Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Survival after prolonged resuscitation with 99 defibrillations due to Torsade De Pointes cardiac electrical storm: a case report | Nakstad et al. Scandinavian Journal of Trauma Resuscitation and Emergency Medicine 2010 18 7 http content 18 1 7 SCANDINAVIAN JOURNAL OF t emergency medicine CASE REPORT Open Access Survival after prolonged resuscitation with 99 defibrillations due to Torsade De Pointes cardiac electrical storm a case report Anders Rostrup Nakstad1 Christian Eek2 Dag Aarhus3 Anne Larsen4 Kristina Hermann Haugaa2 Abstract A 48-year-old previously healthy woman suffered witnessed cardiac arrest in hospital. She achieved return of spontaneous circulation and was transferred to the intensive care unit. During the following 3 hours she suffered a cardiac electrical storm with 98 episodes of Torsade de Pointes ventricular tachycardia rapidly degenerating to ventricular fibrillation. She was converted with a total of 99 defibrillations. There was no response to the use of any recommended anti arrhythmic drugs. However the use of bretylium surprisingly stabilized her heart rhythm and facilitated placing of a temporary pacemaker. Overdrive pacing prevented further arrhythmias and was life saving. A number of beneficial factors may have contributed to the good neurological outcome. Further investigations gave no explanation for her cardiac electrical storm. Background Torsade de Pointes TdP cardiac electrical storm may be defined as the occurrence of more than two distinct episodes of destabilizing TdP in 24 hours 1 2 . It is a rare but challenging medical emergency and effective treatment may be difficult especially when TdP degenerates to VF or when the arrhythmia is a symptom of underlying cardiac disease 3 . TdP ventricular tachycardia was first described in 1966 4 . A number of causes are associated with TdP including inherited long QT-syndrome female gender and some acquired conditions like use of anti-arrhythmic drugs especially class Ia and III electrolyte disturbances heart failure subarachnoidal haemorrhage and hypothermia 2 5 . Magnesium sulfate is recommended as .
