24 hours, with an overall reduction in VT burden of 92 percent over the initial 72 hours [50]. A study of 11 patients who underwent an SGB for electrical storm followed patients for sustained cessation of electrical storm for 24 hours. Cessation of electrical storm for 24 hours was achieved in 90 percent of patients after left SGB. Similarly, 90 percent of patients had no documented episodes of ventricular arrhythmias requiring intervention within six hours after SGB [49]. In a first-in-man case series, transcutaneous magnetic stimulation of the left stellate ganglion significantly reduced episodes of VT and shocks for 48 to 72 hours in five patients with VT storm [51]. SGB is a temporizing measure, and terminal sympathectomy via surgical cardiac sympathetic denervation (CSD) or orthotopic heart transplantation may be needed for eligible non-responders in whom other treatments have also failed. CSD, with one series suggesting bilateral CSD, is more efficacious than isolated left CSD [5,39-41,43,45,52-54]. https://www.uptodate.com/contents/electrical-storm-and-incessant-ventricular-tachycardia/print 12/24 7/6/23, 3:26 PM Electrical storm and incessant ventricular tachycardia - UpToDate Cardiac transplantation. (See "Heart transplantation in adults: Indications and contraindications", section on 'Indications for transplantation'.) Renal artery denervation (RDN), with one small series of four patients showing marked decrease in the frequency of VT episodes following RDN [55,56]. In a study of five patients with refractory VT, stereotactic body radiation therapy reduced the number of VT episodes by 99.9 percent, although the benefit was not quite as significant in a second study of 10 patients (88 percent reduction in VT) [57,58]. PROGNOSIS Electrical storm is generally associated with poor outcomes, with most studies reporting an association between electrical storm and cardiovascular mortality [7,10,15]. As examples: In the AVID trial, electrical storm was a significant independent risk factor for cardiac, non- sudden death (relative risk 2.4), which occurred most frequently within three months [7]. The MADIT II trial found that patients with electrical storm had a 7.4-fold higher risk of death when compared with those without electrical storm, with a 17.8-fold increased risk of death within the first three months after storm onset [8]. What is not clear is whether the ventricular tachyarrhythmias or repeated implantable cardioverter-defibrillator (ICD) shocks themselves contribute to cardiac mortality or are secondary to a degenerating cardiac status. A potential mechanism was suggested by the experimental observation that recurrent ventricular fibrillation (VF) results in increases in intracellular calcium concentrations which might contribute to deterioration of left ventricular systolic function [59,60]. Additionally, repeated shocks can cause myocardial injury leading to acute inflammation and fibrosis [61-63]. Lastly, myocardial injury or stunning from recurrent defibrillations may activate the neurohormonal cascade responsible for worsening heart failure and cardiovascular mortality [28,64,65]. Additional studies are needed to clarify these issues. Electrical storm, particularly when associated with repeated ICD discharges, may induce long- term anxiety that impacts overall health-related quality of life [6,10,11,13,66]. (See "Cardiac implantable electronic devices: Long-term complications", section on 'Quality of life'.) SOCIETY GUIDELINE LINKS https://www.uptodate.com/contents/electrical-storm-and-incessant-ventricular-tachycardia/print 13/24 7/6/23, 3:26 PM Electrical storm and incessant ventricular tachycardia - UpToDate Links to society and government-sponsored guidelines from selected countries and regions around the world are provided separately. (See "Society guideline links: Arrhythmias in adults" and "Society guideline links: Cardiac implantable electronic devices" and "Society guideline links: Ventricular arrhythmias" and "Society guideline links: Catheter ablation of arrhythmias".) INFORMATION FOR PATIENTS UpToDate offers two types of patient education materials, "The Basics" and "Beyond the Basics." th th The Basics patient education pieces are written in plain language, at the 5 to 6 grade reading level, and they answer the four or five key