关键词: 心律失常, 心性, 心动过速, 室性, 脓毒症, 心肌疾病, 心室电风暴, 室性心律失常, 多学科诊疗

Abstract:

Ventricular electrical storm (ES) is a critical medical state defined by severe cardiac electrical instability, manifesting as repeated episodes of sustained ventricular arrhythmias within a short duration. As the cardiac expression of a sympathetic storm, ES significantly elevates the risk of sudden cardiac death. It predominantly occurs in patients with pre-existing structural heart disease or inherited arrhythmia syndromes. Precipitating factors frequently include heart failure, volume overload, electrolyte imbalance and drug-induced proarrhythmic effects. Sepsis can trigger exaggerated sympathetic tone, myocardial impairment and hemodynamic compromise. Clinical management of sepsis is frequently complicated by volume overload and may require the administration of medications with proarrhythmic potential. These elements collectively establish a pathophysiological environment that facilitates the emergence of ES. This article presents a case study of a patient with septic cardiomyopathy who developed ES. Through a multidisciplinary approach involving geriatrics, cardiology, pharmacy and critical care medicine, the study analyzes the pathophysiology of ES, its relationship between sepsis and ES, potential triggers, antiarrhythmic strategy adjustments, selection of electrophysiological interventions and planning of circulatory support. The findings aim to assist clinicians in accurately identifying the causes of ES, implementing appropriate treatment strategies and improving patient outcomes.

Key words: arrhythmias, cardiac, tachycardia, ventricular, sepsis, cardiomyopathies, electrical storm, ventricular arrhythmia, multi-disciplinary treatment