Angiology: Open Access
Open Access

Abstract

Depression of Electrical Storm with Epinephrine

Betul Ozaltun*

Aim: Epinephrine infusions are often used in intensive care and cardiac surgical applications. Major hemodynamic responses to epinephrine have been described and include changes in vascular tone, heart rate and myocardial contractility. Arrhythmias seen in acute coronary syndromes and myocardial infarction cases are bradyarrhythmias and tachyarrhythmias. Case: A 78-year-old woman was admitted to our hospital due to emergency chest pain. The patient was hospitalized with coronary intensive care with myocardial infarction without ST elevation. The patient developed ventricular fibrillation (VF) in coronary intensive care unit and underwent coronary angiography in emergency conditions. The patient who entered VF three times during the procedure was defibrillated. In coronary intensive unite lots of VF occurred. Arrhythmia could not be controlled with routine medical treatment. It was seen that the patient's VF initiation was after ventricular extra systole (VES). RonT was evaluated as a phenomenon. Epinephrine 5mg was administered intravenously to the patient who had undergone uncontrolled arrhythmia. VF was controlled then. Discussion: Beta blockers, amiodarone, and nifekalant (a pure Ikr blocker) have been shown to be effective in suppressing ESs during an acute MI. There have been several reports in which a stellate ganglion block and renal sympathetic nerve ablation may have been effective in suppressing the ES. When an ES could not be suppressed by drug therapy and cardiac support devices, catheter ablation procedures have occasionally been applied to rescue patients. A ventricular premature complex (VPC) triggering polymorphic VT or VF is one of the targets of the ablation. We have not received any response to routine medical treatment in our own case. The adrenalin infusion has depressed ES by suppressing VES with tachycardia.