questions a patient might have about a given condition. These articles are best for patients who want a general overview and who prefer short, easy-to-read materials. Beyond the Basics patient education pieces are longer, more th th sophisticated, and more detailed. These articles are written at the 10 to 12 grade reading level and are best for patients who want in-depth information and are comfortable with some medical jargon. Here are the patient education articles that are relevant to this topic. We encourage you to print or e-mail these topics to your patients. (You can also locate patient education articles on a variety of subjects by searching on "patient info" and the keyword(s) of interest.) Basics links (see "Patient education: Ventricular tachycardia (The Basics)") SUMMARY AND RECOMMENDATIONS Electrical storm, also referred to as arrhythmic storm, refers to multiple recurrences of ventricular arrhythmias over a short period of time, while incessant ventricular tachycardia (VT) is defined as hemodynamically stable VT which persists for hours. In most instances, the arrhythmia is monomorphic VT, but polymorphic VT and ventricular fibrillation (VF) can also result in electrical storm. The definition of electrical storm is different in patients with and without an implantable cardioverter-defibrillator (ICD). (See 'Definition' above.) Common triggers of electrical storm or incessant VT include drug toxicity, electrolyte disturbances, new or worsened heart failure, and acute myocardial ischemia, although a single inciting factor is not identified in the majority of patients. (See 'Triggers of electrical storm' above.) The clinical presentations of electrical storm and incessant are highly variable but rarely if ever asymptomatic. (See 'Clinical presentation' above.) https://www.uptodate.com/contents/electrical-storm-and-incessant-ventricular-tachycardia/print 14/24 7/6/23, 3:26 PM Electrical storm and incessant ventricular tachycardia - UpToDate In patients without an ICD, the range of clinical presentations due to electrical storm spans from relatively minor symptoms such as repeated episodes of palpitations, presyncope, or syncope if the patient remains hemodynamically stable to cardiac arrest in those patients with hemodynamically unstable ventricular arrhythmias. In patients with a preexisting ICD, electrical storm typically presents with multiple ICD therapies (some combination of anti-tachycardia pacing and ICD shocks depending on how the device is programmed to deliver therapy). However, patients with ventricular arrhythmias that are slower than the detection settings of the ICD may present in similar fashion as patients without an ICD. The diagnosis of electrical storm is made when a patient has three or more confirmed episodes of ventricular tachyarrhythmia resulting in symptoms or ICD therapy within a 24- hour period. Typically, the episodes of arrhythmia are confirmed using continuous telemetry monitoring or by reviewing stored intracardiac electrograms from a patient's ICD. The diagnosis of incessant VT is made by confirming the presence of continuous VT for greater than one hour. (See 'Diagnosis' above.) The initial treatment approach to patients with electrical storm or incessant VT is based on hemodynamic stability or instability. Patients with hemodynamically unstable ventricular arrhythmias should initially undergo electrical cardioversion according to advanced cardiac life support protocol ( algorithm 1). (See "Advanced cardiac life support (ACLS) in adults", section on 'Pulseless ventricular tachycardia and ventricular fibrillation'.) Patients with electrical storm or incessant VT who are hemodynamically stable should be treated with both intravenous (IV) antiarrhythmic therapy and a beta blocker. We recommend IV amiodarone, rather than lidocaine, procainamide, or no antiarrhythmic drug, as the initial antiarrhythmic agent given its superior efficacy for terminating most ventricular arrhythmias (Grade 1B). Amiodarone should be given as 150 mg IV over 10 minutes, followed by 1 mg/minute IV infusion for 6 hours, followed by 0.5 mg/minute IV infusion for 18 additional hours. We recommend the nonselective beta blocker propranolol rather than a beta-1 selective beta blocker because of its increased efficacy in terminating VT (Grade 