First VT storm
My dad's situation this weekend has got me super stressed
Age: 57
History:
- MI back in 1999
- ICD in 2016, due to scar tissue on LV. He was revived when he had an arrest while on TMT
- Had a few shocks in between, finally ablated in 2019
- No shocks these past 7 years. Only a couple of ATPs a year
Recent:
- Things started acting up 2 months ago
- Had an episode which escalated to VF with ~240 HR
- Since Thursday,
a) A 3 shock episode first
b) Following which, he's been here at a center of excellence for Cardiac EP, they recommended a new ablation for Monday
c) Took him off meds to simulate VT
d) He had a VT storm for the first time on Saturday, 8 shocks
e) Intubated, deeply sedated and currently in intensive care
f) Sympathetic Denervation was planned but cancelled - Plan still on for 3D Ablation, but doc said going in through blood vessel might not be enough, since the lower part of LV has almost fully calcified now, so might need epicardial ablation which is higher risk
a) Also mentioned, if VT simulation is not possible during ablation then might switch to substrate mapping - Previous ablation has been faultless for 7 years, but now doc says it might not be this time around. Expects to have occasional episodes now though
- Also, wants to upgrade ICD to CRT-D a few days after ablation
Genuinely worried about QoL, outcomes over the next week and playbook for the long-term with all this uncertainty