Suppression of refractory electrical storm by microtubule destabilization and dechanneling therapy in a patient with heart failure with reduced left ventricular ejection fraction and implantable cardioverter-defibrillator: A novel therapeutic approach

Abstract

We investigated the impact of microtubule destabilization and dechanneling therapy on a suppression of refractory electrical storm (ES) in a 63-year-old male patient with ischaemic heart failure with reduced left ventricular ejection fraction (HFrEF), who had a history of previous coronary artery bypass grafting and implantable cardioverter-defibrillator (ICD). We have implemented 0.5mg (a low-dose) adjuvant colchicine once daily with a view to preventing ES of the patient in addition to conventional medication. This should ensure the microtubule destabilization and the pharmacological scar dechanneling because ES of the patient's resistance to conventional pharmacological treatment and multiple antiarrhythmic interventions (ATP). Seventy-two hours later, cardiac rhythm returned to sinus rhythm. In the subsequent follow-up, the patient's electrocardiogram was stabilized continuous sinus and/or pacing rhythm, Adjuvant low-dose colchicine would be beneficial in the treatment and prophylaxis of refractory electrical storm of patients with HFrEF and ICD. It might be replaced instead of proarrhythmic drugs as a novel therapeutic approach.