1B). Propranolol should be given as 40 mg oral doses every 6 hours for the first 48 hours, with additional IV doses as needed for recurrent breakthrough ventricular arrhythmias. (See 'Initial management' above.) https://www.uptodate.com/contents/electrical-storm-and-incessant-ventricular-tachycardia/print 15/24 7/6/23, 3:26 PM Electrical storm and incessant ventricular tachycardia - UpToDate For patients with electrical storm or incessant VT in whom active myocardial ischemia is felt to be a contributing factor, urgent coronary revascularization should be pursued. (See "Overview of the acute management of non-ST-elevation acute coronary syndromes" and "Overview of the acute management of ST-elevation myocardial infarction".) The subsequent management of patients with electrical storm or incessant VT is focused on the prevention of recurrent ventricular tachyarrhythmias. For patients with electrical storm or incessant VT that persists or recurs in spite of medical therapy with amiodarone and a beta blocker, we recommend catheter ablation (Grade 1B). (See 'Catheter ablation' above.) Most patients will require at least a short course of maintenance antiarrhythmic therapy. (See 'Maintenance antiarrhythmic therapy' above.) Patients should also receive medical therapy aimed at the likely underlying cardiac pathology (eg, beta blockers and ACE-inhibitors in patients with heart failure and cardiomyopathy, anti-thrombotic and anti-ischemic therapy for patients with myocardial ischemia). (See 'Condition-specific therapies' above.) Use of UpToDate is subject to the Terms of Use. REFERENCES 1. Kowey PR. An overview of antiarrhythmic drug management of electrical storm. Can J Cardiol 1996; 12 Suppl B:3B. 2. Israel CW, Barold SS. Electrical storm in patients with an implanted defibrillator: a matter of definition. Ann Noninvasive Electrocardiol 2007; 12:375. 3. Kowey PR, Levine JH, Herre JM, et al. Randomized, double-blind comparison of intravenous amiodarone and bretylium in the treatment of patients with recurrent, hemodynamically destabilizing ventricular tachycardia or fibrillation. The Intravenous Amiodarone Multicenter Investigators Group. Circulation 1995; 92:3255. 4. Hariman RJ, Hu DY, Gallastegui JL, et al. Long-term follow-up in patients with incessant ventricular tachycardia. Am J Cardiol 1990; 66:831. 5. Al-Khatib SM, Stevenson WG, Ackerman MJ, et al. 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association https://www.uptodate.com/contents/electrical-storm-and-incessant-ventricular-tachycardia/print 16/24 7/6/23, 3:26 PM Electrical storm and incessant ventricular tachycardia - UpToDate Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol 2018; 72:e91. 6. Credner SC, Klingenheben T, Mauss O, et al. Electrical storm in patients with transvenous implantable cardioverter-defibrillators: incidence, management and prognostic implications. J Am Coll Cardiol 1998; 32:1909. 7. Exner DV, Pinski SL, Wyse DG, et al. Electrical storm presages nonsudden death: the antiarrhythmics versus implantable defibrillators (AVID) trial. Circulation 2001; 103:2066. 8. Sesselberg HW, Moss AJ, McNitt S, et al. Ventricular arrhythmia storms in postinfarction patients with implantable defibrillators for primary prevention indications: a MADIT-II substudy. Heart Rhythm 2007; 4:1395. 9. Haegeli LM, Della Bella P, Brunckhorst CB. Management of a Patient With Electrical Storm: Role of Epicardial Catheter Ablation. Circulation 2016; 133:672. 10. Gatzoulis KA, Andrikopoulos GK, Apostolopoulos T, et al. Electrical storm is an independent predictor of adverse long-term outcome in the era of implantable defibrillator therapy. Europace 2005; 7:184. 11. B nsch D, B cker D, Brunn J, et al. Clusters of ventricular tachycardias signify impaired survival in patients with idiopathic dilated cardiomyopathy and implantable cardioverter defibrillators. J Am Coll Cardiol 2000; 36:566. 12. Stuber T, Eigenmann C, Delacr taz E. Characteristics and relevance of clustering ventricular arrhythmias in defibrillator recipients. Pacing Clin Electrophysiol 2005; 28:702. 13. Hohnloser SH, Al-Khalidi HR, Pratt CM, et al. Electrical storm in patients with an implantable defibrillator: incidence, features, and preventive therapy: insights from a randomized trial. Eur Heart J 2006; 27:3027. 