Renal denervation as a second-line option in a patient with electrical storm resistant to medical treatment and conventional radiofrequency catheter ablation

Electrical storm (ES) represents a critical state of electrical instability. We describe a patient with coronary artery disease, mechanical aortic valve replacement, and reduced left ventricular function with recurrent ICD shocks. Despite medical treatment with beta-blocker and amiodarone, and after successful ablation of different VT morphologies in combination with substrate modification, ES could not be controlled. We performed renal denervation (RDN) to reduce arrhythmic burden. Thereafter, patient remained free from sustained and non-sustained VTs at 6-month follow-up. RDN is an effective second-line treatment option in patients in whom conventional catheter ablation and medical treatment failed to control the VTs.