Manejo rápido y escalonado en la tormenta arrítmica: reporte de un caso

Abstract

Arrhythmic storm is usually defined as the presentation of 3 or more episodes of ventricular arrhythmias within 24 hours. It is widely accepted that this entity is a medical emergency due to the potential for adverse events such as death in up to 54% of cases, probably because the reduction in cardiac chamber filling time significantly reduces cardiac output, leading to cardiogenic shock, multiple organ failure, and death.

The present case describes a patient with arrhythmic storm secondary to viral myocarditis, due to the recurrence of arrhythmic events despite initial management with antiarrhythmic drugs required a stepwise therapeutic approach guided by a multidisciplinary team and early use of extracorporeal membrane oxygenation (ECMO), which allowed maintaining adequate systemic perfusion while implementing therapeutic measures to control arrhythmic events; The patient was discharged early at 14 days, with no recurrence of arrhythmic events. At 6 months outpatient follow-up, the patient did not require cardiac transplantation, with no recurrence of arrhythmic events, with adequate NYHA functional class I and no left ventricular systolic dysfunction; clinical outcomes are attributed to timely decision making, guided by a multidisciplinary team and early use of early mechanical circulatory support, preventing hypoperfusion, multiple organ failure, and death.