• Sean Dyer, Benjamin Mogni, and Michael Gottlieb.
• Department of Emergency Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, United States of America. Electronic address: sdyer2@cookcountyhhs.org.
• Am J Emerg Med. 2020 Jul 1; 38 (7): 1481-1487.

BackgroundElectrical storm is a dangerous condition presenting to the Emergency Department that requires rapid diagnosis and management.ObjectiveThis article provides a review of the diagnosis and management of electrical storm for the emergency clinician.DiscussionElectrical storm is defined as ≥3 episodes of sustained ventricular tachycardia, ventricular fibrillation, or shocks from an implantable cardioverter defibrillator within 24 h. Patients may present with a wide array of symptoms. Initial evaluation should include an electrocardiogram with a rhythm strip and continuous cardiac monitoring, a medication history, assessment of hemodynamic stability, and identification of potential triggers. Management includes an antiarrhythmic and a beta blocker. Refractory patients may benefit from double-sequential defibrillation or more invasive procedures such as intra-aortic balloon pumps, catheter ablation and extracorporeal membrane oxygenation for critically ill patients. These patients will typically require admission to an intensive care unit.ConclusionElectrical storm is a condition associated with significant morbidity and mortality. It is important for clinicians to be aware of the current evidence regarding the evaluation and management of these patients.Copyright © 2020 Elsevier Inc. All rights reserved.

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