{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T10:04:51Z","timestamp":1789034691126,"version":"build-2803163510"},"reference-count":29,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,1,14]],"date-time":"2024-01-14T00:00:00Z","timestamp":1705190400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathophysiology"],"abstract":"<jats:p>An electrical storm (ES) is defined as the presence of at least three episodes of sustained ventricular tachycardia or ventricular fibrillation within 24 h. This patient had a previously known arterial hypertension, type II diabetes mellitus, and chronic kidney disease and has presented to the Emergency Department (ED) with symptoms of retrosternal chest pain lasting for several hours prior. The initial 12-lead electrocardiogram revealed ST segment elevation in the anterior leads (V1\u2013V6). Emergent coronary angiography revealed an acute occlusion of the proximal left anterior descending artery (pLAD) and percutaneous coronary intervention was performed with successful implantation of one drug-eluting stent in the pLAD. On day 8 of hospitalization, the patient developed a refractory ES for which he received 50 DC shocks and did not respond to multiple lines of antiarrhythmic medications. Due to a failure of medical therapy, we decided to implant a temporary pacemaker and initiate ventricular overdrive pacing (VOP) that was successful in terminating ES. Following electrical stabilization, the patient underwent a successful ICD implantation. This case demonstrates that VOP can contribute to hemodynamic and electrical stabilization of a patient that suffers from refractory ES and this treatment modality might serve as a temporary bridge to ICD implantation.<\/jats:p>","DOI":"10.3390\/pathophysiology31010004","type":"journal-article","created":{"date-parts":[[2024,1,15]],"date-time":"2024-01-15T11:15:01Z","timestamp":1705317301000},"page":"44-51","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A Refractory Electrical Storm after Acute Myocardial Infarction: The Role of Temporary Ventricular Overdrive Pacing as a Bridge to ICD Implantation"],"prefix":"10.3390","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4674-426X","authenticated-orcid":false,"given":"Mijo","family":"Meter","sequence":"first","affiliation":[{"name":"Cardiovascular Diseases Department, University Hospital of Split (KBC Split), Spinciceva 1, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4878-8146","authenticated-orcid":false,"given":"Josip Andelo","family":"Borovac","sequence":"additional","affiliation":[{"name":"Cardiovascular Diseases Department, University Hospital of Split (KBC Split), Spinciceva 1, 21000 Split, Croatia"},{"name":"Department of Pathophysiology, University of Split School of Medicine, Soltanska 2, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3027","DOI":"10.1093\/eurheartj\/ehl276","article-title":"Shock Inhibition Evaluation with AzimiLiDe (SHIELD) Investigators. Electrical storm in patients with an implantable defibrillator: Incidence, features, and preventive therapy: Insights from a randomized trial","volume":"27","author":"Hohnloser","year":"2006","journal-title":"Eur. Heart J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1016\/j.amjmed.2008.04.024","article-title":"Early sustained ventricular arrhythmias complicating acute myocardial infarction","volume":"121","author":"Piccini","year":"2008","journal-title":"Am. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1655","DOI":"10.1093\/europace\/euu208","article-title":"Cardiac arrhythmias in acute coronary syndromes: Position paper from the joint EHRA, ACCA, and EAPCI task force","volume":"16","author":"Gorenek","year":"2014","journal-title":"Europace"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1257","DOI":"10.1093\/europace\/euu194","article-title":"EHRA\/HRS\/APHRS expert consensus on ventricular arrhythmias","volume":"16","author":"Pedersen","year":"2014","journal-title":"Europace"},{"key":"ref_5","first-page":"34","article-title":"Electrical Storm: Incidence, Prognosis and Therapy","volume":"11","author":"Proietti","year":"2011","journal-title":"Indian Pacing Electrophysiol. J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1053\/eupc.2000.0104","article-title":"Is electrical storm in ICD patients the sign of a dying heart? Outcome of patients with clusters of ventricular tachyarrhythmias","volume":"2","author":"Greene","year":"2000","journal-title":"Europace"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.pcad.2021.06.007","article-title":"Electrical Storm: Prognosis and management","volume":"66","author":"Elsokkari","year":"2021","journal-title":"Prog. Cardiovasc Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/j.amjcard.2005.08.058","article-title":"Prevalence and predictors of electrical storm in patients with implantable cardioverter-defibrillator","volume":"97","author":"Arya","year":"2006","journal-title":"Am. J. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1272","DOI":"10.1161\/CIRCULATIONAHA.110.950147","article-title":"Who are the long-QT syndrome patients who receive an implantable cardioverter-defibrillator and what happens to them?: Data from the European Long-QT syndrome implantable cardioverter-defibrillator (LQTS ICD) registry","volume":"122","author":"Schwartz","year":"2010","journal-title":"Circulation"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"3997","DOI":"10.1093\/eurheartj\/ehac262","article-title":"2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death","volume":"43","author":"Zeppenfeld","year":"2022","journal-title":"Eur. Heart J."