14. Arya A, Haghjoo M, Dehghani MR, et al. Prevalence and predictors of electrical storm in patients with implantable cardioverter-defibrillator. Am J Cardiol 2006; 97:389. 15. Verma A, Kilicaslan F, Marrouche NF, et al. Prevalence, predictors, and mortality significance of the causative arrhythmia in patients with electrical storm. J Cardiovasc Electrophysiol 2004; 15:1265. 16. Brigadeau F, Kouakam C, Klug D, et al. Clinical predictors and prognostic significance of electrical storm in patients with implantable cardioverter defibrillators. Eur Heart J 2006; 27:700. 17. Streitner F, Kuschyk J, Veltmann C, et al. Predictors of electrical storm recurrences in patients with implantable cardioverter-defibrillators. Europace 2011; 13:668. https://www.uptodate.com/contents/electrical-storm-and-incessant-ventricular-tachycardia/print 17/24 7/6/23, 3:26 PM Electrical storm and incessant ventricular tachycardia - UpToDate 18. Guerra F, Bonelli P, Flori M, et al. Temporal Trends and Temperature-Related Incidence of Electrical Storm: The TEMPEST Study (Temperature-Related Incidence of Electrical Storm). Circ Arrhythm Electrophysiol 2017; 10. 19. Greene M, Newman D, Geist M, et al. Is electrical storm in ICD patients the sign of a dying heart? Outcome of patients with clusters of ventricular tachyarrhythmias. Europace 2000; 2:263. 20. Fries R, Heisel A, Huwer H, et al. Incidence and clinical significance of short-term recurrent ventricular tachyarrhythmias in patients with implantable cardioverter-defibrillator. Int J Cardiol 1997; 59:281. 21. Neumar RW, Otto CW, Link MS, et al. Part 8: adult advanced cardiovascular life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2010; 122:S729. 22. Gorenek B, Blomstr m Lundqvist C, Brugada Terradellas J, et al. Cardiac arrhythmias in acute coronary syndromes: position paper from the joint EHRA, ACCA, and EAPCI task force. Europace 2014; 16:1655. 23. Kudenchuk PJ, Cobb LA, Copass MK, et al. Amiodarone for resuscitation after out-of-hospital cardiac arrest due to ventricular fibrillation. N Engl J Med 1999; 341:871. 24. Scheinman MM, Levine JH, Cannom DS, et al. Dose-ranging study of intravenous amiodarone in patients with life-threatening ventricular tachyarrhythmias. The Intravenous Amiodarone Multicenter Investigators Group. Circulation 1995; 92:3264. 25. Levine JH, Massumi A, Scheinman MM, et al. Intravenous amiodarone for recurrent sustained hypotensive ventricular tachyarrhythmias. Intravenous Amiodarone Multicenter Trial Group. J Am Coll Cardiol 1996; 27:67. 26. Eifling M, Razavi M, Massumi A. The evaluation and management of electrical storm. Tex Heart Inst J 2011; 38:111. 27. Chatzidou S, Kontogiannis C, Tsilimigras DI, et al. Propranolol Versus Metoprolol for Treatment of Electrical Storm in Patients With Implantable Cardioverter-Defibrillator. J Am Coll Cardiol 2018; 71:1897. 28. Nademanee K, Taylor R, Bailey WE, et al. Treating electrical storm : sympathetic blockade versus advanced cardiac life support-guided therapy. Circulation 2000; 102:742. 29. Sweeney MO, Ruetz LL, Belk P, et al. Bradycardia pacing-induced short-long-short sequences at the onset of ventricular tachyarrhythmias: a possible mechanism of proarrhythmia? J Am Coll Cardiol 2007; 50:614. https://www.uptodate.com/contents/electrical-storm-and-incessant-ventricular-tachycardia/print 18/24 7/6/23, 3:26 PM Electrical storm and incessant ventricular tachycardia - UpToDate 30. Authors/Task Force members, Windecker S, Kolh P, et al. 2014 ESC/EACTS Guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur Heart J 2014; 35:2541. 31. Neumann FJ, Sousa-Uva M, Ahlsson A, et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur Heart J 2019; 40:87. 32. Carbucicchio C, Santamaria M, Trevisi N, et al. Catheter ablation for the treatment of electrical storm in patients with implantable cardioverter-defibrillators: short- and long- term outcomes in a prospective single-center study. Circulation 2008; 117:462. 33. Deneke T, Shin DI, Lawo T, et al. Catheter ablation of electrical storm in a collaborative hospital network. Am J Cardiol 2011; 108:233. 34. Tan VH, Yap J, Hsu LF, Liew R. Catheter ablation of ventricular fibrillation triggers and electrical storm. Europace 2012; 14:1687. 35. Nayyar S, Ganesan AN, Brooks AG, et al. Venturing into ventricular arrhythmia storm: a systematic review and meta-analysis. Eur Heart J 2013; 34:560. 