Electrical Storm Associated with H1N1 Infection

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Elsevier Ireland Ltd

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A 47-year old male was admitted to the emergency department with the complaint of recurrent shocks from his ICD. The monitorization of the patient with the ECG showed that he was experiencing recurrent ventricular tachycardia (VT) attacks which resolved successfully with the shocks of the ICD. Due to repetetive shocks at the first evaluation in the emergency department, the patient was sedated. His past medical history was remarkable for an inferior myocardial infarction 2 years ago and a cardiopulmonary arrest and a subsequent implantation of an ICD after the electrophysiologic study in which VT had been documented. He had not received any shocks after the implantation of ICD and no signs or symptoms of either acute coronary syndrome or heart failure were present at the time of presentation. No other pathologies other than a body temperature of 37.5 was found at the physical examination. The patient stated that he had been suffering from high body temperature, nasal flow, a sore throat and myalgia in the past three days. He was on aspirin, atorvastatin, ramipril and 5 mg/d bisoprolol treatments, intravenous amiodarone infusion was added to these treatments and the dose of bisoprolol was increased to 10 mg/d. The patient was hospitalized in the cardiology intensive care unit and it was documented that he had received 89 electrical shocks due to repetetive VT attacks in the last 6 hours. The frequency of the attacks subsided after the infusion of amiodarone and electrical shocks completely resolved after 8 hours of the treatment. The transthoracic echocardiography showed that left ventricular ejection fraction was 40%. Hemogram, serum electrolyte levels, kidney, liver and thyroid functions were in normal ranges, however the blood analyses showed that he had HINI infection. Coronary angiography was performed at the 10th day of treatment to rule out any ischemia which might lead to VT. Distal segments of the circumflex and right coronary arteries were totally occluded whereas LAD was patent. These findings were consistent with the coronary an- giogram which was performed 6 months ago. As new onset ischemia, heart failure, thyrotoxicosis, anemia and electrolyte disturbances were ruled out, repetetive VT attacks were thought to be associated with H1N1 infection. Ventricular tachycardia attacks are known to be associated with infectious diseases under some circumstances. To the best of our knowledge, our patient is the first case report of an electrical storm associated with HINI infection.


Anahtar Kelimeler


International Journal of Cardiology

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Doğan, U., Can, İ., Arıbaş, A., Düzenli, M. A., Yazıcı, M., Erayman, İ., (2010). Electrical Storm Associated with H1N1 Infection. International Journal of Cardiology, (140), S92-S92. Doi.: /10.1016/S0167-5273(10)70328-4