Case report

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 and Kristina Hermann Haugaa²

¹  Department of Anesthesia and Air Ambulance Department, Oslo University Hospital - Ullevål, Oslo, Norway

²  Department of Cardiology, Oslo University Hospital - Rikshospitalet and University of Oslo, Oslo, Norway

³  Department of Anaesthesia, Vestre Viken HF - Drammen, Norway

⁴  Department of Internal Medicine, Vestre Viken HF - Drammen, Norway

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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2010, 18:7doi:10.1186/1757-7241-18-7

Published:	6 February 2010

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.