Management of Electrical Storm in Patients with Left Ventricular Assist Devices

Authors

• Camille Ervalez, University of LynchburgFollow

Specialty

Emergency Medicine

Advisor

Dr. Tom Colletti

Abstract

Electrical Storm (ES) is a rare, life-threatening complication occurring in 7–10% of patients with left ventricular assist devices (LVADs), with a 41% mortality rate. ES is both under-recognized and under-studied despite increasing prevalence of LVAD implantations. The purpose of this narrative literature review is to enhance clinical acumen regarding the diagnosis and management of ES in patients with LVADs by synthesizing evidence from current guidelines, consensus statements, observational studies, meta-analyses, and case reports. The pathophysiology of ES in LVAD patients overlaps with that of ES in non-LVAD populations but includes LVAD-specific triggers. Hemodynamic stability of LVAD patients complicates ES diagnosis as dangerous arrhythmia can be misdiagnosed due to subtle symptomology and EKG artifact. Under the American Heart Association (AHA) and European Society of Cardiology (ESC) guidelines, medical management is the first-line therapy. There is an increasing need for standardized therapeutic management protocols tailored to patients with LVAD physiology and an increased need for further provider education. The increasing prevalence, morbidity, and mortality of ES in LVAD patients demand that clinicians understand the risk factors, presentation, and management of this pathology.

Recommended Citation

Ervalez C. Management of Electrical Storm in Patients with Left Ventricular Assist Devices. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2026; 8(1).