36. Vergara P, Tung R, Vaseghi M, et al. Successful ventricular tachycardia ablation in patients with electrical storm reduces recurrences and improves survival. Heart Rhythm 2018; 15:48. 37. Ballout JA, Wazni OM, Tarakji KG, et al. Catheter Ablation in Patients With Cardiogenic Shock and Refractory Ventricular Tachycardia. Circ Arrhythm Electrophysiol 2020; 13:e007669. 38. Izquierdo M, Ruiz-Granell R, Ferrero A, et al. Ablation or conservative management of electrical storm due to monomorphic ventricular tachycardia: differences in outcome. Europace 2012; 14:1734. 39. Schwartz PJ, Priori SG, Cerrone M, et al. Left cardiac sympathetic denervation in the management of high-risk patients affected by the long-QT syndrome. Circulation 2004; 109:1826. 40. Bourke T, Vaseghi M, Michowitz Y, et al. Neuraxial modulation for refractory ventricular arrhythmias: value of thoracic epidural anesthesia and surgical left cardiac sympathetic denervation. Circulation 2010; 121:2255. 41. Ajijola OA, Lellouche N, Bourke T, et al. Bilateral cardiac sympathetic denervation for the management of electrical storm. J Am Coll Cardiol 2012; 59:91. 42. Burjorjee JE, Milne B. Propofol for electrical storm; a case report of cardioversion and suppression of ventricular tachycardia by propofol. Can J Anaesth 2002; 49:973. https://www.uptodate.com/contents/electrical-storm-and-incessant-ventricular-tachycardia/print 19/24 7/6/23, 3:26 PM Electrical storm and incessant ventricular tachycardia - UpToDate 43. Vaseghi M, Gima J, Kanaan C, et al. Cardiac sympathetic denervation in patients with refractory ventricular arrhythmias or electrical storm: intermediate and long-term follow- up. Heart Rhythm 2014; 11:360. 44. Meng L, Tseng CH, Shivkumar K, Ajijola O. Efficacy of Stellate Ganglion Blockade in Managing Electrical Storm: A Systematic Review. JACC Clin Electrophysiol 2017; 3:942. 45. Cardona-Guarache R, Padala SK, Velazco-Davila L, et al. Stellate ganglion blockade and bilateral cardiac sympathetic denervation in patients with life-threatening ventricular arrhythmias. J Cardiovasc Electrophysiol 2017; 28:903. 46. Fudim M, Boortz-Marx R, Ganesh A, et al. Stellate ganglion blockade for the treatment of refractory ventricular arrhythmias: A systematic review and meta-analysis. J Cardiovasc Electrophysiol 2017; 28:1460. 47. Sanghai S, Abbott NJ, Dewland TA, et al. Stellate Ganglion Blockade With Continuous Infusion Versus Single Injection for Treatment of Ventricular Arrhythmia Storm. JACC Clin Electrophysiol 2021; 7:452. 48. Reinertsen E, Sabayon M, Riso M, et al. Stellate ganglion blockade for treating refractory electrical storm: a historical cohort study. Can J Anaesth 2021; 68:1683. 49. Patel RA, Condrey JM, George RM, et al. Stellate ganglion block catheters for refractory electrical storm: a retrospective cohort and care pathway. Reg Anesth Pain Med 2023; 48:224. 50. Tian Y, Wittwer ED, Kapa S, et al. Effective Use of Percutaneous Stellate Ganglion Blockade in Patients With Electrical Storm. Circ Arrhythm Electrophysiol 2019; 12:e007118. 51. Markman TM, Hamilton RH, Marchlinski FE, Nazarian S. Case Series of Transcutaneous Magnetic Stimulation for Ventricular Tachycardia Storm. JAMA 2020; 323:2200. 52. Vaseghi M, Barwad P, Malavassi Corrales FJ, et al. Cardiac Sympathetic Denervation for Refractory Ventricular Arrhythmias. J Am Coll Cardiol 2017; 69:3070. 53. Assis FR, Sharma A, Shah R, et al. Long-Term Outcomes of Bilateral Cardiac Sympathetic Denervation for Refractory Ventricular Tachycardia. JACC Clin Electrophysiol 2021; 7:463. 54. Cauti FM, Rossi P, Bianchi S, et al. Outcome of a Modified Sympathicotomy for Cardiac Neuromodulation of Untreatable Ventricular Tachycardia. JACC Clin Electrophysiol 2021; 7:442. 55. Remo BF, Preminger M, Bradfield J, et al. Safety and efficacy of renal denervation as a novel treatment of ventricular tachycardia storm in patients with cardiomyopathy. Heart Rhythm 2014; 11:541. https://www.uptodate.com/contents/electrical-storm-and-incessant-ventricular-tachycardia/print 20/24 7/6/23, 3:26 PM Electrical storm and incessant ventricular tachycardia - UpToDate 56. Garg J, Shah S, Shah K, et al. Renal sympathetic denervation for the treatment of recurrent ventricular arrhythmias-ELECTRAM investigators. Pacing Clin Electrophysiol 2021; 44:865. 