},{"key":"ref_11","first-page":"6592927","article-title":"Resistant Ventricular Arrhythmia and the Role of Overdrive Pacing in the Suppression of the Electrical Storm","volume":"2019","author":"Magdi","year":"2019","journal-title":"Case Rep. Cardiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1253\/circj.69.613","article-title":"Temporary overdriving pacing as an adjunct to antiarrhythmic drug therapy for electrical storm in acute myocardial infarction","volume":"69","author":"Kurisu","year":"2005","journal-title":"Circ. J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/S0735-1097(00)00593-3","article-title":"Regional myocardial blood flow in patients with sick sinus syndrome randomized to long-term single chamber atrial or dual chamber pacing: Effect pacing mode and rate","volume":"35","author":"Nielsen","year":"2000","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_14","unstructured":"European Heart Rhythm Association, Heart Rhythm Society, Zipes, D.P., Camm, A.J., Borggrefe, M., Buxton, A.E., Chaitman, B., Fromer, M., Gregoratos, G., and Klein, G. (2006). ACC\/AHA\/ESC 2006 Guidelines for Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology\/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death). J. Am. Coll. Cardiol., 48, e247\u2013e346."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1389","DOI":"10.1093\/europace\/eut272","article-title":"Executive summary: HRS\/EHRA\/APHRS expert consensus statement on the diagnosis and management of patients with inherited primary arrhythmia syndromes","volume":"15","author":"Priori","year":"2013","journal-title":"Europace"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e242100","DOI":"10.1136\/bcr-2021-242100","article-title":"Temporary atrial overdrive pacing during a drug-refractory electrical storm in acute myocardial infarction","volume":"14","author":"Suter","year":"2021","journal-title":"BMJ Case Rep."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1016\/j.hrcr.2023.06.006","article-title":"Ventricular fibril-lation initiated by reentry involving the Purkinje network in a patient with after myo-cardial infarction","volume":"9","author":"Kamakura","year":"2023","journal-title":"HeartRhythm. Case Rep."},{"key":"ref_18","first-page":"e210","article-title":"2017 AHA\/ACC\/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: Executive Summary: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society","volume":"138","author":"Stevenson","year":"2018","journal-title":"Circulation"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1768","DOI":"10.1093\/europace\/euaa232","article-title":"Management of ventricular electrical storm: A contemporary appraisal","volume":"22","author":"Kowlgi","year":"2020","journal-title":"Europace"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1016\/j.jacep.2017.06.006","article-title":"Efficacy of Stellate Ganglion Blockade in Managing Electrical Storm: A Systematic Review","volume":"3","author":"Meng","year":"2017","journal-title":"JACC Clin. Electrophysiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1093\/eurheartj\/ehs453","article-title":"Venturing into ventricular arrhythmia storm: A systematic review and meta-analysis","volume":"34","author":"Nayyar","year":"2013","journal-title":"Eur. Heart J."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2315","DOI":"10.1161\/CIRCULATIONAHA.118.037997","article-title":"Catheter ablation of refractory ventricular fibrillation storm after myocardial infarction: A multicenter study","volume":"139","author":"Komatsu","year":"2019","journal-title":"Circulation"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1161\/CIRCEP.114.001953","article-title":"Early referral for ablation of scar-related ventricular tachycardia is associated with improved acute and long-term outcomes: Results from the Heart Center of Leipzig ventricular tachycardia registry","volume":"7","author":"Dinov","year":"2014","journal-title":"Circ. Arrhythm. Electrophysiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.1016\/j.hrthm.2023.04.052","article-title":"Stereotactic arrhythmia radioablation: A novel therapy for cardiac arrhythmia","volume":"20","author":"Wang","year":"2023","journal-title":"Heart Rhythm."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e281","DOI":"10.1097\/CCM.0000000000002089","article-title":"Effectiveness of Extracorporeal Life Support for Patients with Cardiogenic Shock Due to Intractable Arrhythmic Storm","volume":"45","author":"Flecher","year":"2017","journal-title":"Crit. Care Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.hrthm.2017.08.022","article-title":"Successful ventricular tachycardia ablation in patients with electrical storm reduces recurrences and improves survival","volume":"15","author":"Vergara","year":"2018","journal-title":"Heart Rhythm."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e007080","DOI":"10.1161\/JAHA.117.007080","article-title":"Thoracic Epidural Anesthesia Can Be Effective for the Short-Term Management of Ventricular Tachycardia Storm","volume":"6","author":"Do","year":"2017","journal-title":"J. Am. Heart Assoc."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2255","DOI":"10.1161\/CIRCULATIONAHA.109.929703","article-title":"Neuraxial Modulation for Re-fractory Ventricular Arrhythmias: Value of Thoracic Epidural Anesthesia and Surgical Left Cardiac Sympathetic Denervation","volume":"121","author":"Bourke","year":"2010","journal-title":"Circulation"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"3070","DOI":"10.1016\/j.jacc.2017.04.035","article-title":"Cardiac Sympathetic De-nervation for Refractory Ventricular Arrhythmias","volume":"69","author":"Vaseghi","year":"2017","journal-title":"J. Am. Coll. Cardiol."}],"container-title":["Pathophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1873-149X\/31\/1\/4\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:46:33Z","timestamp":1760103993000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1873-149X\/31\/1\/4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,14]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,3]]}},"alternative-id":["pathophysiology31010004"],"URL":"https:\/\/doi.org\/10.3390\/pathophysiology31010004","relation":{},"ISSN":["1873-149X"],"issn-type":[{"value":"1873-149X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,14]]}}}