Catheter ablation in the treatment of electrical storm: Integrative review

Abstract

Background: The incidence of electrical storm (ES) has been increasing with the rise of the indicated uses of implantable cardioverter defibrillators (ICDs). It is estimated that 20% of patients will evolve to have this complication. Ablative therapy stands out as the treatment for this condition when it is refractory to antiarrhythmic treatment. The objective was to define the current role of catheter ablation in the treatment of electrical storm. Methods: An integrative literature review was performed using the PubMed and BVS databases. All identified articles were screened and verified for eligibility by the authors. Results: Twenty-five out of the initial 951 articles were used in the final analysis. The categories listed for analysis included indication for ablation in ES, modality of the approach, therapeutic success, complications related to the procedure, mortality and cardiovascular follow-up and alternative therapeutic modalities by frequency of these categories in the articles researched. Conclusion: Catheter ablation is the initial therapy for patients with ischemic cardiomyopathy (ICM) and ES. The endocardial approach presents more relevant success rates than the other therapeutic methods presented.

Keywords

• Electrical storm
• Arrhythmogenic storm
• Catheter ablation