57. Cuculich PS, Schill MR, Kashani R, et al. Noninvasive Cardiac Radiation for Ablation of Ventricular Tachycardia. N Engl J Med 2017; 377:2325. 58. Neuwirth R, Cvek J, Knybel L, et al. Stereotactic radiosurgery for ablation of ventricular tachycardia. Europace 2019; 21:1088. 59. Zaugg CE, Wu ST, Barbosa V, et al. Ventricular fibrillation-induced intracellular Ca2+ overload causes failed electrical defibrillation and post-shock reinitiation of fibrillation. J Mol Cell Cardiol 1998; 30:2183. 60. Swynghedauw B. Molecular mechanisms of myocardial remodeling. Physiol Rev 1999; 79:215. 61. Epstein AE, Kay GN, Plumb VJ, et al. Gross and microscopic pathological changes associated with nonthoracotomy implantable defibrillator leads. Circulation 1998; 98:1517. 62. Hurst TM, Hinrichs M, Breidenbach C, et al. Detection of myocardial injury during transvenous implantation of automatic cardioverter-defibrillators. J Am Coll Cardiol 1999; 34:402. 63. Joglar JA, Kessler DJ, Welch PJ, et al. Effects of repeated electrical defibrillations on cardiac troponin I levels. Am J Cardiol 1999; 83:270. 64. Poelaert J, Jordaens L, Visser CA, et al. Transoesophageal echocardiographic evaluation of ventricular function during transvenous defibrillator implantation. Acta Anaesthesiol Scand 1996; 40:913. 65. Runsi M, Bergfeldt L, Brodin LA, et al. Left ventricular function after repeated episodes of ventricular fibrillation and defibrillation assessed by transoesophageal echocardiography. Eur Heart J 1997; 18:124. 66. Sears SE Jr, Conti JB. Understanding implantable cardioverter defibrillator shocks and storms: medical and psychosocial considerations for research and clinical care. Clin Cardiol 2003; 26:107. Topic 1058 Version 47.0 https://www.uptodate.com/contents/electrical-storm-and-incessant-ventricular-tachycardia/print 21/24 7/6/23, 3:26 PM Electrical storm and incessant ventricular tachycardia - UpToDate GRAPHICS Causes of a wide QRS complex tachycardia Ventricular tachycardia (VT) Any type of supraventricular tachycardia (SVT) with a preexistent bundle branch block or a rate-related (functional) bundle branch block Sinus tachycardia Atrial tachycardia Atrial flutter Atrioventricular nodal reentrant tachycardia Atrioventricular reentrant tachycardia (orthodromic) Any SVT which occurs in a patient receiving an antiarrhythmic drug, primarily class IA or IC, or in a patient with severe hyperkalemia Any SVT with antegrade conduction via an accessory pathway (Wolff-Parkinson-White syndrome) Sinus tachycardia Atrial tachycardia Atrial flutter Atrioventricular reentrant tachycardia (antidromic) Electronic pacemaker in certain specific settings Graphic 51512 Version 2.0 https://www.uptodate.com/contents/electrical-storm-and-incessant-ventricular-tachycardia/print 22/24 7/6/23, 3:26 PM Electrical storm and incessant ventricular tachycardia - UpToDate Adult tachycardia with a pulse algorithm 2020 update Reprinted with permission. ACLS Provider Manual. Copyright 2020 American Heart Association, Inc. Graphic 130747 Version 10.0 https://www.uptodate.com/contents/electrical-storm-and-incessant-ventricular-tachycardia/print 23/24 7/6/23, 3:26 PM Electrical storm and incessant ventricular tachycardia - UpToDate Contributor Disclosures Rod Passman, MD, MSCE Grant/Research/Clinical Trial Support: Abbott [Ablation]; AHA [Ablation]; NIH [Stroke prevention]. Consultant/Advisory Boards: Abbott [Ablation]; iRhythm [Monitoring]; Janssen [Atrial fibrillation detection]; Medtronic [Implantable cardiac monitors]. Speaker's Bureau: iRhythm [Monitoring]. All of the relevant financial relationships listed have been mitigated. Mark S Link, MD No relevant financial relationship(s) with ineligible companies to disclose. Nisha Parikh, MD, MPH No relevant financial relationship(s) with ineligible companies to disclose. Contributor disclosures are reviewed for conflicts of interest by the editorial group. When found, these are addressed by vetting through a multi-level review process, and through requirements for references to be provided to support the content. Appropriately referenced content is required of all authors and must conform to UpToDate standards of evidence. Conflict of interest policy https://www.uptodate.com/contents/electrical-storm-and-incessant-ventricular-tachycardia/print 24/24