Thoracic Epidural Anesthesia Can Be Effective for the Short-Term Management of Ventricular Tachycardia Storm

Journal of the American Heart Association
Duc H DoKalyanam Shivkumar

Abstract

Novel therapies aimed at modulating the autonomic nervous system, including thoracic epidural anesthesia (TEA), have been shown in small case series to be beneficial in treating medically refractory ventricular tachycardia (VT) storm. However, it is not clear when these options should be considered. We reviewed a multicenter experience with TEA in the management of VT storm to determine its optimal therapeutic use. Data for 11 patients in whom TEA was instituted for VT storm between July 2005 and March 2016 were reviewed to determine the clinical characteristics, outcomes, and role in management. The clinical presentation was incessant VT in 7 (64%), with polymorphic VT in 3 (27%) and monomorphic VT in 8 (73%). The underlying conditions were nonischemic cardiomyopathy in 5 (45%), ischemic cardiomyopathy in 3 (27%), and hypertrophic cardiomyopathy, Brugada syndrome, and cardiac lipoma in 1 (9%) each. Five (45%) had a complete and 1 (9%) had a partial response to TEA; 4 of the complete responders had incessant VT. All 4 patients with a documented response to deep sedation demonstrated a complete response to TEA. More than half of the patients with VT storm in our series responded to TEA. TEA may be effective and should be conside...Continue Reading

References

Sep 12, 1998·Annals of Internal Medicine·D J CookC Brun-Buisson
Apr 8, 1999·American Journal of Respiratory and Critical Care Medicine·D K HeylandC Brun-Buisson
Sep 1, 1961·The American Journal of Medicine·E H ESTES, H L IZLAR
May 4, 2004·Journal of the American College of Cardiology·Nassir F MarroucheAndrea Natale
Oct 11, 2005·Critical Care Medicine·Nasia SafdarSanjay Saint
Mar 15, 2006·Current Opinion in Anaesthesiology·Alf KozianThomas Hachenberg
May 9, 2008·The New England Journal of Medicine·Arthur A M WildePeter J Schwartz
May 16, 2009·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Etienne M AliotUNKNOWN Heart Rhythm Society
May 27, 2009·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Christopher A ColluraMichael J Ackerman
Jun 27, 2009·IEEE Transactions on Information Technology in Biomedicine : a Publication of the IEEE Engineering in Medicine and Biology Society·Dewar D FinlayRobert L Lux
Oct 1, 2011·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Christian UkenaMichael Böhm
Dec 24, 2011·Journal of the American College of Cardiology·Olujimi A AjijolaKalyanam Shivkumar
Feb 23, 2013·Basic Research in Cardiology·Yukiomi TsujiDobromir Dobrev
Apr 12, 2013·Journal of Cardiovascular Electrophysiology·Justin HayaseDavid E Krummen
Dec 3, 2013·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Marmar VaseghiKalyanam Shivkumar
Jan 7, 2014·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Benjamin F RemoTimm Dickfeld
Mar 13, 2014·Nature Reviews. Cardiology·Peter J Schwartz
Mar 15, 2014·Circulation Research·Mark J Shen, Douglas P Zipes
Aug 31, 2014·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Christian Torp PedersenIrene Savelieva
Apr 22, 2016·The Journal of Physiology·J L ArdellI H Zucker
Apr 27, 2016·The Journal of Physiology·Kalyanam ShivkumarDouglas P Zipes
Dec 27, 2016·Journal of Cardiovascular Electrophysiology·Marat FudimJonathan P Piccini
Mar 31, 2017·Anesthesiology·Kimberly Howard-QuijanoAman Mahajan

❮ Previous
Next ❯

Citations

Feb 9, 2020·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Simone SavastanoGaetano Maria De Ferrari
Mar 21, 2020·European Heart Journal. Acute Cardiovascular Care·Johan S BundgaardHenning Bundgaard
Dec 28, 2018·Arrhythmia & Electrophysiology Review·Pok Tin TangNoel G Boyle
Sep 29, 2020·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Gurukripa N Kowlgi, Yong-Mei Cha
Sep 14, 2019·Circulation. Arrhythmia and Electrophysiology·Ying TianYong-Mei Cha
Jul 29, 2019·Current Cardiology Reports·Christos KontogiannisSofia Chatzidou
Oct 25, 2020·Current Hypertension Reports·Arun GaneshMarat Fudim
Mar 7, 2019·American Journal of Therapeutics·Dragos CozmaLaszlo Geller
Jan 9, 2020·Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine·Jahagirdar AshwiniDate Girish
Jun 4, 2021·Circulation Journal : Official Journal of the Japanese Circulation Society·Akihiko NogamiUNKNOWN JCS/JHRS Joint Working Group
May 30, 2021·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Neal A Chatterjee, Jagmeet P Singh
Aug 2, 2021·Progress in Cardiovascular Diseases·Ihab Elsokkari, John L Sapp
Aug 14, 2021·Journal of Arrhythmia·Akihiko NogamiUNKNOWN JCS/JHRS Joint Working Group
Oct 1, 2021·Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society·Valerie Y H van WeperenOlujimi A Ajijola
Dec 3, 2021·International Heart Journal·Kunihiro Kani, Katsuhito Fujiu
Dec 4, 2021·American Journal of Physiology. Heart and Circulatory Physiology·Joseph HadayaJeffrey L Ardell

❮ Previous
Next ❯

Methods Mentioned

BETA
sedation

Related Concepts

Related Feeds

Brain Ischemia

Brain ischemia is a condition in which there is insufficient blood flow to the brain to meet metabolic demand. Discover the latest research on brain ischemia here.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Cardiomyopathy

Cardiomyopathy is a disease of the heart muscle, that can lead to muscular or electrical dysfunction of the heart. It is often an irreversible disease that is associated with a poor prognosis. There are different causes and classifications of cardiomyopathies. Here are the latest discoveries pertaining to this disease.

Cardiac Regeneration

Cardiac regeneration enables the repair of irreversibly damaged heart tissue using cutting-edge science, including stem cell and cell-free therapy. Discover the latest research on cardiac regeneration here.

Related Papers

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
Stefano BordignonBoris Schmidt
Heart Rhythm : the Official Journal of the Heart Rhythm Society
Aman MahajanKalyanam Shivkumar
Giornale italiano di cardiologia : organo ufficiale della Federazione italiana di cardiologia : organo ufficiale della Società italiana di chirurgia cardiaca
Attilio Del RossoPaolo Bartoli
Circulation. Arrhythmia and Electrophysiology
William G Stevenson, Gregory S Couper
© 2022 Meta ULC. All rights reserved