Year : 2019  |  Volume : 13  |  Issue : 4  |  Page : 359-361

Epinephrine-induced electrical storm after aortic surgery

1 Department of Anesthesiology, UW School of Medicine and Public Health, Madison, WI, USA
2 Department of Anesthesiology and Critical Care Medicine, Albuquerque, NM, USA
3 Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, Portland, OR, USA

Correspondence Address:
Dr. Neal S Gerstein
Department of Anesthesiology and Critical Care Medicine, University of New Mexico School of Medicine - MSC 10 6000; Albuquerque, NM - 87106
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/sja.SJA_745_18

Rights and Permissions

Electrical storm (ES) is a potentially lethal syndrome defined as three or more sustained episodes of ventricular tachycardia or ventricular fibrillation within 24 h. There are multiple inciting factors for ES, one of which involves excess catecholamine (endogenous and exogenous) effects. Exogenous catecholamines used for hemodynamic support can paradoxically engender or exacerbate an underling arrhythmia leading to ES. We report on an 63-year-old man who presented for repair of an ascending aortic dissection. After cardiopulmonary bypass separation assisted with high-dose epinephrine, ES developed requiring over 40 defibrillatory shocks. The epinephrine infusion was held and within 5 min, the ES self-terminated. ES in the context of cardiovascular surgery with the use of epinephrine for hemodynamic support has not be previously reported. Clinicians need to be cognizant of the seemingly paradoxical effect of epinephrine to induce ES. Initial ES treatment involves acute stabilization (treating or removing exacerbating factors (i.e., excess catecholamines)).

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded164    
    Comments [Add]    

Recommend this journal