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Case Reports
. 2023 Aug 14;15(8):e43450.
doi: 10.7759/cureus.43450. eCollection 2023 Aug.

Post-Myocardial Revascularization: As a Nidus for an Electrical Storm!

Najlaa Belharty  1 , Tanae El Ghali  1 , Selma Siagh  1 , Zakaria Choho  1 , Fatima Azzahra Benmessaoud  2 , Ibtissam Fellat  1 , Latifa Oukerraj  1 , Mohamed Cherti  1
Affiliations
Case Reports

Post-Myocardial Revascularization: As a Nidus for an Electrical Storm!

Najlaa Belharty et al. Cureus. .

Abstract

Electrical storm (ES) is a critical and potentially life-threatening cardiac rhythm disorder. It is characterized by the presence of three or more distinct episodes of sustained ventricular tachycardia (VT) or ventricular fibrillation (VF) that necessitate appropriate termination. ES may occur in the setting of acute myocardial infarction or following myocardial reperfusion. An urgent treatment approach is necessary for better outcomes. We represent a case of a 64-year-old patient who presented with sudden chest pain and an episode of palpitations related to non-ST elevation myocardial infarction (NSTEMI), who has undergone percutaneous coronary intervention of the stenotic epicardial artery, but subsequently experienced an ES in the absence of stent thrombosis. ES presented in the form of sustained monomorphic VT that required synchronous direct current cardioversion, anti-arrhythmic drugs, deep sedation, and endotracheal intubation with a favorable course, with the patient being discharged after 14 days hospital stay. The practitioner should be mindful of the potential occurrence of ES following myocardial revascularization and should tailor the management approach.

Keywords: electrical storm; myocardial revascularization; reperfusion injury; ventricular arrhythmias; ventricular tachycardia.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Electrocardiogram showing monomorphic ventricular tachycardia with a ventricular rate of 180 beats per minute
Figure 2
Figure 2. Electrocardiogrampost-electric cardioversion showing sinus rhythm at a rate of 75 beats per minute, with isolated monomorphic ventricular ectopic beats
Figure 3
Figure 3. A. Coronary angiography demonstrating staged lesions of proximal LAD artery, with a distal 90% stenosis (white arrow), followed by an aneurysmal portion (red arrow) and TIMI flow grade 2. B. Successful angioplasty of the LAD. C. Control coronary angiography showing no stent thrombosis and TIMI flow grade 3.
LAD, left anterior descending; TIMI, thrombolysis in myocardial infarction
See this image and copyright information in PMC

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