In this episode of The Internet Book of Critical Care Podcast, Josh and Adam Thomas discuss ventricular tachycardia (VT) and ventricular fibrillation (VF) storm, defining it as three or more episodes of VT/VF within 24 hours. They differentiate between Torsades de Pointes, which involves a prolonged QT interval and polymorphic VT, and non-Torsades VT/VF, which has a normal QT interval. They outline an algorithm for managing VT/VF storm, which includes intubation, sedation, arterial and central lines, and vasopressors. The hosts explore antiarrhythmic medications like amiodarone, esmolol, and lidocaine, and also discuss a novel approach using a stellate ganglion block to reduce the recurrence of VT/VF. They also touch on the importance of consulting with cardiologists for interventions like ICD interrogation, revascularization, catheter ablation, and ECMO, as well as post-cardiac arrest care.
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