Near fatal electrical storm in a patient equipped with an implantable cardioverter defibrillator for Brugada syndrome

A patient with Brugada syndrome experienced incessant ventricular fibrillation 7 years after implantation of an ICD. General anesthesia, fast ventricular pacing, bretylium, and atenolol infusion were ineffective; amiodarone infusion was started. After 190 defibrillation shocks over 36 hours, the electrical storm stopped. A multiorgan failure occurred as a complication of the electrical storm and necessitated prolonged reanimation. Thorough cardiac evaluation revealed no structural abnormality and the patient, now on chronic oral amiodarone therapy, remains free of arrhythmia 1 year after the event.