry while ventricular fibrillation indicating @entity63 is rare. @entity15262 seems to have a low immediate mortality (1%) but frequently (50-80%) leads to hospitalization. Long-term prognostic implications of @entity15262 are unclear. The key intervention in @entity15262 is reduction of the elevated sympathetic tone by beta blockers and frequently @entity1245 . @entity2643 i.v. has also been successful and @entity38800 seems promising while class I antiarrhythmic drugs are usually unsuccessful. Substrate mapping and VT ablation may be useful in treatment and prevention of @entity15262 . Prevention of @entity15262 requires @entity737 programming systematically avoiding unnecessary @entity1457 (long VT detection, antitachycardia pacing where ever possible) which otherwise can fuel the sympathetic tone and prolong @entity15262 .

Electrical storm in XXXX with an implanted defibrillator: a matter of definition.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity2643 :: ('MESH:D000638', 'Chemical') :: ['Amiodarone'] @entity712 :: ('MESH:D006333', 'Disease') :: ['heart failure'] @entity1165 :: ('MESH:D017180', 'Disease') :: ['ventricular tachyarrhythmias', 'VTs'] @entity63 :: ('MESH:D007511', 'Disease') :: ['acute ischemia'] @entity15262 :: ('MESH:C566109', 'Disease') :: ['ES'] @entity1457 :: ('MESH:D012769', 'Disease') :: ['shocks'] @entity294 :: ('MESH:D003967', 'Disease') :: ['diarrhea'] @entity38800 :: ('MESH:C086123', 'Chemical') :: ['azimilide'] @entity737 :: ('MESH:D057873', 'Disease') :: ['ICD', 'implantable cardioverter defibrillator'] @entity1371 :: ('MESH:D007008', 'Disease') :: ['hypokalemia'] @entity1245 :: ('MESH:D001569', 'Chemical') :: ['benzodiazepines'] @entity1642 :: ('MESH:D015775', 'Disease') :: ['psychological stress']
@entity1 :: (9606,Species) :: ['patients']
