Should Sedative Administration Be Recommended as an Antiarrhythmic Therapy to Suppress Ventricular Fibrillation and Ventricular Tachycardia in Patients With Electrical Storm?　― A Scoping Review ―

Abstract

Background: Electrical storm (ES) is defined as a condition in which ventricular tachycardia (VT) or ventricular fibrillation (VF) episodes requiring electrical shock or implantable cardioverter-defibrillator (ICD) shocks occur ≥3 times within 24 h. It is a life-threatening condition, and treatment options include antiarrhythmic drugs, sedation, circulatory support, and catheter ablation. Sedation is conventionally performed for repeated electrical shocks; however, evidence for its effectiveness in ES suppression remains limited. This scoping review aimed to assess whether the use of sedatives is beneficial for ES suppression.

Methods and Results: This scoping review followed the PRISMA extension for scoping reviews (PRISMA-ScR) guidelines. Three online databases were searched to identify studies published from the inception of each database until September 18, 2024. To date, no randomized or quasi-randomized controlled trials or observational analytical studies have met the inclusion criteria for the use of sedation in patients with ES.

Conclusions: This scoping review underscores the need for high-quality studies to enhance the level of evidence and bridge knowledge gaps, ultimately aiming to shift the care paradigm for patients with ES.