{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T09:02:26Z","timestamp":1793437346568,"version":"4.5.0"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2000,8,15]]},"abstract":"<jats:p>\n                    <jats:italic>Background<\/jats:italic>\n                    \u2014Electrical storm (ES), defined as recurrent multiple ventricular fibrillation (VF) episodes, often occurs in patients with recent myocardial infarction. Because treating ES according to the Advanced Cardiac Life Support (ACLS) guidelines yields a poor outcome, we evaluated the efficacy of sympathetic blockade in treating ES patients and compared their outcome with that of patients treated according to the ACLS guidelines.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Methods and Results<\/jats:italic>\n                    \u2014Forty-nine patients (36 men, 13 women, mean age 57\u00b110 years) who had ES associated with a recent myocardial infarction were separated into 2 groups. Patients in group 1 (n=27) received sympathetic blockade treatment: 6 left stellate ganglionic blockade, 7 esmolol, and 14 propranolol. Patients in group 2 (n=22) received antiarrhythmic medication as recommended by the ACLS guidelines. Patient characteristics were similar in the 2 groups. The 1-week mortality rate was higher in group 2: 18 (82%) of the 22 patients died, all of refractory VF; 6 (22%) of the 27 group 1 patients died, 3 of refractory VF (\n                    <jats:italic>P<\/jats:italic>\n                    &lt;0.0001). Patients who survived the initial ES event did well over the 1-year follow-up period: Overall survival in group 1 was 67%, compared with 5% in group 2 (\n                    <jats:italic>P<\/jats:italic>\n                    &lt;0.0001).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusions<\/jats:italic>\n                    \u2014Sympathetic blockade is superior to the antiarrhythmic therapy recommended by the ACLS guidelines in treating ES patients. Our study emphasizes the role of increased sympathetic activity in the genesis of ES. Sympathetic blockade\u2212not class 1 antiarrhythmic drugs\u2212should be the treatment of choice for ES.\n                  <\/jats:p>","DOI":"10.1161\/01.cir.102.7.742","type":"journal-article","created":{"date-parts":[[2012,6,11]],"date-time":"2012-06-11T20:42:29Z","timestamp":1339447349000},"page":"742-747","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":416,"title":["Treating Electrical Storm"],"prefix":"10.1161","volume":"102","author":[{"given":"Koonlawee","family":"Nademanee","sequence":"first","affiliation":[{"name":"From the Electrophysiology and Pacing Center, Division of Cardiology, School of Medicine, University of Southern California, Los Angeles."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Taylor","sequence":"additional","affiliation":[{"name":"From the Electrophysiology and Pacing Center, Division of Cardiology, School of Medicine, University of Southern California, Los Angeles."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William E.","family":"Bailey","sequence":"additional","affiliation":[{"name":"From the Electrophysiology and Pacing Center, Division of Cardiology, School of Medicine, University of Southern California, Los Angeles."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel E.","family":"Rieders","sequence":"additional","affiliation":[{"name":"From the Electrophysiology and Pacing Center, Division of Cardiology, School of Medicine, University of Southern California, Los Angeles."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erol M.","family":"Kosar","sequence":"additional","affiliation":[{"name":"From the Electrophysiology and Pacing Center, Division of Cardiology, School of Medicine, University of Southern California, Los Angeles."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.84.4.1914096"},{"key":"e_1_3_2_2_2","first-page":"13A","volume":"13","year":"1997","unstructured":"Dorian P, Cass D. An overview of the management of electrical storm. Can J Cardiol. 1997;13:13A\u201317A.","journal-title":"Can J Cardiol"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-0736(71)80048-1"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.82.4.2205413"},{"key":"e_1_3_2_5_2","first-page":"177","volume":"85","year":"1992","unstructured":"Schwartz PJ, La Rovere MT, Vanoli E. Autonomic nervous system and sudden cardiac death: experimental basis and clinical observations for post-myocardial infarction risk stratification. Circulation. 1992;85:177\u2013191.","journal-title":"Circulation"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(83)90397-6"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(92)90629-2"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(83)90368-5"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.89.2.8313542"},{"key":"e_1_3_2_10_2","first-page":"2","volume":"3","year":"1998","unstructured":"Schwartz PJ, Motolese M, Pollavini G, et al, and the Italian Sudden Death Prevention Group. Prevention of sudden cardiac death after a first myocardial infarction by pharmacologic or surgical antiadrenergic interventions. J Cardiovasc Electrophysiol. 1998;3:2\u201316.","journal-title":"J Cardiovasc Electrophysiol"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199808203390801"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(95)90441-7"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.73.3.3948357"},{"key":"e_1_3_2_14_2","unstructured":"Cummins RO. Textbook of Advanced Cardiac Life Support. Dallas Tex: American Heart Association; 1994."},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(97)00393-8"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/15.2.80"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199207233270403"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.74.6.631"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(89)90278-0"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.81.3.2106401"},{"key":"e_1_3_2_21_2","doi-asserted-by":"crossref","first-page":"51F","DOI":"10.1016\/0002-9149(93)90963-D","volume":"72","year":"1993","unstructured":"Yusuf S, Venkatesh G, Teo KK. Critical review of the approaches to the prevention of sudden cardiac death. Am J Cardiol. 1993;72:51F\u201358F.","journal-title":"Am J Cardiol"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)63067-X"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.92.11.3264"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.92.11.3255"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(78)90816-0"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(83)90398-3"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.CIR.102.7.742","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T09:05:45Z","timestamp":1715504745000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.CIR.102.7.742"}},"subtitle":["Sympathetic Blockade Versus Advanced Cardiac Life Support\u2013Guided Therapy"],"short-title":[],"issued":{"date-parts":[[2000,8,15]]},"references-count":26,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2000,8,15]]}},"alternative-id":["10.1161\/01.CIR.102.7.742"],"URL":"https:\/\/doi.org\/10.1161\/01.cir.102.7.742","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2000,8,15]]},"assertion":[{"value":"1999-12-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2000-03-10","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2000-08-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}